Nursing inquiry
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Recovering at home: participating in a fast-track colon cancer surgery programme Fast-track surgery programmes are examples of the changes in health care toward implementation of evidence-based practice, decreasing hospitalisation, and increasing demands on patients for self-care after discharge. Documented knowledge of fast-track programmes is primarily related to a medical perspective whereas the patients' perspective is lacking. The aim of this study was to explore the lived experience of participating in a fast-track programme after discharge from the patients' perspective. ⋯ For the patients, the illness represented a fall from equilibrium into an existential limbo, and they needed to re-establish a sense of balance. Recovering from surgery and regaining strength was only one aspect of this process. Healthcare professionals need to pay more attention to the individual patient's lifeworld and to recognise the influence of lifeworld on the individual patient's recovery process.
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Historical Article
Reform and community care: has de-institutionalisation delivered for people with intellectual disability?
Reform and community care: has de-institutionalisation delivered for people with intellectual disability? In this paper we provide a post structural analysis of the theoretical shifts informing changes to service delivery over the past 150 years in relation to people with intellectual disability. We utilise the New Zealand experience of reform as it reflected global knowledge at any given period. Firstly, we address the historical modes of treatment and care, with reference to the eugenics movement, the concepts informing 'Prisons of protection' and moral treatment. ⋯ Covering such significant changes leads us to assess the state of de-institutionalisation' as it stands today and how it may be perceived in the future. We assert that Foucault's genealogical approach provides analytic tools to uncover the dynamics of changing attitudes and approaches to service delivery. In applying a Foucauldian lens to the trajectory of reforms concerning institutionalisation to de-institutionalisation we question whether a form of re-institutionalisation may be occurring.