The social context and the relevancy of nursing curricula : a thesis ... for the degree of M.A. (Soc. Sc.) in Nursing at Massey University
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A study based on a perception of nursing as a socially prescribed service, initiated and developed to assist a society to care for members with some inability to maintain self-care. It is argued that, to fulfil its purpose, nursing has an ongoing need to identify and adapt to the changing social realities of a society. 'Social realities' have been defined as the actual conditions, pressures, disabilities and abilities, limitations and resources that exist in the lifespace of people and form the environment within which nursing practises. A system approach was adopted since it provides for the identification as well as the solution of problems. As a first step a theoretical framework, the 'triadic nursing model' was developed to delineate the key issues nursing has to contend with in contemporary societies. Next, from the operative component of the triadic nursing model an educational tool, with a system approach, named the 'curriculum relevancy process' (CRT) was developed. CRP, defined as an information-seeking, problem solving, and evaluative process, has three phases. Only the first or information-seeking phase of CRP has been activated, and, moreover, further elaborated to form an information system or process. Two main activities were undertaken to gain information about contemporary social realities and resultant disorders. To define the social context in which nursing practises an examination was made of: - dominant trends and problems; - the effects of contemporary social realities on social institutions, particularly the family; - changing patterns of ill-health; - the management of technology; and the clarification of values in an age of degenerative and man-made disease. From this review it was noted that major issues of today included the problems of rapid and persistent change, and its effects on social institutions and individuals. As well, diseases associated with increasing urbanisation, industrial and technological developments, mobile populations, and the hazards of pollution were found to be prominent. The rapidly escalating costs of health care was also emphasised, and the need to clarify values in order to make optimal choices in the use of available resources. The need for individuals, groups, and societies to have their self-care abilities promoted was also stressed. The second, and more specific activity, was the use of the information system to focus on the social context in which nursing functions in NZ. For this purpose, information was sought from both voluntary and official sources. The need for broader information about a society's socio-health and nursing needs and problems has been stressed as a basic requirement for maximizing curricular choices. Particular emphasis has been given to the collection of information from the 'mass media' since it provides perceptions of socio-health needs closer to the grass-roots of society. Characteristics of data collected from the mass media showed that 33% of items were related to specific health problems. Problems of most concern were alcoholism, mental ill-health, inadequate health care knowledge, chronic disorders associated with genetic, pathological, and traumatic incidents, drug addiction, and increasing sexually transmitted disease. Twenty-six percent of items related to family issues including delinquency in children and adolescents, stress due to psychosocio-economic issues, children-at-risk through abuse, accidents, and marital issues, assaults in the family, and stress due to weakened kinship ties and communication problems. Twenty-eight and one half % of items affected the community in general. Over 52% of this class related to some concern about inadequate and/or inappropriate health services. Alienation, reduced social exchange, particularly for the elderly, and suicide incidents were also of considerable concern. Twelve and one half % of items dealt with environmental problems such as exploitation of natural resources, industrial/technological hazards, traffic congestion and accidents. Based on the priority of socio-health needs shown above relevant curricula for NZ nurses would be concerned with: - the degenerative disorders of an ageing population in an increasingly industrial society; - behavioural disorders such as alcoholism, drug dependency, smoking, wrong dietary habits, and trauma associated with behavioural and other 'life-style disease; - the problems of the basic social unit, the family; - the care of the frail elderly; the physically/mentally disabled (genetic and pathological). - and the changing social patterns of relationships. For the consumers of nursing curricula - clients, students, and society-one implication drawn is that there is urgent need to increase the level of responsibility for health care. And amongst the recommendations it is stressed that, as the use of the 'self' in relating to and caring for others is so vital, the development of good interpersonal skills is essential.
Nursing, Social aspects, Curricula, Study and teaching