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Abstract |
This study aimed to explore the range of issues that surround the continuity of wound care between hospital and community care settings in a provincial area of New Zealand, from the perspective of the health care professionals providing the wound care. Previous research into continuity of care concentrated predominantly upon purely nursing issues. This means that both the profound implications of the interprofessional relationships of the various health care professionals involved in wound care, and the far-reaching effects of the socio-economic context within which wound care was given were often not considered. A critical ethnographic approach was employed to explore continuity of care in this community. Health professionals were interviewed twice. A first interview discussed some of the unacknowledged power relations and the contextual issues that effect continuity of wound care, as well as offering the opportunity for the participants to reflect on the issues that emerged. Following preliminary analysis of the data from the first interview, a summary of findings was given to each of the participants which served as a focus for the second interview. Following these, the data were analysed, and the main themes that influenced the continuity of wound care for the participants were identified. Analysis of the data revealed all the participants practicing under considerable socio-political constraints which interfered with their ability to provide high quality wound care for their patients: these constraints dictated both who gave the wound care and how they were able to do it. The data also revealed the various relationships between the different professionals as another major area of influence upon continuity of wound care. Medical dominance was identified as having a profound impact upon nurses ability to optimise continuity of wound care. The study concluded there are a number of areas that need to be addressed in order to optimise continuity of wound care, at both local and governmental level. The development of a nurse-led wound clinic is one initiative that would go a long way to address these issues |
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