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Registered Nurses’ Patient Education in Everyday Primary Care Practice:: Managers Discourses
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
University of Stavanger, Norway.
University of Lund, Sweden.
University of West, Trollhättan, Sweden.
2015 (English)In: Global Qualitative Nursing Research., ISSN 2333-3936, Vol. 2Article in journal (Refereed) Published
Abstract [en]

Nurses’ patient education is important for building patients’ knowledge, understanding, and preparedness for self-management.

The aim of this study was to explore the conditions for nurses’ patient education work by focusing on managers’ discourses

about patient education provided by nurses. In 2012, data were derived from three focus group interviews with primary care

managers. Critical discourse analysis was used to analyze the transcribed interviews. The discursive practice comprised a

discourse order of economic, medical, organizational, and didactic discourses. The economic discourse was the predominant

one to which the organization had to adjust. The medical discourse was self-evident and unquestioned. Managers reorganized

patient education routines and structures, generally due to economic constraints. Nurses’ pedagogical competence

development was unclear, and practice-based experiences of patient education were considered very important, whereas

theoretical pedagogical knowledge was considered less important. Managers’ support for nurses’ practical- and theoreticalbased

pedagogical competence development needs to be strengthened.

Place, publisher, year, edition, pages
Sage Publications, 2015. Vol. 2
Keyword [en]
discourse analysis, education professional, health care primary, teaching
National Category
Medical and Health Sciences
Research subject
Människan i vården
Identifiers
URN: urn:nbn:se:hb:diva-3954DOI: 10.1177/2333393615599168OAI: oai:DiVA.org:hb-3954DiVA: diva2:878708
Available from: 2015-12-09 Created: 2015-12-09 Last updated: 2016-08-12Bibliographically approved
In thesis
1. Sjuksköterskors patientundervisande arbete: Ett otydligt fält
Open this publication in new window or tab >>Sjuksköterskors patientundervisande arbete: Ett otydligt fält
2016 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of this thesis is to explore, describe and critically assess conditions for nurses’ patient education work. This was carried out in two stages. In the first stage, the aim was to describe nurses’ experiences and perceptions of patient education work in relation to organisation, environment, professional cooperation and pedagogical competence, as well as describe differences between primary, municipal and hospital care. In the second stage, the aim was to identify discourses in the ways managers speak of the conditions for nurses’ patient education work in primary and hospital care.

Methods: In studies I and II, a randomised selection of nurses (842) received a questionnaire of 47 items concerning factual experiences and perceptions patient education, and 13 background items. Questionnaires were returned by 83 % of the participants. The items concerned organisation, environment, professional cooperation (I), and pedagogical competence (II). Descriptive statistics, non-parametric tests and content analysis for open-ended items were used. In studies III and IV, data was collected from three focus group interviews with managers (n=10) in hospital care, and three focus groups interviews with managers (n=10) in primary care. An explorative, qualitative design with a social constructionist perspective was used. The data was analysed with a critical discourse analysis.

Results: Nurses’ perceptions of conditions for patient education differ between healthcare settings, in favour of primary care (I, II). The nurses in primary care had better conditions and more managerial support, for example in the allocation of uninterrupted time (I). The primary care nurses had an advantage in relation to those in municipal or hospital care when it came to following research in patient education as well as how they perceived their own competences, pedagogical education and post graduate specialisations (II). Due to a heavy workload and a lack of time, the managers in hospital care could neither see the importance of their role as a supporter of the patient education provided by the nurses nor their role in the development of the nurses’ pedagogical competence. The managers used (mainly) organisational, financial, medical and legal discourses for explaining their failure to support the nurses’ providing patient education (III). The discursive practice in primary care comprised a discourse order of economic, medical, organisational and didactic discourses. The economic discourse was the predominant one, to which the organisation had to adjust. The medical discourse was self-evident and unquestioned. The managers initiated reorganisations, generally due to financial constraints. The nurses’ pedagogical competence development was unclear. Practicebased experiences of patient education were considered very important, whereas theoretical pedagogical knowledge was considered less important (IV).

Conclusions: Nurses’ patient education work must be made visible and be given sufficient resources. In this process, support from their managers is considered vital. Managers’ support for nurses’ practical and theory-based pedagogical competence development needs to be strengthened.

Place, publisher, year, edition, pages
Göteborg: Göteborgs universitet, 2016. 68 p.
Keyword
nurse, manager, patient education, teaching, information, pedagogical, critical discourse analysis
National Category
Medical and Health Sciences Nursing
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-9555 (URN)978-91-628-9744-4 (ISBN)978-91-628-9745-1 (ISBN)
Public defence
2016-04-29, Sal: Åke Göransson, Medicinaregatan 11, Göteborgs universitet, Göteborg, 13:00 (Swedish)
Available from: 2016-04-07 Created: 2016-04-07 Last updated: 2017-05-04Bibliographically approved

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