Kirkman Amber, Wilkinson Jill, Scahill Shane
New Zealand Registered Nurse, New Zealand.
Victoria University, Graduate School of Nursing, Midwifery and Health, Wellington, New Zealand.
J Prim Health Care. 2018 Dec;10(4):331-337. doi: 10.1071/HC18053.
INTRODUCTION Challenges facing the primary health-care sector mean that policymakers and clinicians need to think and act differently to move forward. The principles of social entrepreneurship have been implemented successfully for improved health outcomes in other developed nations. There is a knowledge gap around whether nurse practitioners (NPs) in New Zealand primary health care (PHC) align with these principles. AIM To explore whether and how the innovative activities of primary care NPs can be described as socially entrepreneurial. METHODS A descriptive qualitative approach was used with data collected using semi-structured interviews with NPs working in primary care (n = 7). Data were analysed using general inductive thematic analysis techniques. RESULTS Nurse practitioners interviewed worked in government-subsidised private general practice businesses. Two main themes emerged: (1) the nursing model of care aligned with social entrepreneurship; and (2) building social capital. NPs described a desire to see health care delivered differently and this aligned with acting as a social entrepreneur. Social capital emerged through the requirement to establish significant collaborative relationships. DISCUSSION It was found that NPs' work can be described as socially entrepreneurial. The holistic, person and community-centred model of NP care has an ultimate mission of improved health outcomes. Social capital is built through collaborative relationships with other health-care providers, individual service users and the community. However, the juxtaposition of the business model in primary care prevents NPs from initiating and leading sustainable change.
引言 初级卫生保健部门面临的挑战意味着政策制定者和临床医生需要以不同的方式思考和行动，才能取得进展。社会创业原则已在其他发达国家成功实施，以改善健康结果。关于新西兰初级卫生保健（PHC）中的执业护士（NP）是否符合这些原则，存在知识空白。目的 探讨初级保健NP的创新活动是否以及如何被描述为具有社会创业性质。方法 采用描述性定性方法，通过对从事初级保健工作的NP进行半结构化访谈（n = 7）收集数据。使用一般归纳主题分析技术对数据进行分析。结果 接受访谈的NP在政府补贴的私人全科医疗企业工作。出现了两个主要主题：（1）护理模式与社会创业相一致；（2）建立社会资本。NP们表示希望看到医疗服务以不同的方式提供，这与作为社会企业家的行为相一致。社会资本通过建立重要合作关系的要求而产生。讨论 研究发现，NP的工作可以被描述为具有社会创业性质。NP护理的整体、以个人和社区为中心的模式最终使命是改善健康结果。社会资本通过与其他医疗服务提供者、个体服务使用者和社区的合作关系建立。然而，初级保健商业模式的并存阻碍了NP发起和引领可持续变革。
