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. 2019 Nov;75(11):2969-2979.
doi: 10.1111/jan.14109. Epub 2019 Jul 26.

Does improved postgraduate capacity shift the balance of power for nurse specialists in a low-income country: A mixed methods study

Judith C Bruce  1 , Jennifer Baumann  1 , Shelley Schmollgruber  2
Affiliations

Does improved postgraduate capacity shift the balance of power for nurse specialists in a low-income country: A mixed methods study

Judith C Bruce et al. J Adv Nurs. 2019 Nov.

Abstract
in English, Chinese

Aim: To explore nurse specialists' experiences of change and influence on practice two years after graduating with a postgraduate degree.

Background: In the absence of further study opportunities for nurses in their own country, a master's degree was introduced to train the first group of nurse specialists in Mozambique.

Design: Within a hybrid evaluation framework an exploratory, sequential mixed methods design was followed.

Methods: Qualitative data from focus group interviews with nurse specialists (N = 12) led to five thematic data sets from which survey questions were formulated for the sequential quantitative component.

Findings: "Change expectations", "Ambiguous practice environments", "Feeling powerless", "Having some influence" and "Workplace support" were emergent themes from interview data. Areas of positive change occurred in research (100%) and the use of evidence (88.9%) and involvement in decision-making (77.8%). For some change did not happen as anticipated-reasons included lack of nurse mentors to support new graduates (55.6%); lesser respect compared with doctors (44.4%) and poor understanding of the value of a master's degree (44.4%). Improvements in service quality and elevating the status of nursing were areas of greatest influence (77.8%).

Conclusion: Several enabling and limiting factors were identified in the experiences of change and influence on practice of newly qualified nurse specialists. Tacit change with respect to the value of the degree in improving the status of nursing seems not to have affected nurse specialists' own ability and power to influence practice. Improved postgraduate capacity on its own does not empower nurses in their role as specialists.

Impact: The findings point to a two-tiered strategy to be developed to dismantle barriers to the empowerment and advancement of nurse specialists. The identification of designated nurse mentors is essential to induct and sustain newly graduated nurse specialists. A clear research policy should be developed that supports the conduct of relevant research and the use of evidence in specialist practice.

目的: 探讨专业护理人员研究生毕业两年后的经验变化及其对护理实践的影响。 背景: 本国缺乏让护士进一步学习的机会,因此引进了一个硕士学位来培训莫桑比克的第一批专业护理人员。 设计: 在混合评价框架下,进行了探索性的、顺序混合方法设计。 方法: 从专业护理人员的小组讨论访谈中获得的定性数据(N = 12)得出了五个专题数据集,从中调查制定的连续定量组成部分。 发现: “变化预期”、“模棱两可的实践环境”、“感觉无能为力”、“有一些影响”以及“工作支持”都是采访数据中涌现出来的各个主题。出现正相关改变的领域包括调查(100%)、证据的使用(88.9%)以及参与决策(77.8%)。没有按预期出现某些改变--原因包括缺乏指导刚毕业学生的护理导师(55.6%);与医生相比不受人尊重(44.4%)以及对硕士学位的理解不够(44.4%)。服务质量的改变和护理地位的提高是影响最大的领域(77.8%)。 结论: 新合格的专业护理人员的实践中确定了一些改变和影响实践的有利因素和限制因素。学位在改善护理状况中价值的隐形改变似乎还未影响专业护理人员自身的能力和影响实践的权力。研究生能力提高本身并不能使他们成为专业护理人员。 影响: 研究结果指出了一个旨在消除阻碍专业护理人员授权和进步障碍的两级策略。认同指定的护理导师是吸纳和留住刚毕业的专业护理人员的基本。应制定支持相关研究开展和护理实践中证据使用的明确研究政策。.

Keywords: capacity development; empowerment; nurse education; nurse specialist; postgraduate; power; specialist practice.

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References

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