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ABSTRACT
Nurses' perceptions of their role are influenced by societal attitudes, government policies and trends in professional issues. Dynamic factors in contemporary health environments challenge traditional nursing roles, in particular those of community nurses. Role theory is a conceptual framework that defines how individuals behave in social situations and how these behaviours are perceived by external observers. This paper reviews the role theory literature as a conceptual framework to explore community nurses' perceptions of their role. Three theoretical perspectives of role theory have emerged from the literature review:
(i) social structuralism;
(ii) symbolic interactionism; and
(iii) the dramaturgical perspective.
These philosophical perspectives provide a useful framework to investigate the role of community nurses in the contemporary health care system.
Received 20 April 2004 Accepted 21 May 2007
KEYWORDS
role theory; conceptual framework; community nurses; models of care
INTRODUCTION
In recent decades, nursing has witnessed unprecedented changes in both medical and nursing science and in relation to models of health service delivery (Tiedeman & Lookinland 2004). Many facets of clinical nursing practice and the nature of nursing specialties have undergone significant change (Porter-O'Grady 2003a; Porter-O'Grady 2003b).This has brought about a certain ambiguity in terms of the definition of nursing roles across all areas of clinical practice. This is made even more complex by the variance in nomenclature of roles within individual organisations and health systems. Traditionally, the term 'community nursing' has referred to nurses practising primary health care in the community, such as child and family health nurses (McMurray 2003). More recently, however, nurses delivering care acute care services in a community setting have been described as community nurses. Such nurses are not necessarily working within a primary care framework, where there is an integrated, coordinated and responsive approach to community based care (World Health Organisation 1978). As a consequence of the increase in early hospital discharge and outpatient management of complex and chronic care conditions, the nature of community nursing has altered dramatically (Brookes et al. 2004; Kemp et al. 2002; Kemp, Harris & Comino 2005). New models of care have been developed and implemented in response to changes in policy, clinical management and fiscal constraints (Wagner 2001). Many of these models have proposed significant changes to the historical role of the nurses working...