Nursing Inquiry最新文献

The past two decades have witnessed a great interest in psychometric research in nursing, characterised by a marked increase in measurement tools. This approach has been lauded for its methodological sophistication-yet beneath this polish lies an unexamined ethical cost. This paper interrogates the proliferation of psychometric instruments as an indicator of deeper disciplinary tensions: the quest for legitimacy, the valorisation of quantifiable research output and the bureaucratic allure of metrics. We examine three core risks-namely ethical redundancy, resource misallocation and evidence fragmentation-and argue for a recalibration of instrument development grounded in collective accountability, theoretical coherence and editorial restraint.

A positive healthcare environment and effective nurse recruitment are widely recognized as interconnected factors that improve outcomes for patients, families, and staff. Despite this, frontline nurses and their managers often have conflicting views on workplace issues. Although some hospitals have implemented "speak-up" initiatives, nurses in acute care settings still feel silenced, as interventions designed to improve workplace culture have had limited long-term impact. This underscores the need for a deeper understanding of how nurses are silenced. This qualitative, ethnographic study aimed to improve our understanding of how nurses are silenced in the acute care workplace. Through semi-structured interviews with registered nurses (n = 14) and administrators (n = 9), observational field notes (20 h), and documents (n = 8), we found that although nurses used various channels to voice concerns about patient safety, patient-centered care, and workplace health to their managers, they still felt ignored and unsupported, leading to feelings of vulnerability, anger, and abandonment. Administrators understood staff frustrations but felt powerless, seeing themselves as conduits for top-down directives rather than active participants in organizational initiatives. These findings offer crucial insights for clinicians, researchers, educators, and administrators aiming to create a more inclusive culture that prioritizes collaboration and high-quality care.

A code of ethics, as proof of nursing professionalism, is used to promote nursing's core values. In the United States, the American Nurses Association's (ANA) Code of Ethics is accepted as the primary source for professional nursing values. Particular processes are used within nursing to embed professional values into nursing discourse. A historical review of the ANA Code of Ethics, a review of published articles about professional nursing values, and an examination of the development and globalization of the Nurses Professional Values Scale informed our examination of nursing's efforts to delineate, instill, and measure professional nursing values. The analysis was informed theoretically by Bourdieu and his concept of "playing the game." Constructing and reinforcing professional nursing values reveals difficulties about what constitutes core nursing values and what they mean, particularly with respect to values that comprise the good nurse; the inability to measure and evaluate said values; and the colonization of Western values globally. The inordinate amount of time and energy spent on nursing values surfaced the vexing nature of such efforts. The concept of profession and its accompanying values must be regarded with suspicion.

The literature largely agrees in recognizing care as a central and defining aspect of nursing. However, this concept takes on diverse nuances, as evidenced by the variety of nursing theories. We align with the perspective of Chris Gastmans and others who conceptualize the ontology of nursing from a relational standpoint: at the core of nursing practice lies the personal nurse-patient relationship-the caring relationship. This relationship possesses an intrinsic moral dimension, stemming from the integration of scientific knowledge and sound ethical judgment, all directed toward the provision of good care-the intrinsic teleological dimension of nursing. In a virtue ethics framework, questions concerning the character of the ethical agent take precedence over those regarding correct actions, principles, or consequences. The primary concern is to identify the qualities a person must cultivate to be ethically good, given that the moral value of actions is largely shaped by the character of the agent performing them. This approach supports reflection from a praxis-oriented perspective. The aim of this paper is to explore the role that virtues and phronesis-as developed within a Neo-Aristotelian perspective-play in fulfilling the telos of nursing practice, and consequently, in the flourishing of the professional. Trial Registration: Not applicable.

Curriculum designed to promote the cultural safety of health professionals is now expected in Australia. There is, however, limited research demonstrating the relationship between this curriculum content and the ability to work in a culturally safe manner. Eleven advisory group members were recruited from various First Nations groups in Australia. Through participation in Yarns, members were invited to describe their experiences of cultural safety in healthcare and their desires regarding the education of healthcare students. Yarns were digitally audio-recorded and analysed using reflexive thematic analysis. For First Nations Peoples, cultural safety is a multifaceted, lifelong journey, marked by continuous growth and relational learning. The experience of cultural safety is unique to each person receiving care. Authentic relationships and respect for cultural protocols and responsibilities are essential. Forming genuine connections with local First Nations Communities and sustaining authentic relationships through empathy, respect and deep listening is fundamental. Structural barriers to addressing cultural safety were identified, including: constraints on the time and resources of health professionals; the enduring impact of colonial policies; the role of tertiary institutions in marginalising Indigenous knowledges and voices, and the fact that opportunities for creating respectful and direct engagement with First Nations Communities remain limited in tertiary education programmes.

Male infertility contributes to nearly half of the global infertility, yet nursing scholarship continues to marginalize men's experiences, reflecting entrenched assumptions that equate reproduction with femininity. This article reframes male infertility as a relational, socially embedded phenomenon and a site of disciplinary transformation. Drawing on intersectionality, masculinity theory, performativity, and stigma, this article shows how race, class, sexuality, disability, and cultural context intersect to produce compounded stigma, invisibility, and restricted access to care. For example, queer and trans men remain largely invisible in heteronormative reproductive discourse, while men from low-resource settings face systemic barriers to psychosocial support. To address these silences, this paper proposes an intersectional nursing proposition grounded in reflexivity, cultural humility, couple-centeredness, and structural awareness. Visual scaffolding (one table and two figures) clarifies the pathway from entrenched binaries to intersectional praxis. The manuscript presents male infertility as both a clinical and theoretical challenge, urging nursing to reconceptualize care, vulnerability, and reproductive justice to serve diverse masculinities and reduce structural inequities.

Effective collaboration between professional and informal caregivers is essential in residential dementia care, but often disrupted by relational tensions. This 2-year case study explores how these tensions emerge and develop. Using visual and inductive analysis of qualitative data, we study a strained professional-informal caregiver relationship in a Dutch residential dementia care facility, focusing on the personal, relational, and organizational factors that shape it. Findings indicate that divergent conceptualizations of good care, rooted in distinct ethical frameworks, lead to relational tensions between professional and informal caregivers. These tensions tend to escalate through a series of interrelated dynamics that ultimately result in a tug of war over power, which triggers a downward spiral in the relationship. Organizational processes such as pseudo-participation and unintentional support for distancing practices further entrench these dynamics. Professional and informal caregivers are prompted to work around rather than resolve the conflict. Set within a Dutch residential dementia care context, the study offers broader implications for similar care settings globally. It advocates a shift from person-centered care to relational care, emphasizing multidirectionality to address power asymmetries. Key implications include promoting relational care as the moral standard, implementing organizational changes to support relational care and embedding moral skills into nursing education.