Reflective action--strategies for solving client-nurse partnerships in primary care

In this grounded theory study, which addressed the research question. 'What strategies do nurses use to form client-nurse partnerships,' a variety of data sources were used. The first data set consisted of participant observation, and reports of focus groups formed as part of the 'First International Conference on Nursing Theory and Primary Health Care' at Massey University, New Zealand which was attended by an international group of 80 nurses in 1990. As an adjunct to the formal presentations, members of the focus groups addressed four questions: a) Is a nurse-client partnership viable in primary care? b) What do you plan to do to promote this partnership? c) What do you think others should do? and d) What is the next step? Reports from these focus groups, pooled with questionnaires (n = 17) and informal interviews completed this data set. The central process that described participants' perceptions of the viability of nurse-client partnerships was named reflective action. Ethical questions arose and were placed along a continuum of viability. A second data set consisted of interviews with, and selected literature by, Canadian nurses on partnerships in primary care. The perceptions of this international study group are seen as adding to our knowledge of barriers to nurse-client partnerships in primary care, and strategies for transcending these barriers.