Lincoln, Yvonna, and Egon Guba, "Postpositivism and the Naturalist Paradigm," pp. 14-46 in Yvonna Lincoln and Egon Guba, Naturalistic Inquiry . Beverly Hills, CA: Sage, 1985.*

Five subscales were derived from the Nursing Work Index (NWI) to measure the hospital nursing practice environment, using 1985-1986 nurse data from 16 magnet hospitals. The NWI comprises organizational characteristics of the original magnet hospitals. The psychometric properties of the subscales and a composite measure were established. All measures were highly reliable at the nurse and hospital levels. Construct validity was supported by higher scores of nurses in magnet versus nonmagnet hospitals. Confirmatory analyses of contemporary data from 11,636 Pennsylvania nurses supported the subscales. The soundness of the new measures is supported by their theoretical and empirical foundations, conceptual integrity, psychometric strength, and generalizability. The measures could be used to study how the practice environment influences nurse and patient outcomes.

Practice Environment Scale of the Nursing Work Index

Book review818 pages The Practice of Nursing Research: Conduct, Critique and Utilization, N. Burns, S.K. Grove, W B Saunders (1993), ISBN: 0 721 63 742 6

/pdf/real-world-research-2nd-ed-by-colin-robson-3i4s3quyl7.pdf

Real World Research (2nd ed.) by Colin Robson

Transforming Practice through Clinical Education, Professional Supervision and Mentoring

Purpose: To examine the perspectives of persons living with traumatic spinal cord injuries (tSCI) on their access to health and support services. The specific aims were to identify the perceived gaps in access, classify the nature of the perceived gaps and compare differences in perceptions of access between urban and rural participants. Method: Using a descriptive, qualitative approach, semi-structured interviews were conducted with 23 adults living with tSCI, 13 of whom had paraplegia. Ten participants resided in rural areas and 16 were male. Thematic analysis allowed for the identification of patterns, which were then categorized according to the dimensions of access. Results: Opportunities to engage in health-promoting activities through a broad range of health and support services were at times limited, particularly by issues of affordability. In addition to core healthcare services, participants reported the need for complementary therapies, sports and leisure, peer support, equipment and mo...

Access to health and support services: perspectives of people living with a long-term traumatic spinal cord injury in rural and urban areas

Introduction The global shortage of rural healthcare professionals threatens the access these communities have to adequate healthcare resources. Barriers to recruitment and retention of nurses in rural facilities include limited resources, professional development opportunities, and interpersonal ties to the area. Mentorship programs have been used to successfully recruit and retain rural nurses. This study aimed to explore (i) employee perceptions of mentorship in rural healthcare organizations, (ii) the processes involved in creating mentoring relationships in rural healthcare organizations, and (iii) the organizational features supporting and inhibiting mentorship in rural healthcare organizations. This study was conducted in one rural health region in Saskatchewan, Canada. Methods Volunteer participants who were employed at one rural healthcare facility were interviewed. A semi-structured interview guide that focused on exploring and gaining an understanding of participants' perceptions of mentorship in rural communities was employed. Data were analyzed using interpretive description methodology, which places high value on participants' subjective perspective and knowledge of their experience. Results All seven participants were female and employed as registered nurses or licensed practical nurses. Participants recognized that the rural environment offered unique challenges and opportunities for the transition of nurses new to rural healthcare. Participants believed mentorships facilitated this transition and were vital to the personal and professional success of new employees. Specifically, their insights indicated that this transition was influenced by three factors: rural community influences, organizational influences, and mentorship program influences. Facilitators for mentorships hinged on the close working relationships that facilitated the development of trust. Barriers to mentorship included low staff numbers, limited selection of volunteer mentors, and lack of mentorship education. Conclusions The rural community context clearly presents challenges for the transition of nurses. Participants described mentorship as a vital component to personal and professional success of new employees in rural areas. The findings of this qualitative exploratory study inform the development of creative and supportive ways to establish mentorships to address the challenges specifically associated with integration of nurses into rural practice.

Supporting nurses' transition to rural healthcare environments through mentorship

The benefits of peer student mentorship programs are making them increasingly popular in nursing education. This manuscript reviews and synthesizes 20 articles outlining key elements, outcomes, and...

