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Exploring self-care practices and health beliefs among men in the context of emerging infectious diseases: Lessons from the Mpox pandemic in Brazil. 探索新发传染病背景下男性的自我保健做法和健康信念:巴西 Mpox 大流行的教训。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-07-01 Epub Date: 2024-04-01 DOI: 10.1111/nin.12635
Carolina da Silva Bulcão, Pedro E G Prates, Iago M B Pedrosa, Guilherme R de Santana Santos, Layze B de Oliveira, Jhonata de Souza Joaquim, Lilian C G de Almeida, Caíque J N Ribeiro, Glauber W Dos Santos Silva, Felipe A Machuca-Contreras, Anderson R de Sousa, Isabel A C Mendes, Álvaro F L de Sousa

Our goal was to explore self-care practices among men who have sex with men in the context of Mpox in Brazil. This study used qualitative research methods, including interviews and thematic analysis, to collect and analyze data from male participants across the Brazilian territory. The narratives unveil men's perspectives on self-care, risk reduction, and health beliefs during the Mpox pandemic. Our findings highlight a multifaceted approach to self-care among men, encompassing hygiene, physical contact management, mask usage, skin lesion vigilance, and adherence to official guidelines. Men's attitudes toward sexual behaviors emphasize the importance of reducing sexual partners, practicing safe sex, and combating misinformation through accurate information dissemination. The development of these behaviors and self-care practices can be facilitated by nurses guided by Dorothea Orem's Self-Care Theory, supported by patient-centered care, with strategies to address and confront the stigma associated with the disease and provide emotional support. Thus, the study underscores the pivotal role of self-care in mitigating infection risks, especially in the context of emerging infectious diseases. It acknowledges the impact of socio-cultural factors and healthcare policies on men's preventive measures. However, it also recognizes limitations, such as potential bias due to stigma concerns and a nonrepresentative sample. Ultimately, the research advocates for tailored education, promotion of gender equity, and healthcare empowerment to effectively manage health risks in such contexts.

我们的目标是探索巴西男男性行为者在感染麻风腮病毒后的自我护理方法。本研究采用定性研究方法,包括访谈和主题分析,收集和分析来自巴西各地男性参与者的数据。这些叙述揭示了男性在麻风腮流行期间对自我保健、降低风险和健康信念的看法。我们的研究结果凸显了男性自我保健的多面性,包括卫生、身体接触管理、口罩使用、皮损警惕以及遵守官方指南。男性对性行为的态度强调了减少性伴侣、安全性行为以及通过准确的信息传播来消除误导的重要性。护士可以在多萝西娅-奥雷姆(Dorothea Orem)的自我护理理论指导下,在以病人为中心的护理支持下,通过解决和面对与疾病相关的耻辱感以及提供情感支持的策略,促进这些行为和自我护理实践的发展。因此,这项研究强调了自我护理在降低感染风险方面的关键作用,尤其是在新发传染病的情况下。研究承认社会文化因素和医疗保健政策对男性预防措施的影响。不过,它也认识到了研究的局限性,例如由于耻辱感和样本不具代表性而可能造成的偏差。最终,该研究提倡有针对性的教育、促进性别平等和增强医疗保健能力,以便在这种情况下有效管理健康风险。
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引用次数: 0
Toward diverse SOGIESC-transformative theorizing in nursing: A revisitation and expansion of Im and Meleis' guidelines for gender-sensitive theorizing. 在护理工作中开展多样化的性别变革理论研究:重新审视和扩展 Im 和 Meleis 的性别敏感理论化指南。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-07-01 Epub Date: 2024-03-20 DOI: 10.1111/nin.12632
Jerome Visperas Cleofas

Over two decades have passed since Im and Meleis proposed "gender-sensitive theories" as a category of nursing theories in 2001. Since then, the global conditions of women and minoritized identities across the various spectra of sexual orientation, gender identity and expression, and sexual characteristics (SOGIESC) have changed. Moreover, feminist theorizing has evolved, prompting the need to update how nurses theorize and research the interactions of gender and health in their practice. This discursive essay aims to (1) provide a summary of Im and Meleis' characterization and guidelines in the development of gender-sensitive theories in nursing and present exemplars that use these guidelines; (2) assess the gender-sensitive nursing theory guidelines in terms of gender-responsiveness; and (3) expand the transformative potential of gender-sensitive theorizing in nursing by proposing Diverse SOGIESC-Transformative Theories. Diverse SOGIESC-Transformative Theories include three additional aspects to enhance the transformative potential of gender-responsive theorizing in nursing: inclusion of diverse SOGIESC, elaboration of intersectionality, and consideration of men and masculinities.

