Primary Health Care Nurses Research Articles

Factors associated with final year nursing students' desire to work in the primary health care setting: Findings from a national cross-sectional survey

BackgroundRegistered nurses are under-represented in the primary health care setting both internationally and in Australia, and this shortage is predicted to worsen. To address the increasingly complex healthcare needs of an ageing population, it is vital to develop and sustain a primary health care nursing workforce, yet attracting nurses is challenging. In Australia, registered nurses graduating from university typically commence their careers in hospital-based transition to professional practice programs. Similar programs in primary health care settings may be a valuable strategy for developing the primary health care nursing workforce, yet little is known about nursing students desire to work in this setting, factors that influence this, or their expectations of primary health care-focused transition to professional practice programs. ObjectivesThis study sought to identify factors associated with final year nursing students' desire to work in primary health care setting including demographic factors, expectations of future employment conditions, and job content. It also explored expectations of graduate transition programs based in primary health care. DesignA cross-sectional survey design comprising a quantitative online survey. Setting14 Australian universities from all states/territories, both rural and urban. Participants530 final-year nursing students. MethodsBinary logistic regression identifying factors contributing to desire to work in primary health care. ResultsThe desire of nursing students to work in primary health care is associated with older age, greater perceived value of employment conditions including flexibility, and less perceived importance of workplace support. ConclusionsCollaborative efforts from primary health care nurses, health professionals, academics and policy makers are needed to attract new graduate nurses to primary health care.

The motivational needs of primary health care nurses to acquire power as leaders in a mine clinic setting

Motivation is a process that influences and directs behaviour in order to satisfy a need. It links with goal 3 of the sustainable development goals that focus on ensuring healthy lives and promoting well-being at all ages. Motivation of nurses is important in the primary health care environment of, for instance, mine settings; since low levels of motivation among Primary Health Care (PHC) nurses could have a negative effect on the achievement of high standards in health service delivery. The study was conducted within the theoretical framework of McClelland's Acquired Motivation Theory which consists of three basic needs, – the need for achievement, the need for power, and the need for affiliation. One of the research questions posed was “What are the motivational needs of PHC nurses to acquire power in the workplace at mine clinic settings?” A quantitative, explorative, descriptive design was followed. The accessible population in this study was PHC nurses (N = 30) working at 13 mine clinics, that also served as the total sample. A 7 point Likert scale was used in a self-administered structured questionnaire that was developed from a literature review. Ethical considerations were adhered to and respondents gave written informed consent. Data was analysed by using descriptive and inferential statistics. TheManne Whitney test compared the mean ranks and a p-value of p < 0.05 was indicative of a significant difference between male and female groups. Validity and reliability principles were applied during the entire research process. The results indicated that PHC nurses needed acknowledgement, organisational responsibility, strategic planning and promotion, as well as support. Significant differences between gender were not found in relation to the need to acquire power.

Desempeño de las enfermeras en Atención Primaria de Salud: un Enfoque Fenomenológico

The objective of this study was to identify the performance of Chilean primary health care nurses. This was a qualitative study based on the approach of social phenomenology. Data collection was conducted between January and April 2013 through interviews with 13 nurses. Nurse performance showed that they experience greater professional autonomy and are closer to users; however, they suffered from professional burnout. Their expectations included the desire to be recognized for their work and better service management. Contributions of this study include the possibility of considering new designs for professional management practices in primary health care from the perspective of Chilean nurses. These designs should be based on the reorganization of work processes and by occupying spaces in macropolitics, influencing the professional performance of nurses at this level of health care.

Involvement·Development·Make progress--The role of nurses in primary health care

Involvement·Development·Make progress--The role of nurses in primary health care

Swedish primary healthcare nurses' perceptions of using digital eHealth services in support of patient self-management.

Nurses have expressed doubts about the ongoing digitalisation of Swedish primary health care. Given the potential role of eHealth in primary health care, including supporting interactive self-management for people with chronic conditions, it is important to highlight nurses' experiences. This study is part of a larger project aimed at implementing person-centred interactive self-management support (iSMS) in primary health care. The aim of this study was to describe Swedish primary healthcare nurses' perceptions of using digital eHealth systems and services to support patient self-management. Focus group interviews were conducted with primary healthcare nurses (n = 20). The interview transcriptions were analysed using qualitative content analysis. Three themes emerged from the content analysis: caregiving in the midst of digital chaos; a lack of overview and control in daily work; and mixed feelings towards digitalisation. Each theme was subdivided into three subthemes. The results of this study provide insight into a number of concerns that stand in the way of success when it comes to the implementation and use of digital technology. If nurses are to adapt to the new policies and practices that accompany the current digitalised development in Swedish primary health care, the concept of a nurse's traditional work role needs to be amended in terms of the scope of work tasks and established views of traditional nursing. The study also highlights the need for more research to enable eHealth systems/services to be designed to fulfil multiple requirements. The digitised systems should be a tool for achieving good quality self-management support as well as giving the primary healthcare nurses adequate resources to support patients' self-management while still maintaining the values associated with person-centred care.

