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Introduction: The educational function of the nursing role is considered an instance of link with the community. Objective: to unveil health promotion practices based on educational radio advertisements of nurses in 1983 in Chile. Material and method: qualitative perspective, with linguistically oriented discourse analysis, and review of the literature in databases: Scielo, Google scholar, Science direct, with keywords: community health nursing, role of the nurse, health education, history of nursing. Results: the education function in the nursing role shows power edges and is associated with the political context of the time. The care of the child and the family is associated with the responsibility of the woman, with explicit instructions that the mother must comply with in order to obtain optimal health for her children. Hygiene measures such as hand washing are strongly instilled in the prevention of infectious - contagious diseases. Discussion and Conclusion: Health promotion, exercised as a radio educational activity, was an alternative for linking and channeling with the most vulnerable population, to achieve states of family well-being and made it possible to make visible the educational function of the role of professional nurses. [ABSTRACT FROM AUTHOR]

Home visiting programs for marginalized families have included both Public Health Nurses (PHNs) and Community Home Visitors (CHV). Support for families requires health care providers to implement effective communication and collaboration practices; however, few studies have examined how this is carried out. The purpose of this qualitative research study was to explore how an Enhanced Home Visiting (EHV) program in Nova Scotia Canada was organized, delivered through the experiences of PHNs and CHVs. Feminist post-structuralism informed by discourse analysis was used to understand how their experiences were socially and institutionally constructed. Individual semi-structured interviews were conducted with 6 PHNs and 8 CHVs and one focus group was held with 10 of the participants. A social discourse on mothering layered within a social discourse of working with a vulnerable population added a deeper understanding of how communication was constructed through the everyday practices of PHNs and CHVs. Findings may be used to inform reporting and communication practices between health care providers who work with marginalized families. [ABSTRACT FROM AUTHOR]

Aims and objectives To critically examine surveillance practices of health visitors ( HV) in the UK and public health nurses ( PHNs) in Canada. Background The practice and meaning of surveillance shifts and changes depending on the context and intent of relationships between mothers and HVs or PHNs. Design We present the context and practice of HVs in the UK and PHNs in Canada and provide a comprehensive literature review regarding surveillance of mothers within public health systems. We then present our critique of the meaning and practice of surveillance across different settings. Methods Concepts from Foucault and discourse analysis are used to critically examine and discuss the meaning of surveillance. Results Surveillance is a complex concept that shifts meaning and is socially and institutionally constructed through relations of power. Conclusions Healthcare providers need to understand the different meanings and practices associated with surveillance to effectively inform practice. Relevance to clinical practice Healthcare providers should be aware of how their positions of expert and privilege within healthcare systems affect relationships with mothers. A more comprehensive understanding of personal, social and institutional aspects of surveillance will provide opportunities to reflect upon and change practices that are supportive of mothers and their families. [ABSTRACT FROM AUTHOR]

Purpose: to present the opinion of professionals about street dwellers undergoing treatment of tuberculosis and identify strategies of control of tuberculosis in this population. Method: an exploratory and descriptive study involving 17 health professionals working in street clinics. A semi-structured study composed of closed questions and a guiding question. The statements were analyzed using the discourse analysis technique, resulting in the identification of two analytical categories: 1. Meanings attributed to street dwellers with tuberculosis, and 2. Control of tuberculosis in homeless people. Results: the analysis identified situations that limited adherence to tuberculosis treatment, including the reasons for staying in the streets, living conditions, and risk factors (dependence on alcohol and other drugs, short-sightedness, constant relocations, and lack of perspectives). Street dwellers were knowledgeable about the disease. Furthermore, there were difficulties in solving several problems of people living in the streets, including living conditions and lifestyle, social stigma, relocations, drug abuse, and lack of life project. Conclusion: coping with the complexity of situations related to living in the streets limits to the work of health professionals because these situations go beyond health care and require intersectoral actions. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this qualitative study was exploring what the roles and challenges of health care providers working within Northern Canadian Aboriginal communities are and what resources can help support or impede their efforts in working toward addressing health inequities within these communities. Design: The qualitative research conducted was influenced by a postcolonial epistemology. The works of theorists Fanon on colonization and racial construction, Kristeva on semiotics and abjection, and Foucault on power/knowledge, governmentality, and biopower were used in providing a theoretical framework. Methods: Critical discourse analysis of 25 semistructured interviews with health care providers was used to gain a better understanding of their roles and challenges while working within Northern Canadian Aboriginal communities. Findings: Within this research study, three significant findings emerged from the data. First, the Aboriginal person’s identity was constructed in relation to the health care provider’s role of delivering essential health services. Second, health care providers were not treating the “ill” patient, but rather treating the patient for being “ill.” Third, health care providers were treating the Aboriginal person for being “Aboriginal” by separating the patient from his or her identity. The treatment involved reforming the Aboriginal patient from the condition of being “Aboriginal.” [ABSTRACT FROM AUTHOR]

