Atieno Wagoro Miriam Carole, Duma Sinegugu E
Senior Lecturer, School of Nursing Sciences, University of Nairobi, Kenya.
Dean of Teaching and Learning, College of Health Sciences, University of Kwa Zulu-Natal, South Africa.
J Res Nurs. 2021 Sep;26(6):557-571. doi: 10.1177/1744987120965651. Epub 2020 Dec 2.
The Government's aspiration to make Kenya a middle-income country and achieve the United Nations' sustainable development goal 3, 'good health and well-being', are threatened by poor quality of mental health services. Environment and lack of a conceptual model of nursing to guide care were some of the reasons that were attributed to poor quality of mental health services. The purpose of the study was to discover and describe an appropriate conceptual model of mental health nursing practice. This paper describes the environment which is one of the metaparadigms of a conceptual model grounded on data collected from Kenyan mental health nurses.
A grounded theory study was conducted with 33 mental health nurses selected by purposive, open and theoretical sampling procedures. The study sites were level 5 and 6 mental health facilities across the country. Data were collected over a period of 11 months through audio-recorded in-depth interviews and field notes. Analysis was performed using Straussian Grounded Theory steps of open, axial and selective coding processes aided by NVivo version 10. Dimensions and properties of environment metaparadigm grounded on nurses' views were discovered. The study was conducted within the dictates of the institutional and national ethics and research review boards.
Environment evolved as an intervening condition and a supra-system for mental health nursing. A homely environment emerged as a space with properties that nurture optimum mental health contrary to a hostile environment that precipitates mental disorders and prolongs recovery.
Grounded theory methodology was useful in discovering an environment metaparadigm as the context that influences mental health while nursing practice is the central phenomenon for optimum mental health. Nurses can ensure homely environments from diverse cultures and conduct comparative studies on the recovery of patients in the two environments.
肯尼亚政府欲使本国成为中等收入国家并实现联合国可持续发展目标3“良好健康与福祉”，但心理健康服务质量欠佳对其构成了威胁。环境因素以及缺乏指导护理的护理概念模型是导致心理健康服务质量低下的部分原因。本研究旨在发现并描述一种合适的心理健康护理实践概念模型。本文描述了该环境，它是基于从肯尼亚心理健康护士收集的数据构建的概念模型的元范式之一。
采用扎根理论研究方法，通过立意、开放和理论抽样程序选取了33名心理健康护士。研究地点为全国的5级和6级心理健康机构。在11个月的时间里，通过录音深度访谈和实地笔记收集数据。使用NVivo 10软件辅助，按照施特劳斯扎根理论的开放、轴心和选择性编码步骤进行分析。发现了基于护士观点的环境元范式的维度和属性。该研究是在机构和国家伦理及研究审查委员会的要求范围内进行的。
环境演变为心理健康护理的一种干预条件和超系统。与促使精神障碍发生并延长康复时间的恶劣环境相反，温馨的环境成为了一个具有培育最佳心理健康属性的空间。
扎根理论方法有助于发现环境元范式，它是影响心理健康的背景，而护理实践是实现最佳心理健康的核心现象。护士可以确保营造来自不同文化的温馨环境，并对患者在这两种环境中的康复情况进行比较研究。
