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Sherman AD, Febres-Cordero S, Bonds Johnson K, Clark KD, Klepper M, Duroseau B, Lin Y, Zhang W, Coleman M, Prakash D, Daniel GA, Chand AT, Kalu U, Tarter R, Allgood S, Cohen S, Kelly U, Balthazar M. Intersectionality in nursing research: A scoping review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2023; 5:100155. [PMID: 37982092 PMCID: PMC10655863 DOI: 10.1016/j.ijnsa.2023.100155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 11/21/2023] Open
Abstract
Background An intersectional approach to health research provides an analytical foundation to explain the multidimensionality of health status, resource accessibility, privilege, oppression, and current and historical context. The use of intersectionality in health research has known limitations. Its use in health-related fields too often focuses on outcomes, such as health disparities, rather than processes, such as power structures and social determinants. Objective This scoping review serves to examine how intersectionality has been implemented by nurses in the peer-reviewed literature. We offer insight into how it may be incorporated to inform future nursing research and healthcare provision. Design & Methods Systematic searches of PubMed (n = 257), SCOPUS (n = 807), EMBASE (n = 396), CINAHL (n = 224), and Health Source: Nursing and Academics (n = 491), published since the seminal publication on intersectionality (1989 - 2023), identified 131 research articles that met inclusion and exclusion criteria. Data extraction and synthesis were used to describe the breadth and depth of the literature specific to the application of intersectionality in nursing research. Results The included studies used intersectionality to examine the intersections of numerous identities, such as race, gender, and immigration status. However, most studies were descriptive/observational in nature, underreported their methods, and conducted deficit-based research instead of strength-based inquiries. Of note, the vast majority of included articles were published within the last five years. Conclusions Future researchers using intersectionality as a framework can improve their approach by reporting clear definitions and operationalization of intersectionality. Observational science dominated the included studies; future research should focus on intervention development and evaluation using an intersectional lens. Lastly, caution should be placed on research that focuses solely on deficits among marginalized communities, which places scientists at risk of perpetuating stereotypes or enhancing already-existing stigmas.
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Affiliation(s)
- Athena D. F. Sherman
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Sarah Febres-Cordero
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Kalisha Bonds Johnson
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Kristen D. Clark
- Department of Nursing, University of New Hampshire, Durham, NH, USA
| | | | | | - Yufen Lin
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Wenhui Zhang
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Mercy Coleman
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Diane Prakash
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Gaea A. Daniel
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Arzina Tabassum Chand
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Ugo Kalu
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Robin Tarter
- Oregon Health and Science University, Portland, OR, USA
| | | | - Sydney Cohen
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Ursula Kelly
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
- Atlanta VA Health Care System, Atlanta, Georgia, USA
| | - Monique Balthazar
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
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Chi W, Nguyen B, Ma Q, Gray D, Bailly E, LoSasso A, Agrawal S. Impact of COVID-19 on Behavioral Health Services Use Among Medicaid Enrollees with Chronic Behavioral Needs by Race and Ethnicity. Popul Health Manag 2023; 26:325-331. [PMID: 37676993 DOI: 10.1089/pop.2023.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023] Open
Abstract
The COVID-19 pandemic may widen the disparities in access to behavioral health (BH) services among groups that have been historically marginalized. However, the rapid expansion of telehealth presents an opportunity to reduce these disparities. The objective was to assess the impact of COVID-19 on BH visits, including in-person and telehealth, and BH treatments by different race and ethnicity groups. This was a retrospective, observational study using administrative claim data. Two cohorts were created: a before-COVID-19 group and a during-COVID-19 group. A difference-in-differences analysis was conducted to assess the access to BH-related visits between the 2 groups by different race and ethnicity groups. The study sample included 90,268 patients aged 18 to 64 years with repeated BH diagnoses in baseline periods and continuous medical and pharmacy enrollment. During the pandemic, BH telehealth visits surged, whereas the overall utilization of BH services, mental health medication, and counseling declined among all racial groups as the BH telehealth increase did not fully compensate for the reduction of in-person visits. Latino patients had a higher likelihood of using BH telehealth visits than White patients. However, Black patients had a lower likelihood of using substance use disorder (SUD) treatment than their White counterparts. Our results also suggested that care continuation and pre-established care-seeking behaviors are associated with increasing BH visits and treatments. As policy makers and payers are expanding offerings of telehealth visits, it is imperative to do so through a health equity lens and center the needs of groups that have been economically and socially marginalized to advance equitable adoption of telehealth.
