Campbell Karen A, MacKinnon Karen, Dobbins Maureen, Van Borek Natasha, Jack Susan M
1School of Nursing, McMaster University, Hamilton, Ontario Canada.
2School of Nursing, University of Victoria, Victoria, British Columbia Canada.
BMC Nurs. 2019 May 2;18:17. doi: 10.1186/s12912-019-0341-3. eCollection 2019.
Pregnant girls/young women and new mothers living in situations of social and economic disadvantage are at increased risk for poor health. Rural living may compound marginalization and create additional challenges for young mothers. Public health nurses (PHNs) delivering the Nurse-Family Partnership (NFP) to mothers living in rural communities may help to improve maternal and child health outcomes. The purpose of this analysis, grounded in data collected as part of a broader process evaluation, was to explore and understand the influence of rural geography on the delivery of NFP in British Columbia, Canada.
For the analysis of this qualitative data, principles of inductive reasoning based on the methodology of interpretive description were applied. A total of 10 PHNs and 11 supervisors providing the NFP program in rural communities were interviewed.
The results of this analysis reflect the factors and challenges of providing the NFP program in rural communities. PHNs noted the importance of NFP in the lives of their rural clients, especially in the face of extreme financial and social disparity. Remaining flexible in their approach to rural nursing and protecting time to complete NFP work supported nurses practicing in rural environments. Rural PHNs were often the sole NFP nurse in their office and struggled to remain connected to their supervisors and other NFP colleagues. Challenges were compounded by the realities of rural geography, such as poor weather, reduced accessibility, and long travel distances; however, these were considered normal occurrences of rural practice by nurses.
PHNs and NFP supervisors are well-positioned to identify the modifications that are required to support the delivery of NFP in rural geography. NFP nurses need to articulate what classifies as rural in order to effectively determine how to best provide services to these populations. Environmental conditions must be considered when offering NFP in rural communities, particularly if they impact the time required to deliver the program and additional services offered to young mothers. Regular NFP meetings and education opportunities address common problems associated with rural nursing but could be enhanced by better use of technology.
生活在社会和经济不利环境中的怀孕少女/年轻女性及新妈妈健康状况不佳的风险更高。农村生活可能会加剧边缘化，并给年轻妈妈带来更多挑战。为居住在农村社区的妈妈们提供护士-家庭伙伴关系（NFP）的公共卫生护士（PHN）可能有助于改善母婴健康结局。本分析基于作为更广泛过程评估一部分收集的数据，目的是探索和理解农村地域对加拿大不列颠哥伦比亚省NFP实施的影响。
对于该定性数据的分析，应用了基于诠释性描述方法的归纳推理原则。总共采访了10名在农村社区提供NFP项目的公共卫生护士和11名主管。
该分析结果反映了在农村社区提供NFP项目的因素和挑战。公共卫生护士指出NFP在其农村客户生活中的重要性，尤其是面对极端的经济和社会差距时。在农村护理方法上保持灵活性并留出时间完成NFP工作，有助于支持在农村环境中工作的护士。农村公共卫生护士通常是其办公室唯一的NFP护士，难以与主管和其他NFP同事保持联系。农村地域的现实情况，如恶劣天气、交通不便和路途遥远，使挑战更加复杂；然而，护士们认为这些是农村工作的正常情况。
公共卫生护士和NFP主管很适合确定支持在农村地域实施NFP所需的调整。NFP护士需要明确农村的定义，以便有效确定如何最好地为这些人群提供服务。在农村社区提供NFP时必须考虑环境条件，特别是如果它们影响实施该项目所需的时间以及为年轻妈妈提供的额外服务。定期的NFP会议和教育机会可解决与农村护理相关的常见问题，但更好地利用技术可加以改进。
