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Torabi P, Chouinard MC, Sévigny MM, Bilodeau K. Health promotion nursing interventions for female breast cancer survivors: A scoping review. J Adv Nurs 2024. [PMID: 39011943 DOI: 10.1111/jan.16328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 05/23/2024] [Accepted: 06/29/2024] [Indexed: 07/17/2024]
Abstract
AIM Map the existing health promotion nursing interventions for female breast cancer survivors (BCS) to describe the approaches used and the characteristics of these interventions in the available studies. DESIGN A scoping review. DATA SOURCE Five electronic databases were systematically searched for eligible studies, published between 2002 and 2022. METHODS Following the Joanna Briggs Institute's methodology, two reviewers independently used Covidence to screen the title, abstract and full text of evidence against the inclusion criteria and extracted data using an extraction table. The PRISMA Extension for Scoping Reviews (PRISMA-ScR) guided the reporting. No patient or public contribution was necessary. RESULTS This review included 22 studies on nursing health promotion interventions for BCSs, primarily conducted in specialized care centres. In 20 of 22 studies, nurses employed the educational approach to promote the health of BCSs. Many interventions aimed to support survivors in adopting healthy lifestyles, improving their sexual health, promoting overall well-being and addressing their individual needs by equipping them with self-care skills. Nurses utilized self-monitoring, health education materials and technologies to support survivors' health. CONCLUSION The review concludes that the nurse used various approaches and interventions with different characteristics to improve the health of BCSs. This review also emphasizes that a limited number of determinants of health have been considered by nurses in the development of health promotion interventions. IMPACT The review highlights the important role that nurses can play in enhancing the health of female BCSs after cancer treatments. This review can guide future research for developing nursing health promotion interventions in primary care settings for female BCSs. Additionally, the review offers insights to support future research, education and training on diverse approaches and characteristics that nurses can utilize to establish interventions that enhance the health of female BCSs.
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Affiliation(s)
- Pegah Torabi
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Ile-de-Montréal Research Center, Montreal, Quebec, Canada
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada
| | - Maud-Christine Chouinard
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Ile-de-Montréal Research Center, Montreal, Quebec, Canada
| | - Marie-Maxim Sévigny
- Centre Intégré Universitaire de Santé et de Services Sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Karine Bilodeau
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
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Chen J, Wu Y, Li L, He F, Zou B, Zhuang Y, Tuersun Y, Yang J, Wu F, Kan Y, Lyu K, Lu Y, Ming WK, Sun X, Wang D. How is family health related to health-related quality of life among middle-aged and older adults in rural China? A cross-sectional study. Int J Older People Nurs 2024; 19:e12605. [PMID: 38374792 DOI: 10.1111/opn.12605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 12/30/2023] [Accepted: 01/12/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Health-related quality of life (HRQOL) is unequal between countries and regions, and the emphasis on HRQOL of populations of low-income countries and regions is unprecedented. OBJECTIVES To examine the association between family health and HRQOL among middle-aged and older adults in rural China, and determine whether this association differs by age, gender and chronic disease subgroup. METHODS Cross-sectional survey carried out from July to September 2021. The participants were 1059 people aged 46 and over living in rural China. We used the European Quality of Life Five Dimension Five Level (EQ-5D-5L) and Family Health Scale-Short Form (FHS-SF) to assess health-related quality of life (HRQOL) and family health, respectively. RESULTS The mean EQ-VAS was 75.66, the mean EQ index score was 0.92, and the mean FHS was 37.90 in rural middle-aged and older adults. After Bonferroni correction, generalised linear regression models showed that FHS was significantly associated with the EQ-VAS (β = 0.829; 95% confidence interval [CI]: 0.660 to 0.997; p < .001) and the EQ index score (β = 0.003; 95%CI: 0.001 to 0.004; p < .001). Binary logistic regression models showed that FHS was associated with three dimensions of HRQOL (mobility, self-care and usual activities) (p < .01). Based on subgroup analyses, the effect of FHS on EQ-VAS and the EQ index score was significant in three subgroups after Bonferroni correction (p < .01), but the association between FHS and the dimensions of HRQOL differed by age, gender and chronic disease group (p > .01). CONCLUSIONS This study is the first to explore that family health and its dimensions are significant positive predictors of HRQOL among middle-aged and older adults in rural China. Family-based measures may have more potential and value because better family health significantly improves HRQOL. IMPLICATIONS FOR PRACTICE In the health strategy, the government and primary health care workers should include family health as an indicator and assess it before and after the implementation of the strategy.
