Nursing Inquiry最新文献

Prisons are debilitating and disorienting spaces. Temporal realities themselves are altered from those of the outside world. This paper builds upon a study of prison staff work with aging incarcerated persons in Canadian federal penitentiaries, wherein the prison environment itself contributes to accelerated aging and slow death. Simultaneously, temporal experiences in prison both slow and become cyclic, rhythmic. These multiple temporalities flow independent of the "outside" world, which, from the perspective of incarcerated persons, accelerates. To reconcile these multiple, conflicting simultaneous temporalities, we turn to science fiction, specifically the works of Philip K. Dick, to build a conceptual world where such paradoxical temporalities coexist. A bricolage approach is adopted to interrogate these temporalities, and their effects on incarcerated persons, including debilitation and institutionalization, and the production of persons often incapable of transitioning back to the "real" world outside of prison. Proposals for both nursing practice and future research possibilities are provided.

Moral distress increased among healthcare workers during the first three years of the COVID-19 pandemic. This qualitative descriptive study explored the experiences of thirteen healthcare professionals with expertise in supporting healthcare workers experiencing moral distress within Canadian healthcare systems during this time. Participants reported multiple factors driving moral distress, such as resource scarcity (e.g., staffing shortages), policies (e.g., vaccination), and sociopolitical issues (e.g., diminishing support for healthcare workers). A range of interventions was employed to address moral distress, including: education, debriefing, consultation, mentorship, and general wellness programs. A strong knowledge of moral distress and counselling skills were both cited as necessary tools for individuals facilitating moral distress interventions. Values central to experiences of moral distress (e.g., transparency, accountability, respect, care) were identified, and participants described factors that could support organizational change to align with these values to better address moral distress (e.g., transparent communication, capacity-building). Finally, participants called for societal and political support for resource allocation to healthcare systems to ensure system sustainability and the ability of healthcare professionals to provide ethically sound care to all members of society.

Cardiovascular disease remains the leading cause of mortality for women globally and presents a considerable health burden despite decades of awareness campaigns. Messaging in these campaigns includes a significant focus on individual lifestyle behaviour modification for the prevention of cardiovascular disease, with health promotion campaigns and clinical organizations stating that 80%-90% of cardiovascular disease is preventable. Public messaging campaigns on prevention strategies have historically lacked differentiation for gender. As a result, they can overlook the complex factors that may hinder women from achieving the suggested lifestyle modifications, including the long-promoted trio of diet, exercise and tobacco. The non-coherence between the logics guiding cardiovascular disease prevention messaging and the competing logics of everyday life for women deserves attention. In this paper, we explore the assumptions evident in common cardiovascular disease prevention narratives and propose that nurses are well-positioned to advocate for gender-transformative health promotion.

Pregnancy during the COVID-19 pandemic presented unique challenges for all women; however, the experiences of Black women were particularly affected by intersecting processes and systems such as race, class, gender, socioeconomic status, and healthcare access. The objective of this study was to explore the perinatal experiences of Black women amidst the COVID-19 pandemic. This was a qualitative study. Inclusion criteria were self-identification as a Black woman aged 18-49; experienced at least one pregnancy from March 2020 to May 2023; received at least one dose of COVID-19 vaccine during the perinatal period; and residence in Greater Philadelphia. Interviews (n = 22) were conducted by trained researchers and were audio-recorded and transcribed verbatim, and analyzed inductively. Participants were incentivized for their time. The average age of the participants was 33.5 (±6.2) years. Of 28 pregnancies, 22 resulted in live births, two ended in miscarriages, two in abortions, and two participants were pregnant during data collection. Three main themes were identified: (1) emotional impact of COVID-19; (2) experiences of COVID-19 illness during pregnancy and postpartum; and (3) impact of COVID-19 mitigation measures on perinatal experiences. The perinatal experiences of Black women during the COVID-19 pandemic revealed critical gaps in our maternal healthcare system. Hence, culturally sensitive and targeted crisis preparedness and readiness strategies, such as community-led response teams, for minority groups during health crises like the COVID-19 pandemic, are warranted.

This article explores the hospital care provided by the Hospitaller Order of Saint John of God in sixteenth- and seventeenth-century Spain, with particular emphasis on its conception of end-of-life care. Rooted in a context deeply shaped by Christian spirituality, the Order developed a holistic model grounded in charity, justice, and profound respect for the dignity of the sick. Through a critical analysis of normative and doctrinal sources, the study reconstructs caregiving practices surrounding dying and post-mortem care, highlighting their institutionalization and the Order's hopeful understanding of death as a transition to eternal life. These practices were codified in detailed regulations concerning the accompaniment of the dying, the administration of sacraments, care for the deceased body, and the offering of suffrages. Employing a hermeneutic lens, the article interprets these practices within their original theological and cultural horizon, consciously avoiding the imposition of contemporary frameworks. Simultaneously, it argues that this historical legacy of ethical and spiritual care can enrich current reflections on death, nursing practice, and the role of institutions in safeguarding human dignity at the end of life.

Across nursing literature and guiding documents, nurses are persistently encouraged to engage in advocacy. Many examples exist, however, of the marked lack of consistency and criticality in how the term advocacy has been conceptualized and operationalized within nursing. In this paper, we first examine the dominant constructions of advocacy in the nursing literature, in service of exploring the benefits and unintended consequences of these constructions. Second, we offer a novel conceptualization of advocacy for the nursing profession, grounded in a philosophically rooted and practice-oriented approach which can be adopted across health care environments from the bedside to policy tables. Overall, greater clarity and consistency among nurses as it relates to advocacy is important for ensuring that we, as a profession, contribute to and draw upon a coherent foundational body of knowledge in nurse-led advocacy efforts.