Nursing Inquiry最新文献

In this article, we aimed to evaluate the utility of critical posthumanism for nurses interested in planetary health-a growing area of study that requires a decentering of the human, and environmental justice considerations. We used Chinn and colleagues' method to describe and critically reflect on critical posthumanism, extending the theory analysis method to include a wide range of academic and video sources. We found that critical posthumanism is like a double-edged sword: It provides a lens through which to transcend human-centric approaches to healthcare but is marred by its lack of clarity and inaccessibility. We argue critical posthumanism can be adapted to enhance its potential at the intersection of nursing and planetary health. An analysis of critical posthumanism is followed by a discussion framed by five ways of knowing in nursing, highlighting real-world examples of how critical posthumanism can aid nurses in dealing with planetary health concerns. By exploring the intersections of critical posthumanism with nursing knowledge, we demonstrate how critical posthumanism can enable nurses to comprehend and tackle environmental issues intricately linked to human health.

Many people want to spend the last stages of their lives at home, in familiar surroundings, and possibly with people they know. However, this increasing desire on the part of older, ill, or even dying people also makes support from other people unavoidable, which in many cases involves family members, loved ones, or even friends. These family caregivers care for the person concerned, even though they lack the professional skills of nursing staff, for example, and have usually not been prepared for this task. This article focuses on the ethical significance of the moral identity of family caregivers. While the effects of this care constellation on the caregivers have often been discussed in the scientific literature, ethical considerations regarding moral identity have so far been neglected. In the first step, the question of what is actually meant by the term moral identity is examined. The second step shifts attention to those people who have taken on the care of a loved one. The relevance of this previously discussed identity is emphasized by using study results and work in this context, and placed in relation to family caregivers. The third step shows that (1) moral identity must be understood as a necessary prerequisite for adequate and humane care, (2) this identity can be enhanced through the caregiving relationship, and (3) the activities undertaken by family caregivers reveal their moral identity. These considerations are finally summarized, provided with ethical aspects, and awareness of this important work of family caregivers is raised.

Social justice is widely advanced as a central nursing value, and yet conceptual understandings of social justice remain inconsistent and vague. Further, despite persistently articulated commitments to upholding social justice, the profession of nursing has been implicated in perpetuating inequities in health and health care. In this context, it is essential to establish both conceptual clarity and tangible guidance for nurses in enacting practices to advance social justice-particularly through regulatory, education and accreditation documents that shape the nursing profession. This Foucauldian discourse analysis examines how social justice is discursively positioned within nursing professional documents in Canada, and illustrates that social justice was largely discursively excluded from these texts. Where social justice discourses were invoked, we identified that four central discursive patterns obscured and de-centred this nursing value: (i) Vague language undermined professional commitments to social justice; (ii) Constructions of knowledge and awareness de-emphasized practice; (iii) Individualism discourses minimized institutional/professional responsibility; and (iv) Aspirational language obscured present action. Extending from this analysis, we contend that the nursing profession must re-examine how social justice is understood and articulated, and call for a re-conceptualization of social justice grounded in nursing practice toward remediating inequities in health and health care.

Existing challenges to the legitimacy of mental health nursing in the United Kingdom and beyond have stimulated a critical self-reflection and discourse around the mental health nursing role, forcing the profession to question its identity and critically re-evaluate its position within the wider healthcare arena. In this discussion paper, I suggest that the current difficulties in conceptualising mental health nurse identity arise from our role being inherently interwoven with distinctive challenges and unique needs of our service users. Emerging from this idea is that the 'being' (and the 'doing') of mental health nursing is firmly situated within the sphere of intersubjective relations. Drawing upon Hegel's ideas of reciprocal recognitive relations, to support the notion that our profession's role and purpose are better understood when defined in relation to the work that we do with our service users, I argue that it is in the understanding (and even embracing) of intersubjectivity as a core principle of mental health nursing, where we might not just better understand ourselves but also know how to shift asymmetric relations with our service users towards those which are more commensurate and mutually beneficial.