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Affiliation(s)
- Jiangyun Chen
- School of Health Management, Southern Medical University, Guangzhou, China
- Institute of Health Management, Southern Medical University, Guangzhou, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
| | - Lehuan Li
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Feiying He
- Southern Medical University, Guangzhou, China
| | - Biqing Zou
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Yishan Zhuang
- School of Public Health, Southern Medical University, Guangzhou, China
| | | | - Jiao Yang
- School of Public Health, Capital Medical University, Beijing, China
| | - Fangjing Wu
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Yifan Kan
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Ke Lyu
- School of Public Health, China Medical University, Shenyang, China
| | - Yefeng Lu
- Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
| | - Xinying Sun
- School of Public Health, Peking University, Beijing, China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, China
- Institute of Health Management, Southern Medical University, Guangzhou, China
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Pogue CA, Schlak AE, McHugh MD. Effect of Discharge Readiness on 30-Day Readmissions Among Older Adults Living With Multiple Chronic Conditions. Med Care 2024; 62:205-212. [PMID: 38241081 PMCID: PMC10922299 DOI: 10.1097/mlr.0000000000001976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
BACKGROUND Despite decreases in readmissions among Medicare beneficiaries after the implementation of the Hospital Readmissions Reduction Program, older adults living with multiple chronic conditions (MCCs) continue to experience higher readmission rates. Few strategies leverage nursing to identify patients at risk for readmission. OBJECTIVES Examine the effect of nurse assessments of discharge readiness on 30-day readmissions. RESEARCH DESIGN Cross-sectional study linking 3 secondary data sources (ie, nurse survey, hospital survey, and Medicare claims data) representing 424 hospitals. SUBJECTS A total of 188,806 Medicare surgical patients with MCCs. MEASURES Discharge readiness was derived from the 2016 RN4CAST-US survey. Medicare claims data was used to determine the MCC count. The outcome was 30-day readmissions across the MCC count. RESULTS The average discharge readiness score was 0.45 (range=0-0.86) indicating that, in the average hospital, <50% of nurses were confident their patient or caregiver could manage their care after discharge. Nearly 8% of patients were readmitted within 30 days of discharge; the highest rates of readmissions were among individuals with ≥5 MCCs (4293, 13.50%). For each 10% increase in the proportion of nurses in a hospital who were confident in their patients' discharge readiness, the odds of 30-day readmission decreased by 2% (95% CI: 0.96-1.00; P =0.028) for patients with 2-4 MCCs and 3% (95% CI: 0.94-0.99; P =0.015) for patients with ≥5 MCCs, relative to patients with 0-1 MCCs. CONCLUSIONS Nurse assessments of discharge readiness may be a useful signal for hospitals to reduce readmissions and examine factors interfering with discharge processes.
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Affiliation(s)
- Colleen A Pogue
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA
| | | | - Matthew D McHugh
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA
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Wood EB, Brown A, Douglas CS, Lawrence J, Wotherspoon Z, Gollenberg A. Engaging Emergency Nurses in Strategies to Address the Social Determinants of Health. J Emerg Nurs 2024; 50:145-152. [PMID: 37552150 DOI: 10.1016/j.jen.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 08/09/2023]
Abstract
INTRODUCTION For patients with social needs, emergency departments can be an essential bridge between the health care system and the community. Emergency nurses' knowledge of and engagement in this work need to be examined to ensure that efforts for social determinants of health screening and the resulting community connections are effective. However, there is limited research in this area of nursing practice. The purpose of this study is to describe emergency nurses' knowledge about social needs in their community, assess their knowledge of existing community resources, and examine their perceived confidence to respond to the social needs of their patients. METHODS A cross-sectional survey was conducted with 243 nurses employed in a large regional health care system. Data were collected using an adapted 81-item social determinants of health survey instrument to measure knowledge of social determinants of health, confidence, and frequency of discussing social determinants of health with emergency department patients and awareness of social resources available in the community. Survey participants were asked about barriers to incorporating social determinants of health into their emergency department workflow and to provide general demographic information. Descriptive statistics were used to analyze study results. RESULTS Most of the 243 emergency nurse participants believed that addressing social determinants of health was important and that emergency nurses should be involved in issues around social determinants of health. However, most nurses reported limited knowledge about social determinants of health and had very limited knowledge about the resources available in their community to help patients with needs related to food, housing, medical care, and transportation. Nurses reported that although they know that their patients are unlikely to ask for help with social needs during an emergency department visit, they are still unlikely to ask their patients about social needs owing to low confidence about having social needs conversations, limited time, and competing care priorities. Participants advocated for greater case manager presence. Feeling connected to the community was significantly correlated to increased knowledge, confidence, and likelihood to ask about social needs (P < .05). DISCUSSION The emergency department is a logical place for screening for social determinants of health and connecting patients with social needs to community resources. Emergency nurses included in this study acknowledged that they want to address the social needs of their patients but reported that they lack knowledge about both social determinants of health and more importantly about the resources available to help patients with social needs. In general, they did not feel confident discussing social determinants of health with their patients in the emergency department and are unlikely to ask about social needs. Barriers to screening include time, competing care priorities, and lack of knowledge and support needed from case managers. Findings from this study have implications for supporting emergency nurses employed in institutions that seek to address social influences of health for the patients in their communities.
