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Title: Bringing 'practice' to the clinic : an excavation of the effects of health promotion discourse on nursing practice in a community health clinic
Author: Purkis, Mary Ellen
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1993
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Health promotion is investigated as a concept which has intruded into debates about nursing practice. Review of the literature on health promotion reveals two major problems with the way in which the relationship between theory and practice is conceptualized in nursing literature. A critical review reveals that 'power' has received inadequate treatment and an absence of critical debate regarding the conceptualization of action as a social accomplishment in accounts of nursing practice. The argument is advanced that much research into nursing practice is currently based on functionalist frameworks influencing not only decisions made regarding changes in practice but, more importantly, the way in which the field of practice is conceptualized as a research 'site'. The thesis advances a theoretical position which addresses these problems by keeping action as a social accomplishment and power in the foreground of a study of nursing practice. The position draws on Giddens' structuration theory (1976, 1984), which offers an explanatory locus for an analysis of social action. Foucault's writings on 'procedures of power' (1963/1973, 1975/1977, 1978/1991) are used to situate the study as an investigation of how knowledge of action has implications for constituting viable interests in practice settings. Ethnographic methods are employed, generating contextualized accounts of nursing practice in one setting: a community health clinic. Transcribed interactions between nurses and clients were drawn on as the primary source for interpretation. Interpretations were cross-checked first with observational fieldnotes and secondly with interviews conducted with nurses and clients after the clinic interactions. 'Conversation' is excavated as a strategy-in-use by nurses conducting immunization clinic visits. The analysis demonstrates that nurses are presently in the process of instituting a new 'nstitution' (Lyotard, 1979/1984) in their accomplishment of work in this setting. This has the effect of moving parents out of the home and into the clinic, a move which has implications for the 'fracturing' of the parent-child life-world.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available