Previous studies have reported a conflict between nurses' motivation to provide humanized care and practical requirements impeding them from doing so. This exploratory descriptive qualitative study aimed to explore nurses' perspectives on humanized care, the challenges they face, and, most importantly, their recommendations to overcome these barriers. Semistructured individual interviews were conducted with 17 auxiliary and registered nurses working in various health care units in a Canadian hospital. Participants demonstrated a good understanding of what humanized care covers and entails. They also described it as the very core of their profession and main source of job satisfaction. However, nurses reported that they are confronted with organizational barriers, mainly a lack of staff, the burden of administrative tasks, unsuitable physical environments or equipment, and little managerial support. Nurses stressed the need for a cultural change in managerial practices in order to be able to improve their provision of humanized care. Based on the findings, 4 structuring recommendations were identified: adopting an institutional policy promoting the implementation of humanized care, incorporating humanized care in nurses' tasks and procedures, improving participatory management, and ensuring adequate staffing.
The theoretical frameworks presently dominating health promotion practices mainly focus on the individual's psychosocial and cognitive components. When focusing on environments, these frameworks barely relate contextual elements to the individuals who give them a real existence. Because of the disjunction and reduction they create, the main theoretical readings only partially recognize the complexity of social life and therefore lose the Subject. Lacking theoretical reliance, these readings fail to meet the Ottawa Charter principles. Based on critical analysis of the main theoretical frameworks, we discuss the influence of disciplinary backgrounds on our modes of knowledge, tackling how epidemiological and behavioral thinking affect how we understand, conceive and problematize the objects in these fields. Based on this analysis, we illustrate how these epistemologies oversimplify social realities related to health. In order to encounter the lost subject of health promotion and thereby achieve Ottawa Charter's principles, we propose an innovative theoretical approach based on Schütz' socio-phenomenological thinking and Morin's complexity paradigm. Our theoretical proposal aims to recognize and reconcile significant aspects of individuals' meaningful life experiences, while integrating common sense principles. By transiting through the subject's identity, this theoretical proposal tends to unify all meaningful aspects that subtend social life at the subject's scale.
Dominé par un paradigme bio-mécaniste, les systèmes de santé occidentaux souffrent d’un grand nombre de problèmes. L’un d’entre eux consiste tout particulièrement en un manque de considération de l’expérience vécue et de toute la complexité et l’épaisseur de sens qui la caractérisent. Évoquant alors ces problèmes, nous soulignons dans ce texte l’importance de plonger dans le vécu du sujet soigné, et de changer de point de vue sur son mal. À l’aide de quelques réflexions empruntées à Georges Canguilhem nous défendons ce point et proposons ensuite de nous inscrire dans une approche socio-phénoménologique inspirée des travaux d’Alfred Schütz afin d’élaborer une lecture qui puisse nous permettre de saisir les expériences vécues. Nous réhabilitons ainsi le sujet dans un prendre-soin à travers ses rapports au corps, au temps, aux autres et à l’espace, et à partir de référents identitaires qui donnent sens à son existence. L’ensemble de cette réflexion consiste en un essai de théorisation sur le prendre-soin qui va dans le sens de la collaboration professionnelle et de l’interdisciplinarité, et qui n’ignore pas la pratique concrète d’acteurs et de professionnels soucieux de personnes préoccupées par leur existence.
Definitions and understandings of the term “community health” are numerous, but generally orient themselves around an expanded understanding of health exceeding biomedical imperatives. Rethinking the conception of community health through a vitalistic approach with the idea of health, and thus the community, at its core allows for a deeper understanding of health experiences’ complexity and could eventually inspire practice innovations in community health centers. In this paper, we will present this theoretical conception of health and discuss how it can help to understand the innovative interventions approach conducted within community health centres in Canada. Specifically, the practical implications of this theoretical conception will be illustrated through two Canadian community health centres. A new perspective on health could have numerous implications for health professionals with the development of cutting-edge interventions potentially leading to change benefiting the community, but also for teaching and research innovations empowered by a deeper understanding of the wider story behind health issues.
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