自 Im 和 Meleis 于 2001 年提出 "性别敏感理论 "作为护理理论的一个类别以来,20 多年过去了。从那时起,全球妇女和少数群体在性取向、性别认同、性别表达和性特征(SOGIESC)等方面的状况发生了变化。此外,女权主义理论也在不断发展,这促使我们需要更新护士在实践中对性别与健康的相互作用进行理论研究的方式。本论文旨在:(1)总结 Im 和 Meleis 在护理性别敏感理论发展过程中的特点和指导原则,并介绍使用这些指导原则的范例;(2)从性别反应的角度评估性别敏感护理理论指导原则;以及(3)通过提出多元 SOGIESC-Transformative 理论,拓展护理性别敏感理论的变革潜力。多元社会性别意识变革理论包括三个方面,以增强护理领域性别敏感理论的变革潜力:纳入多元社会性别意识、阐述交叉性以及考虑男性和男子气概。
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引用次数: 0
Answering the call: Experiences of nurses of color during COVID-19. 响应号召:有色人种护士在 COVID-19 期间的经历。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-07-01 Epub Date: 2024-06-09 DOI: 10.1111/nin.12647
Kyla F Woodward, Mayumi Willgerodt, Elaine Walsh, Susan Johnson

In the years following the COVID-19 pandemic, issues such as high job demands, burnout, and turnover continue to influence the nursing workforce, with heavier impacts to marginalized groups. Understanding the work and life contexts of nurses of color can help guide strategies for workplace equity and meaningful support. This qualitative study explored the experiences of nurses of color in the United States during the pandemic, focusing on feelings about the profession and job decisions. The overarching theme was "answering the call," with subthemes of "COVID shone a light," "being consumed by COVID," and "is it worth it?" Participants shared how their racial identities shaped their perceptions and job decisions in positive and negative ways, noting how racism impacted many facets of their work and added to the stressors felt in the workplace and the community. Findings provide insight into the underrepresented perspectives of nurses of color and suggest strategies to eliminate racism in nursing.

在 COVID-19 大流行后的几年里,高工作要求、职业倦怠和人员流动等问题继续影响着护理人员队伍,对边缘化群体的影响更为严重。了解有色人种护士的工作和生活环境有助于指导工作场所公平和有意义的支持策略。这项定性研究探讨了美国有色人种护士在大流行病期间的经历,重点是对职业和工作决策的感受。研究的总主题是 "响应号召",副主题是 "COVID 照亮了一盏灯"、"被 COVID 吞噬 "和 "值得吗?参与者分享了他们的种族身份如何以积极和消极的方式影响了他们的观念和工作决定,指出种族主义如何影响了他们工作的许多方面,并增加了他们在工作场所和社区感受到的压力。研究结果为有色人种护士代表不足的观点提供了见解,并为消除护理工作中的种族主义提出了策略建议。
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引用次数: 0
Toward disrupting normalized incivility in our nursing workplaces. 努力消除护理工作场所中的不文明现象。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-07-01 DOI: 10.1111/nin.12654
Sally Thorne
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引用次数: 0
From plaster casts to picket lines: Public support for industrial action in the National Health Service in England. 从石膏模型到纠察线:公众对英格兰国家医疗服务机构工业行动的支持。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-07-01 Epub Date: 2024-03-27 DOI: 10.1111/nin.12637
Martin Ejnar Hansen, Steven David Pickering

This paper explores public sentiment towards strike action among healthcare workers, as a result of their perceived inadequate pay. By analysing survey data collected in England between 2022 and 2023, the study focuses on NHS nurses and junior doctors, due to their critical role in delivering essential public services. Results indicate higher public support for strikes by nurses and junior doctors compared to other professions such as postal workers, teachers, rail workers, airport workers, civil servants and university lecturers. However, variation in support for strikes by healthcare workers is observed across societal segments. Significant disparities in support are linked to individual political affiliations, left-right ideological positions and trust in the NHS. In short, nonconservative voters, individuals leaning towards left-wing politics and those with greater trust in the NHS demonstrate higher likelihoods of supporting strikes by health workers. These findings carry implications for future strike decisions and highlight specific target groups for enhanced communication efforts to garner increased public support.

