Rural influences on the social network dynamics of district nursing services: a qualitative meta‐synthesis
Rural influences on the social network dynamics of district nursing services: a qualitative meta‐synthesis
Background and aims: as demands on healthcare services grow, fiscal restrictions place increased emphasis on services outside of traditional healthcare settings. Previous research into long-term-conditions suggests that social network members (including weaker ties such as acquaintances, community groups, and healthcare professionals) play a key role in illness management. There is limited knowledge about the engagement of social networks in supporting people who are receiving medical interventions at home. This qualitative metasynthesis explores the work and the interactions between district nurses (DN) and informal network members supporting people who are receiving medical interventions at home and living in rural areas.
Methods: a search was undertaken on CINAHL, Medline, and PsychINFO for qualitative research articles from 2009 to 2019. Studies that examined DN in rural locations and/or social network support in rural locations were eligible. Fourteen articles were selected.
Results: thematic analysis of results and discussion data from the studies resulted in four themes being developed: the development of both transactional and friend-like nurse-patient ties in rural localities, engagement of the wider network in the delivery of good care, blurring of professional boundaries in close community relationships, and issues accessing and navigating formal and informal support in the context of diminishing resources in rural areas. These findings suggest that DNs in rural localities work beyond professional specialties and experience to provide emotional support, help with daily tasks, and build links to communities. There was also evidence that nurses embedded within rural localities developed friend-like relationships with patients, and negotiated with existing support networks and communities to find support for the patient.
Conclusions: findings indicated that developing strong links with patients and members of their networks does not automatically translate into positive outcomes for patients, and can be unsustainable, burdensome, and disruptive. DNs developing weak ties with patients and building awareness of the structure of individual networks and local sources of support offers avenues for sustainable and tailored community-based nursing support.
community nurse, district nurse, nursing, rural, rurality, social networks, social support
Gillham, Jack
f1392946-798c-4b37-8ae7-cce233f790c6
Vassilev, Ivaylo
d76a5531-4ddc-4eb2-909b-a2a1068f05f3
Band, Rebecca
be8901bb-bb1b-4131-8e19-c1d4a3bdfb8d
Gillham, Jack
f1392946-798c-4b37-8ae7-cce233f790c6
Vassilev, Ivaylo
d76a5531-4ddc-4eb2-909b-a2a1068f05f3
Band, Rebecca
be8901bb-bb1b-4131-8e19-c1d4a3bdfb8d
Gillham, Jack, Vassilev, Ivaylo and Band, Rebecca
(2021)
Rural influences on the social network dynamics of district nursing services: a qualitative meta‐synthesis.
Health Science Reports, 4 (3), [e336].
(doi:10.1002/hsr2.336).
Abstract
Background and aims: as demands on healthcare services grow, fiscal restrictions place increased emphasis on services outside of traditional healthcare settings. Previous research into long-term-conditions suggests that social network members (including weaker ties such as acquaintances, community groups, and healthcare professionals) play a key role in illness management. There is limited knowledge about the engagement of social networks in supporting people who are receiving medical interventions at home. This qualitative metasynthesis explores the work and the interactions between district nurses (DN) and informal network members supporting people who are receiving medical interventions at home and living in rural areas.
Methods: a search was undertaken on CINAHL, Medline, and PsychINFO for qualitative research articles from 2009 to 2019. Studies that examined DN in rural locations and/or social network support in rural locations were eligible. Fourteen articles were selected.
Results: thematic analysis of results and discussion data from the studies resulted in four themes being developed: the development of both transactional and friend-like nurse-patient ties in rural localities, engagement of the wider network in the delivery of good care, blurring of professional boundaries in close community relationships, and issues accessing and navigating formal and informal support in the context of diminishing resources in rural areas. These findings suggest that DNs in rural localities work beyond professional specialties and experience to provide emotional support, help with daily tasks, and build links to communities. There was also evidence that nurses embedded within rural localities developed friend-like relationships with patients, and negotiated with existing support networks and communities to find support for the patient.
Conclusions: findings indicated that developing strong links with patients and members of their networks does not automatically translate into positive outcomes for patients, and can be unsustainable, burdensome, and disruptive. DNs developing weak ties with patients and building awareness of the structure of individual networks and local sources of support offers avenues for sustainable and tailored community-based nursing support.
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Rural influences on the social network dynamics of district nursing services
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Rural influences on the social network dynamics of district nursing services Figures and tables
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Health Science Reports - 2021 - Gillham - Rural influences on the social network dynamics of district nursing services A
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Accepted/In Press date: 15 July 2021
e-pub ahead of print date: 17 August 2021
Additional Information:
Funding Information:
We would like to acknowledge the University of Southampton and the Dorset County Hospital Foundation Trust for the joint funding and resources for the PhD program of the author JG. Without this, the author would not be able to dedicate the time required to complete this work. The views expressed are those of the authors and not necessarily those of the university or the NHS trust who took no part in designing the study or collection, analysis, and interpretation of data, writing of the report, or the decision to submit the report for publication.
Publisher Copyright:
© 2021 The Authors. Health Science Reports published by Wiley Periodicals LLC.
Keywords:
community nurse, district nurse, nursing, rural, rurality, social networks, social support
Identifiers
Local EPrints ID: 471976
URI: http://eprints.soton.ac.uk/id/eprint/471976
ISSN: 2398-8835
PURE UUID: ee3addb1-83d2-4d12-937c-efb1e79f9f58
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Date deposited: 23 Nov 2022 17:35
Last modified: 06 Jun 2024 02:00
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Author:
Jack Gillham
Author:
Rebecca Band
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