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Poverty in Older Adulthood: A Health and Social Crisis 老年贫困:健康与社会危机
Pub Date : 2024-01-31 DOI: 10.3912/ojin.vol29no01man03
Marleen Thornton, Katherine Bowers
In the transition to older adulthood, people often experience health, social, and economic challenges related to increased chronic health conditions, retirement, decreased social connections, a reduction in income and earning capacity, and increased health related costs. These factors can contribute to financial insecurity, social instability, and even poverty for older adults. In the United States, one in ten older adults is living in poverty. However, standard poverty measures do not account for inflation and many costs specific to older adulthood, and thus underestimate the number of older adults living in poverty. Older adults in poverty conditions experience early mortality and high rates of disability, depression, anxiety, and loneliness. It is estimated that more than a third of older adults experience loneliness. Loneliness within this population is associated with poor physical and mental health, cognitive decline, and early mortality. Poverty and loneliness are independently detrimental to older adults and when experienced together impact the health and wellbeing of older adults in ways that are unique compared to other age cohorts. Nurses are well positioned to address these intersecting issues. The purpose of this article is to discuss the challenges of poverty in older adults, with particular focus on the intersection of poverty and loneliness within this population. Nursing implications for education, practice, research, and policy implications are discussed.
在向老年期过渡的过程中,人们往往会遇到与慢性病增加、退休、社会关系减少、收入和赚钱能力下降以及与健康有关的费用增加等相关的健康、社会和经济挑战。这些因素会导致老年人经济无保障、社会不稳定,甚至贫困。在美国,每十个老年人中就有一个生活贫困。然而,标准的贫困衡量标准并没有考虑通货膨胀和老年人特有的许多成本,因此低估了贫困老年人的数量。贫困老年人死亡率高,残疾、抑郁、焦虑和孤独的发生率也很高。据估计,超过三分之一的老年人会感到孤独。这一人群的孤独感与身心健康状况不佳、认知能力下降和过早死亡有关。贫穷和孤独对老年人本身有害,但如果同时出现,则会以不同于其他年龄段人群的方式影响老年人的健康和福祉。护士完全有能力解决这些相互交织的问题。本文旨在讨论老年人面临的贫困挑战,尤其关注贫困与孤独在这一人群中的交集。文章讨论了护理对教育、实践、研究和政策的影响。
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引用次数: 0
First, Seek to Understand: Deconstructing the Concept of Poverty for Nursing Education 首先,寻求理解:解构护理教育中的贫困概念
Pub Date : 2024-01-31 DOI: 10.3912/ojin.vol29no01man04
Rebecca Lee, Misty Bauer
Poverty, an important social determinant of health, is a multifaceted issue that impacts the health of individuals, families, and communities. People who live in impoverished communities have limited access to many necessary resources. This deficit often results in increased risk for mental illness, chronic disease, higher mortality, and lower life expectancy and greater need for healthcare services. There is a call for nurse educators to provide multiple opportunities throughout curricula for students at all levels to develop competencies to assess and intervene in outcomes impacted by social determinants of health. Doing so requires a perspective of empathy, grounded in cultural humility, to advance health equity and advocate for persons facing challenges, such as those who experience poverty. This article provides an overview of poverty in the context of the social determinants and discusses strategically designed experiential learning experiences, such as simulations and community-academic partnerships. An exemplar of an interprofessional community-academic partnership is provided to illustrate an ongoing successful effort that has fostered a deeper understanding of the lived experience of poverty for students of nursing and other professions.
贫困是影响健康的一个重要社会决定因素,是一个影响个人、家庭和社区健康的多方面问题。生活在贫困社区的人们获得许多必要资源的机会有限。这种匮乏往往会导致精神疾病、慢性疾病、高死亡率、低预期寿命以及对医疗保健服务需求的增加。人们呼吁护士教育者在整个课程中为各级学生提供多种机会,培养他们评估和干预受健康社会决定因素影响的结果的能力。这样做需要以文化谦逊为基础的同理心视角,以促进健康公平,并为面临挑战的人们(如经历贫困的人们)代言。本文从社会决定因素的角度概述了贫困问题,并讨论了战略性设计的体验式学习经历,如模拟和社区-学术合作。本文提供了一个跨专业社区-学术合作的范例,以说明一项正在进行的成功努力,该努力促进了护理专业和其他专业的学生对贫困的生活体验有了更深入的了解。
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引用次数: 0
Recognizing and Responding to Poverty in College Students: What Can Nurses Do? 认识和应对大学生贫困问题:护士能做些什么?