本文探讨了公众对医护人员因认为薪酬不足而采取罢工行动的情绪。通过分析 2022 年至 2023 年期间在英格兰收集的调查数据,本研究重点关注英国国家医疗服务系统的护士和初级医生,因为他们在提供基本公共服务方面发挥着关键作用。结果表明,与邮政工作人员、教师、铁路工作人员、机场工作人员、公务员和大学讲师等其他职业相比,护士和初级医生的罢工获得了更高的公众支持率。然而,不同社会阶层对医护人员罢工的支持程度也不尽相同。支持率的显著差异与个人政治派别、左右意识形态立场和对国家医疗服务体系的信任度有关。简而言之,非保守派选民、倾向于左翼政治的个人以及对 NHS 信任度较高的人支持医护人员罢工的可能性较高。这些发现对未来的罢工决策具有启示意义,并强调了需要加强沟通努力以争取更多公众支持的特定目标群体。
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引用次数: 0
Supporting each other towards independence: A narrative analysis of first-year nursing students' collaborative process. 相互支持,实现独立:对护理专业一年级学生合作过程的叙事分析。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-07-01 Epub Date: 2024-02-13 DOI: 10.1111/nin.12627
Marie Stenberg, Mariette Bengtsson, Elisabeth Mangrio, Elisabeth Carlson

Collaboration for nursing is a core competence and therefore educational interventions are essentials for collaborative skills. To identify such interventions, we carried out a study to understand nursing students' collaborative process. A narrative inquiry method was used to explore the collaborative process of first-year undergraduate nursing students. The analysis was conducted on field notes from 70 h of observation of 87 nursing students' collaboration during skills lab activities. It also included transcriptions of four focus group discussions with 11 students. The results are presented as a sequential process of (1) navigating in unfamiliar territory, (2) navigating together to cope, and (3) navigating together towards independency and the future nursing profession. We identified a transition from teacher-led assistance and guidance to student interdependency and reciprocal learning, ending with student-led assistance supporting independency. In line with Vygotsky's theory of zone of proximal development, different scaffolding interventions are needed depending on where the students are in the collaborative process.

护理协作是一项核心能力,因此教育干预对协作技能至关重要。为了确定此类干预措施,我们开展了一项研究,以了解护理专业学生的协作过程。我们采用了叙事探究法来探索护理专业一年级本科生的协作过程。我们对 87 名护理专业学生在技能实验室活动中的协作过程进行了 70 小时的观察,并对观察记录进行了分析。分析还包括与 11 名学生进行的四次焦点小组讨论的记录。分析结果以一个连续的过程呈现:(1) 在不熟悉的领域中导航,(2) 共同导航以应对,(3) 共同导航以走向独立和未来的护理专业。我们确定了从教师主导的协助和指导到学生相互依赖和互惠学习的过渡,最后以学生主导的协助支持独立学习结束。根据维果斯基的 "最近发展区 "理论,学生在合作过程中所处的阶段不同,需要不同的支架干预措施。
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引用次数: 0
Five pathways into one profession: Fifty years of debate on differentiated nursing practice. 一个职业的五种途径:关于差异化护理实践的五十年争论。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-07-01 Epub Date: 2024-03-12 DOI: 10.1111/nin.12631
Hugo Schalkwijk, Martijn Felder, Pieterbas Lalleman, Manon S Parry, Lisette Schoonhoven, Iris Wallenburg

The persistence of multiple educational pathways into the nursing profession continues to occupy scholars internationally. In the Netherlands, various groups within the Dutch healthcare sector have tried to differentiate nursing practice on the basis of educational backgrounds for over 50 years. Proponents argue that such reforms are needed to retain bachelor-trained nurses, improve quality of care and strengthen nurses' position in the sector. Opponents have actively resisted reforms because they would mainly benefit bachelor-trained nurses and neglect practical experience and technical skills. This historical case study aims to provide insight in this apparent stalemate. Our analysis of this debate is informed by literature on institutional work and current debates within the historiography of nursing. This study contributes to a better understanding of this contemporary debate by examining a broader timeframe than is usually studied, and by highlighting nurses' roles in complex processes of change. We argue that, rather than being stuck in their professional development, different groups of nurses have forged their own path forward in their professional development, albeit via different strategies.

