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Managements' perspective on Canadian public health nurses' primary health care practice

Published online by Cambridge University Press:  29 March 2007

Donna M. Meagher-Stewart
Affiliation:
School of Nursing, Dalhousie University, Nova Scotia, Canada
Megan L. Aston
Affiliation:
School of Nursing, Dalhousie University, Nova Scotia, Canada
Nancy C. Edwards
Affiliation:
School of Nursing, University of Ottawa, Ottawa, Canada
Linda Young
Affiliation:
Public Health Services, Capital District Health Authority, Nova Scotia, Canada
Donna Smith
Affiliation:
South Shore District Health Authority, Nova Scotia, Canada
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Abstract

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An interpretive qualitative study was conducted to examine public health nurses' (PHNs') practice in fostering citizen participation and collaborative practice and the impact of a decade (1992–2002) of health care restructuring. This article presents the perspectives of public health management and a public policy analysis as they relate to PHNs' primary health care practice in Nova Scotia, a province in Eastern Canada. Seven face-to-face interviews were conducted with public health management from across Nova Scotia and 26 relevant public policy documents were analyzed. Three major themes emerged from the coded transcripts and the document analysis: (1) opportunistic shifts in values: constraining structures, operations, and governance; (2) insufficient funding and infrastructure support; (3) opportunities and challenges to PHN capacity and competency. The emergent themes illustrate the unique population health perspective and day-to-day contested realities of public health and PHN practice. The study provides preliminary understanding of PHNs' primary health care practice in Nova Scotia that may resonate with other national and international settings. This knowledge can form a basis for more research to explore the PHNs' practice in the organizational context in which it is embedded. This study was undertaken at a pivotal time in Nova Scotia as the provincial government embarked on primary health care renewal to improve the health of Nova Scotians. The success of this study is in large part attributable to the collaborative effort of university researchers and public health decision makers.

Type
Research
Copyright
2007 Cambridge University Press