Portillo Mari Carmen
School of Nursing, University of Navarre, C/ Irunlarrea s/n, Pamplona, Navarre, Spain.
J Clin Nurs. 2009 Jan;18(2):234-45. doi: 10.1111/j.1365-2702.2008.02527.x.
This paper aims to present and reflect on the process of practical and theoretical change in an action research project in which the issue of social rehabilitation was developed.
Action research is a useful method to change and advance practice. Consequently, grounded knowledge, which forms the basis of the practical change, is developed. 'Social rehabilitation' was the field of clinical practice which needed enhancement as the literature lacked nurse-led social rehabilitation programmes in the neurology field.
This was a cyclic action research project.
The project took place in a highly specialised hospital in Spain and aimed to promote social life of neurological patients and relatives through the planning, implementation and evaluation of a nurse-led social rehabilitation programme based on individual needs. In this project, which lasted 30 months, multiple triangulation of sources and methods was applied. Thirty-seven nurses participated and 22 and 18 patients and their relatives constituted a baseline and an intervention group, respectively.
Several issues were carefully treated in this action research project to develop practical and theoretical knowledge about social rehabilitation: the validity and reliability of the project, the work organisation of the wards, the nurses' attitudes towards new care, the researcher-participant relationship and the controversial role of professionals in social rehabilitation.
The nurses' emancipation in the process of practice change led to practical and theoretical assimilation of social rehabilitation. Intensive work on practitioners' attitudes and the provision of empirical evidence were key interventions to foster controversial roles and enhance services.
Details about the process of change of nursing practice in response to clients' needs have been provided. Some reflections about how to integrate social care and knowledge about social rehabilitation in clinical daily practice are made.
