安大略省家庭和社区护理工作中的适应力：注册实习护士需要来自自身、家庭和客户以及雇主的支持。
Resilience for working in Ontario home and community care: registered practical nurses need the support of themselves, family and clients, and employers.
机构信息
School of Physical Therapy, Western University, London, ON, Canada.
School of Nursing, Western University, London, ON, Canada.
出版信息
BMC Health Serv Res. 2024 Oct 1;24(1):1157. doi: 10.1186/s12913-024-11635-3.
BACKGROUND
The context of practice is often not explicit in the discourse around the personal and professional resilience of nurses. The unique factors related to providing nursing care in home and community care may provide novel insight into the resilience of this health workforce. Therefore, this research addressed how nurses build and maintain resilience working in the home and community care sector.
METHOD
A qualitative study was conducted between November 2022 to August 2023 using 36 in-depth interviews (29 registered practical nurses [RPNs], five supervisors of RPNs, two family/care partners (FCPs) of clients receiving home and community care services). Analysis was consistent with a grounded theory approach including coding and comparative methods.
RESULTS
The factors of personal and professional resilience were not distinct but rather mixed together in the experience of nurses having resilience working in the home and community care sector. The process of building and maintaining resilience as home and community care nurses was informed by three categories: (1) The conditions of working in HCC; (2) The rapport RPNs held with FCPs; and (3) The nurses' ability for supporting the 'self'. Multiple components to inform these categories were identified and illustrated by the words of the nurse participants.
CONCLUSION
The process of building and maintaining resilience by RPNs working in the home and community care sector was guided by the day-to-day experiences of providing care for clients and the conditions of being a mobile health care provider. However, nurses may sense when they need to support their 'self' and must be empowered to request and receive support to do so.
背景
在讨论护士的个人和职业韧性时，实践背景往往不明确。在家庭和社区护理中提供护理服务的独特因素可能为这支卫生工作队伍的韧性提供新的见解。因此，本研究旨在探讨护士在家庭和社区护理部门工作时如何建立和维持韧性。
方法
本研究采用定性研究方法，于 2022 年 11 月至 2023 年 8 月期间进行，共进行了 36 次深度访谈（29 名注册实习护士[RPN]、5 名 RPN 主管、2 名接受家庭和社区护理服务的客户的家庭/护理伙伴[FCP]）。分析方法符合扎根理论方法，包括编码和比较方法。
结果
个人和职业韧性的因素并不是明显区分的，而是在护士在家庭和社区护理部门工作时的韧性体验中混合在一起。作为家庭和社区护理护士建立和维持韧性的过程受到三个类别的影响：（1）在 HCC 工作的条件；（2）RPN 与 FCP 之间的融洽关系；（3）护士支持“自我”的能力。这些类别通过护士参与者的话语得到了识别和说明，其中确定了多个组成部分。
结论
在家庭和社区护理部门工作的 RPN 建立和维持韧性的过程受到为客户提供护理的日常经验和作为流动医疗保健提供者的条件的指导。然而，护士可能会感觉到他们需要支持自己，并必须有权要求和获得支持来实现这一目标。
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