Fjørtoft Ann-Kristin, Oksholm Trine, Førland Oddvar, Delmar Charlotte, Alvsvåg Herdis
Center of Diaconia and Professional Practice VID Specialized University Oslo Norway.
Faculty of Health Sciences VID Specialized University Bergen Norway.
Nurs Open. 2020 Mar 5;7(4):1011-1019. doi: 10.1002/nop2.473. eCollection 2020 Jul.
To explore prevailing discourses on nursing competence in homecare nursing to boost understanding of practice within this field.
A qualitative study with a social constructivist perspective.
Six focus-group interviews with homecare nurses in six different municipalities in Norway. Adapting a critical discourse analysis, data were linguistically, thematically and contextually analysed in the light of theories on competence, institutional logic and discourses.
The analysis found homecare nursing to be a diverse and contradictory practice with ever-increasing work tasks. Presented as binary oppositions, we identified the following prevailing discourses: individualized care versus organizing work; everyday-life care versus medical follow-up; and following rules versus using professional discretion. The binary oppositions represent contradictory requirements that homecare nurses strive to balance. The findings indicate that medical follow-up and organizational work have become more dominant in homecare nursing, leaving less time and attention paid to relational and everyday-life care.
探讨家庭护理中关于护理能力的主流话语，以增进对该领域实践的理解。
一项采用社会建构主义视角的定性研究。
对挪威六个不同市镇的家庭护理护士进行了六次焦点小组访谈。采用批判性话语分析方法，根据能力、制度逻辑和话语理论，对数据进行语言、主题和语境分析。
分析发现家庭护理是一种多样化且相互矛盾的实践，工作任务不断增加。以二元对立的形式呈现，我们识别出以下主流话语：个性化护理与工作组织；日常生活护理与医疗随访；遵循规则与运用专业判断力。这些二元对立代表了家庭护理护士努力平衡的相互矛盾的要求。研究结果表明，医疗随访和组织工作在家庭护理中变得更加突出，从而减少了对关系性和日常生活护理的时间和关注。
