How Community Nurses Modify Relational, Social, and Institutional Environments to Enable Participation in a Rural...

Area of Science:

• Rehabilitation science
• Community health nursing
• Environmental psychology

Background:

• Participation is key in rehabilitation, influenced by environmental factors per the International Classification of Functioning, Disability and Health (ICF).
• Mechanisms by which healthcare professionals modify environments to enable participation are not well understood.
• This study explores how community nurses adapt environments for enhanced participation.

Purpose of the Study:

• To examine the environmental modification strategies employed by community nurses.
• To understand how these modifications facilitate participation in community settings.
• To operationalize the environmental factors component of the ICF framework in practice.

Main Methods:

• Qualitative secondary analysis of community nurse activity logs and reflective records.
• Thematic analysis of data from a rural community over several months.
• Analysis guided by the environmental factors of the ICF framework.

Main Results:

• Identified four key environmental modification processes: creating enabling social environments, strengthening relational aspects, restructuring roles, and bridging barriers.
• Nurses facilitated activities, encouraged new participants, collaborated with organizations, and promoted resource sharing.
• These actions reconstructed environments, fostering meaningful social interaction and sustained community engagement.

Conclusions:

• Community nurses actively modified physical, relational, and institutional environments to enable participation.
• Environmental modification is a crucial mechanism for participation in community-based rehabilitation.
• Findings highlight the significance of environmental facilitation in participation-focused rehabilitation and operationalize ICF concepts.