Savio, Monica
(1994)
A pathway to professionalism: The development of community psychiatric nursing in Britain and Italy.
PhD thesis, London School of Economics and Political Science.
Abstract
This thesis focuses on a comparative analysis of Community Psychiatric Nursing in Britain and Italy. The nursing role is examined cross-nationally in relation to the development of community care in the two countries. The central role acquired by nurses in developing and implementing deinstitutionalisation is the starting point for the investigation of professional attitudes and experiences in relation to institutional changes. The purpose of the study is threefold: a) to investigate similarities and differences between community psychiatric nursing practices in the two countries in relation to organisational models, ideological approaches to care, and professional cultures; b) to analyse whether there are universal elements in the nursing profession which are central to the process of change in both countries; c) to identify contextual factors which can constrain or facilitate the professionalisation of psychiatric nursing in Britain and in Italy. The methodology is based on case study research methods. Two samples of nurses have been interviewed, in Britain and Italy, by means of two sets of questionnaires. The thesis is organized into two main parts. First, the theoretical chapters provide an historical account of community care and psychiatric nursing developments in the two countries. A conceptual framework for the empirical study is built through the discussion of contributions from the sociology of professions, the sociology of knowledge, and organizational analysis. Secondly, the empirical chapters describe and analyse results obtained from fieldwork. Whilst the empirical investigation has been limited to England, the literature review includes the whole of Britain. The results suggest that both British and Italian community psychiatric nurses are professionally at a turning point. The advent of community care significantly changed nursing practices and models of intervention, influencing also the self-perceived professional role and identity. The findings also indicate that the different organization of labour, of nursing training, and of ideological approaches to psychiatric care are explanatory variables for the diversity in nurses' practices and experiences in the two countries. Despite these differences, both British and Italian nurses seem to enjoy a considerable degree of professional autonomy, which makes psychiatric nursing into a particular case within the overall nursing field. Finally, the prospects for the professionalisation of community psychiatric nursing are discussed by comparing the national situations with indications from the literature on professions.
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