There is a global shortage of nurses, leading many countries to recruit internationally qualified nurses (IQNs) to fill the gap. However, IQNs encounter challenges in integrating into their new professional environment, particularly in their interactions with locally qualified nurses (LQNs). Intraprofessional cultural competence (IPCC), defined as 'a set of congruent behaviours and attitudes that enable professionals to work respectfully and effectively in cross-cultural situations', may be a strategy to address these challenges. Content analysis was used to examine nursing regulatory documents (Standards for Practice [Standards] and Codes of Conduct [Codes]) from the United Kingdom, New Zealand and Australia. Data were extracted and organised based on four key themes relevant to IPCC. The analysis revealed a focus on 'Mutual collaboration and professional relationships' in six regulatory documents, with explicit commitments to preventing racism and discrimination in the Australian and NZ Codes. However, issues such as racism, discrimination, bullying and harassment faced by IQNs are not comprehensively addressed, as the documents mainly prioritize culturally appropriate patient interactions over relationships between colleagues. Using regulatory documents to address IPCC may influence positive change such as improving communication, and preventing racism, bullying, discrimination and harassment within nursing.

In this manuscript, we explore the connections between Florence Nightingale's Cassandra and Virginia Woolf's A Room of One's Own while taking the authors' personal and social contexts into account. We conduct a detailed textual analysis from a feminist perspective. Cassandra and A Room of One's Own exhibit singular textual commonalities, such as evidence of trauma, the integration of myth and fiction as literary devices aimed at facilitating the author's access to various social spheres, the use of interpellations to impact the audience, and an argument for education as a path by which privileged women can enter the public realm. Both authors' personal wounds and intellectual frustrations influenced their work, thus making their writing very powerful.

This scoping review mapped the academic literature focused on the therapeutic itinerary of children who seek care in health services and proposed an explanatory model to expand the concept and classification of these health itineraries. A total of 789 articles were reviewed, of which 28 were eligible for inclusion. In these 28 it was possible to observe that the child's therapeutic itinerary is more than a physical path, but also encompasses all choices within a specific social and cultural environment in which the child is inserted. Our proposal is to expand the concept beyond the therapeutic, classifying the itinerary also according to the objective, the decision-making agent, respect for the presence of company, the health subsystem used, according to the physical continuity of the itinerary, the perception of efficacy of the patient, the nature of the illness, the administration of healthcare, the means of transport used, the person providing information about the itinerary, the planning of the itinerary and its completeness. Knowing the child's itineraries toward healthcare allows the development of innovative discourses and practices for future public policies, through which the principles of comprehensiveness and resoluteness in children's health would be strengthened. There is still a need to deepen knowledge about the meanings and feelings regarding their interpretations of the events suffered in childhood.

The quality of phenomenological research in nursing has been a subject of long-standing debate and critique, but conversation took a particularly contentious turn following publication of John Paley's 2017 Phenomenology as Qualitative Research (Routledge), which elicited strong reactions. Faculty in nursing doctoral programs now face a challenge: in light of current controversies, what can we teach that is appropriately labeled phenomenological, and is there a way to present philosophical concepts that might equip students to avoid the most egregious mistakes of the past? In this article, I suggest that ordinary clinical nursing practice is an inherently phenomenological enterprise, and creative bedside insights belong at the center of our teaching, as they embody an everyday phenomenology which exemplifies core elements of the phenomenological method. Instead of following ever-more-precisely elaborated instructional manuals, I propose, our students should begin their studies of phenomenology by returning attention to the way creative insight emerges during routine care. Bedside insights have been rendered invisible by our discipline's valuing of technical proceduralism over artistry in research and by the turn to evidence-based practice in clinical work, but they are a valuable pathway to learning and should be part of our response to the current crisis.

Phenomenological researchers are obliged to grasp the epistemological and ontological differences between the Husserlian and Heideggerian branches of phenomenology to avoid misappropriating phenomenological terms or mischaracterizing study design. To that end, we spell out the key differences between both phenomenological traditions as background for describing the indelible role that the researcher's background assumptions, or fore-structure, play in interpretive studies. We draw on our four studies to illustrate how we traversed the hermeneutic circle to disclose, challenge, and refine the personal, cultural, clinical, and scientific assumptions hidden in our fore-structures. Our reflections highlight how understanding evolves, not by bracketing or disengaging ourselves from the phenomena we study, but by engaging in an open dialog that seeks understanding as lived by patients and families.