Quality of care is a prominent discourse in modern health‐care and has previously been conceptualised in terms of ethics. In addition, the role of knowledge has been suggested as being particularly influential with regard to the nurse–patient–carer relationship. However, to date, no analyses have examined how knowledge (as an ethical concept) impinges on quality of care. Qualitative semi‐structured interviews were conducted with 26 patients with palliative and supportive care needs receiving district nursing care and thirteen of their lay carers. Poststructural discourse analysis techniques were utilised to take an ethical perspective on the current way in which quality of care is assessed and produced in health‐care. It is argued that if quality of care is to be achieved, patients and carers need to be able to redistribute and redevelop the knowledge of their services in a collaborative way that goes beyond the current ways of working. Theoretical works and extant research are then used to produce tentative suggestions about how this may be achieved. [ABSTRACT FROM AUTHOR]

Objective: to analyze the meanings Primary Health Care users attribute to their health-disease process and the services used. Methods: this qualitative research uses the focus group technique to interview two groups of users the service monitors. The first is a group of elderly people and the second of pregnant women. To analyze the meanings, the discourse analysis technique and the reference framework of health promotion are used. Results: the group of elderly, being mostly female arterial hypertension and diabetes mellitus patients, visualizes the health-disease process as the evolution of human existence controlled by divine power, signifying the health service as a blessing in the control of the disease. The Group of young pregnant women signified health as the ability for self-care and disease as the disability for that purposes, considering the Primary Health Care service as responsible for the recovery of individual and family health. Final considerations: the users demonstrated dissatisfaction with bureaucratic and vertical relations present at the health services. In each group, it was observed that the meanings for health and disease and meanings of the health service the users elaborated can be related. [ABSTRACT FROM AUTHOR]

Aim To examine health worker-client interactions during care planning to understand processes that foster client empowerment and disempowerment. Background It is unclear how health worker-client exchanges and information sharing through chronic condition care planning currently operate in primary health care. Moreover, it is unclear how control in these exchanges either enhances collaborative decision-making, partnership and client empowerment, or works to create client disempowerment and dependency on workers and health services. Design Critical discourse analysis of qualitative data from ethnographic observations and audio-taped worker-client consultations. Method Multidisciplinary teams in two Australian community-based primary healthcare sites participated. This included nurses, general practitioners and allied health workers and their clients who had a chronic condition care plan. Nineteen worker-client consultations were observed/recorded in 2011. Results Control was expressed through multiple processes inherent in the worker role and in their interactions with clients. When workers exercised disproportionate control and clients relinquished their own control, client disempowerment and dependency were evident. Clients' attempts to gain control and workers' attempts to relinquish control alleviated clients' disempowerment and dependency. However, structural features of information sharing systems and workers' care planning behaviours diminished such efforts. Conclusion Worker awareness of their communication style and the power of their role must improve for client chronic condition self-care management to be achieved. Training on the impacts of control in worker communication and systems where they work must be provided if unbeneficial forms of client dependency are to be overcome and true self-care management is to be realized. [ABSTRACT FROM AUTHOR]

Aims: Health care is under constant change creating new and demanding tasks for public health nurses. The curriculum for public health nursing students is controlled by governmental directives that decide the structure and content of their education. This paper analyses manifest and latent discourses in the curriculum, in order to reveal underlying governmental principles for how public health nurses should promote health and prevent diseases. Methods: A critical discourse analysis of the Norwegian public health nursing curriculum was conducted. Results: The study indicates i) ‘a competing biomedical and social-scientific knowledge-discourse’, with biomedical knowledge dominating the content of the curriculum; ii) ‘a paternalistic meta-discourse’, referring to an underlying paternalistic ideology despite a clear focus on user participation; and iii) ‘a hegemonic individual discourse’. Even though the curriculum stipulates that public health nurses should work at both an individual and a societal level, there is very little population focus in the text. Conclusions: Recent political documents concerning public health nursing focus more on health promotion, however, this is not sufficiently explicit in the curriculum. The lack of emphasis on social scientific knowledge, and the blurred empowerment and population perspective in the curriculum, can lead to less emphasis on health promotion work in public health nursing education and practice. The curriculum should be revised in order to meet the recent governmental expectations. [ABSTRACT FROM PUBLISHER]

