In a nutshell, it's the very basics: remote area nurses' constructions of primary health care
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This study explores the constructions of primary health care held by remote area nurses working in indigenous communities without resident medical practitioners, in the Northern Territory. Primary health care is increasingly permeating health policy in Australia, and nurses in remote areas are responsible for its implementation. The study investigates past and present discussions of the meaning of the concept of primary health care to begin to identify the major forces which have problematically impacted on its evolution and interpretation. It traces the threads which emerge from these forces through the more recent developments of health promotion and new pubflc health to explore the discourses and strategies they have produced, and which overtly and covertly influence the implementation of primary health care. Remote area nurses are individually interviewed and their discussions analysed to explore the constructions of primary health care which they hold. The analysis also explores some of the ways in which these constructions may have come to exist, the evident impact of current discourses, and the absence of effective support in the further development of these constructions. The remote area nurses' discussions display a view of primary health care as the most basic of health services, focussed on personal hygiene and the individual's responsibility in prevention of illness, operated through encounters which offer opportunities for education and basic curative care. While several of the nurses indicate discomfort with the paternalistic nature of such a service, none are aware of ways in which they might resolve their concerns about it. The study briefly explores positive approaches towards the democratization of health care, and examines the support needed by remote area nurses if primary health care is to be effectively implemented by them.
Master of Philosophy (MPhil)
School of Nursing and Midwifery
Remote area nursing
primary health care