Pub Date : 2024-01-31 DOI: 10.3912/ojin.vol29no01man02
Amber Kolesar, Angela Karakachian, Jessica Devido, Denise Lucas, Kate DeLuca
People may not consider college students when they think about populations who experience poverty. However, rising costs of college and changes in student demographics have contributed to poverty within this group. Many students experience poverty and subsequent basic needs insecurity; they may lack safe housing and the ability to access adequate amounts of nutritious food. Poverty has significant mental, physical, and academic implications for these college students. Recognizing that education is a social determinant of health, it is clear that nurses can address this issue. This article provides an overview of poverty in the context of college student concerns, including actions to promote students’ well-being and academic success. We describe current interventions to support students as well as the stigma that often accompanies poverty and may prohibit a student from asking for help. The authors present information for nurses in various roles on college campuses, such as educator and advocate; advanced practice program faculty; and student healthcare provider. An exemplar describes how faculty at one school of nursing have responded to student poverty concerns. Finally, we suggest recommendations to begin or enhance current efforts to address poverty in college students.
提起贫困人口,人们可能不会想到大学生。然而,大学学费的上涨和学生人口结构的变化导致了这一群体的贫困。许多学生经历了贫困和随之而来的基本需求无保障;他们可能缺乏安全的住房和获得足够营养食物的能力。贫困对这些大学生的精神、身体和学业都有重大影响。认识到教育是健康的社会决定因素,护士显然可以解决这一问题。本文从大学生关心的问题出发,概述了贫困问题,包括促进学生福祉和学业成功的行动。我们介绍了当前为学生提供支持的干预措施,以及往往伴随着贫困并可能阻碍学生寻求帮助的耻辱感。作者为大学校园中扮演不同角色的护士提供了信息,如教育者和倡导者、高级实践课程教师和学生医疗服务提供者。一个范例介绍了一所护理学院的教师如何应对学生的贫困问题。最后,我们就如何开始或加强当前解决大学生贫困问题的工作提出了建议。
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引用次数: 0
Poverty Post Pandemic, Lapsed Public Policy, and Rising Rates: A Call to Action for Nursing 大流行后的贫困、失效的公共政策和不断上升的比率:护理工作的行动呼吁
Pub Date : 2024-01-31 DOI: 10.3912/ojin.vol29no01man01
Martha Y Kubik
Poverty is a pressing societal problem, adversely affecting the lives and livelihoods of millions of people in the United States and beyond. During this period of pandemic recovery, nurses, as the largest health workforce, are well positioned for action with the potential to improve health outcomes for many experiencing poverty. An actionable plan begins with an understanding of poverty and how poverty is experienced. It builds on nursing’s disciplinary perspective, patterns of knowing and a new model of professional nursing education advanced by the American Association of Colleges of Nursing. Finally, a feasible and sustainable plan is responsive to the challenges of a contemporary and complex health care delivery system.
贫困是一个紧迫的社会问题,对美国及其他地区数百万人的生活和生计造成了不利影响。在大流行病恢复期间,护士作为最大的医疗卫生队伍,完全有能力采取行动,改善许多贫困人口的健康状况。要制定可行的计划,首先要了解贫困以及贫困是如何产生的。它建立在护理学的学科视角、认知模式和美国护理学院协会提出的专业护理教育新模式之上。最后,一个可行且可持续的计划要能应对当代复杂的医疗保健服务体系所带来的挑战。
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引用次数: 0
The Poverty Simulation: A Tool to Experience the Social Determinants of HealthThe Poverty Simulation: A Tool to Experience the Social Determinants of Health 贫困模拟:贫困模拟:体验健康的社会决定因素的工具贫困模拟:体验健康的社会决定因素的工具体验健康的社会决定因素的工具
Pub Date : 2024-01-31 DOI: 10.3912/ojin.vol29no01man05
Tracey Motter, Taryn Burhanna, Jennifer Metheney
To provide holistic care that addresses all aspects of patient needs, nurses must understand the complexities of healthcare for the large population of people who live in poverty. The World Health Organization (WHO) recognizes the Social Determinants of Health (SDOH) as individual income, living conditions, social supports, and access to adequate food sources, education, and healthcare. Eighty percent of a person’s ability to attain health and well-being is related to the SDOH. In the United States, Healthy People 2030 and accrediting bodies for professional nursing programs focus on the SDOH and the impact of these determinants on health equity and access to care. Thus, as nursing students learn about challenges faced by persons who live in poverty conditions, it can be beneficial to also experience what their everyday life entails. One option available is the use of poverty simulation tools. This article provides an overview of the Missouri Community Action Network Community Action Poverty Simulation (CAPS) used in a Bachelor of Science in Nursing (BSN) curriculum to enhance student understanding about the experiences of living in poverty, to increase their ability to analyze the relationship between the SDOH and poor health outcomes, and to identify potential personal attitudes and biases. We offer information about our experiences with poverty simulation planning, implementation, and evaluation.