In preventive health-care settings, professionals need to encourage clients to talk about their problems before they become critical. We use multimodal conversation analysis to demonstrate how public health nurses encourage parents to elaborate on their problems in a sample of preventive maternity and child health (MCH) clinics in Finland. The nurses topicalize the problem-relevant aspects of the parents’ problem-indicative talk by issuing a formulation of what the parent has just said (that is, by redescribing it in problem-related terms). This verbal practice is synchronized with a visual one—the nurse issues the formulation, receives the parent's response, and then gazes directly at them. This has the effect of prompting the parent to take up the problem and talk about it. We discuss the findings in relation to the institutional tasks in MCH care and to the role of gaze in constituting actions, such as formulations. Data are in Finnish with English translation. [ABSTRACT FROM AUTHOR]

Ethical care is beginning to be recognised as care that accounts for the views of those at the receiving end of care. However, in the context of palliative and supportive district nursing care, the patients’ and their carers’ views are seldom heard. This qualitative research study explores these views. Data were collected through semi-structured interviews with 26 patients with palliative and supportive care needs receiving district nursing care, and 13 of their carers. Participants were recruited via community nurses and hospices between September 2010 and October 2011. Post-structural discourse analysis is used to examine how discourses operate on a moral level. One discourse, ‘busyness’, is argued to preclude a moral form of nursing care. The discourse of friendship is presented to contrast this. Discussion explores Gallagher’s ‘slow ethics’ and challenges the currently accepted ways of measuring to improve quality of care concluding that quality cannot be measured. [ABSTRACT FROM PUBLISHER]

The aim of this work was to characterize the views of nurses about factors modulating smoking cessation. Results of this study will allow us to design helping interventions with the maximum specificity for nurses. A qualitative study through a semi-structured interview of 15 Primary Health Care nurses who were smokers was performed. In contrast with other studies in which nurses were not aware of any particular social pressure to give up smoking, 18 months after the application of the Anti-Smoking Spanish Law, this feeling was expressed. Therefore, the main reasons for giving up smoking include that smoking in public is every day worse seen, together with a sense of shame and guilt in front of their social and family environment, especially for being a professional group dedicated to health. [ABSTRACT FROM AUTHOR]

The purpose of this article is to explore enduring ethical vulnerabilities of the nursing profession as illustrated in historical chapters of nursing's past. It describes these events, then explores two ethical vulnerabilities in depth: conflicting loyalties and duties, and relationships with patients as 'other'. The article concludes with suggestions for more ethical approaches to the other in current nursing practice. The past may be one of the most fruitful sites for examining enduring ethical vulnerabilities of the nursing profession. First of all, professional identity, which includes moral identity, comes in part from knowledge of the nursing profession's past. Second, looking to the past to understand better how events and ideologies have brought vulnerabilities to the fore raises questions about ethical nursing practice today. [ABSTRACT FROM AUTHOR]

This paper draws on the ideas of Foucault to analyse the government's recent review of the role of health visitors in England, 'Facing the future'. It outlines the Foucauldian concepts of discourse, knowledge and power and examines the review document following an accepted six-step process for the analysis of discourse. The analysis considers how 'Facing the future' constructs the present and future roles of health visitors, and elucidates the 'regimes of truth' that operate in official policy. It highlights the way in which the document proposes a shift away from health visitors' traditional emphasis on building supportive relationships with clients, toward a stronger emphasis on outcome-oriented service provision by multi-skilled teams. In line with contemporary public health discourse, 'Facing the future' also reinforces the future role of health visitors as being one that supports individuals to make lifestyle changes to improve health rather than addressing wider environmental and social determinants. Although 'Facing the future' purports to reflect a consultative review and to encourage debate within the health visiting profession, its form is more akin to a promotional document to implement government proposals for social change. [ABSTRACT FROM AUTHOR]