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Home care nurses’ perceptions of their nursing practice in today’s health care delivery system Keyes, Nancy Joanne

Abstract

Major health care changes have arisen recently that have affected the delivery of health care by community home care nurses. The reason for this research study was to explore and describe the experiences of home care nurses in order to gain an understanding of home care nursing practice from the perspectives of home care nurses in the current restructured health care system, and to identify the needs or concerns of these nurses with regard to their nursing practice. Phenomenology as defined by Colaizzi (1978) was the research method that was used to obtain and determine the perspectives of the participants in this study. Phenomenology is the study of every day life as it is actually lived and experienced (Ornery, 1983). Nine home care nurses who worked in a large urban health department and who were interested and could clearly and accurately articulate their perceptions and experiences of home care nursing practice participated in this research investigation. Data collection involved two informal, minimally structured indepth interviews that were limited to one hour in length, audiotape recorded, and transcribed verbatim. Data analysis and data collection occurred concurrently so that areas for clarification and exploration were discerned, recurrent themes and theme clusters were identified, and data saturation was ascertained. A third interview took place with a focus group of six participants in order to present and to validate the research findings as being representative of the participants' experiences and perceptions. Major theme categories emerged from the analysis of the interviews. Three primary categories and subsequent subcategories evolved from the participants' data. The first category identified the nature of home care practice and three subcategories, the context of home care nursing practice, the attitudes towards home care nursing practice, and the context of the client. The second category identified the prerequisites for home care nursing and two subcategories, the knowledge and skills requirements and the strategies necessary for home care nursing practice. The third category identified the organizational issues in home care nursing and two subcategories, the professional issues relevant to home care nursing practice and recommendations for home care nursing practice. These study findings had implications for home care nursing practice, administration, health policy, education, and research.

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