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Alexander S, Rajamani S, Austin RR. Promoting Health Equity: The Role of Nurses in Addressing Social Determinants of Health. CLIN NURSE SPEC 2023; 37:262-265. [PMID: 37870511 DOI: 10.1097/nur.0000000000000785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Affiliation(s)
- Susan Alexander
- Author Affiliations: College of Nursing, University of Alabama in Huntsville (Dr Alexander); and School of Nursing, University of Minnesota (Drs Alexander, Rajamani, and Austin), Twin Cities
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Savela RM, Nykänen I, Koponen S, Suominen AL, Schwab U, Välimäki T. Older family caregivers' diet-related disparities: Cross-sectional evidence from Finland. Int J Older People Nurs 2023; 18:e12570. [PMID: 37592405 DOI: 10.1111/opn.12570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 06/15/2023] [Accepted: 07/28/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Some older family caregivers experience financial vulnerabilities due to their caregiving role, which may affect their ability to afford appropriate food. This study aimed to assess the extent to which there are diet-related disparities among older family caregivers in Eastern Finland. METHODS This study is based on the multidisciplinary LifEstyle, NutriTion and Oral health in caregivers (LENTO) study. In total, 125 family caregivers were included. Data were collected between June and December 2019. Participants were assessed on health, nutritional status and sociodemographic factors. The associations and predictors of diet-related disparities were assessed using the independent samples t-test, ANOVA-test, χ2 -tests and binary logistic regression. RESULTS The mean age of family caregivers was 74 years (SD = 8). Most were female (72%), 20% had malnutrition risk and 30% reported having 'moderately enough money' or less, which was identified as 'subjective poverty'. Family caregivers experiencing subjective poverty were less likely to consume two or more portions of fruit and vegetables daily and were more likely overweight. Study participants' diet-related disparities were further associated with several health inequalities, including comorbidity, depression, diabetes (Type I or II) and osteoporosis. CONCLUSIONS Older family caregivers have diet-related disparities, further associated with health inequalities. Family caregivers' diet-related disparities require increasing attention in healthcare. Addressing family caregivers' food insecurity risk would enhance their health equity. Lack of assessment of diet-related disparities will only deepen health inequalities.
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Affiliation(s)
- Roosa-Maria Savela
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Irma Nykänen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Sohvi Koponen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Mizumoto J, Son D, Izumiya M, Horita S, Eto M. The impact of patients' social backgrounds assessment on nursing care: Qualitative research. J Gen Fam Med 2023; 24:332-342. [PMID: 38025935 PMCID: PMC10646291 DOI: 10.1002/jgf2.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/10/2023] [Accepted: 09/11/2023] [Indexed: 12/01/2023] Open
Abstract
Background Although nurses are expected to address the social determinants of health (SDH) in clinical settings, the perspectives of front-line nurses on the integration of SDH into their clinical practice remain unclear. Understanding the dynamism of this integration and its outcomes can yield crucial insights into effective nursing care. This study aims to elucidate the integration and adoption of tool-based SDH assessment nursing programs and their impacts on daily nursing care. Methods We conducted qualitative research at a small community-based hospital in Japan, where a tool-based program characterized by social background interviews and documentation was implemented. Nurses at the hospital were recruited via purposive and snowball sampling. After hypothesis generation, semi-constructed in-depth online interviews were conducted. Each interview lasted between 30 and 50 min. The data were analyzed via thematic analysis using the framework approach. Results A total of 16 nurses participated. Participants' incorporation of the novel SDH assessment program was bolstered by prior learning and their recognition of its practical value. Institutional support and collaborative teamwork further facilitated the adoption of this innovation. Enhanced knowledge about the social contexts of their patients contributed to increased respect, empathy, and self-affirmation among participants, consequently enhancing the quality of nursing care. Conclusion Through team-based learning, reflection, and support, nurses can integrate a tool-based SDH assessment program into their daily nursing practice. This program has the potential to empower nurses to deliver more holistic care and redefine their professional identity. Further research is warranted to assess patient-reported outcomes.
