Public health nursing: a comparison of theoretical and actual practice

Abstract

To clarify how nursing practice influences programme outcomes, the purpose of the research reported here was to examine the relationship that exists between client factors, system characteristics, provider actions and client outcomes in a postpartum programme. The programme is a community-based service primarily delivered by public health nurses in a large urban city in Western Canada. Relationships between structure, process and outcome dimensions in the programme were examined from both an explicit programme theory (normative programme) grounded in primary health care principles and philosophy, and an implicit programme condition (implemented programme) reflecting actual programme delivery. Elements of the McGill model of nursing were used as the basis from which to develop the normative programme theory that guided the research. One finding from this descriptive study was that nursing practice in the programme is still very much rooted in a ‘traditional’ model of health service delivery. There was little evidence of practice consistent with generally accepted health promotion standards.