Effects of cutbacks on motivating factors among nurses in primary health care.

When financial cuts are made, staff redundancies and reorganisation in the healthcare system often follow. Little is known how such cutbacks affect work motivation of nurses in primary health care. Examine the effects of cutbacks on motivating factors among nurses in primary health care. A phenomenological approach involving a purposeful sample of ten nurses in primary health care. Average age 44. The participants identified the job itself, autonomy, independence, good communication with co-workers, and the potential for professional training, learning and development as the main internal motivational factors related to their work. However, increased stress and uncertainty, growing fatigue and understaffing were starting to have a negative impact on these internal motivational factors. Moreover, reduced opportunities for professional training and development had negative effects on the participants. Many saw these opportunities as a vital part of recognition for their job performance. Regarding external motivation, the factors identified were job security, salaries and rewards, and interaction with management. The participants expressed their interest in more consultation with managers and most preferred an increased flow of information from managers to staff members during cutbacks. Salaries, professional training opportunities and appreciation were rewards named by participants for a job well done. All agreed that salaries are stronger motivational factors than before cutbacks. In the case of cutbacks, nursing managers should increase consultations with staff and make sure that nurses maintain their independence, autonomy, opportunities for professional training as well as appreciation for job well done.

Experiences of registered nurses transitioning from employment in acute care to primary health care-quantitative findings from a mixed-methods study.

To describe the experiences of registered nurses who transition from acute to primary health care (PHC) employment. Internationally the provision of health care in PHC settings is increasing. Nurses are moving from acute care employment to meet the growing demand for a PHC workforce. However, little is known about the transition experiences of these nurses. A sequential mixed-methods study comprising a survey, and semi-structured interviews. This study reports on survey findings relating to the transition experience. Convenience and snowballing techniques were used to recruit 111 registered nurses who had transitioned from Australian acute settings to PHC employment within the last 5years. An online survey gathered data relating to personal and professional demographics, type of PHC setting and transition experiences. Most respondents (n=90, 81.1%) reported receiving some orientation, although the length and content varied considerably. Those working in metropolitan locations were more likely to report concerns associated with their orientation, with respondents from rural or remote locations more likely to have access to a preceptor than city/metropolitan respondents. Just under half of respondents found prioritising workload (n=47; 42.7%) or organisational knowledge (n=45; 40.9%) difficult or very difficult, and 47.7% (n=53) felt isolated or unsupported. 49.5% (n=55) reported being overwhelmed with the new role either sometimes or regularly. Barriers to transitioning successfully included limited employer support to attend professional development activities. Availability of specific support measures may assist in the transition process. Findings from our study should be considered by employers when recruiting nurses new to PHC, and when designing orientation and ongoing education programmes. This study highlights the challenges faced by nurses who transition from acute care into PHC employment. Understanding the barriers and facilitators to successful transitions enhances the process for future recruitment and retention of PHC nurses. This evidence can inform managers, educators and policymakers in developing support programmes for nurses moving into PHC.

Influence of work environment on the quality of benefits provided by primary health care nurses

Influence of work environment on the quality of benefits provided by primary health care nurses

Assessment of Myocardial Infarction Risk among Patients in Babylon City

IntroductionThe idea of assessment of myocardial infarction risk factors among patients comes while Cardiovascular disease is the leading cause of death in Iraq.1 While myocardial infarction has been described to have an epidemic like spread all over the world with special emphasis on countries experiencing the transition to lifestyle, it is important to evaluate the life style and behaviors of those patients after the onset of myocardial infarction.2ObjectivesPresented study aimed to assess and find out the frequency and significance of known risk factors in our patient population in Babylon City of myocardial infarction patients.Materials and MethodsDescriptive design for risk factors of myocardial infarction among patients life in Babylon City were assessed.150 patients were a purposive sample from Babylon community to participate in this study (108 Male, 42 Female). Those are patients with myocardial infarction included from two main hospitals an Al-Hilla hospital n=100, Marchan hospital n=50, CCU unit. Microsoft Excel and SPSS software were used to analyze the data collected and to obtain results.ResultsMost of sample study participants were more than 40 years old. The majorities of participants live in Babylon city, finished their secondary level of education and illiteracy patients level. The results according to the gender were 64.81%of males and 66.67% of females of the study sample were diabetic, and 80.56% of males and 71.42% of female of the study sample were hypertensive, while 59.26% of males and 35.71% of females of the study sample electives had cardiac diseases. All participants were surveyed for diet, physical activity, smoking, knowledge, attitude, practice, and drugs compliance. Most of patients have no physical activity (86% of males and 98% of females), no control diet (65% of males and 48% of females), while percent of smoking patients were high according to their health situation (60% of males and 21% of females).ConclusionThe political and economical situations of Patients in Babylon city, and lack of health information among patients and their families, were the major reason of the lifestyle impairment. Patients who survived acute myocardial infarction need more attention and rehabilitation programs, this needs the efforts of primary health care centers, Nurses and cardiologists.

