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What is the purpose of nurse education (and what should it be)? 护士教育的目的是什么(应该是什么)?
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2024-04-30 DOI: 10.1111/nin.12640
Freya Collier‐Sewell, Sebastian Monteux
Can we take the purpose of nurse education for granted, and, more importantly, should we? That is the issue at stake in this paper. The question of purpose is conspicuously absent in the nursing literature; our aim here is to urge that it not be overlooked by demonstrating its importance to the future of nursing. We approach the question of nurse education's purpose in concrete and speculative terms through two distinct yet interrelated questions: what is the purpose of nurse education? and what should it be? Amidst the complexity and uncertainty of our time, we cast doubt on the adequacy of manualised and regulated approaches—ubiquitous in nurse education—to prepare nurses who can meet the challenges of contemporary practice. We also assert that transgressive approaches to education, as the antithesis of manualisation, reach the same impasse by (over)predetermining what the educational ‘output’ will be. To move beyond this impasse, we draw on the theory of Gert Biesta and Ron Barnett to contrast cultivation and existential‐type education. In so doing, we do not seek to provide ‘answers’ to nurse education's purpose but, rather, raise the profile of what we believe is a right and proper question for the discipline to grapple with.
我们能否将护士教育的目的视为理所当然,更重要的是,我们是否应该这样做?这就是本文要讨论的问题。目的问题在护理文献中明显缺失;我们在此的目的是通过展示其对护理未来的重要性,敦促大家不要忽视这一问题。我们通过两个不同但又相互关联的问题来具体和推测护士教育的目的:护士教育的目的是什么?在我们时代的复杂性和不确定性中,我们对护士教育中普遍存在的手工化和规范化方法是否足以培养出能够应对当代实践挑战的护士表示怀疑。我们还断言,作为手工化的对立面,超越性的教育方法(过度)预先确定了教育的 "产出",从而陷入了同样的僵局。为了打破这一僵局,我们借鉴了格特-比埃斯塔(Gert Biesta)和罗恩-巴内特(Ron Barnett)的理论,将培养型教育与存在型教育进行了对比。在这样做的过程中,我们并不是要为护士教育的目的提供 "答案",而是要提高我们对这门学科所要解决的一个正确而恰当的问题的认识。
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引用次数: 0
Older people's experiences of vulnerability in a trust‐based welfare society affected by the COVID‐19 pandemic 受 COVID-19 大流行影响的以信任为基础的福利社会中老年人的弱势体验
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2024-04-30 DOI: 10.1111/nin.12643
Hilde Lausund, Nina Jøranson, Grete Breievne, Marius Myrstad, Kristi Elisabeth Heiberg, Marte Meyer Walle‐Hansen, Anne Kari Tolo Heggestad
The early coronavirus disease 2019 (COVID‐19) outbreak inflicted vulnerability on individuals and societies on a completely different scale than we have seen previously. The pandemic developed rapidly from 1 day to the next, and both society and individuals were put to the test. Older people's experiences of the early outbreak were no exception. Using an abductive analytical approach, the study explores the individual experiences of vulnerability as described by older people hospitalised with COVID–19 in the early outbreak. In these older people, we found that the societal context and the individual experiences of vulnerability were inextricable linked. The study demonstrates that despite significant individual stress, informants displayed an interesting ability to also view their situation to reorient their perspective. The experience of vulnerability is both conditional and individual, which imposes a degree of unpredictability that neither they nor others were able to negotiate. The article discusses the phenomenon of unpredictability in light of a modern society with regard to how individuals and society may encounter unexpected events in the future where the potential to reorient will be vital.
