Chalmers K I, Bramadat I J
Faculty of Nursing, University of Manitoba, Winnipeg, Canada.
J Adv Nurs. 1996 Oct;24(4):719-26. doi: 10.1046/j.1365-2648.1996.24810.x.
Despite the importance currently given to community development as an increasingly significant role for community nurses, there is little analysis of the role in the nursing literature. This paper provides background information on the historical origins of community development work through an extensive review of the literature. As well, four models of community development are synthesised from literature in sociology, social psychology, education and political science. These include economic development models, education models both formal and informal, confrontational models, and empowerment models. Each is discussed, and the relevance for community health nursing practice is critiqued. Finally, issues which may arise when community health nurses attempt to practice within a community development model are discussed. Issues are examined related to the structures of organizations in which nurses work, characteristics of nurses themselves, and the communities which nurses serve. The argument is advanced that despite the pitfalls and problems, this new role shows promise as an important mechanism for community health nurses to promote the community's health. However, much additional work will be needed to test out models for community development in actual practice. Evaluation of the role will also be important to determine the degree to which it can be implemented and the resultant health outcomes for the population.
尽管目前社区发展被视为社区护士日益重要的角色，但护理文献中对这一角色的分析却很少。本文通过广泛的文献综述，提供了社区发展工作历史起源的背景信息。此外，还从社会学、社会心理学、教育和政治学的文献中综合了四种社区发展模式。这些模式包括经济发展模式、正规和非正规教育模式、对抗模式和赋权模式。对每种模式进行了讨论，并对其与社区健康护理实践的相关性进行了批判。最后，讨论了社区健康护士试图在社区发展模式内开展实践时可能出现的问题。研究了与护士工作的组织结构、护士自身的特点以及护士所服务的社区相关的问题。本文提出的观点是，尽管存在缺陷和问题，但这一新角色有望成为社区健康护士促进社区健康的重要机制。然而，在实际实践中测试社区发展模式还需要大量额外的工作。对这一角色的评估对于确定其可实施的程度以及对人群产生的健康结果也很重要。
