Letitia Del Fabbro

Exploring health promotion practitioners' experiences of moral distress in Canada and Australia

This article introduces moral distress – the experience of painful feelings due to institutional constraints on personal moral action – as a significant issue for the international health promotion workforce. Our exploratory study of practitioners’ experiences of health promotion in Australia and Canada during 2009–2010 indicated that practitioners who work in upstream policy- and systems-level health promotion are affected by experiences of moral distress. Health promotion practitioners at all levels of the health promotion continuum also described themselves as being engaged in a minority practice within a larger dominant system that does not always value health promotion. We argue that health promotion practitioners are vulnerable to moral distress due to the values-driven and political nature of the practice, the emphasis on systems change and the inherent complexity and diversity of the practice. This vulnerability to moral distress poses significant challenges to both workers and organisations and the communities they seek to benefit. We propose that further research should be undertaken to fully identify the causes and symptoms of moral distress in health promotion. Extensive existing research on moral distress in nursing provides ample resources to conduct such research.

Learning among nursing faculty: insights from a participatory action research project about teaching international students.

It is imperative that nursing education addresses the issues arising from globalization. The adjustment challenges faced by international nursing students globally highlight the need to understand how nursing faculty experience and teach nursing classes with a mix of domestic and foreign students. This article reports on a participatory action research (PAR) study to examine and enhance the scholarly teaching of international nursing students. The overarching research question for this PAR was: How did participation in a PAR study contribute to shared learning and professional development of nursing faculty teaching international students? Five major themes were identified across the PAR: creating sharing spaces, recognizing and respecting diversity, developing and acknowledging teaching capabilities, utilizing precious time, and valuing the research. In summary, PAR was a useful approach to engage faculty in research by providing a process and a space to address concerns about the teaching and learning of international students.

Rebuilding community: considerations for policy makers in the wake of the 2011 Queensland floods

In 2011, Queensland was inundated by the worst flood since 1974. Over 70 communities were affected by flood waters, 75% of the State was declared a natural disaster area, lives were lost and thousands of homes were destroyed. As a formal Commission of Inquiry gets underway, and these events resonate through the media, we are reminded of the emergency needs of individuals, families and communities around us. However, the slow process of recovery and community rebuilding is now beginning and it is timely to consider the scope of the task.

Political Challenges in Complex Place-Based Health Promotion Partnerships: Lessons From an Exploratory Case Study in a Disadvantaged Area of Queensland, Australia.

Settings-based health promotion involving multiple strategies and partners is complex, especially in disadvantaged areas. Partnership development and organizational integration are examined in the literature; however, there is more to learn from the examination of practice stakeholders’ experience of intersectoral partnership processes. This case study examines stakeholder experiences of challenges in new partnership work in the context of a culturally diverse and socioeconomically disadvantaged region in Queensland, Australia. Health promotion staff and community representatives participated in interviews and focus groups, and the thematic analysis included observations and documentary analyses. Our findings highlight the retrogressive influence of broader system dynamics, including policy reform and funding changes, upon partnership working. Partnership enablers are disrupted by external political influences and the internal politics (individual and organizational) of health promotion practice. We point to the need for organization level commitment to a consistent agreed vision specifically accounting for place, as a cornerstone of intersectoral health promotion partnership resilience. If organizations from diverse sectors can embed a vision for health that accounts for place, complex health promotion initiatives may be less vulnerable to broader system reforms, and health in all policy approaches more readily sustained.

Spaces of knowing: an Australian case study of capacity building across boundaries in a health promotion learning network.

This article explores the potential for health promotion capacity building across boundaries in a place-based health promotion learning network generated as part of a recent Australian Research Council-funded project in Queensland, Australia. We emphasise in particular the potential of creating new ‘at the boundary’ spaces of knowing that encourage and enable health promotion workers to work in interdisciplinary and intersectoral ways. The article discusses the way that diverse health promotion workers from different disciplines and government and non-government organisations came together to learn ‘how to do’ in new or re-invigorated ways. For many network participants, this cross-boundary space of knowing and capacity building provided a welcome respite from their daily contexts of practice which may be limited by institutional, disciplinary or other boundaries.