为了提供全面的护理,满足患者各方面的需求,护士必须了解大量贫困人口在医疗保健方面的复杂性。世界卫生组织(WHO)认为,健康的社会决定因素(Social Determinants of Health,SDOH)包括个人收入、生活条件、社会支持以及获得充足食物来源、教育和医疗保健的机会。一个人获得健康和幸福的能力有 80% 与 SDOH 有关。在美国,"健康2030 "和专业护理课程认证机构都关注SDOH以及这些决定因素对健康公平和获得护理的影响。因此,当护理专业学生了解生活在贫困环境中的人所面临的挑战时,体验一下他们的日常生活也是有益的。其中一种方法就是使用贫困模拟工具。本文概述了密苏里社区行动网络(Missouri Community Action Network)在护理学学士(BSN)课程中使用的 "社区行动贫困模拟"(CAPS),以加深学生对贫困生活经历的理解,提高他们分析 SDOH 与不良健康结果之间关系的能力,并识别潜在的个人态度和偏见。我们将介绍我们在贫困模拟规划、实施和评估方面的经验。
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引用次数: 0
Overview and Summary: Contemporary Perspectives on Poverty 概述与总结:关于贫困的当代视角
Pub Date : 2024-01-31 DOI: 10.3912/ojin.vol29no01manos
Carolyn Montoya
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引用次数: 0
Challenges Faced by Refugee Nurses to Integrate into Jordan's Labor Market: A Phenomenological Study 难民护士融入约旦劳动力市场所面临的挑战:现象学研究
Pub Date : 2024-01-31 DOI: 10.3912/ojin.vol29no01man06
Rowaida Al-Maaitah, S. Abuhammad, Hani Nawafleh, Hadeel Al-Maaitah, Laila Akhu-Zaheya, M. Gharaibeh, Raeda Abu ALRub
One concern that professionals with refugee status often face upon relocating to a different country is the process to secure a position that reflects the credentials and previous experience they bring from their former homeland. In Jordan, some refugees have the means to earn a living to support themselves and their families but live in poverty conditions due to the complexity of the process to vet their education and credentials that results in inability to gain professional employment in the new country. This article describes a descriptive qualitative study that explored challenges faced by refugee health professionals in their attempts to integrate into Jordan's labour market. We conducted individual semi structured interviews and/or focus group sessions with a sample of 16 refugee nurses. The nurses described their perceptions and experiences of being refugees and their challenges to find a professional nursing position. Qualitative content analysis led to seven emerging themes: legal issues, financial issues, working environment issues, education and professional issues, family issues, physical and mental health issues, and gender issues. This study was an important first step to understand the challenges hindering refugee health professionals' employment opportunities and access to the labour market. The findings suggest implications for practice related to promoting awareness, creating legal employment opportunities, and informing policy.
具有难民身份的专业人员在迁往另一个国家时经常面临的一个问题是,如何获得一个能反映他们从以前的祖国带来的证书和以往经验的职位。在约旦,一些难民有谋生手段来养活自己和家人,但由于审查其学历和资历的过程十分复杂,导致他们无法在新国家获得专业工作,从而生活在贫困之中。本文介绍了一项描述性定性研究,该研究探讨了难民卫生专业人员在试图融入约旦劳动力市场时所面临的挑战。我们对 16 名难民护士进行了个人半结构化访谈和/或焦点小组会议。这些护士描述了他们作为难民的看法和经历,以及他们在寻找专业护理职位时所面临的挑战。定性内容分析得出了七个新出现的主题:法律问题、财务问题、工作环境问题、教育和专业问题、家庭问题、身心健康问题以及性别问题。这项研究是了解阻碍难民卫生专业人员就业机会和进入劳动力市场的挑战的重要第一步。研究结果对提高意识、创造合法就业机会和提供政策信息方面的实践产生了影响。
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引用次数: 0
Advances in Technology Mediated Nursing Education 以技术为媒介的护理教育的进步
Pub Date : 2023-05-31 DOI: 10.3912/ojin.vol28no02man06
M. Aebersold, Laura Gonzalez
The use of virtual reality and other technology mediated simulations is in early stages. Guidelines and protocols are still being developed. However, much of what we have used in other forms of simulation can be successfully adapted and implemented. This article will highlight selected areas for use of virtual reality in nursing education. Current literature describes the evidence in this area that includes immersive and desktop virtual realities. Both modalities provide an experiential learning platform that has demonstrated gains in knowledge acquisition and effective learning outcomes. There are several options available to use virtual reality in nursing education. Appropriate educational frameworks and alignment of the virtual reality experience with learning outcomes are important considerations. Infrastructure and support for immersive or desktop virtual reality will look different. It is beneficial to collaborate with instructional technology support staff early in the process as options are explored. Overall, technology mediated simulations using virtual reality is a promising new area for nurse educators. A thoughtful, informed approach can facilitate positive learner experiences and strong outcomes.