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Affiliation(s)
- Junki Mizumoto
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Daisuke Son
- Department of Community‐based Family Medicine, School of MedicineTottori University Faculty of MedicineYonagoJapan
| | - Masashi Izumiya
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Shoko Horita
- Center for Medical Education, School of MedicineTeikyo UniversityTokyoJapan
| | - Masato Eto
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of MedicineThe University of TokyoTokyoJapan
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Allen S, Onsando WM, Patel I, Canavan C, Goodman D, Dev A. Food Insecurity and Food Access Among Women in Northern New England During the Perinatal Period. J Obstet Gynecol Neonatal Nurs 2023; 52:374-383. [PMID: 37524310 DOI: 10.1016/j.jogn.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/21/2023] [Accepted: 06/27/2023] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVE To describe the experience of food insecurity and food access among women in northern New England during the perinatal period. DESIGN Qualitative descriptive. SETTING Hospital system in northern New England. PARTICIPANTS Twelve pregnant women and two women who gave birth. METHODS We interviewed participants during pregnancy and the postpartum period about their experiences of food insecurity, including screening, their willingness and ability to access food programs, and the extent to which their food needs were met through referrals. We analyzed interview transcripts to identify themes related to participants' experiences of food insecurity; food support, including screening and referral; and opportunities for improvement in current food support interventions. RESULTS Most participants accepted being screened for food insecurity and were satisfied with the food distributed in their perinatal care settings. Food insecurity consistently occurred alongside general financial strain, housing insecurity, and transportation needs, which affirmed the interconnectedness of social determinants of health. Other co-occurring risks included intimate partner violence, substance use, and mental health challenges. Food receipt was facilitated by care team members who were knowledgeable about food distribution programs. Barriers to food receipt included challenges with enrolling in public assistance programs, poor awareness among participants of available resources, the persistence and unpredictability of food insecurity, and stigma. We identified three distinct themes that described participants' experiences with food insecurity during pregnancy and the postpartum period: Experience of Being Screened for Food Insecurity, Intersecting Social Needs, and Experience of Accessing Resources. CONCLUSION These findings can be used to inform comprehensive food support programs that reflect the needs and values of women during the perinatal period. Interventions to screen and intervene for food insecurity during and after pregnancy align with the quality standards of The Joint Commission and should be integrated into nursing practice.
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Trochez RJ, Sharma S, Stolldorf DP, Mixon AS, Novak LL, Rajmane A, Dankwa-Mullan I, Kripalani S. Screening Health-Related Social Needs in Hospitals: A Systematic Review of Health Care Professional and Patient Perspectives. Popul Health Manag 2023. [PMID: 37092962 DOI: 10.1089/pop.2022.0279] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
Abstract
Health outcomes are markedly influenced by health-related social needs (HRSN) such as food insecurity and housing instability. Under new Joint Commission requirements, hospitals have recently increased attention to HRSN to reduce health disparities. To evaluate prevailing attitudes and guide hospital efforts, the authors conducted a systematic review to describe patients' and health care providers' perceptions related to screening for and addressing patients' HRSN in US hospitals. Articles were identified through PubMed and by expert recommendations, and synthesized by relevance of findings and basic study characteristics. The review included 22 articles, which showed that most health care providers believed that unmet social needs impact health and that screening for HRSN should be a standard part of hospital care. Notable differences existed between perceived importance of HRSN and actual screening rates, however. Patients reported high receptiveness to screening in hospital encounters, but cautioned to avoid stigmatization and protect privacy when screening. Limited knowledge of resources available, lack of time, and lack of actual resources were the most frequently reported barriers to screening for HRSN. Hospital efforts to screen and address HRSN will likely be facilitated by stakeholders' positive perceptions, but common barriers to screening and referral will need to be addressed to effectively scale up efforts and impact health disparities.
