La pratique infirmière de promotion de la santé et de prévention en CSSS, mission CLSC
La série "Rapport synthèse" met en relief les faits saillants des principales études, recherches, projets d'intervention ou promotion réalisés dans les différents domaines de la santé publique. Ce rapport synthèse présente les résultats d'une étude réalisée en étroite collaboration par des chercheurs de la Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal (DSP,de l'Université de Montréal et de quatre centres de santé et de services sociaux de Montréal(CSSS).Cette démarche participative s'inscrit dans une volonté d'ajuster la recherche aux réalités des CSSS, dans le but de formuler des recommandations et d'entreprendre des actions afin de favoriser une actualisation accrue de la pratique infirmière de promotion de la santé et de prévention dans une perspective populationnelle.
Available from: Gaston Godin
- "Training needs were not expressed as a facilitating factor to playing the proposed role by the respondents, although there is a consensus in the literature on the development of competencies with respect to an expanded role of school nurses [17,18,55,66]. In their study, Beaudet et al.  noted that nurses tended to mention that they needed training, but when questioned about the nature, they had difficulty identifying required training and competencies. The authors attributed this to the fact that public nurses tend to limit their educational needs to the individual and family. "
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ABSTRACT: The quest for greater efficiency in the provision of primary healthcare services and the implementation of a "health-promoting school" approach encourage the optimal redefinition of the role of school nurses. School nurses are viewed as professionals who might be significant actors in the promotion of youth health. The aim of this study was to identify the determinants of the intention of elementary school nurses to adopt a new health-promotion role as a strategic option for the health-promoting school.
This study was based on an extended version of the theory of planned behaviour (TPB). A total of 251 respondents (response rate of 70%) from 42 school health programs across the Province of Québec completed a mail survey regarding their intention to adopt the proposed health-promotion role. Multiple hierarchical linear regression analyses were performed to assess the relationship between key independent variables and intention. A discriminant analysis of the beliefs was performed to identify the main targets of action.
A total of 73% of respondents expressed a positive intention to accept to play the proposed role. The main predictors were perceived behavioural control (β = 0.36), moral norm (β = 0.27), attitude (β = 0.24), and subjective norm (β = 0.21) (ps < .0001), explaining 83% of the variance. The underlying beliefs distinguishing nurses who had a high intention from those who had a low intention referred to their feelings of being valued, their capacity to overcome the nursing shortage, the approval of the school nurses' community and parents of the students, their leadership skills, and their gaining of a better understanding of school needs.
Results suggest that leadership is a skill that should be addressed to increase the ability of school nurses to assume the proposed role. Findings also indicate that public health administrators need to ensure adequate nurse staffing in the schools in order to increase the proportion of nurses willing to play such a role and avoid burnout among these human resources.
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ABSTRACT: This paper aims to identify organizational readiness for change towards adoption of a redefined role of the school nurse as a strategic option in the context of a health promoting school approach. This new role is consistent with planned change directed at life habits and life conditions.
A questionnaire based on a modified version of the organizational readiness for change (ORC) framework was e-mailed to 122 top and middle managers (response rate of 74 percent) in 42 local health organizations in the Province of Quebec, Canada, during the fall of 2009.
In total, 90 percent of participants perceived the proposed role as a solution to fulfil their school health program needs, especially to plan and integrate health promotion projects. The lack of resources and nursing support emerged as factors hampering the capacity of school nurses to play such a role.
Additional implications of the ORC framework are needed in order to better address organizational readiness for complex changes in specific health-related settings.
Access to information technology and the development of computer skills would help enhance this encompassing role in health promotion.
Findings have the potential to better inform health authorities regarding the new role of the school nurse as a strategic option in health promotion. This study also provides an application of the theoretical framework showing the need for additional empirical tests.
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