虚拟现实和其他技术中介模拟的使用尚处于早期阶段。指导原则和协议仍在制定之中。不过,我们在其他形式的模拟中使用过的许多方法都可以成功地加以调整和实施。本文将重点介绍在护理教育中使用虚拟现实技术的选定领域。目前的文献描述了这一领域的证据,其中包括身临其境和桌面虚拟现实。这两种模式都提供了一个体验式学习平台,在知识获取和有效学习成果方面都取得了显著成效。在护理教育中使用虚拟现实技术有多种选择。适当的教育框架以及虚拟现实体验与学习成果的一致性是重要的考虑因素。沉浸式或桌面虚拟现实的基础设施和支持将有所不同。在探索各种方案的过程中,尽早与教学技术支持人员合作是有益的。总之,对于护士教育者来说,以技术为媒介的虚拟现实模拟是一个前景广阔的新领域。一个深思熟虑、知情的方法可以促进学习者获得积极的学习体验和良好的学习效果。
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引用次数: 0
The Virtual Nurse Program in a Community Hospital Setting 社区医院虚拟护士计划
Pub Date : 2023-05-31 DOI: 10.3912/ojin.vol28no02man02
Ruth Sagastume, Jessica Peterson
While nursing shortages are not new, the nursing profession is entering a “new era,” that challenges nurse leaders to create novel ways to provide adequate nursing resources and efficient patient care workflows. Virtual nursing care models are emerging as options to provide nursing services to support providers in the immediate bedside patient care environment. This article describes a virtual nursing care program implemented on medical-surgical acute care units to support inexperienced staff, maintain patient safety and quality, and improve patient care outcomes.
虽然护理人员短缺已不是什么新鲜事,但护理行业正在进入一个 "新时代",这对护士领导者提出了挑战,要求他们创造新的方法来提供充足的护理资源和高效的病人护理工作流程。虚拟护理模式正在成为在床边病人护理环境中提供护理服务以支持提供者的选择。本文介绍了在内外科急症护理病房实施的虚拟护理计划,该计划旨在为缺乏经验的员工提供支持,维护患者安全和质量,改善患者护理效果。
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引用次数: 0
Meaningful Recognition of Pediatric Nurses via a Closed Facebook Group 通过封闭式 Facebook 群组对儿科护士进行有意义的表彰
Pub Date : 2023-05-31 DOI: 10.3912/ojin.vol28no02man04
Christine LaGrasta, Shannon Olbrot, Kerri Fournier, Colleen O’Shaughnessy, Paula Conrad, Patricia Hickey, Michele DeGrazia
Hospitals where nurses report higher levels of meaningful recognition also report greater job satisfaction, decreased intent to leave, and increased quality of care. Despite a hospital-wide effort to recognize nurse achievements at a free-standing, pediatric, academic hospital, few nurses received recognition external to their units. A nursing council charged to address this problem chose to create an active social media community to provide meaningful recognition of nurses by highlighting their clinical inquiry and achievement via a closed Facebook (FB) Groups platform. This article describes implementation methods as the council identified aims and goals of the FB group, designated monthly moderators, and promoted the FB group to the nursing community. Consistent membership growth and FB group engagement were tracked using FB platform metrics. Results demonstrated meaningful recognition of nursing clinical inquiry and achievement. With this accomplishment, the successful platform was expanded to incorporate hospital-wide achievements from other disciplines.
在那些护士对医院的认可度较高的医院,护士的工作满意度也较高,离职意向降低,护理质量提高。在一家独立的儿科学术医院,尽管全院都在努力表彰护士的成就,但很少有护士在科室之外获得表彰。负责解决这一问题的护理委员会选择创建一个活跃的社交媒体社区,通过一个封闭的 Facebook (FB) 群组平台突出护士的临床探索和成就,从而对护士进行有意义的表彰。本文介绍了该委员会在确定 FB 小组的宗旨和目标、指定每月版主以及向护理社区推广 FB 小组时所采用的实施方法。使用 FB 平台指标跟踪了成员的持续增长和 FB 小组的参与情况。结果显示,护理临床探究和成就得到了有意义的认可。有了这一成就,成功的平台得以扩展,纳入了全院其他学科的成就。
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引用次数: 0
期刊
OJIN: The Online Journal of Issues in Nursing
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