AN EXAMINATION OF THE CHANGING HOMECARE NURSING ROLES IN A REGIONAL HEALTH SYSTEM IN SINGAPORE

Abstract

This thesis examined the changing roles of homecare nurses in an integrated Regional Health System (RHS) in Singapore. Phase I, which involved qualitative historical research, was first conducted by interviewing a snowball sample of 13 participants who have worked as nurses providing care at home, focusing on the post-World War II period. Data from old archives were also collected. Phase II involved qualitative research into a RHS through four case studies (organisations): two general home-nursing organisations, one home hospice organisation, and one hospital transitional care team. Of the purposive sample of 16 registered nurses which non-participatory observations were conducted, 15 participated in an individual face-to-face interview. Individual interviews of eight managers and 12 other healthcare professionals, and document analysis were also conducted. A conceptual framework is proposed to understand how structural developments can facilitate informal interactions between individuals to result in the patterns of evolving roles in the integrated RHS.