Lawrence S. Bloomberg School of Nursing, University of Toronto, Hamilton, ON, Canada.
School of Nursing, McMaster University, Hamilton, ON, Canada.
J Adv Nurs. 2017 Dec;73(12):2997-3006. doi: 10.1111/jan.13355. Epub 2017 Jun 29.
To explore community members' stories of their experiences with a Nurse Navigator programme serving an urban neighbourhood and primary care practice to address persistent health and social barriers adversely affecting health equity and well-being.
In response to striking health and social inequalities existing across neighbourhoods in a large southern city in Ontario, Canada, a pilot programme was designed to improve health and social outcomes in a specific "at-risk" neighbourhood. The programme includes nurse-led navigation support for individuals and families and networking to facilitate improved service integration at a systems level.
A narrative inquiry approach based on the Three-Dimensional Narrative Inquiry Space method, as described by Clandinin & Connelly (Narrative inquiry: Experience and story in qualitative research, ).
A thematic analysis of nine community members' life stories from narrative semi-structured interviews (January-June 2014) in conjunction with field notes, observations and documents. Participants' life stories created a common narrative of the experience of navigation in a community setting.
There were four main themes: "opening the door"; "more than just a conversation"; "making connections"; and "on a new trajectory". Participants valued the development of a therapeutic relationship, which optimized social inclusion, barrier reduction and connectivity to supportive health and social services.
The relational process of navigation as an antecedent to barrier reduction has direct implications for programme development, continuing education of navigators and quality improvement of existing navigation services. Study findings have implications for development of navigation competencies for nurses working with priority populations to address health inequities.
探索社区成员在为城市社区和初级保健实践服务的护士导航员计划中的体验故事，以解决持续存在的健康和社会障碍，这些障碍对健康公平和福祉产生不利影响。
为了应对加拿大安大略省一个大城市中不同社区存在的明显健康和社会不平等问题，设计了一个试点计划，旨在改善特定“高风险”社区的健康和社会结果。该计划包括护士主导的导航支持，为个人和家庭提供支持，并建立网络，以促进系统层面服务的整合。
一种基于 Clandinin 和 Connelly（叙事探究：定性研究中的经验和故事，）描述的三维叙事探究空间方法的叙事探究方法。
对来自 9 名社区成员的叙事半结构化访谈（2014 年 1 月至 6 月）的生活故事进行主题分析，结合现场笔记、观察和文件。参与者的生活故事创造了一个关于在社区环境中导航体验的共同叙事。
有四个主要主题：“打开大门”；“不仅仅是对话”；“建立联系”；和“走上新的轨道”。参与者重视发展治疗关系，这优化了社会包容、减少障碍和与支持性健康和社会服务的联系。
作为减少障碍的前提的导航的关系过程对计划的发展、导航员的继续教育以及现有导航服务的质量改进具有直接影响。研究结果对开发与优先人群合作的护士的导航能力以解决健康不平等问题具有启示意义。