A enfermagem e a vacinação: evolução do cumprimento da vacina combinada contra o sarampo, parotidite e rubéola

Background : Immunization is an important activity per- formed by primary health care nurses in Portugal. Objectives : This study aims to assess ...

Nurses’ perceptions on nursing supervision in Primary Health Care

Objective: to understand the perceptions of nurses on nursing supervision in the work process. Methods : this is a qualitative research, with a semi-structured interview, performed with 16 nurses. Data analysis was performed through content analysis. Results : two meanings topics emerged from the speeches of the participants: Nurses´ activities in Primary Health Care Units and Nurses´ perceptions about nursing supervision. In the first category, the actions listed were filling out forms and reports under the supervision of the nursing service. In the second category, supervision was perceived as a function of management and follow-up of the activities planned by the team, in opposition to the classical supervision concept, which is inspecting. Conclusion: nursing supervision has been configured for primary care nurses as an administrative function that involves planning, organization, coordination, evaluation, follow-up and support for the health team.

A visão do profissional enfermeiro sobre o tratamento da hanseníase na atenção básica

Objective: To evaluate Primary Health Care (PHC) nurses’ view on leprosy treatment. Methods: Qualitative descriptive study conducted with nine nurses working in the municipality of Cocal, Piaui, Brazil, from January to March 2016. Data were collected using guiding questions about leprosy treatment and the answers were transcribed and submitted to content analysis. Results: The nurses stated that polychemotherapy is effective in the treatment of leprosy, as well as in reducing the burden of disease and curing the patient. Supervision is related to correct treatment, guarantee of cure, reduction of sequelae and interruption of disease transmission. Treatment failure is mainly associated with patient’s and family’s lack of engagement, lack of medication at the health clinic, lack of patient guidance, low levels of education, and drug side effects. Noncompliance with or cessation of treatment were related to complications such as aggravation of symptoms, disabilities, and amputations. Conclusion: The study showed that the nurses evaluated have adequate knowledge about aspects of leprosy treatment in PHC, highlighting points that must be corrected in order to achieve excellence in the fight against leprosy, such as the importance of encouraging family participation as a coadjutant in the treatment.

Australia’s first Transition to Professional Practice in Primary Care Program: Qualitative findings from a mixed-method evaluation

BackgroundIn Australia, there is an increasing demand for registered nurses in primary health care. Registered nurses graduating from university typically enter the workforce via supported transition to professional practice programs in acute-care hospital settings. A prospective strategy to create a sustainable primary health care workforce is to develop comparable transition programs in primary health care settings, such as general practice. We developed, implemented, and evaluated Australia’s first transition to professional practice in primary care program. AimTo explore the experiences and perceptions of graduate registered nurses and practice nurses participating in a novel transition to professional practice in primary care program. MethodsThematic analysis of semi-structured interviews with graduate registered nurses (n=4) and their preceptors (practice nurses, n=5) on completion of the program. FindingsThree themes emerged from the graduate registered nurse interviews: opportunities for education and clinical development, job satisfaction, and career progression opportunities. Graduate registered nurses were satisfied with the available learning opportunities, indicated a career in primary health care could be potentially rewarding, and anticipated moderate career progression opportunities within general practice. Preceptor themes included program positivity and early career opportunities. The preceptors were positive about the program and believed it supported the graduate registered nurses to become confident and competent. However, both the graduate registered nurses and preceptors perceived an acute-care hospital transition to professional practice program was necessary to gain adequate nursing skills, even if they intended to have a future career in primary health care. Furthermore, they appeared to believe that a career in general practice is more appropriate for “older nurses”. DiscussionThese beliefs may be a barrier for transition to professional practice in primary care programs to develop and support a sustainable primary health care workforce. ConclusionsImproved primary health care transition programs, policy, and educational strategies are required.

