| Author: | Chan, Mee Kie Maggie |
| Title: | The lived experience of community nurses forming a professional identity in healthcare reform : a hermeneutic phenomenological study |
| Advisors: | Chan, Angela (SN) |
| Degree: | DHSc |
| Year: | 2017 |
| Subject: | Hong Kong Polytechnic University -- Dissertations Community health nursing -- China -- Hong Kong Community health nursing -- Psychological aspects |
| Department: | Faculty of Health and Social Sciences |
| Pages: | xii, 189 pages : illustrations |
| Language: | English |
| Abstract: | The Community Nursing Service in Hong Kong is currently facing significant challenges from the healthcare reform that emphasizes the development of enhanced community care services. The ongoing rapid changes have not only increased the work demands on community nurses, but also may cause them to suffer from professional ambivalence and an unclear sense of their roles, resulting in poor job satisfaction and departures from the profession. A sense of belonging to the profession and a clear concept of professional identity are important factors in retaining nurses in the field. Therefore, to obtain a clear representation of the profession, there is a need to explore and understand how healthcare reform influences community nurses' views of their roles and their value as professionals, and how their experiences influence the development of their identities. The aim of this study is to understand community nurses' experiences of the healthcare reform, which may affect how they define and refine their professional identities. Specifically, this qualitative study will address the question: What is it like to be a community nurse experiencing the changes brought about by healthcare reform, in particular in terms of their professional identity? This study utilized Heidegger's hermeneutic phenomenology as a philosophical and methodological framework. Heidegger's hermeneutic phenomenology allows me, someone who is already being in the world of community nurses, to have an in-depth understanding of what community nurses feel, think, and believe about their professional identity. Purposive sampling was used for this study. Ten community nurses were recruited from different community centers, and open-ended, in-depth interviews were used to collect and generate data. All the interviews were tape-recorded and then transcribed. I used my knowledge and experience to interpret the meaning with respect to the professional identities of community nurses. In addition, this study adopted Crist and Tanner's (2003) circular process of hermeneutic interpretative phenomenology to guide the data analysis while the framework of rigor for interpretive phenomenology devised by de Witt and Ploeg (2006) was employed to assess the rigor of this study. The findings of this study revealed that there are both similarities and differences in the temporality and spatiality experiences community nurses have that influence their practices and professional identities. The findings of this study show that the working environment shapes community nurses' feelings and perceptions as part of their past and present experiences as well as their future expectations. Three themes emerged inductively from the data: 1) relational practice versus specialty practice, 2) practice-based evidence versus evidence-based practice, and 3) empowerment of the client versus empowerment of community nurses. "Crossing the threshold: celebrating and struggling" represents the constitutive pattern of the tensional feelings shared at different levels of competence among community nurses. The findings of this study offer insights into the importance of organization to create positive changes in the culture and working environment of community nurses, so that they can see that their time is valuable, and can expect their future to be better. This will increase their potential to sustain practice improvement and transformative change. In addition, the findings of this study provide nurse educators with relevant information for designing appropriate educational contexts that can guide the development of nursing students' professional identities. These insights, particularly those regarding the positive formation of professional identity and the roles of professional nurses, will help shape the nursing profession in the future. |
| Rights: | All rights reserved |
| Access: | restricted access |
Files in This Item:
| File | Description | Size | Format | |
|---|---|---|---|---|
| 991022052656303411.pdf | For All Users (off-campus access for PolyU Staff & Students only) | 1.09 MB | Adobe PDF | View/Open |
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