Empowering Nurses to Provide Humanized Care in Canadian Hospital Care Units: A Qualitative Study.

Previous studies have reported a conflict between nurses' motivation to provide humanized care and practical requirements impeding them from doing so. This exploratory descriptive qualitative study aimed to explore nurses' perspectives on humanized care, the challenges they face, and, most importantly, their recommendations to overcome these barriers. Semistructured individual interviews were conducted with 17 auxiliary and registered nurses working in various health care units in a Canadian hospital. Participants demonstrated a good understanding of what humanized care covers and entails. They also described it as the very core of their profession and main source of job satisfaction. However, nurses reported that they are confronted with organizational barriers, mainly a lack of staff, the burden of administrative tasks, unsuitable physical environments or equipment, and little managerial support. Nurses stressed the need for a cultural change in managerial practices in order to be able to improve their provision of humanized care. Based on the findings, 4 structuring recommendations were identified: adopting an institutional policy promoting the implementation of humanized care, incorporating humanized care in nurses' tasks and procedures, improving participatory management, and ensuring adequate staffing.

[Restoring the complexity of reality in theoretical health promotion approaches through incorporating the identity of the subject]. / Retrouver la complexité du réel dans les approches théoriques de promotion de la santé: transiter par l'identité du sujet.

The theoretical frameworks presently dominating health promotion practices mainly focus on the individual's psychosocial and cognitive components. When focusing on environments, these frameworks barely relate contextual elements to the individuals who give them a real existence. Because of the disjunction and reduction they create, the main theoretical readings only partially recognize the complexity of social life and therefore lose the Subject. Lacking theoretical reliance, these readings fail to meet the Ottawa Charter principles. Based on critical analysis of the main theoretical frameworks, we discuss the influence of disciplinary backgrounds on our modes of knowledge, tackling how epidemiological and behavioral thinking affect how we understand, conceive and problematize the objects in these fields. Based on this analysis, we illustrate how these epistemologies oversimplify social realities related to health. In order to encounter the lost subject of health promotion and thereby achieve Ottawa Charter's principles, we propose an innovative theoretical approach based on Schütz' socio-phenomenological thinking and Morin's complexity paradigm. Our theoretical proposal aims to recognize and reconcile significant aspects of individuals' meaningful life experiences, while integrating common sense principles. By transiting through the subject's identity, this theoretical proposal tends to unify all meaningful aspects that subtend social life at the subject's scale.

[Encountering the subject in the health field: a human care theory based on lived experience]. / Renouer avec le sujet dans le champ de la santé: proposition théorique pour un soin fondé sur l'expérience vécue.

Dominated by a bio-mechanistic paradigm, Western health systems are suffering from numerous problems. One such problem is the lack of consideration for lived experiences and the complexity and depth of meaning that characterize them. We accordingly emphasize in this text the importance of talking a deep look at the experiences of the cared-for Subject and changing the viewpoint on his or her problems. We defend this viewpoint with the help of a few ideas borrowed from Georges Canguilhem. We then refer to a socio-phenomenological approach inspired by the work of Alfred Schütz which allows us to better grasp people's lived experiences. We thus rehabilitate the Subject by proposing a human care theory that focuses on its' relationship(s) with the body, others, time and space, as well as on self-referent identity labels that give meaning to one's existence. This study is a theoretical reflection on human care that considers professional collaboration and interdisciplinarity, and that does not ignore the concrete practices of stakeholders and professionals.