Employment conditions of Australian primary health care nurses

BackgroundThe primary health care (PHC) nursing workforce is growing to meet the demand for community based health services. To facilitate the recruitment and retention of nurses in PHC settings it is important that positive employment conditions exist. AimTo explore the employment characteristics of Australian PHC nurses, including employment patterns and remuneration considerations. MethodsA descriptive survey of Australian PHC nurses was conducted during 2015 as part of a larger mixed methods study. This paper reports the survey findings relating to employment patterns, conditions and remuneration. FindingsOne thousand one hundred sixty six nurses responded to the survey, most respondents were employed in general practice and many were employed part-time. Rates of pay were significantly lower for those employed general practice compared to other PHC settings. Most respondents hadn’t received a pay increase in the last 5 years. There were considerable differences in the allowances received between nurses employed in general practice and other PHC settings. ConclusionWhilst more nurses are moving into PHC, the remuneration and allowances differ between PHC settings and continue to lag behind the acute sector. To attract skilled younger nurses to meet future workforce requirements, there is an urgent need to review pay and conditions in PHC nursing. Equally, PHC nurses must develop skills to better negotiate their employment conditions and remuneration and industrial organisation must continue to support industrial advances in this area.

Moral sensitivity in Primary Health Care nurses.

to characterize the profile and describe the moral sensitivity of primary health care nurses. this is a quantitative, transversal, exploratory, descriptive study. The data were collected through the Moral Sensitivity Questionnaire translated and adapted to Brazil. 100 primary health care nurses participated, from Rio Grande do Sul, Brazil. The data collection took place during the months of March and July 2016, in an online form. The analysis of the data occurred through descriptive statistical analysis. the nurses had an average moral sensitivity of 4.5 (out of 7). The dimensions with the greatest moral sensitivity were: interpersonal orientation, professional knowledge, moral conflict and moral meaning. the nurses of Rio Grande do Sul have a moderate moral sensitivity, which may contribute to a lower quality in Primary Health Care.

Sexual health in primary health care - a qualitative study of nurses' experiences.

To illuminate nurses' experiences and opportunities to discuss sexual health with patients in primary health care. Sexual health is a concept associated with many taboos, and research shows that nurses feel uncomfortable talking to patients about sexual health and therefore avoid it. This avoidance forms a barrier between patient and nurse which prevents nurses from giving satisfactory health care to patients. A qualitative descriptive design. Semi-structured interviews were conducted with nine nurses in primary health care in Sweden. Data were analysed using qualitative content analysis. During the analysis phase, five subcategories and two main categories were identified. The two main categories were as follows: 'factors that influence nurses' opportunities of talking to patients about sexual health' and 'nurses' experiences of talking to patients about sexual health'. Social norms in society were an obstacle for health professionals' opportunities to feel comfortable and act professionally. The nurses' personal attitude and knowledge were of great significance in determining whether they brought up the topic of sexual health or not. The nurses found it easier to bring up the topic of sexual health with middle-aged men with, for example, diabetes. One reason for this is that they found it easier to talk to male patients. A further reason is the fact that they had received training in discussing matters of sexual health in relation to diabetes and other conditions affecting sexual health. Nurses in primary care express the necessity of additional education and knowledge on the subject of sexual health. The healthcare organisation must be reformed to put focus on sexual health. Guidelines for addressing the topic of sexual health must be implemented to establish conditions that will increase nurse's knowledge and provide them with the necessary tools for discussing sexual health with patients.

Knowledge, attitudes and behaviors of primary health care nurses and midwives in breast cancer early diagnosis applications.

PurposeThe purpose of this research was to analyze the knowledge, attitudes and behaviors of the nurses and midwives about the early diagnosis of breast cancer.Materials and methodsThis cross-sectional study was carried out at 9 family medical centers (FMCs) and 1 community health center (CHC) in Bingol; the population of this research consisted of 25 midwives and 38 nurses. The protocol for this study was approved by the regional ethics committee of Bingol University. The study was performed in accordance with the principles of the Declaration of Helsinki. The purpose of this study was explained to the nurses and midwives who participated, and their written and verbal permission was obtained; great care was taken to ensure that they understood participation was voluntary. A questionnaire of 41 questions was used for the data collection.ResultsWhen the age distribution of nurses and midwives was examined, it was found that 96.8% of them were aged ≤39 years. A total of 92.0% of midwives and 84.2% of nurses practiced breast self-examination (BSE). A total of 56% of the married women practiced family planning, and the most frequent method was using contraceptive pills. A total of 88.9% of the women had never had hormonal treatment for any reason. The BSE knowledge level of 65% of the women, who performed clinical breast examination, was complete. Among the women who had full knowledge of BSE, 38.5% of them performed examination once every 6 months, 23.0% of them once a year and 38.5% of them once every 3 years.ConclusionThis research showed that the deficiencies for nurses and midwives regarding the early diagnosis methods of breast cancer have been identified, and supporting these deficiencies with training is recommended.

