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Development Practices in Senior Nursing and Midwifery Leadership: Pathways to Improvement in South Pacific Health Policy. 高级护理和助产领导的发展实践:改善南太平洋卫生政策的途径。
IF 1.8 Q2 HEALTH POLICY & SERVICES Pub Date : 2022-08-01 DOI: 10.1177/15271544221095768
Michele Rumsey, Elizabeth Iro, Di Brown, Michael Larui, Harriet Sam, Fiona Brooks

The Pacific Islands countries consist of thousands of isolated islands with a combined population of over 10 million people. It is a heterogeneous and diverse region culturally, linguistically economically and politically. Health challenges are considerable and healthcare systems are often overstretched. Framed in the context of the World Health Organisation's strategic directions and policy priorities, this paper describes an account of collaboration across these countries to develop leadership skills in the nursing and midwifery professions. It outlines lessons for nursing leadership, healthcare policy development and the valuable role of Government Chief Nursing and Midwifery Officers. The South Pacific Chief Nursing and Midwifery Officers Alliance (SPCNMOA) is a cooperative partnership, which was formed to improve the quality of healthcare in the region. It acts as an enabler to promote leadership skills and provide a safe space for learning, developing policy and the sharing of good practice. Through mentorship programs, international meetings and strong relationship-building, the SPCNMOA has strengthened partnerships within the region and improved community health services in even the most remote areas. By strengthening leadership and collaboration, these health professionals are now recognised by key policy makers as knowledgeable experts who have a legitimate role in guiding policy development, changing practice and delivering health policy improvements at local, country and international levels.

太平洋岛国由数千个孤立的岛屿组成,总人口超过1000万。它是一个在文化、语言、经济和政治上异质多样的地区。卫生方面的挑战相当大,卫生保健系统往往超负荷运转。在世界卫生组织的战略方向和政策重点的背景下,本文描述了这些国家在发展护理和助产专业领导技能方面的合作。它概述了护理领导、保健政策制定和政府首席护理和助产官的宝贵作用的经验教训。南太平洋首席护理和助产官联盟(SPCNMOA)是一个合作伙伴关系,其成立是为了提高该地区的保健质量。它起到促进领导技能的作用,并为学习、制定政策和分享良好做法提供安全空间。通过指导方案、国际会议和建立牢固的关系,SPCNMOA加强了区域内的伙伴关系,改善了甚至是最偏远地区的社区卫生服务。通过加强领导和协作,这些卫生专业人员现在被主要决策者视为知识渊博的专家,在地方、国家和国际各级指导政策制定、改变做法和改进卫生政策方面具有合法作用。
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引用次数: 2
A Theoretically Derived Approach to Impact: Implementing Policy Influence Strategies 影响的理论推导方法:实施政策影响战略
IF 1.8 Q2 HEALTH POLICY & SERVICES Pub Date : 2022-06-03 DOI: 10.1177/15271544221100164
P. de Raeve, Francesco Bolzonella, Patricia M. Davidson
Advocacy is an intentional act of influencing government and an important precondition for successful policy change in society. Drawing from an existing framework on policy influence, we propose an approach to quantifying the impact of policy influence efforts, specifically within the context of European Public Health (EPH) advocacy. The analysis hinges on the article “Moving from tokenism” which provides a starting point to conceptualize strategies to quantify impact. An exploratory case study approach allowed to integrate literature on advocacy evaluation in parallel with the internal documentation of a EPH advocacy organization We provide recommendations to advocacy organizations that aim to create an infrastructure towards quantifying the impact of their efforts. The framework is mostly tailored to the needs of EPH advocacy, but it can also have resonance beyond the scope of a specific sector.