2019 年冠状病毒病(COVID-19)的早期爆发给个人和社会带来了与以往完全不同的脆弱性。疫情从一天迅速发展到第二天,社会和个人都经受了考验。老年人在疫情爆发初期的经历也不例外。本研究采用归纳分析方法,探讨了在疫情爆发初期因感染 COVID-19 而住院的老年人所描述的个人脆弱经历。在这些老年人身上,我们发现社会环境与个人的脆弱体验密不可分。研究表明,尽管个人承受着巨大的压力,但信息提供者也表现出了一种有趣的能力,即他们也能审视自己的处境,重新定位自己的视角。弱势体验既是有条件的,也是个人的,这就带来了一定程度的不可预测性,而他们和其他人都无法对此进行协商。文章从现代社会的角度讨论了不可预测性现象,探讨了个人和社会在未来可能遇到的意外事件,在这些事件中,重新定位的潜力至关重要。
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引用次数: 0
A call for theory‐inspired analysis in qualitative research: Ways to construct different truths in and about healthcare 呼吁在定性研究中进行理论启发式分析:构建医疗保健领域和相关领域不同真相的方法
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2024-04-19 DOI: 10.1111/nin.12642
Stinne Glasdam, Hongxuan Xu, Ragnhild J. A. Gulestø
Over the last 50 years, there has been significant development of qualitative research and related methods in healthcare. Theoretical frameworks support researchers in selecting appropriate research approaches, procedures and analytical tools. However, the implications of the choice of theory are sparsely elucidated. Based on a text excerpt from a public debate article, the study aimed to show how different theory‐inspired analytical perspectives produced varied understandings of the same text. The study presented three subanalyses inspired by Bourdieu's sociological theory, Lazarus and Folkman's psychological theory and utilitarian ethics, respectively. The analyses showed that by using different theoretical analytical perspectives in inductive processes, an immediate interpretation of the text was not obvious. It became possible to spot the underlying meta‐theoretical assumptions, as the interpretations were not taken for granted or indisputable. Our analyses suggest that different theoretical lenses lead to different interpretations of the same empirical material, recognising the existence of multiple truths or realities. Thus, utilising a theoretical perspective in inductive analyses can enhance transparency and rigour because the analytical optics are made explicit to the reader. This allows the reader to follow the analysis processes and comprehend from which theoretical starting point a truth arises.
在过去的 50 年里,医疗保健领域的定性研究和相关方法有了长足的发展。理论框架为研究人员选择适当的研究方法、程序和分析工具提供了支持。然而,理论选择的意义却鲜有阐明。本研究以一篇公开辩论文章的文本节选为基础,旨在说明不同理论启发下的分析视角如何对同一文本产生不同的理解。研究分别从布迪厄的社会学理论、拉扎勒斯和福克曼的心理学理论以及功利主义伦理学角度出发,进行了三项子分析。分析表明,在归纳过程中使用不同的理论分析视角,对文本的直接解释并不明显。由于解释并非理所当然或无可争议,因此有可能发现潜在的元理论假设。我们的分析表明,不同的理论视角会对相同的经验材料做出不同的解释,承认多种真理或现实的存在。因此,在归纳分析中使用理论视角可以提高透明度和严谨性,因为分析视角对读者是明确的。这样,读者就能跟踪分析过程,理解真理是从哪个理论出发点产生的。
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引用次数: 0
Exploring the dark side of informal mentoring: Experiences of nurses and midwives working in hospital settings in Uganda 探索非正式指导的阴暗面:在乌干达医院工作的护士和助产士的经历
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2024-04-12 DOI: 10.1111/nin.12641
Tracy Alexis Kakyo, Lily Dongxia Xiao, Diane Chamberlain
Mentoring literature explores the dark side of mentoring as factors such as gender and race and how they affect the overall mentoring experience. The sociocultural context of the nursing and midwifery professions presents unique characteristics warranting a qualitative exploration of negative mentoring experiences. We aimed to characterise the dark side of mentoring based on informal mentoring relationships occurring among nurses and midwives working in hospitals. Utilising semistructured interviews in a qualitative descriptive design and reflexive thematic analysis, we examined the perceptions of 35 nurses and midwives from three public hospitals located in the Western, Northern and North‐western regions of Uganda. Findings emerged in four overarching themes mentoring process deficits, mentoring relational problems, organisational challenges in mentoring and implications of negative mentoring experiences. Our study findings underscore that, while mentoring is frequently beneficial, it can also be interspersed with negative experiences arising from relational dynamics, particular mentoring processes and the overarching hospital environment. Notably, nurses and midwives actively transformed these challenges into opportunities for growth and self‐improvement, while introspectively examining their roles in contributing to these negative experiences. Such a proactive approach highlights their resilience and steadfast commitment to professional development, even in the face of adversity.