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Affiliation(s)
- Winnie Chi
- Department of Health Services Research, Elevance Health, Inc., Indianapolis, Indiana, USA
| | - Binh Nguyen
- Department of Health Services Research, Elevance Health, Inc., Indianapolis, Indiana, USA
| | - Qinli Ma
- Department of Health Services Research, Elevance Health, Inc., Indianapolis, Indiana, USA
| | - Darrell Gray
- Department of Health Outcomes Organizations, and Elevance Health, Inc., Indianapolis, Indiana, USA
| | - Eric Bailly
- Department of Behavioral Health, Elevance Health, Inc., Indianapolis, Indiana, USA
| | - Anthony LoSasso
- Department of Economics, DePaul University, Chicago, Illinois, USA
| | - Shantanu Agrawal
- Department of Health Outcomes Organizations, and Elevance Health, Inc., Indianapolis, Indiana, USA
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Women service users' experiences of inpatient mental health services and staff experiences of providing care to women within inpatient mental health services: A systematic review of qualitative evidence. Int J Nurs Stud 2021; 118:103920. [PMID: 33857788 DOI: 10.1016/j.ijnurstu.2021.103920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/21/2021] [Accepted: 02/24/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND With austerity measures and cuts to community mental health services, more women are accessing UK inpatient mental health services. Inpatient services have been found to lead to further retraumatisation for women, exacerbating mental health conditions. However, recent reviews of service user experiences of inpatient services have neglected the unique perspectives of women and have omitted important dynamics in attitudes and experience between staff and women service users. OBJECTIVES The aim of this systematic review was to synthesise women service users' experiences of inpatient mental health services and staff experiences of providing care to women within inpatient mental health services, to appraise the methodological quality of research in this area and provide recommendations for clinical practice and future research. REVIEW METHODS A systematic search of the literature was undertaken in the databases: AMED, CINAHL plus, Embase and PsychINFO. The Critical Appraisal Skills Programme checklist for qualitative research was used to evaluate data quality. Thematic synthesis was conducted on papers meeting the inclusion criteria. RESULTS Eighteen studies were identified and encapsulated the views of 168 staff and 187 service users, with one paper including both staff and service user samples. Three themes derived from the data: Safe haven, Broken system and Therapeutic milieu. Safe haven related to aspects of care such as relational security which made women feel safer in hospital. Broken system pertained to experiences of being fearful of inpatient environments, inadequate acknowledgement of abuse histories, women feeling coerced into compliance with medication and systemic pressures of services being under-resourced. The therapeutic milieu of inpatient services was an important mediator of women experiencing the environment as a 'safe haven' or 'broken system'. Staff and women service users reflected on: the impact on social roles, interaction of peers, physical environment and the importance of meaningful activity, which were deemed to be important contributors to the therapeutic milieu. CONCLUSIONS The review made recommendations to improve future research by encouraging studies to include more detail on reflexivity (including the relationship between researcher and participant) and provide more information on the methodological approach to data analysis. Clinical recommendations include: ensuring staff access clinical supervision, for staff to receive training in exploring and supporting women disclosing experiences of abuse, for staff to facilitate choice within inpatient settings and support women in maintaining relationships, particularly parenting roles. REGISTRATION PROSPERO database (CRD42020156222).