倡导是一种有意影响政府的行为,是成功改变社会政策的重要前提。根据现有的政策影响框架,我们提出了一种量化政策影响努力影响的方法,特别是在欧洲公共卫生(EPH)倡导的背景下。这一分析取决于文章“从象征主义移动”,这为概念化量化影响的策略提供了一个起点。探索性案例研究方法允许将倡导评估的文献与EPH倡导组织的内部文件相结合。我们向倡导组织提供建议,旨在创建一个量化其努力影响的基础设施。该框架主要是根据EPH宣传的需要量身定制的,但它也可以在特定部门范围之外产生共鸣。
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引用次数: 1
Differences in Hospitals' Workplace Violence Incident Reporting Practices: A Mixed Methods Study. 医院工作场所暴力事件报告做法的差异:混合方法研究。
IF 2.1 Q2 HEALTH POLICY & SERVICES Pub Date : 2022-05-01 Epub Date: 2022-03-23 DOI: 10.1177/15271544221088248
Rachel Odes, Susan Chapman, Sara Ackerman, Robert Harrison, OiSaeng Hong

Workplace violence (WV) is a significant and growing problem for health care workers. Increased recognition of the need for improved protections has led to policy initiatives at the state and federal levels, including national Joint Commission requirements that went into effect January 2022. California's WV prevention legislation was phased in during 2017-2018 and requires hospitals to use a new incident reporting system, the Workplace Violent Incident Reporting System (WVIRS) for Hospitals. We analyzed WVIRS data collected during the first three years of its implementation, July 1, 2017 - June 30, 2020. In addition, we collected qualitative data from six California hospitals/hospital systems during 2019-2020 to better understand reporting practices. Over the three-year period, the 413 hospitals using the WVIRS reported between zero and six incidents per staffed bed. Sixteen hospitals (3.9%) reported two or more incidents per staffed bed while the rest reported fewer than two incidents. Qualitative analysis identified that reporting procedures vary considerably among hospitals. Several organizations rely on workers to complete incident reports electronically while others assign managers or security personnel to data collection. Some hospitals appear to report only those incidents involving physical harm to the worker. Regulatory guidance for reporting practices and hospitals' commitment to thorough data collection may improve consistency. As hospitals throughout the U.S. consider practice changes to comply with new WV standards, those engaged in implementation efforts should look closely at reporting practices. Greater consistency in reporting across facilities can help to build evidence for best practices and lead to safety improvements.

工作场所暴力(WV)是医疗工作者面临的一个日益严重的问题。越来越多的人认识到需要改善保护措施,这导致了州和联邦层面的政策倡议,包括 2022 年 1 月生效的国家联合委员会要求。加利福尼亚州的 WV 预防立法在 2017-2018 年期间逐步实施,并要求医院使用新的事件报告系统,即医院工作场所暴力事件报告系统(WVIRS)。我们分析了 WVIRS 实施前三年(2017 年 7 月 1 日至 2020 年 6 月 30 日)收集的数据。此外,我们还收集了 2019-2020 年期间六家加州医院/医院系统的定性数据,以更好地了解报告实践。在这三年期间,使用 WVIRS 的 413 家医院报告了每张员工床位零至六起事件。16 家医院(3.9%)报告每张病床发生两起或更多事件,其余医院报告的事件少于两起。定性分析发现,各医院的报告程序差异很大。有几家医院依靠员工以电子方式完成事件报告,而其他医院则指派管理人员或安保人员负责数据收集。有些医院似乎只报告那些对工人造成人身伤害的事件。对报告实践的监管指导和医院对全面数据收集的承诺可能会提高一致性。当美国各地的医院考虑改变做法以符合新的威望标准时,那些参与实施工作的医院应该仔细研究报告做法。提高各机构报告的一致性有助于为最佳实践提供证据,从而提高安全性。
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引用次数: 0
Structural Racism in America: A Summative Content Analysis of National Nursing Organization Statements 美国的结构性种族主义:国家护理组织声明的总结性内容分析
IF 1.8 Q2 HEALTH POLICY & SERVICES Pub Date : 2022-04-04 DOI: 10.1177/15271544221089657
Naila C Russell, Sherrie Flynt Wallington
The public and brutal death of Black American George Floyd was a tragedy that had the potential to push the profession of nursing toward a perspective transformation. A summative content analysis of 49 professional nursing organization statements served as a pilot to explore the research question: Did the nursing profession experience a perspective transformation relating to racial justice and health equity following the death of George Floyd? Texts from the statements were analyzed for the presence of an equity lens, which is necessary for a perspective transformation. Each statement was assigned a rating score to determine the organization's readiness for a perspective transformation based on equity competencies adapted from CommonHealth Action. Findings demonstrated that the nursing profession is beginning to articulate the issue of racism in health care and is committed to advocating for patients of color; however, further understanding of the historical context of structural racism and the development of meaningful policy remains necessary for the profession to experience a perspective transformation.
