Willcox, Adrienne (2010) Nurse-led pre-travel health consultations : evaluating current practice and developing a new model. PhD thesis, University of Warwick.

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Abstract

This study explores the pre-travel consultation between nurses and people who plan to travel abroad from the UK. Travel health services have developed ad hoc in response to rising public demand, and are mainly nurse-led in UK general practice. There is little research evidence to describe or evaluate pre-travel healthcare provision. Using a mainly qualitative bricolage design of six methods, the research traces the ‘journey’ of health recommendations made to travellers. Starting with guidance documents produced by experts, it then tracks the fulfilment of these recommendations through consultations conducted by nurses and captures the ways in which travellers use or discard the recommendations while travelling. It explores the clinical reasoning behind activities in pre-travel consultations, and generates ideas for practice development. The key findings are that pre-travel healthcare is medicine-centric and issues of time, organisation, and the model adopted by nurses affects the quality of consultations. Two styles of consultation were identified: the Kitchen Sink style was comprehensive and verbose; the Medical and Minimal style focused on vaccinations. Travellers recalled or used very little of what was imparted during their consultations, but far from being ‘blank slates’, travellers usually managed their health appropriately and had far more knowledge than nurses recognised. The thesis offers conceptual insights to the pre-travel consultation which relate to patient safety, quality and the legal integrity of practitioners. It offers a prototype model of the pre-travel consultation that takes account of the challenges associated with current practice. The implications for practice relate to education for nurses in consultation management, patient-centredness, proactive versus reactive service provision, and patient education. PRE-TRAVEL - the new model for consultations - contributes a framework for engaging with these issues, subject to post-doctoral testing.

Item Type:	Thesis or Dissertation (PhD)
Subjects:	R Medicine > R Medicine (General)
Library of Congress Subject Headings (LCSH):	Travel -- Health aspects -- Great Britain, Primary care (Medicine) -- Great Britain
Date:	December 2010
Institution:	University of Warwick
Theses Department:	Warwick Medical School
Thesis Type:	PhD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Adams, Ann ; Dale, Jeremy, 1958-
Sponsors:	International Society of Travel Medicine
Extent:	396 leaves
Language:	eng
URI:	http://wrap.warwick.ac.uk/id/eprint/38542

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