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Nurse-led pre-travel health consultations : evaluating current practice and developing a new model
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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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Official URL: http://webcat.warwick.ac.uk/record=b2533331~S1
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 (PhD) | ||||
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Subjects: | R Medicine > R Medicine (General) | ||||
Library of Congress Subject Headings (LCSH): | Travel -- Health aspects -- Great Britain, Primary care (Medicine) -- Great Britain | ||||
Official Date: | December 2010 | ||||
Dates: |
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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 |
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