美国黑人乔治·弗洛伊德(George Floyd)公开而残酷的死亡是一场悲剧,它有可能推动护理专业走向观点转变。摘要对49个专业护理组织声明的总结性内容分析作为试点,以探讨研究问题:在乔治·弗洛伊德去世后,护理专业是否经历了与种族正义和健康公平相关的观点转变?对来自报表的文本进行分析,以确定是否存在公平镜头,这对于透视转换是必要的。每个陈述都被分配了一个评级分数,以确定组织是否准备好进行基于“共同健康行动”改编的公平能力的观点转换。研究结果表明,护理专业开始阐明医疗保健中的种族主义问题,并致力于倡导有色人种患者;然而,进一步了解结构性种族主义的历史背景和制定有意义的政策对于该专业经历观点转变仍然是必要的。
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引用次数: 4
The European Standard EN 17398:2020 on Patient Involvement in Health Care – a Fairclough-Inspired Critical Discourse Analysis 关于患者参与医疗保健的欧洲标准EN 17398:2020 - fairclough启发的关键话语分析
IF 1.8 Q2 HEALTH POLICY & SERVICES Pub Date : 2022-03-21 DOI: 10.1177/15271544221088250
Sigrid Stjernswärd, S. Glasdam
The concept of ‘patient involvement’ is highlighted in healthcare. However, hindrances can prevent its implementation. This article explored how ‘patient involvement’ is understood and on what ideas this understanding is based through a critical textual analysis of the European document on patient involvement in health systems using a Fairclough-inspired critical discourse analysis. The findings showed that the document arose from a social discourse based on a mix of a neoliberal ideology, with a marketisation of care focusing on a cost-effective and evidence-based logic of care, and a humanistic ideology of patient involvement. It had the form of a normative, consensus-based standard, supported by European organisations. The document incorporated a visionary, well-intentioned abstract guide to promote patient involvement across European care contexts, however without addressing hindrances nor differences across the contexts in which it ought to be implemented. It raises questions about its usability, inviting further research into empirical applications.
“患者参与”的概念在医疗保健中得到强调。然而,障碍可能会阻碍其实施。本文探讨了“患者参与”是如何被理解的,以及这种理解是基于什么思想,通过对欧洲关于患者参与卫生系统的文件的批判性文本分析,使用费尔克劳夫启发的批判性话语分析。研究结果表明,该文件源于一种基于新自由主义意识形态、注重成本效益和循证护理逻辑的护理市场化以及患者参与的人文主义意识形态的社会话语。它的形式是一种规范性的、基于共识的标准,得到了欧洲组织的支持。该文件纳入了一份富有远见、用心良苦的抽象指南,以促进患者在整个欧洲护理环境中的参与,但没有解决应实施该指南的障碍或差异。它引发了人们对其可用性的质疑,从而引发了对实证应用的进一步研究。
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引用次数: 1
Social Construction of Target Populations: A Theoretical Framework for Understanding Policy Approaches to Perinatal Illicit Substance Screening. 目标人群的社会建构:理解围产期非法物质筛查政策途径的理论框架。
IF 1.8 Q2 HEALTH POLICY & SERVICES Pub Date : 2022-02-01 DOI: 10.1177/15271544211067781
Norlissa M Cooper, Audrey Lyndon, Monica R McLemore, Ifeyinwa V Asiodu

Perinatal illicit substance use is a nursing and public health issue. Current screening policies have significant consequences for birthing individuals and their families. Racial disparities exist in spite of targeted and universal screening policies and practices. Thus, new theoretical approaches are needed to investigate perinatal illicit substance use screening in hospital settings. The purpose of this analysis is to evaluate the social construction of target populations theory in the context of perinatal illicit substance use screening. Using the theoretical insights of this theory to interrogate the approaches taken by policy makers to address perinatal illicit substance use and screening provides the contextual framework needed to understand why specific policy tools were selected when designing public policy to address these issues. The analysis and evaluation of this theory was conducted using the theory description and critical reflection model.