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Affiliation(s)
- Ricardo J Trochez
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sahana Sharma
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Amanda S Mixon
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Laurie L Novak
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Amol Rajmane
- IBM Watson Health, Cambridge, Massachusetts, USA
| | | | - Sunil Kripalani
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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McGowan DA, Mather C, Stirling C. Use of Social Determinants of Health Screening among Primary Health Care Nurses of Developed Countries: An Integrative Review. NURSING REPORTS 2023; 13:194-213. [PMID: 36810271 PMCID: PMC9944459 DOI: 10.3390/nursrep13010020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
The aims of the study are to evaluate and synthesise research that has investigated social determinants of health screening by primary healthcare nurses; how and when primary health care nurses perform social determinants of health screening; and implications for advancing nursing practice. Systematic searches in electronic databases identified fifteen published studies which met the inclusion criteria. Studies were synthesised using reflexive thematic analysis. This review found little evidence of primary health care nurses using standardised social determinants of health screening tools. Eleven subthemes were identified and collapsed into three main themes: organisation and health system supports are required to enable primary health care nurses; primary health care nurses are often reluctant to perform social determinants of health screening; and the importance of interpersonal relationships for social determinants of health screening. The social determinants of health screening practices of primary health care nurses are poorly defined and understood. Evidence suggests that primary health care nurses are not routinely using standardised screening tools or other objective methods. Recommendations are made for valuing therapeutic relationships, social determinants of health education and the promotion of screening by health systems and professional bodies. Overall, further research examining the best social determinant of health screening method is required.
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Affiliation(s)
- Deirdre A. McGowan
- School of Nursing, College of Health and Medicine, University of Tasmania, Glebe, TAS 7000, Australia
- Correspondence:
| | - Carey Mather
- Australian Institute of Health Services Management, College of Business and Economics, University of Tasmania, Launceston, TAS 7250, Australia
| | - Christine Stirling
- School of Nursing, College of Health and Medicine, University of Tasmania, Glebe, TAS 7000, Australia
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Van Wicklin SA. Health Disparities Experienced by Patients of Color. PLASTIC AND AESTHETIC NURSING 2023; 43:6-7. [PMID: 36583579 DOI: 10.1097/psn.0000000000000473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
- Sharon Ann Van Wicklin
- Sharon Ann Van Wicklin, PhD, RN, CNOR, CRNFA(E), CPSN-R, PLNC, FAAN, ISPAN-F, is editor-in-chief, Plastic and Aesthetic Nursing , and is a perioperative and legal nurse consultant, Aurora, CO
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Leonard A, Broussard J, Jain J, Kumar S, Santos GM, Dawson-Rose C. Prevalence and correlates of methamphetamine use in transitional age youth experiencing homelessness or housing instability in San Francisco, CA. J Nurs Scholarsh 2022; 55:711-720. [PMID: 36480216 DOI: 10.1111/jnu.12856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/10/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Substance use, including methamphetamine use, is a contributing factor in HIV acquisition and treatment. Stimulant use is linked to mental health yet there is limited data from youth in community-based settings. DESIGN One hundred marginally housed or homeless transitional age youth (TAY) were recruited at Larkin Street Youth Services and completed a survey on mental health and substance use. METHODS We conducted secondary data analysis using multivariable logistic regression models to identify the correlates of methamphetamine use among TAY. RESULTS The participants' mean age was 22. Of those who reported methamphetamine use in the past 3 months, 64% were Gay, Bisexual, or Pansexual. Factors independently associated with methamphetamine use were; living with HIV (adjusted odds ratio [aOR] = 3.18, 95% CI = 1.11-9.15), depressive symptoms (aOR = 6.02, 95% CI = 1.46-24.78), symptoms of PTSD (aOR = 13.38, 95% CI = 1.59-112.73), polysubstance use in the past 3 months (aOR = 50.02, 95% CI = 9.72-257.46) and a history of injection drug use (aOR = 8.38, 95% CI = 1.87-37.53). CONCLUSIONS Results from this study suggest a need to develop, adapt, and rapidly implement comprehensive interventions that address the combined epidemics of substance use, HIV, and mental health among TAY. CLINICAL RELEVANCE This article examines factors associated with methamphetamine use among transitional age youth (TAY) experiencing homelessness or housing instability. Several factors were associated with use, including depression, PTSD, HIV status, polysubstance use, and injection drug use. These findings highlight the need for nurses to assess for methamphetamine use among youth as well as associated mental health and physical health problems. Nurses should link TAY who are using methamphetamine to evidence-based treatment programs to address substance use and comorbid conditions.