指导文献探讨了指导的阴暗面,如性别和种族因素及其如何影响整体指导体验。护理和助产专业的社会文化背景呈现出独特的特点,因此需要对负面指导经历进行定性研究。我们的目标是根据在医院工作的护士和助产士之间发生的非正式指导关系来描述指导的阴暗面。我们采用半结构式访谈的定性描述设计和反思性主题分析,研究了来自乌干达西部、北部和西北部地区三家公立医院的 35 名护士和助产士的看法。研究结果归纳为四大主题:指导过程中的缺陷、指导关系问题、指导过程中的组织挑战以及负面指导经历的影响。我们的研究结果表明,虽然指导经常是有益的,但也可能因关系动态、特定的指导过程和医院的总体环境而产生负面经验。值得注意的是,护士和助产士积极地将这些挑战转化为成长和自我完善的机会,同时反省自己在促成这些负面经历中所扮演的角色。这种积极主动的做法凸显了她们的韧性和对专业发展的坚定承诺,即使在逆境中也是如此。
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引用次数: 0
Advancing health equity in prelicensure nursing curricula: Findings from a critical review 促进执业前护理课程中的健康公平:严格审查的结果
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2024-04-07 DOI: 10.1111/nin.12629
Anna Graefe, Christine Mueller, Linda Bane Frizzell, Carolyn M. Porta
Nurses play a crucial role in reducing health disparities and advancing health equity for individuals and communities. The future nursing workforce relies on their nursing education to prepare them to promote health equity. Nursing educators prepare students through a variety of andragogical learning strategies in the classroom and in clinical experiences and by intentionally updating and revising curricular content to address knowledge and competency gaps. This critical review aimed to determine the extent to which health equity concepts are explicitly present in prelicensure undergraduate nursing curricula globally. Of 434 articles screened, 22 articles describing 20 studies met inclusion criteria. Frequency and quantity of health equity content, concepts and topics, teaching strategies, evaluation strategies, and the overall extent of integration varied widely. Notably, only two articles described overall well‐integrated explicit health equity content, and there was little attention to whether students transfer this learning into practice. A focus on individualism rather than population and community was noted, highlighting the presence of whiteness in nursing. Results from this review confirm that nursing education has room to improve with respect to health equity in the curricula.