围产期非法药物使用是一个护理和公共卫生问题。目前的筛查政策对生育个体及其家庭产生了重大影响。尽管有针对性和普遍的筛查政策和做法,种族差异仍然存在。因此,需要新的理论方法来调查围产期非法药物使用筛选在医院设置。本分析的目的是评价围产期非法药物使用筛查背景下目标人群理论的社会建构。利用这一理论的理论见解来询问政策制定者为解决围产期非法药物使用和筛查所采取的方法,提供了理解在设计公共政策以解决这些问题时为什么选择特定政策工具所需的背景框架。运用理论描述和批判性反思模型对该理论进行了分析和评价。
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引用次数: 2
How diverse and inclusive are policy process theories? 政策过程理论的多样性和包容性如何?
IF 1.8 Q2 HEALTH POLICY & SERVICES Pub Date : 2022-01-01 DOI: 10.1332/030557321x16309516764367
Tanya Heikkila, Michael D. Jones
Numerous published efforts have compared and contrasted policy process theories. Few assessments, however, have examined the extent to which they are inclusive or diverse. Here we summarise lessons from previous assessments, paying attention to how Paul Sabatier’s science-based criteria have shaped the contours of the field. In looking at these contours, we explore evidence of diversity and inclusivity of policy process approaches in terms of methods, concepts, topics, geography and authors. We conclude with strategies to address challenges revealed by our examination: creating space for conversations among scholars of differing perspectives and approaches; building sustained and meaningful efforts to recruit and train researchers with diverse backgrounds; establishing research coordination networks that focus on policy problems; and creating better metrics to assess our diversity and inclusivity.
许多已发表的文章对政策过程理论进行了比较和对比。然而,很少有评估审查了它们在多大程度上具有包容性或多样性。在这里,我们总结了以前评估的经验教训,关注Paul Sabatier基于科学的标准如何塑造了该领域的轮廓。在研究这些轮廓时,我们从方法、概念、主题、地理和作者等方面探索了政策过程方法的多样性和包容性的证据。最后,我们提出了应对我们的研究所揭示的挑战的策略:为不同观点和方法的学者之间的对话创造空间;建立持续和有意义的努力,招募和培训具有不同背景的研究人员;建立以政策问题为重点的研究协调网络;创造更好的指标来评估我们的多样性和包容性。
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引用次数: 4
Analysing boundaries of health and social care in policy and media reform narratives 分析政策和媒体改革叙述中卫生和社会保健的界限
IF 1.8 Q2 HEALTH POLICY & SERVICES Pub Date : 2022-01-01 DOI: 10.1332/030557321x16420783121324
Sarah van Duijn, D. Bannink, H. Nies
Collaboration has become an imperative of many new healthcare policies; however, little attention has been paid to how system-level narratives in both policy documents and the media create boundaries that shape implementation processes. By using boundary work as a theoretical lens, this article critically analyses the discourse found in both policy documents and the media surrounding the 2015 Dutch LTC reform. This discourse analysis contributes, first, by revealing two separate narratives – one epic, one tragic – which we argue represent different rhetorical styles used to (de-)legitimise symbolic boundaries. Second, we contribute by unravelling boundary work in both the social and symbolic dimensions to show how the design of the 2015 reform led to a tension-ridden position for local actors: symbolic boundaries demanded integration, while social boundaries imposed differentiation. These findings have implications for literature on boundary work as well as for policy design and its local implementation.
