Jongudomkarn Darunee, Macduff Colin
Center for Research and Training on Gender and Women Health (CRTGWH), Faculty of Nursing, Khon Kaen University, Khon Kaen Province, Thailand E-mail :
Asian Pac J Cancer Prev. 2014;15(23):10367-74. doi: 10.7314/apjcp.2014.15.23.10367.
Cancer and non-communicable diseases are a major issue not only for the developed but also developing countries. Public health and primary care nursing offer great potential for primary and secondary prevention of these diseases through community and family-based approaches. Within Thailand there are related established educational curricula but less is known about how graduate practitioners enact ideas in practice and how these can influence policy at local levels.
The aim of this inquiry was to develop family nursing practice in primary care settings in the Isaan region or Northeastern Thailand and to distill what worked well into a nursing model to guide practice.
An appreciative inquiry approach involving analysis of written reports, focus group discussions and individual interviews was used to synthesize what worked well for fourteen family nurses involved in primary care delivery and to build the related model.
Three main strategies were seen to offer a basis for optimal care delivery, namely: enacting a participatory action approach mobilizing families' social capital; using family nursing process; and implementing action strategies within communities. These were distilled into a new conceptual model.
The model has some features in common with related community partnership models and the World Health Organization Europe Family Health Nurse model, but highlights practical strategies for family nursing enactment. The model offers a basis not only for planning and implementing family care to help prevent cancer and other diseases but also for education of nurses and health care providers working in communities. This articulation of what works in this culture also offers possible transference to different contexts internationally, with related potential to inform health and social care policies, and international development of care models.
癌症和非传染性疾病不仅是发达国家面临的重大问题，也是发展中国家面临的重大问题。公共卫生和初级保健护理通过基于社区和家庭的方法，在这些疾病的一级和二级预防方面具有巨大潜力。泰国国内已有相关的既定教育课程，但对于研究生从业者如何在实践中践行理念以及这些理念如何影响地方政策，人们了解得较少。
本研究的目的是在泰国东北部伊桑地区的初级保健机构中发展家庭护理实践，并提炼出有效的做法形成护理模式以指导实践。
采用一种包括分析书面报告、焦点小组讨论和个人访谈的 appreciative inquiry 方法，综合参与初级保健服务的 14 名家庭护士的有效做法，并构建相关模式。
三种主要策略被视为提供最佳护理服务的基础，即：采用参与式行动方法调动家庭的社会资本；运用家庭护理流程；在社区内实施行动策略。这些策略被提炼成一个新的概念模型。
该模型与相关的社区伙伴关系模型以及世界卫生组织欧洲家庭健康护士模型有一些共同特征，但突出了家庭护理实践的实用策略。该模型不仅为规划和实施家庭护理以帮助预防癌症和其他疾病提供了基础，也为社区护士和医疗保健提供者的教育提供了基础。这种对在这种文化中有效的做法的阐述，也有可能在国际上转移到不同背景下，具有为卫生和社会护理政策以及护理模式的国际发展提供信息的相关潜力。
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