进入护理行业的多种教育途径的持续存在一直困扰着国际学者。在荷兰,50 多年来,荷兰医疗保健部门的各种团体一直试图根据教育背景区分护理实践。支持者认为,为了留住接受过本科培训的护士、提高护理质量和加强护士在该行业中的地位,有必要进行此类改革。反对者则积极抵制改革,因为改革主要有利于受过学士培训的护士,而忽视了实践经验和技术技能。本历史案例研究旨在深入探讨这一明显的僵局。我们对这一争论的分析参考了有关机构工作的文献以及当前护理史学界的争论。本研究通过考察比通常研究更广泛的时间范围,并通过强调护士在复杂的变革过程中的作用,有助于更好地理解这一当代辩论。我们认为,不同的护士群体并没有在其职业发展中停滞不前,而是通过不同的策略在其职业发展中开辟了自己的道路。
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引用次数: 0
"We are not the person we will be when these things happen:" Reflections on personhood from an ethnography of neuropalliative care. "当这些事情发生时,我们不是我们自己:"神经姑息治疗人种学对人格的思考。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-07-01 Epub Date: 2024-06-05 DOI: 10.1111/nin.12646
Marianne Sofronas, Franco A Carnevale, Mary Ellen Macdonald, Vasiliki Bitzas, David Kenneth Wright

Neuropalliative care developed to address the needs of patients living with life-limiting neurologic disease. One critical consideration is that disease-related changes to cognition, communication, and function challenge illness experiences and care practices. We conducted an ethnography to understand neuropalliative care as a phenomenon; how it was experienced, provided, conceptualized. Personhood served as our conceptual framework; with its long philosophical history and important place in nursing theory, we examined the extent to which it captured neuropalliative experiences and concerns. Personhood contextualized complex losses, aligning the impact of functional and relational changes. Cognition, communication, and functional alterations stretched conceptions of personhood, insinuating it can be relational, fluid, adaptive. Although normative conceptions of personhood guided research and decision-making, ethical considerations suggested personhood could be transformed, remade. We consider the implications of our findings through three themes. First, we examine how literature on illness experience fails to integrate the realities of people living with and dying from neurologic disease; we counter this by interrogating the concept of experience. Second, we turn to Ricoeur's work on recognition to illuminate relational conceptions of personhood to inform care practices. Finally, we reflect on how personhood can bridge the gap left by functional changes, enhance relational engagement, and promote dignity at the end of life.

神经姑息治疗是为满足患有局限生命的神经系统疾病的患者的需求而发展起来的。一个重要的考虑因素是,与疾病相关的认知、交流和功能变化对疾病体验和护理实践提出了挑战。我们开展了一项人种学研究,以了解神经姑息治疗这一现象;它是如何被体验、提供和概念化的。人格是我们的概念框架;由于其悠久的哲学历史和在护理理论中的重要地位,我们研究了它在多大程度上捕捉到了神经姑息治疗的经验和关注点。人格将复杂的损失背景化,将功能和关系变化的影响统一起来。认知、交流和功能改变扩展了人格的概念,暗示人格可以是关系性的、流动的和适应性的。虽然人格的规范性概念指导着研究和决策,但伦理方面的考虑表明,人格可以转变、重塑。我们通过三个主题来思考研究结果的意义。首先,我们研究了有关疾病体验的文献如何未能将神经系统疾病患者的现实生活与死亡结合起来;我们通过质疑体验的概念来反驳这一观点。其次,我们借鉴了呂科爾(Ricoeur)关于 "认可"(recognition)的著作,以阐明人格的关系概念,为护理实践提供参考。最后,我们反思了人格如何弥补功能变化所留下的空白,加强关系参与,并在生命末期提升尊严。
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引用次数: 0
Deconstructing spiritual care: Discursive underpinnings within palliative care research. 解构精神关怀:姑息关怀研究的话语基础。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-07-01 Epub Date: 2024-01-04 DOI: 10.1111/nin.12622
Emma Lundberg, Joakim Öhlén, Lisen Dellenborg, Anneli Ozanne, Daniel Enstedt

Religion and spirituality are integral to the philosophy of palliative care, shaping its approach to spiritual care. This article aims to examine the discourses within palliative care research to illuminate prevailing assumptions regarding spiritual care. Eighteen original articles were analyzed to examine how spiritual care is understood within palliative care. The analysis, informed by Foucault, aimed to identify recurring discourses. The finding reveals that, in palliative care research, spirituality is viewed as enigmatic yet inherently human and natural, assuming that every individual has a spiritual dimension. The analysis points to healthcare professionals being expected to hold certain qualities to put spiritual care into practice. The analysis also reveals that in the analyzed articles, the concept of spiritual care is rooted in a Christian context, with the belief that all individuals possess inherent spirituality or religiosity, a concept often associated with Christian theology. The included articles often utilize theological terms and emphasize a monotheistic viewpoint. Spirituality is articulated as a complex, distinct concept, challenging clear definitions and professional responsibilities. Further, a moral formation of healthcare professionals is described, interpelling and ascribing qualities that healthcare professionals need to provide spiritual care.