协作已成为许多新医疗保健政策的必要条件;然而,很少注意到政策文件和媒体中的系统级叙述如何形成影响执行过程的界限。本文以边界工作为理论视角,批判性地分析了围绕2015年荷兰LTC改革的政策文件和媒体中的话语。这种话语分析的贡献在于,首先,揭示了两种不同的叙事——一种是史诗,一种是悲剧——我们认为这两种叙事代表了不同的修辞风格,用于使象征性边界合法化。其次,我们通过在社会和象征维度上展开边界工作,展示2015年改革的设计如何导致地方行动者的紧张处境:象征边界要求整合,而社会边界则强加分化。这些发现对边界工作的文献以及政策设计及其地方实施具有启示意义。
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引用次数: 1
How partisan politics influence government policies in response to ageing populations 党派政治如何影响政府应对人口老龄化的政策
IF 1.8 Q2 HEALTH POLICY & SERVICES Pub Date : 2022-01-01 DOI: 10.1332/030557321x16316356206483
Yesola Kweon, Kohei Suzuki
Since old-age programmes mitigate life-course risks that are relevant to individuals across socio-economic groups in ageing societies, all parties have a political incentive to support these initiatives. Nevertheless, pre-existing partisan commitments bind the policy instruments that parties use. Cabinet-level analyses of OECD economies demonstrate that left incumbency relies more on public expenditure than right-wing governments. What is more important is that, in the context of large elderly populations, pension coverage is greater under right-leaning governments, while pension replacement rates are higher in left-leaning governments. This shows that party behaviour related to life course-related policies cannot be explained by the conventional pro-expansion versus the pro-retrenchment partisan politics. Rather, a focus on partisan variation in the use of policy instruments is required.
由于老年方案减轻了与老龄化社会各社会经济群体个人有关的生命过程风险,所有各方都有支持这些倡议的政治动机。然而,预先存在的党派承诺约束了政党使用的政策工具。对经合组织经济体的内阁级分析表明,左翼政府比右翼政府更依赖公共支出。更重要的是,在老年人口众多的背景下,右倾政府的养老金覆盖面更大,而左倾政府的养老金替代率更高。这表明,与生命历程相关的政党行为不能用传统的支持扩张与支持紧缩的党派政治来解释。相反,需要关注政策工具使用中的党派差异。
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引用次数: 0
Making interpretive policy analysis critical and societally relevant: emotions, ethnography and language 使解释性政策分析关键和社会相关:情感,民族志和语言
IF 1.8 Q2 HEALTH POLICY & SERVICES Pub Date : 2022-01-01 DOI: 10.1332/030557321x16129850569011
Anna P. Durnová
This article summarises the main achievements of interpretive approaches to policy analysis and signposts ways to develop them to strengthen inclusivity and diversity. By visualising tangible strategies used in the approach, it demonstrates how we can better understand how policies are made and understood. At the same time, the article places a strong focus on emotions and ethnography as a way to strengthen the societal relevance of the approach. Focusing on emotions in policy research goes beyond a simple interest in emotions, using them as a specific critical lens to view the researched phenomenon while considering how policy ideas are framed as relevant or irrelevant through expressive language. Analogously, the article describes ethnography as an epistemological lens for analysing policy wherein researchers embrace human bias and the normativity of their research. To illustrate how these two lenses work in practice, the article concludes by discussing the research design of an analysis of the role of fathers in the policy debate around birth care in Czechia.
本文总结了政策分析解释性方法的主要成果,并指出了发展这些方法以加强包容性和多样性的途径。通过可视化方法中使用的具体战略,它展示了我们如何更好地理解政策是如何制定和理解的。与此同时,本文将重点放在情感和人种学上,作为加强该方法的社会相关性的一种方式。在政策研究中关注情绪超越了对情绪的简单兴趣,将它们作为一个特定的批判性镜头来看待所研究的现象,同时考虑如何通过表达性语言将政策思想框定为相关或不相关。类似地,本文将民族志描述为分析政策的认识论镜头,其中研究人员接受人类偏见和他们的研究的规范性。为了说明这两个镜头在实践中是如何工作的,文章最后讨论了父亲在捷克生育护理政策辩论中的作用分析的研究设计。
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引用次数: 5
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