护士在减少健康差距、促进个人和社区的健康公平方面发挥着至关重要的作用。未来的护理人员队伍有赖于护理教育为他们促进健康公平做好准备。护理教育者通过在课堂和临床经验中采用各种教学法学习策略,并有意识地更新和修订课程内容以弥补知识和能力差距,为学生做好准备。本批判性综述旨在确定全球护理本科执照前课程中明确提出健康公平概念的程度。在筛选出的 434 篇文章中,有 22 篇描述 20 项研究的文章符合纳入标准。健康公平内容、概念和主题、教学策略、评估策略的频率和数量,以及整合的总体程度差异很大。值得注意的是,只有两篇文章介绍了整体上整合良好的明确的健康公平内容,而且很少关注学生是否将这些学习内容转化为实践。文章关注的重点是个人主义,而不是人群和社区,这凸显了白人在护理领域的存在。本综述的结果证实,护理教育在课程的健康公平方面还有待改进。
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引用次数: 0
Examining and mitigating racism in nursing using the socio‐ecological model 利用社会生态模式检查和减轻护理工作中的种族主义问题
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2024-04-03 DOI: 10.1111/nin.12639
Iheduru‐Anderson Kechi, Roberta Waite, Teri A. Murray
Racism in nursing is multifaceted, ranging from internalized racism and interpersonal racism to institutional and systemic (or structural) elements that perpetuate inequities in the nursing profession. Employing the socio‐ecological model, this study dissects the underlying challenges across various levels and proposes targeted mitigation strategies to foster an inclusive and equitable environment for nursing education. It advances clear, context‐specific mitigation strategies to cultivate inclusivity and equity within nursing education. Effectively addressing racism within this context necessitates a tailored, multistakeholder approach, impacting nursing students, faculty, administration, professional organizations, and licensing and accrediting bodies. This all‐encompassing strategy recognizes that the interplay of interpersonal dynamics, community culture, institutional policies, and broader societal structures intricately shapes individual experiences. Nurses, nurse leaders, educators, organizations, and policymakers can work together to create a more equitable and inclusive nursing profession by targeting each of these levels. This transformational process can yield positive outcomes across various environments where nurses learn, work, and serve people and enable the demographic composition of nurses to better match the populations served.
护理工作中的种族主义是多方面的,既包括内在化的种族主义和人际间的种族主义,也包括使护理行业不平等现象长期存在的制度性和系统性(或结构性)因素。本研究采用社会生态模式,剖析了各个层面的潜在挑战,并提出了有针对性的缓解策略,以营造一个包容、公平的护理教育环境。它提出了明确的、针对具体情况的缓解策略,以培养护理教育的包容性和公平性。要在这种背景下有效解决种族主义问题,就必须采取有针对性的、多方参与的方法,影响到护理专业的学生、教师、管理部门、专业组织以及许可和评审机构。这种全方位的策略认识到,人际动态、社区文化、机构政策和更广泛的社会结构之间的相互作用错综复杂地影响着个人的经历。护士、护士长、教育者、组织和决策者可以通过针对上述各个层面的努力,共同创建一个更加公平、更具包容性的护理行业。这一转变过程可以在护士学习、工作和服务的各种环境中产生积极的成果,并使护士的人口构成与所服务的人群更加匹配。
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引用次数: 0
The discourse of delivering person-centred nursing care before, and during, the COVID-19 pandemic: Care as collateral damage. 在 COVID-19 大流行之前和期间提供以人为本的护理服务的论述:作为附带损害的护理。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-04-01 Epub Date: 2023-08-15 DOI: 10.1111/nin.12593
Amy-Louise Byrne, Clare Harvey, Adele Baldwin

The global COVID-19 pandemic challenged the world-how it functions, how people move in the social worlds and how government/government services and people interact. Health services, operating under the principles of new public management, have undertaken rapid changes to service delivery and models of care. What has become apparent is the mechanisms within which contemporary health services operate and how services are not prioritising the person at the centre of care. Person-centred care (PCC) is the philosophical premise upon which models of health care are developed and implemented. Given the strain that COVID-19 has placed on the health services and the people who deliver the care, it is essential to explore the tensions that exist in this space. This article suggests that before the pandemic, PCC was largely rhetoric, and rendered invisible during the pandemic. The paper presents an investigation into the role of PCC in these challenging times, adopting a Foucauldian lens, specifically governmentality and biopolitics, to examine the policies, priorities and practical implications as health services pivoted and adapted to changing and acute demands. Specifically, this paper draws on the Australian experience, including shifting nursing workforce priorities and additional challenges resulting from public health directives such as lockdowns and limitations. The findings from this exploration open a space for discussion around the rhetoric of PCC, the status of nurses and that which has been lost to the pandemic.

