School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada.
Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada.
J Adv Nurs. 2023 Feb;79(2):686-697. doi: 10.1111/jan.15487. Epub 2022 Nov 11.
To explore nurse practitioners' experiences of medication abortion implementation in Canada and to identify ways to further support the implementation of medication abortion by nurse practitioners in Canada.
A qualitative approach informed by feminist theory and integrated knowledge translation.
Qualitative interviews with stakeholders and nurse practitioners between January 2020 and May 2021. Data were analysed using critical feminist theory.
Participants included 20 stakeholders, 16 nurse practitioner abortion providers, and seven nurse practitioners who did not provide abortions. We found that nurse practitioners conduct educational, communication and networking activities in the implementation of medication abortion in their communities. Nurse practitioners navigated resistance to abortion care in the health system from employers, colleagues and funders. Participants valued making abortion care more accessible to their patients and indicated that normalizing medication abortion in primary care was important to them.
When trained in abortion care and supported by employers, nurse practitioners are leaders of abortion care in their communities and want to provide accessible, inclusive services to their patients. We recommend nursing curricula integrate abortion services in education, and that policymakers and health administrators partner with nurses, physicians, midwives, social workers and pharmacists, for comprehensive provincial/territorial sexual and reproductive health strategies for primary care.
The findings from this study may inform future policy, health administration and curriculum decisions related to reproductive health, and raise awareness about the crucial role of nurse practitioners in abortion care and contributions to reproductive health equity.
This study focused on provider experiences. In-kind support was provided by Action Canada for Sexual Health & Rights, an organization that provides direct support and resources to the public and is committed to advocating on behalf of patients and the public seeking sexual and reproductive health services.
探索加拿大执业护士在实施药物流产方面的经验，并确定进一步支持加拿大执业护士实施药物流产的方法。
受女权主义理论启发并结合综合知识转化的定性方法。
2020 年 1 月至 2021 年 5 月期间，对利益相关者和执业护士进行了定性访谈。使用批判女权主义理论对数据进行分析。
参与者包括 20 名利益相关者、16 名提供药物流产服务的执业护士以及 7 名不提供堕胎服务的执业护士。我们发现，执业护士在其社区中开展药物流产实施方面的教育、沟通和网络活动。执业护士在卫生系统中面临来自雇主、同事和资助者的对堕胎护理的抵制。参与者重视为患者提供更便捷的堕胎护理，并表示将药物流产在初级保健中规范化对他们很重要。
当接受堕胎护理培训并得到雇主支持时，执业护士是社区堕胎护理的领导者，并希望为患者提供可及、包容的服务。我们建议护理课程将堕胎服务纳入教育，政策制定者和卫生行政人员与护士、医生、助产士、社会工作者和药剂师合作，制定全面的省级/地区初级保健性和生殖健康策略。
本研究结果可能为未来与生殖健康相关的政策、卫生管理和课程决策提供信息，并提高人们对执业护士在堕胎护理中的关键作用以及对生殖健康公平的贡献的认识。
本研究侧重于提供者的经验。加拿大性健康和权利行动组织提供了实物支持，该组织为公众提供直接支持和资源，并致力于代表寻求性和生殖健康服务的患者和公众进行倡导。
