Health empowerment theory as a guide for practice.

Empowerment in the midwifery context—a concept analysis

The authors present a reformulation of empowerment based upon historical and current perspectives of empowerment and a synthesis of existing literature and Rogerian thought. Reformulation of non-Rogerian concepts familiar to nurses is proposed as a strategy to accelerate the mainstreaming of Rogerian thought into nursing practice and research. The reformulation of empowerment as a participatory process of well-being inherent among human beings may provide nurses with new insights for practice. This paper may also serve as a model for reformulating other non-Rogerian concepts and theories for wider dissemination across the discipline.

Empowerment: Reformulation of a Non-Rogerian Concept

Background Participatory action research (PAR) offers potential for people with an intellectual disability to have an active voice in service provision. However, ensuring their meaningful engagement is not without challenges. Guided by PAR, a recent project to develop a quality of life tool provided learning opportunities for the lead researchers. This paper addresses 3 issues raised by Ramcharan, Grant, and Flynn (2004) in relation to participation of people with intellectual disability in research.Method Informed by reflective practice, this paper draws on a combination of field notes and written reports to critically examine the 3 issues related to effective participation.Results Although the project achieved its goal of people with intellectual disability authoring a quality of life tool, there was variation in participants' contribution. With both data collection and analysis, prior experience and confidence influenced the participation of co-researchers. The financial and the practical suppo...

Reflections on a participatory project: the rewards and challenges for the lead researchers.

OBJECTIVE: To identify and quantify the socioeconomic determinants of schistosomiasis in the urban section of Sao Lourenco da Mata, a town in the Northeast of Brazil. METHODS: A cross-sectional study was carried out in 1988 to measure the prevalence of schistosomiasis in Sao Lourenco da Mata among individuals aged 10-25 years and to estimate the socioeconomic characteristics of the households of those individuals. Household aggregation was tested. The data were analyzed on two levels, the family level and the individual level. On the family level we estimated the odds ratios for the association of schistosomiasis and socioeconomic variables related either to the head of the family or to the household. On the individual level we investigated if for the infected individuals there were differences in the intensity of infection (mean egg count) for the different levels of the socioeconomic variables. RESULTS: We found a significant degree of household aggregation of schistosomiasis (allowing for sex and area of residence (neighborhoods with similar socioeconomic conditions, according to census data)). In the analysis on the family level, better socioeconomic indicators for the place in the productive process (occupation, economic sector, and position in production of the head of the family, plus family income) and better socioeconomic indicators for patterns of consumption (level of education of the head of the family, type of housing, household possessions, water supply for the home, sanitation (that is, excreta collection), and family access to medical care) were all associated with a lower risk of schistosomiasis. The estimation of the probability of schistosomiasis for different levels of the socioeconomic variables showed a lower risk (0.072) for individuals whose households were at the top (best) levels of the indicators relative to the risk (0.715) for individuals whose households were at the baseline (lowest) levels of the indicators. Infected individuals whose families had better socioeconomic conditions had lower mean egg count values. CONCLUSIONS: Control measures that may have a long-term effect, such as improvements in the water supply and sanitation, should be strongly encouraged. The theoretical reduction that we found in the probability of being infected if water supply and sanitation were improved highlights the importance of these measures. Implementing them would have a more permanent effect on the control of schistosomiasis and would also result in other benefits to the population.

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Papers

Community and professional empowerment.