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Affiliation(s)
- Adam Leonard
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Janessa Broussard
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Jennifer Jain
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA.,Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Shanil Kumar
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Glenn-Milo Santos
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA.,Center on Substance Use and Health, San Francisco Department of Public Health, San Francisco, California, USA
| | - Carol Dawson-Rose
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
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Health systems and health equity: Advancing the agenda. Nurs Outlook 2022; 70:S66-S76. [PMID: 36446541 DOI: 10.1016/j.outlook.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/13/2022] [Accepted: 05/22/2022] [Indexed: 11/27/2022]
Abstract
Despite a compelling body of evidence and decades of policy recommendations, deep inequities in health persist with historically marginalized groups. Operationalizing strategies to achieve equity in health and health care continues to remain elusive to health systems. We propose several focus areas; attention to semantics and concepts, building knowledge of health inequities, redesigning care and transforming cultures, to advance health equity work by health system nurse leaders and clinical nurses. Health equity frameworks, traditionally applied in population and public health, are also discussed to tackle health equity issues and formulate, implement and evaluate solutions to inequities. Examples illustrate ongoing work in our health system in targeted areas and challenges in advancing health equity work. Future efforts by health system nurse leaders should concentrate on technology for point of care health screening and data acquisition, data-driven decisions, and organizational performance measures to narrow health equity gaps.
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Muirhead L, Echt KV, Alexis AM, Mirk A. Social Determinants of Health: Considerations for Care of Older Veterans. Nurs Clin North Am 2022; 57:329-345. [PMID: 35985723 DOI: 10.1016/j.cnur.2022.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Social determinants of health (SDOH), the environments and circumstances in which people are born, grow, live, work and age, are potent drivers of health, health disparities, and health outcomes over the lifespan. Military service affords unique experiences, exposures, and social and health vulnerabilities which impact the life course and may alter health equity and health outcomes for older veterans. Identifying and addressing SDOH, inclusive of the military experience, allows person-centered, more equitable care to this vulnerable population. Nurses and other health professionals should be familiar with how to identify and address health-related social needs and implement interdiciplinary, team-based approaches to connect patients with resources and benefits specifically available to veterans.
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Affiliation(s)
- Lisa Muirhead
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA 30322, USA.
| | - Katharina V Echt
- Veterans Affairs Birmingham/ Atlanta Geriatric Research, Education and Clinical Center (GRECC), Atlanta VA Health Care System, 3101 Clairmont Road Northeast, Brookhaven, GA 30329-1044, USA; Division of Geriatrics and Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Andrea M Alexis
- Atlanta VA Health Care System, Nursing Education, 1M-116A, 1670 Clairmont Road, Decatur, GA 30033, USA
| | - Anna Mirk
- Veterans Affairs Birmingham/ Atlanta Geriatric Research, Education and Clinical Center (GRECC), Atlanta VA Health Care System, 3101 Clairmont Road Northeast, Brookhaven, GA 30329-1044, USA; Division of Geriatrics and Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
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Schoon PM, Krumwiede K. A holistic health determinants model for public health nursing education and practice. Public Health Nurs 2022; 39:1070-1077. [PMID: 35201627 DOI: 10.1111/phn.13063] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/02/2022] [Accepted: 02/09/2022] [Indexed: 11/30/2022]
Abstract
Baccalaureate nursing graduates (BSNs) in the 21st century need to be prepared to manage the population health needs of diverse populations across the lifespan and take actions to improve health equity. A need for a Holistic Health Determinants Model that included the Social Determinants of Health was identified. A model incorporating the Healthy People 2020 Health Determinants Model and the Healthy People 2030 Social Determinants of Health Model was developed. Two theoretical approaches provided a foundation for the model. Social ecological theory stresses the lived experience in an ever-changing environment from the micro to the macro biological, behavioral, social and physical environmental levels. Public health intersectionality added the construct of constant interactions among the health determinants that resulted in different levels of health status among individuals and groups. This Holistic Health Determinants Model is a tool to use in teaching nursing students how to address the needs of individuals/families, diverse populations, and communities. It also facilitates integration of the new AACN Population Health Competencies across the curriculum. The model facilitates the preparation of BSN graduates to address the factors that shape health status and to take actions to improve health equity.