The motivational needs of primary health care nurses to acquire power as leaders in a mine clinic setting

Motivation is a process that influences and directs behaviour in order to satisfy a need. It links with goal 3 of the sustainable development goals that focus on ensuring healthy lives and promoting well-being at all ages. Motivation of nurses is important in the primary health care environment of, for instance, mine settings; since low levels of motivation among Primary Health Care (PHC) nurses could have a negative effect on the achievement of high standards in health service delivery. The study was conducted within the theoretical framework of McClelland's Acquired Motivation Theory which consists of three basic needs, – the need for achievement, the need for power, and the need for affiliation. One of the research questions posed was “What are the motivational needs of PHC nurses to acquire power in the workplace at mine clinic settings?” A quantitative, explorative, descriptive design was followed. The accessible population in this study was PHC nurses (N = 30) working at 13 mine clinics, that also served as the total sample. A 7 point Likert scale was used in a self-administered structured questionnaire that was developed from a literature review. Ethical considerations were adhered to and respondents gave written informed consent. Data was analysed by using descriptive and inferential statistics. The Mann–Whitney test compared the mean ranks and a p-value of p < 0.05 was indicative of a significant difference between male and female groups. Validity and reliability principles were applied during the entire research process. The results indicated that PHC nurses needed acknowledgement, organisational responsibility, strategic planning and promotion, as well as support. Significant differences between gender were not found in relation to the need to acquire power.

Expectation of Brazilian nurses about the reception held at the primary health care

To know the expectations of Brazilians nurses in relation to the reception held for them at the Primary Health Care. Method: This is a qualitative study based on the social phenomenology by Alfred Schutz. The nurses report that the host is something far from their reality, dependent on policy, management, population and physical structure of the workplace. The findings of this study showed that the reality of care performed by nurses in primary health care is characterized by calls for the evaluation of acute complaints, and that the solution to the host be ideal, providing changes in the relationship between him and the user they require far capabilities of its reality, which was called in this study magic output. It was evident that for nurses the reorganization of the host and their work process depends only on external factors to their actions, forgetting its commitment to provide a humanized care and based on the application of its relational competence.

Stakeholders’ perspectives on the management of diabetic retinopathy for a district health system – South Africa

Background: Clinical practice guidelines for the management of diabetic retinopathy (DR) adopted in various countries show variations in methods of examinations, screeners and classification systems. The South African National Guidelines for the frequency of referral of patients with diabetes mellitus (DM) for DR assessment were developed more than a decade ago. They do not specify the role of primary healthcare workers (PHCW) to manage DR at primary healthcare (PHC) level. The primary objective of this study was to establish the current role of PHCW in managing diabetic eye disease.Method: A cross-sectional study was conducted, and questionnaires were distributed to a total of 181 healthcare practitioners (HCPs) in public health institutions situated in the northern eThekwini district of KwaZulu-Natal. Clinics and community health centres (CHCs) were selected based on the assumption that PHC nurses, general practitioners or medical officers (MOs) and ophthalmic nurses practice at these institutions. The hospitals selected were the referral institutions for the selected clinics and CHCs. The questionnaires distributed included questions relating to the DR classification systems usage, HCP interaction and opinions on how HCPs could be valuable in managing DR.Results: Only two out of the five ophthalmic nurses were familiar with the grading classification systems for DR. Ophthalmic nurses had less interaction with general practitioners or MOs (40.0%) than the PHC nurses (60.0%). Only 2.4% of the PHC nurses interacted with ophthalmologists. Four of the five ophthalmic nurses indicated that PHC nurses would be valuable in the management of DR by taking visual acuity (VA) and conducting a pinhole test. More than 60% of the general practitioners or MOs (65.6%) suggested that ophthalmic nurses do a fundus examination. Ophthalmologists indicated that the PHC nurses were the least capable (17.7%) to screen for DR.Conclusion: Primary healthcare workers such as PHC nurses, ophthalmic nurses, general practitioners or MOs and optometrists have specific roles to play in DR management, which includes its prevention, detection, grading, referral and monitoring.