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Finding a balance: participatory action research with primary health care nurse practitioners on the relevance of collaboration to nurse practitioner role integrationBurgess, Judith 01 September 2009 (has links)
This health services study employed a participatory action research (PAR) approach to engage nurse practitioners (NPs) from two health authorities in British Columbia in separate and concurrent inquiry groups to examine the research question: How does collaboration advance NP role integration within primary health care (PHC)? The inquiry with NPs is significant and timely, because the introduction of the NP role was only recently formalized in BC, supported by the passage of legislation and regulation, and the introduction of graduate education programs. For this PAR study, a first-, second-, third-person action research framework was adapted and applied to facilitate graduate student research. PAR fostered an iterative process of social investigation, education, and action, in which NPs strengthened their relations, shared and generated practice and policy knowledge, and engaged in collective visioning and action to improve health care delivery.
The findings of this PAR study include design and substantiation of an ecological framework about collaborative health care culture. This collaborative culture framework was applied to and substantiated by the NP inquiry discussions. NP practice patterns were examined and found to parallel the PHC principles, indicating the importance of the NP role to PHC renewal efforts. The meaning of role integration was explicated and collaboration was found to be foundational to NP practice. The study revealed the political nature of the NP role and the extent to which NPs are reliant on collaborative relations at all levels of the health system to attain role integration. Given that NP role development is still at an early stage in this province, this study provides important information about the current progress of role implementation and direction for future role advancement.
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