COVID-19 在全球的流行对世界提出了挑战--世界如何运作,人们如何在社会世界中活动,以及政府/政府服务和人们如何互动。在新公共管理原则下运作的医疗卫生服务机构迅速改变了服务方式和医疗模式。显而易见的是当代医疗服务的运作机制,以及医疗服务如何没有把人放在护理的中心位置。以人为本的护理(PCC)是制定和实施医疗护理模式的哲学前提。鉴于 COVID-19 对医疗服务和提供医疗服务的人员造成的压力,有必要探讨这一领域存在的紧张关系。本文认为,在大流行之前,PCC 在很大程度上是空谈,而在大流行期间则变得无影无踪。本文采用福柯学派的视角,特别是政府性和生物政治学的视角,对 PCC 在这一充满挑战的时期所扮演的角色进行了调查,以研究在医疗服务转向并适应不断变化的紧急需求时的政策、优先事项和实际影响。具体而言,本文借鉴了澳大利亚的经验,包括护理人员工作重点的变化以及公共卫生指令(如封锁和限制)带来的额外挑战。本文的探讨结果为围绕 PCC 的言论、护士的地位以及大流行病所造成的损失展开讨论开辟了空间。
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引用次数: 0
'They tried to evil me': An explanatory model for Black Africans' mental health challenges. “他们试图伤害我”:一个解释非洲黑人心理健康挑战的模型。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-04-01 Epub Date: 2023-09-21 DOI: 10.1111/nin.12602
Isaac Tuffour

This paper explores the explanatory models of mental challenges among Black Africans in England. It argues that understanding these models is critical for providing culturally appropriate care to this population. The study employed qualitative methodology, and interpretative phenomenological analysis (IPA). Twelve mental health service users who are living in England and self-identified as first or second-generation Black Africans were purposively selected. The data were gathered using face-to-face semistructured interviews. Data were manually analysed in accordance with IPA concepts of searching for common, unique and idiosyncratic themes across transcripts. The findings revealed three themes Black Africans associated to their explanatory model of mental health challenges: complexities of migration, African-centred worldview and negative life experiences. To help alleviate the Eurocentric nature of mental health practice in England, it is hoped that this explanatory model will become an integral part of mental health practice in England and around the world.

本文探讨了英国非洲黑人心理挑战的解释模型。它认为,了解这些模式对于为这一人群提供文化上合适的护理至关重要。该研究采用了定性方法和解释性现象学分析(IPA)。有意选择了12名居住在英国并自称为第一代或第二代非洲黑人的心理健康服务使用者。这些数据是通过面对面的半结构化访谈收集的。数据是根据IPA在转录本中搜索共同、独特和特殊主题的概念进行手动分析的。研究结果揭示了与非洲黑人心理健康挑战解释模型相关的三个主题:移民的复杂性、以非洲为中心的世界观和负面生活经历。为了帮助缓解英国心理健康实践以欧洲为中心的性质,希望这种解释性模型将成为英国和世界各地心理健康实践的一个组成部分。
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引用次数: 0
Why and how is photovoice used as a decolonising method for health research with Indigenous communities in the United States and Canada? A scoping review. 在美国和加拿大,摄影语音为什么以及如何被用作与土著社区进行健康研究的非殖民化方法?范围审查。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-04-01 Epub Date: 2023-10-08 DOI: 10.1111/nin.12605
Rebecca Vining, Mairéad Finn

Globally, including in North America, Indigenous populations have poorer health than non-Indigenous populations. This health disparity results from inequality and marginalisation associated with colonialism. Photovoice is a community-based participatory research method that amplifies the voices of research participants. Why and how photovoice has been used as a decolonising method for addressing Indigenous health inequalities has not been mapped. A scoping review of the literature on photovoice for Indigenous health research in the United States and Canada was carried out. Five electronic databases and the grey literature were searched, with no time limit. A total of 215 titles and abstracts and 97 full texts were screened resulting in 57 included articles. Analysis incorporated Lalita Bharadwaj's Framework For Building Research Partnerships with First Nations Communities. Photovoice was selected to improve knowledge mobilisation and participant empowerment and engagement. Studies incorporated relationship building, meaningful data collection, and public dissemination but had a lesser focus on the inclusion of Indigenous peer researchers or participant involvement in analysis. For photovoice to truly realise its decolonising potential, it must be incorporated into a broader participatory and decolonising research paradigm. In addition, more resources are required to support the involvement of Indigenous people in the research process.

