Background
Method
Concept Analysis terminology | |
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Concept | Conceptual representations of a phenomenon |
Attribute | A characteristic of a concept that appears over & over again |
Boundary | What is & what is it not part of the concept (delimiting cases) |
Variation | A similar term with some overlapping attributes |
Consequence | The effect brought about by attributes of a concept |
Morse’s method of concept analysis
Applying Morse method to twinning in healthcare
Search strategy |
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Midwi* OR Nurse* OR Health personnel OR |
Healthcare workers OR Doctor* OR Physician*, AND |
Twinning, AND |
International OR Intercultural OR Cultural |
Attributes | |||||||
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Author | Health care professional | Definition of twinning | Based on reciprocity or similar | Building personal relation-ships | Between two cultures | Is a dynamic process | Boundaries examples |
[19] AIHA, 2010 | mixed | a partnership that links two entities with shared characteristics to achieve a common goal’ | Y sharing | Y peer relationships | Y | Y | – |
[20] Breiddal, 2009 | mixed | ‘a professional and social collaboration between organizations in different countries to achieve mutual benefits through combined efforts and a common vision’ | Y reciprocity | Y developing friendships with like-minded people | E Canada sub-Sahara Africa | Y | fundraising by ‘Western’ partner, provide one way assistance |
[21] Busse, 2013 | mixed | ‘ when two or more academic institutions or community organizations share collective knowledge and resources to address issues and concerns’ | Y reciprocity | Y builds collective efficacy | Y Ethiopia & USA | Y | – |
[23] Cadée, 2013 | midwives | methodology of mutual exchange between different organisations | Y reciprocity | Y being like sisters | Y Netherlands & Sierra Leone | Y | – |
[28] Chiu, 2005 | nurses | none | N | E | Y Malaysia & Australia | N | obtaining bachelor degree, one way visit |
[24] Dawson,2014 | midwives | partnerships through pairing organisations | Y mutual learning & ownership | Y immersing each other’s practice | Y | E | – |
[29] Foster, 2013 | nurses | none | Y mutual respect and dialogue | Y compassion fatigue | Y USA & Dominican Re-public | Y | – |
[48] Hopkins, 2013 | nurses, physicians | two-way transfer of expertise, advice, knowledge and skills | Y mutual respect from both sides of the partnership is crucial. | N | Y | Y | – |
[18] ICAD, 1999 | nurses, physicians | uses WHO 2001 definition: a formal substantive collaboration between two organisations’ | Y a 2 way process, win-win | Y | N Canadian & different ‘southern’ partners | Y | North/South connections |
[5] ICM, 2014 | midwives | a two-way mutually beneficial exchange between two member Midwives Associations. It is a formal and substantive collaboration between two organisations’[7] | Y collaborative relationships, mutual learning | Y being like sisters (no big or little sister) | Y Canada & Tanzania, Sierra Leone & The Netherlands Mali & Switzerland Papua new Guinea & Australia Japan & Philippines | Y | – |
[16] Foster, 2009 | physicians | none | E | E | E | E | matching organisations |
[25] Ireland, 2015 | midwives | none | Y reciprocity | Y | Y Nepal & England | E | one way help |
[30] Jiang, 2015 | nurses | A collaborative relationship between 2 similar organizations. | Y mutual respect | Y | Y China & USA | Y dynamic cooperative atmosphere | funding by ‘Western’ partner |
[17] Kohi, 2010 | nurses | none (matching) | ? | N | Y Tanzania & US | N | matching organisations |
[22] Macdonagh, 2002 | mixed | The establishment of a formal link between a specific department/ institution in the UK and a corresponding department/institution in the developing world | Y mutuality | E | Y Tanzania & UK | Y | help from a developed country |
[33] Qaddoumi, 2009 | physicians | none | Y mutual relationship | E | Y Jordan & Canada | Y | help from a developed country |
[26] RCM, 2015 | midwives | none | Y reciprocity and mutuality | Y sisterhood | Y England & Nepal Scotland & Uganda Wales & Cambodia | E | – |
[49] Herschderfer, 2012 | midwives | two midwifery organisations and 40 midwives are linked with the joint aim of improving maternal health, basing the relationship on reciprocity | Y reciprocity | Y Being like sisters | Y Netherlands & Sierra Leone Netherlands & Morocco | Y | – |
[32] Veerman, 2005 | physicians | twinning is an established form of cooperation between resource rich and resource limited countries. | E | N | Y Indonesia & The Netherlands | E | – |
Results
Definitions of twinning in healthcare
Participants in twinning
Attributes of twinning in healthcare
‘In situations where economic disparity exists, a conscious effort needs to be made to ensure that the Twinning relationship and activities are approached as equal partners.’ P10 [5]‘…building a twinning partnership is grounded in shared guiding principles that emphasize the importance of building long-term relationships…based on equality, reciprocity, shared responsibility.’P1312 [21]‘Specifically, the dynamic cooperative atmosphere fosters learning through the sharing of respective experiences’ P118 [30]‘The most successful twinning projects are those that are two-way – i.e. each organization learns from the other. Two-way twinning is empowering to both organizations.’P25 [18]
‘ You must be open to examining your own attitudes and behaviour. Reflect honestly on your willingness to wait and watch (when appropriate), to learn from your twinning partner, to refrain from “fixing” and giving advice, and to become aware of assumptions or prejudgments.’ P5 [20]‘Despite the language challenges and 7300 miles that separate our 2 facilities, nurses speak a common language.’ P121 [30]
Boundaries of twinning in healthcare
’The demand for a degree for Malaysian nurses provided the impetus for this offshore post-registration nursing programme, developed as a twinning venture between an Australian university and a Malaysian private institution.’P46 [28]‘The goal was to ensure that nursing students would have entry-level knowledge and skills in the care and treatment of people living with HIV.’P93 [17]
Consequences of Twinning in healthcare
‘Specifically, the dynamic cooperative atmosphere fosters learning through the sharing of respective experiences….twinning requires the implementation of shared strategies and developmental goals.’ P118 [30]‘Recognising that the UK has much to learn from low-income countries, the meaning and process of true exchange, reciprocity and mutuality should be further explored.’ P5 [26]‘Reciprocity is an important aspect of twinning as the RCM also hopes to strengthen midwifery in the UK.‘p26 [25]