宗教和灵性是姑息关怀理念中不可或缺的一部分,决定了姑息关怀的灵性关怀方式。本文旨在研究姑息关怀研究中的论述,以阐明有关灵性关怀的普遍假设。文章分析了 18 篇原创文章,以研究姑息关怀中如何理解灵性关怀。该分析借鉴了福柯的观点,旨在找出反复出现的论述。研究结果表明,在姑息关怀研究中,灵性被视为神秘的、人类固有的和自然的,并假定每个人都有灵性维度。分析指出,人们期望医护专业人员具备某些素质,以便将灵性关怀付诸实践。分析还显示,在所分析的文章中,灵性关怀的概念植根于基督教背景,认为所有人都具有与生俱来的灵性或宗教性,这一概念通常与基督教神学有关。收录的文章经常使用神学术语,并强调一神论观点。灵性被阐述为一个复杂、独特的概念,对明确的定义和专业责任提出了挑战。此外,文章还描述了医护专业人员的道德修养,解释并归纳了医护专业人员提供精神关怀所需的素质。
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引用次数: 0
Standards of proficiency for registered nurses-To what end? A critical analysis of contemporary mental health nursing within the United Kingdom context. 注册护士的能力标准--目的何在?对英国当代精神健康护理的批判性分析。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-07-01 Epub Date: 2024-03-04 DOI: 10.1111/nin.12630
Oladayo Bifarin, Freya Collier-Sewell, Grahame Smith, Jo Moriarty, Han Shephard, Lauren Andrews, Sam Pearson, Mari Kasperska

Against the backdrop of cultural and political ideals, this article highlights both the significance of mental health nursing in meeting population needs and the regulatory barriers that may be impeding its ability to adequately do so. Specifically, we consider how ambiguous notions of 'proficiency' in nurse education-prescribed by the regulator-impact the development of future mental health nurses and their mental health nursing identity. A key tension in mental health practice is the ethical-legal challenges posed by sanctioned powers to restrict patients' freedom at the same time as the desire (and obligation) to promote patients' self-determined recovery. The genericism of the UK's Future Nurse Standards do little to prepare mental health nurses to navigate the tensions that ensue. This has consequences for nurses and patients alike, as both risk experiencing the distress and dissonance that attends giving or receiving poor care. We argue that more needs to be done to enable mental health nurses to define and articulate the nuances of the profession as part of becoming critical, thoughtful and confident practitioners. Educators can contribute to this mission by aligning curriculum, pedagogy and assessment to create meaningful opportunities for mental health nursing students to engage with the complexities of mental health nursing practice. Without this, the credibility of the profession will continue to be questioned; its future uncertain.

在文化和政治理想的背景下,本文强调了心理健康护理在满足人口需求方面的重要性,以及可能阻碍其充分发挥作用的监管障碍。具体而言,我们考虑了监管机构规定的护士教育中模棱两可的 "能力 "概念是如何影响未来心理健康护士的发展及其心理健康护理身份的。心理健康实践中的一个主要矛盾是,在促进患者自主康复的愿望(和义务)的同时,限制患者自由的制裁权力所带来的伦理和法律挑战。英国《未来护士标准》的通用性并没有让心理健康护士做好准备来应对随之而来的紧张局势。这对护士和患者都有影响,因为双方都有可能经历因提供或接受不佳护理而带来的痛苦和失调。我们认为,还需要做更多的工作,使心理健康护士能够定义和表达这一职业的细微差别,从而成为批判性的、深思熟虑的和自信的从业者。教育者可以通过调整课程、教学法和评估,为心理健康护理专业的学生创造有意义的机会,让他们参与到复杂的心理健康护理实践中来,从而为这一使命做出贡献。如果做不到这一点,护理专业的公信力将继续受到质疑,护理专业的未来也将充满不确定性。
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