Skip to main content

Open Access The Influence of Geographical and Social Distance on Nursing Practice and Continuity of Care in a Remote First Nations Community L'influence de la distance géographique et sociale sur l'exercice des soins infirmiers et la continuité des soins dans une communauté autochtone éloignée

Download Article:
(PDF 166.1875 kb)
The purpose of this article, which draws on the findings of a larger ethnographic study, is to explore the influences of geographical and social distancing on nursing practice and continuity of care in a remote First Nations community in Canada. Employing an ethnographic design, the authors use multiple data sources to ground the analysis in the unique context of health services in the selected community. The findings suggest that remote geographical location, the inequitable social conditions that shape the health and well-being of First Nations people, and nurses' level of preparedness to practise in this complex environment fostered patterns of social distancing in nurse-patient relationships. These patterns constrained nurses' ability to engage in practice that promotes continuity of care. In some cases, social distancing took the form of Othering practices and relational disengagement from patients. Changing the social determinants of Aboriginal people's health in remote communities is an important first step in supporting the changes in nurses' practice that are key to improving continuity of care and to effecting long-term, sustainable health improvements.

Le but de cet article est d'explorer, à partir des conclusions d'une étude ethnographique, l'influence de la distance géographique et sociale sur l'exercice des soins infirmiers et la continuité des soins dans une communauté autochtone éloignée du Canada. Les auteures ont eu recours à des sources de données multiples afin de situer leur analyse dans le cadre unique que constituent les services de santé au sein de la communauté à l'étude. Leurs conclusions révèlent que l'éloignement géographique, les conditions sociales inéquitables qui influent sur la santé et le bien-être de la population autochtone, de même que le degré de préparation des infirmières face aux exigences d'un environnement complexe, engendraient des modèles de distanciation sociale en matière de relation thérapeutique. Ces modèles restreignent la capacité des infirmières à adopter une approche qui favoriserait la continuité des soins. Dans certains cas, la distanciation sociale s'est traduite par des pratiques d'étiquetage de l'Autre et par un désengagement à l'égard des patients. Transformer les déterminants de la santé autochtone dans les communautés éloignées constitue un premier pas important vers l'adoption de pratiques infirmières susceptibles de favoriser la continuité des soins et d'engendrer des améliorations durables en matière de santé.

14 References.

No Supplementary Data.
No Article Media
No Metrics


Document Type: Research Article

Publication date: 2007-09-01

More about this publication?
  • To the CJNR Readership:

    We are excited to report that as of January 2016, the CJNR (Canadian Journal of Nursing Research) is being published under the SAGE Publications, Inc. banner.

    All inquiries relating to future issues of CJNR should be directed to:

    Daniel Ruth
    Senior Acquisitions Editor
    SAGE Publications In
    T (805) 410-7251
    E [email protected]

    Currently published issues of the CJNR (1969-2015) are being moved to the McGill online archives where they will be hosted in perpetuity. This migration should be completed by Spring 2016. During this transition, all issues of CJNR remain accessible to our readers as before:

    1) Past issues of CJNR from 2003 to December 2015 through ingentaconnect.

    2) Issues from 2002 to 1969 can be accessed through the CJNR digital archive.

    We understand that this is a significant change. Please be confident that all parties are working diligently to make this a seamless transition that will further advance the scope and impact of CJNR.

    Thank you.
  • Editorial Board
  • Information for Authors
  • Subscribe to this Title
  • Archives
  • Overview / Permissions
  • Ingenta Connect is not responsible for the content or availability of external websites
  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more