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Sy A, Moglia B, Aragunde G, Derossi P. Emergency care under the magnifying glass: a review of ethnographic studies in the scientific literature on hospital emergency services. CAD SAUDE PUBLICA 2021; 37:e00026120. [PMID: 33503159 DOI: 10.1590/0102-311x00026120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 09/23/2020] [Indexed: 12/20/2022] Open
Abstract
The article presents a review of ethnographic studies in the scientific literature on hospital emergency services, with the objective of systematizing the studies and their principal findings, referring to the health-disease-healthcare process in hospital emergency services from an ethnographic perspective. An integrative literature review was performed of studies published in Argentine and international indexed journals and in the following electronic databases: PubMed, VHL, Scopus, Redalyc, and SciELO. The corpus of the analysis consisted of a total of 69 articles, which were submitted to content analysis, having identified the following analytical dimensions: quality of care, communication and bonds, subjectivity, application of information technologies, methodological reflection, patients' experiences and practices, decision-making, and violence. The results allowed identifying a process that differs from guidelines and protocols, in which healthcare workers' subjective aspects, communication and interpersonal relations, and working conditions shape, orient, and condition the treatment and care provided in the hospital. The article thus highlights the approach to subjective aspects in health studies, to understand not only health workers' perspectives and experiences but also the persistent barriers to providing better quality of care, complexifying a problem ignored by a large share of the analyses.
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Affiliation(s)
- Anahi Sy
- Instituto de Salud Colectiva, Universidad Nacional de Lanús, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Brenda Moglia
- Instituto de Salud Colectiva, Universidad Nacional de Lanús, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Gisele Aragunde
- Instituto de Salud Colectiva, Universidad Nacional de Lanús, Buenos Aires, Argentina
| | - Paula Derossi
- Instituto de Salud Colectiva, Universidad Nacional de Lanús, Buenos Aires, Argentina
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Mertens A, Vander Laenen F. Pains of Imprisonment Beyond Prison Walls: Qualitative Research With Females Labelled as Not Criminally Responsible. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2020; 64:1343-1363. [PMID: 31524000 DOI: 10.1177/0306624x19875579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Research on the importation and deprivation models has focused almost exclusively on male inmates, and these models have not yet been studied in any setting other than prison. This research explores the importation and deprivation experiences of females labelled as not criminally responsible (FNCR). During the first part of the study, all the participants interviewed were in prison (n = 51). Follow-up interviews were carried out 18 months later, and while some participants were still in prison, others had been moved to (forensic or general) care. At that point, the study transcended the prison walls and extended its theoretical framework to forensic and general care facilities. In conclusion, the importation and deprivation framework, and the pains defined by Crewe, can be applied to FNCR in different types of setting. Most women were strongly affected by deprivations in prisons and in forensic care. Participants in forensic care sometimes felt more deprived than those in prison facilities.
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Affiliation(s)
- Anouk Mertens
- National Institute of Criminalistics and Criminology, Department of Criminology, Brussels, Belgium
| | - Freya Vander Laenen
- Ghent University, Department of Criminology, Penal Law and Social Law, Institute for International Research on Criminal Policy, Ghent, Belgium
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Baiden D, Evans M. Black African Newcomer Women's Perception of Postpartum Mental Health Services in Canada. Can J Nurs Res 2020; 53:202-210. [PMID: 32551939 DOI: 10.1177/0844562120934273] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
STUDY BACKGROUND The stress of immigrating, settling into Canada, and being a new mother, may place newcomer women at risk of mental health challenges. However, little is known on Black African newcomer women's perspectives of postpartum mental health care after experiencing childbirth in Canada. PURPOSE To explore sociocultural factors that impact Black African newcomer women's perception of mental health and mental health service utilization within a year after childbirth in Canada. METHODS This qualitative study, set in Southern Ontario, purposively sampled 10 African newcomer women who birthed a baby in Canada within the past year. Open-ended, semistructured interviews were conducted individually, transcribed and analyzed using thematic analysis. RESULTS Black African newcomer women rely on mental strength, nonmedical treatment preferences, spirituality, and spousal support for fostering postpartum mental health. Furthermore, cultural beliefs, racial discrimination, and temporary immigration status impact their decision making around postpartum mental health services utilization. CONCLUSION Our findings suggest that Black African newcomer women use mental strength to minimize maternal mental illness. Also, the spouses of Black African newcomer women are crucial in their postpartum mental health support. There is an urgent need for culturally safe interventions to meet the postpartum mental health needs of Black African newcomer mothers.
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Affiliation(s)
- Deborah Baiden
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Marilyn Evans
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
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