Concept analysis: lack of anonymity

The purpose of this study was to explore past intimate partner violence as it occurred in Appalachian women residing in rural and non-urbanized areas. The methodology was qualitative description. Twelve former intimate partner violence female victims shared their experiences through the socioculturally appropriate tradition of story-telling. The meta-theme, Turning Points, reflecting the perceived non-linearity of intimate partner violence was supported by three themes: (1) The Process of Abuse: (2) Learn from my Story; Don’t Let it be Your Story; and (3) Does Where I Live Make a Difference? All participants experienced patterns of abuse that cycled in frequency and severity, similar injuries and health problems, fear, helplessness, and, at times, hopelessness. Application of knowledge gained through naturalistic methods can advance our understanding of intimate partner violence as it occurs in vulnerable populations and the depth and breadth of sociocultural influences which may affect the public health threat of this type of violence.

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“…Lack of anonymity is perceived as prevalent in rural areas. Rural nursing theory identifies this as a concept (Swan & Hobbs, 2017).…”

Section: Discussionmentioning

confidence: 99%

Intimate Partner Violence Stories of Appalachian Women

2021

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“…These encounters can blur personal and professional boundaries because rural nurses are often familiar with intimate details of community members (Halverson & Brownlee, 2010). Similarly, a professional identity is visible to many and can place limits on a rural nurses' ability to maintain a personal, or private self (Swan & Hobbs, 2017.…”

Section: Lack Of Anonymitymentioning

confidence: 99%

Lack of Anonymity and Secondary Traumatic Stress in Rural Nurses

Swan

Hobbs

2021

OJRNHC

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Purpose: The purpose was to determine the prevalence of lack of anonymity (LA) and secondary traumatic stress (STS) among nurses; determine if nurses’ LA and STS differ by population density and examine the relationship between lack of anonymity and STS. Design and Method: A descriptive correlational study examined LA and STS in a random sample of 271 nurses from counties with differing population densities (rural, micropolitan and metropolitan) of a Midwestern US State. A 3-group design was used to examine the relationship between LA and STS in nurses, living and working in these counties. Data on lack of anonymity, secondary trauma and demographics were collected through online questionnaires. Findings: Rural nurses had a higher prevalence of LA than micropolitan and metropolitan nurses. While the prevalence of STS among rural nurses was higher than either micropolitan or metropolitan nurses; there was no difference in STS among the three population groups. Lack of anonymity and STS were related; however, analysis revealed that LA and STS are inversely correlated, indicating that as LA increases, STS decreases. A majority of rural nurses (90%) reported living in a rural community prior to their 18th birthday. Conclusions: Rural nurses experience STS at similar rates as their metropolitan and micropolitan counterparts, indicating that population density may not be a factor related to the development of STS. LA appears to have a positive effect on reducing STS in rural nurses. Clinical Relevance: The study advanced the understanding of LA and STS among nurses who live and work in different population densities. The social support within rural health care facilities and communities may play a role in mitigating the effects of indirect stress. Keywords: rural, rural nursing, lack of anonymity, traumatic stressDOI: https://doi.org/10.14574/ojrnhc.v21i1.651

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“…[3][4][5][6][7][8][9][10][11] Such community involvement increases interactions with neighbours and decreases anonymity, leading to a higher likelihood of being recognised as a health care professional in social settings, and as a community member in clinical settings. 12 Belonging to their community has meant that rural physicians cannot avoid incidental encounters with patients outside of the clinical setting 13,14 nor clinical encounters with friends as patients 8,[15][16][17] and therefore must manage the intersections of personal and professional relationships. 12,13,15,18 The need to navigate overlapping relationships in rural communities has been described not only by physicians, 13,17,19 but also by nurses, 20,21 social workers, 22 psychologists 23 and mental health clinicians with overwhelming similarity in their experiences.…”

Section: Introductionmentioning

confidence: 99%

“…12 Belonging to their community has meant that rural physicians cannot avoid incidental encounters with patients outside of the clinical setting 13,14 nor clinical encounters with friends as patients 8,[15][16][17] and therefore must manage the intersections of personal and professional relationships. 12,13,15,18 The need to navigate overlapping relationships in rural communities has been described not only by physicians, 13,17,19 but also by nurses, 20,21 social workers, 22 psychologists 23 and mental health clinicians with overwhelming similarity in their experiences. [24][25][26] Students from various health professions report that the lack of anonymity and overlapping relationships, such as non-clinical interactions with patients and social interactions with staff, helped them feel welcomed by rural and remote communities during clinical placements or longitudinal integrated clinical clerkships [27][28][29][30][31][32][33][34] but could be such a challenge to navigate [27][28][29][35][36][37][38] that it often interfered with their learning.…”

Section: Introductionmentioning

confidence: 99%

“…A desire to feel connected with their community is one of the many reasons given by physicians who do choose rural practice 3‐11 . Such community involvement increases interactions with neighbours and decreases anonymity, leading to a higher likelihood of being recognised as a health care professional in social settings, and as a community member in clinical settings 12 . Belonging to their community has meant that rural physicians cannot avoid incidental encounters with patients outside of the clinical setting 13,14 nor clinical encounters with friends as patients 8,15‐17 and therefore must manage the intersections of personal and professional relationships 12,13,15,18 .…”

Section: Introductionmentioning

confidence: 99%

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Urban ideals and rural realities: Physiotherapists navigating paradox in overlapping roles

et al. 2021

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Objectives: Rural practitioners who develop a sense of belonging in their community tend to stay; however, belonging means neighbours become patients and non-clinical encounters with patients become unavoidable. Rural clinical experiences expose students to overlapping personal and professional relationships, but students cannot be duly prepared to navigate them because ethical practice standards primarily reflect urban, and not rural, contexts. To inform such educational activities, this study examines rural physiotherapists' strategies for navigating overlapping relationships.Methods: Constructivist grounded theory guided iterative recruitment of 22 physiotherapists (PTs) living and practising in rural, northern or remote (RNR) communities in British Columbia, Canada, and analysis of their experiences navigating overlapping relationships.Results: PTs routinely navigate overlapping relationships while mindful of practice standards, neighbourly and community expectations, personal well-being and patient welfare. While off-duty, they balance opposing expectations and manage various responsibilities to achieve contradictory goals such as being a professional who protects patient confidentiality while being an active and cordial community member. While on-duty, they face ethical dilemmas where deciding not to treat acquaintances potentially denies access to care but allows for clearer personal-professional boundaries and deciding to treat contravenes (urban) practice standards but could allow for customised patient care based on knowledge gained through both clinical and social interactions. Conclusion:Overlapping relationships are a rural norm. Urban ethical practice standards imposed on rural contexts put RNR practitioners in a paradoxical situation where clinical and social interactions must be but cannot be partitioned. Examining the identified strategies through the lens of paradox theory shows sophisticated cognitive framing of the conflicting and interrelated aims inherent to living and practising in RNR communities. Consequently, introducing a paradox mindset in educational activities could be explored as a way to prepare students for the ethically complex overlapping relationships that they will need to navigate during RNR clinical experiences.

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Concept analysis: lack of anonymity

Cited by 15 publications

References 37 publications

Intimate Partner Violence Stories of Appalachian Women

Intimate Partner Violence Stories of Appalachian Women

Lack of Anonymity and Secondary Traumatic Stress in Rural Nurses

Urban ideals and rural realities: Physiotherapists navigating paradox in overlapping roles

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