在全球范围内,包括在北美,土著人口的健康状况比非土著人口差。这种健康差距源于殖民主义带来的不平等和边缘化。Photovoice是一种基于社区的参与式研究方法,它放大了研究参与者的声音。为什么以及如何将摄影语音作为解决土著健康不平等问题的非殖民化方法,尚未绘制地图。对美国和加拿大土著健康研究的摄影语音文献进行了范围审查。检索了五个电子数据库和灰色文献,没有时间限制。共筛选了215篇标题和摘要以及97篇全文,共收录57篇文章。分析纳入了Lalita Bharadwaj的《与原住民社区建立研究伙伴关系框架》。选择Photovoice是为了提高知识动员、增强参与者的能力和参与度。研究包括建立关系、有意义的数据收集和公共传播,但较少关注土著同行研究人员或参与者参与分析。为了让摄影之声真正实现其非殖民化潜力,必须将其纳入更广泛的参与性和非殖民化研究范式。此外,还需要更多的资源来支持土著人民参与研究过程。
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引用次数: 0
Socialisation of children to nurse and nursing images: A Goffman-inspired thematic analysis of children's picture books in a Swedish context. 儿童对护士和护理形象的社会化:Goffman启发的瑞典背景下儿童绘本主题分析。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-04-01 Epub Date: 2023-09-28 DOI: 10.1111/nin.12603
Stinne Glasdam, Hongxuan Xu, Sigrid Stjernswärd

Picture books are often part of children's socialisation processes, contributing to the children forming images of the world, including ideas about (categories of) people, such as nurses. The study aims to explore how nurses/nursing are portrayed in children's picture books in a Swedish context. Through a systematic search, 44 books were included for analysis using thematic analysis and a theoretical lens inspired by Goffman. The results were presented in three themes: 'The costume characterised and designated nurses', 'Nurses and nursing were defined through specific activities and accessories', and 'Nurses' role as caregivers and decency practitioners'. The results showed that nurses were depicted/described in varied contexts, performing their roles mainly front stage in 'hands-on work' in close contact with patients and relatives. Nurses were attributed different accessories and personality characteristics. Nurses/nursing were generally set within a healthcare context, oftentimes within an overarching medical logic. Historical depictions of nurses' uniforms still appeared as a signifier for nurses/nursing. The presentation of nurses/nursing might have potential implications on children's understanding of and for reputations of nurses/nursing in the long term as primary socialisation and related understandings of the (sub)world(s) are deeply rooted in humans.

图画书通常是儿童社交过程的一部分,有助于儿童形成世界形象,包括关于(类别)人的想法,如护士。本研究旨在探讨瑞典背景下儿童绘本中护士/护理人员的形象。通过系统搜索,收录了44本书,采用主题分析和受戈夫曼启发的理论视角进行分析。研究结果分为三个主题:“服装的特点和指定护士”,“护士和护理是通过特定的活动和配件来定义的”,以及“护士作为护理人员和礼仪从业者的角色”。结果显示,护士在不同的背景下被描述/描述,主要在与患者和亲属密切接触的“动手工作”的前台履行职责。护士被赋予不同的配饰和个性特征。护士/护理通常是在医疗保健背景下设置的,通常是在总体医疗逻辑中设置的。护士制服的历史描述仍然是护士/护理的象征。从长远来看,护士/护士的介绍可能会对儿童对护士/护理的理解和声誉产生潜在影响,因为初级社会化和对(亚)世界的相关理解深深植根于人类。
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引用次数: 0
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Nursing Inquiry
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