Structures and systems in everday home care nursing work: Impacts on nurse-patient relationships from the patient perspective
Bibliographic record
Abstract
This thesis examines the institutional structures and systems that coordinate everyday home care nursing work, and how they impact development of nurse-patient relationships from the perspective of patients. Using an institutional ethnographic methodology and incorporating patient-oriented research approaches, I interviewed patients and caregivers to gather rich descriptions of what actually happens in the day-to-day work of receiving home care nursing services, including the work of home care nurses that is visible to patients. Though institutional constraints related to efficiency and productivity can make providing relational care challenging, patients and home care nurses work around these ruling relations and find ways to meet the relational care needs of patients. The often-invisible labour of relational care needs to be recognized and valued at an institutional level to ensure home care nurses can meet the holistic care needs of patients and provide high quality, personalized, patient-centred care within a resource-constrained system.,
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.010 | 0.014 |
| Scholarly communication | 0.012 | 0.004 |
| Open science | 0.001 | 0.012 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".