Nursing student peer mentorship: a review of the literature

Healthcare provider experiences with access to care for disabled patient populations may inform healthcare system change and improve health outcomes. Persons with spinal cord injury often require access to life-long care. The objective of this study was to explore healthcare provider perspectives on client access to care in traumatic spinal cord injury. We used an interpretive qualitative study with semi-structured interviews and focus groups to explore provider perspectives on five access dimensions: availability, accessibility, affordability, accommodation , and acceptability. Volunteer (n=23) healthcare providers (therapists, physicians, nurses, home care workers and managers) working with traumatic spinal cord injury clients in Saskatchewan participated. Nine healthcare providers serviced rural areas. Healthcare providers felt restricted in their ability to ensure availabilit y of services. In rural areas, therapy and counselling services were often not available. Parking and transportation barriers severely impacted the accessibility of services. Inconsistencies related to the affordability of equipment and accessible housing were expressed. Efforts to accommodate clients to remain in their home communities were apparent. Night time or early morning care seemed impossible to accommodate.  Healthcare providers accepted that attitudes and efforts concerning health advocacy among clients, families , and other care providers impacted access. Barriers related to availability, accessibility , and affordability were perceived to affect traumatic spinal cord injury care. Healthcare providers identified the need to accommodate clients’ needs by assuming different healthcare and advocacy roles, especially in the face of service shortages. However, restrictions imposed by administrative guidelines, policies or cost were perceived to limit the ability to fully accommodate client’s needs.

/pdf/access-to-traumatic-spinal-cord-injury-care-in-saskatchewan-33kyrip50c.pdf

Access to traumatic spinal cord injury care in Saskatchewan, Canada: A qualitative study on community healthcare provider perspectives

Introduction: Recruitment to and retention of healthcare professionals in rural workplaces are often difficult due to inadequate resources, limited positions, and facility remoteness. Mentorship of employees can serve as a recruitment and retention strategy in rural organizations. Purpose: The purpose of this study was to explore managers’ perceptions of their roles in creating mentoring cultures, discover the processes in creating a culture of mentoring, and explore the organizational features supporting and inhibiting mentoring cultures. The objectives included: (a) exploring managers’ perceptions of their role in creating a mentoring culture, (b) discovering the processes of creating a culture of mentoring, and (c) exploring the organizational features supporting and inhibiting this process of developing a mentoring culture. The rural-specific findings from the larger study will be discussed. Sample: Twenty-seven front-line nurse managers working in acute care hospitals, long term care, and integrated facilities from both urban and rural locations were interviewed. Twelve participants managed rural facilities and their opinions surrounding rural mentorship strategies and challenges emerged. Method: Data was analyzed using Glaserian Grounded Theory. Findings: Nurse managers discussed the impact of being in a rural area and highlighted the rural-specific considerations for mentoring. They outlined the strategies, challenges, and opportunities for supporting staff mentoring relationships in rural organizations. Participants stated all employees were responsible for mentoring new individuals, regardless of occupation. Managers believed cross-professional mentoring enabled staff to understand team member roles and established collaborative work environments. Conclusions: In order to successfully recruit and retain healthcare employees in rural areas, innovative mentorship initiatives to ensure quality work environments are encouraged. Interprofessional mentorship can assist with the challenges of socializing new employees to rural workplaces by offering a means to encourage collaborative relationships and ultimately foster positive patient outcomes. Key Words: Mentorship, Rural Organizations, Interprofessional, Healthcare

/pdf/mentorship-in-rural-healthcare-organizations-challenges-and-alcng3cjpt.pdf

Noelle Rohatinsky

Papers

Access to health and support services: perspectives of people living with a long-term traumatic spinal cord injury in rural and urban areas

Supporting nurses' transition to rural healthcare environments through mentorship

Nursing student peer mentorship: a review of the literature

Access to traumatic spinal cord injury care in Saskatchewan, Canada: A qualitative study on community healthcare provider perspectives

Mentorship in Rural Healthcare Organizations: Challenges and Opportunities