Saskatchewan Public Health Nursing Survey: Perceptions of Roles and Activities

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ABSTRACT

Objective: To explore perceived roles and activities of Saskatchewan public health nurses (PHNs).

Methods: This replication study surveyed Saskatchewan PHNs using the instrument developed by the Hamilton-Wentworth Social and Public Health Services Division in a 1992 survey of Ontario PHNs. This instrument is based on the roles and activities for community/public health nurses described by the Canadian Public Health Association (1990). Descriptive statistics were used to analyze the 124 responses received,

Results: Most of the nurses perceived that they were at least somewhat prepared for all of the roles. The activities of: caring for individuals and families; immunizing; educating individuals, families, and groups; acting as a resource person for clients and lay helpers; linking those needing services to appropriate community resources; and using marketing strategies were carried out most often by PHNs. Activities within the roles of community developer, policy formulator, researcher and evaluator, and resource manager/planner/coordinator were carried out to a much lesser degree. The roles and activities being done less often were also the ones PHNs felt less prepared to do.

Interpretation: it is important, as health authorities begin to support a more preventive approach to health care, that PHNs are competent in the roles outlined by the Canadian Public Health Association. As well as preparing new graduates for these roles, it is essential to provide continuing education for practicing PHNs. Public health administrators must also support public health nurses in carrying out these roles.

One of the main goals of health reform in Canada in general, and in Saskatchewan in particular, is to focus on the wellness of the population through an increased emphasis on health promotion and illness/injury prevention.1-5 Public health services in Saskatchewan have attempted to implement this goal by adapting existing programs and creating new approaches that focus on population health promotion.6-10 The Report of the Working Group on a Changing Role of the Public Health Nurse determined that 70-90% of Saskatchewan PHN practice is centered around providing health education and clinical services.9 The working group indicated that the Canadian Public Health Association (CPHA) document, Community-Public Health Nursing in Canada Preparation and Practice, which outlines the scope of practice for public health nurses, was appropriate as the basis for PHN practice in Saskatchewan" and recommended that at least 40% of PHN time be spent on the broader health promotion strategies of strengthening community action, building healthy public policy, and creating supportive environments. This places expectations on public health nurses (PHNs) to be involved in community development and other population health promotion programming, as well as maintaining many of their current roles and activities. In light of this, it is timely to examine PHNs' perceptions of their present and future roles and activities.

This study was done to determine how the CPHA document11 compares with current roles and activities of Saskatchewan public health nurses. It is a replication of a study done in Ontario in 1992.(12)

METHOD

Permission was granted to use the survey instrument developed by the Hamilton-- Wentworth Social and Public Health Services Division for a 1992 survey of Ontario public health nurses.12 In this instrument, the PHN activities listed in the CPHA document11 were condensed into eight areas: caregiver/service provider; educator/consultant; social marketer; facilitator/communicator/collaborator; community developer; policy formulator; researcher and evaluator; and resource manager/planner/coordinator. Respondents were asked to indicate, using a five-point Likert scale: 1) how often they performed each activity, 2) whether this activity should be increased or decreased, and 3) how well they felt their education or experience prepared them for this activity. …