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Affiliation(s)
- Patricia M Schoon
- Associate Professor, College of Nursing and Health Sciences, Metropolitan State University, St. Paul, Minnesota, USA
| | - Kelly Krumwiede
- Associate Professor, College of Allied Health & Nursing, School of Nursing, Minnesota State University Mankato, Mankato, Minnesota, USA
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Policy advocacy and health equity: Implications for advanced practice nurses. Nurse Pract 2022; 47:38-43. [PMID: 36006819 DOI: 10.1097/01.npr.0000855316.18930.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Advanced practice nurses are key partners in achieving health equity and are encouraged to use their advocacy skills and policy acumen in doing so. While conducting social determinants of health screenings and providing referrals are important elements in our quest to achieve health equity, meaningful advancements in this area are dependent on the enactment of public policies that yield equitable solutions.
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Colburn DA. Nursing Education and Social Determinants of Health: A Content Analysis. J Nurs Educ 2022; 61:516-523. [PMID: 36098540 DOI: 10.3928/01484834-20220705-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND By integrating a social determinants of health (SDOH) perspective into nursing programs, there is potential to reduce health disparities shaped by these forces. However, little is known about the extent to which nursing program curricula include SDOH education. METHOD This study used course descriptions from 32 nursing programs in the United States to perform a frequency and content analysis on required course offerings. Healthy People 2020 was referenced to determine coding categories. RESULTS Although 18.5% of courses implicitly referenced SDOH, only 1% made explicit references to SDOH. Implicit references were likely to include themes such as cultural sensitivity and diversity, or social, cultural, economic, and political factors influencing health. CONCLUSION Although several required nursing course descriptions made implicit references to SDOH, explicit use of the term SDOH is still limited. Faculty, administrators, and program accrediting bodies must push to incorporate SDOH more thoroughly into nursing education. [J Nurs Educ. 2022;61(9):516-523.].
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Green H, MacPhail C, Alananzeh I, Fernandez R. Association between economic wellbeing and ethnicity, socioeconomic status, and remoteness during the COVID-19 pandemic. Public Health Nurs 2022; 39:1195-1203. [PMID: 35714669 PMCID: PMC9349871 DOI: 10.1111/phn.13107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/11/2022] [Accepted: 05/16/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE The aim of this study is to explore the association between economic wellbeing and ethnicity, socioeconomic status, and remoteness during the COVID-19 pandemic. DESIGN A cross-sectional study via SurveyMonkey was conducted in Australia between August 2020 and October 2020. Descriptive and inferential statistics were used to analyze the data. RESULTS A total of 1211 individuals responded to the survey. Income loss was significantly associated with those from low socioeconomic status (OR = 1.65; 95% CI 1.01-2.68). Access of superannuation was significantly associated with those in outer regional (OR = 3.61; 95% CI 0.81-16.03) and low socioeconomic status (OR = 2.72; 95% CI 1.34-5.53). Financial inability to pay for services was significantly associated with living in remote areas (OR = 2.26; 95% CI 0.88-5.80). CONCLUSIONS The economic wellbeing of people who identify as Aboriginal and Torres Strait Islander, live in regional or remote areas, and reside in low socioeconomic areas have been substantially impacted during the pandemic. Findings call for policies to address the underlying social determinants of health.
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Affiliation(s)
- Heidi Green
- Centre for Research in Nursing and HealthSt George HospitalKogarahNew South WalesAustralia,School of NursingUniversity of WollongongWollongongNew South WalesAustralia,Illawarra Health and Medical Research InstituteUniversity of WollongongWollongongAustralia
| | - Catherine MacPhail
- School of Health and SocietyUniversity of WollongongWollongongNew South WalesAustralia
| | - Ibrahim Alananzeh
- School of HumanitiesUniversity of Wollongong DubaiDubaiUnited Arab Emirates
| | - Ritin Fernandez
- Centre for Research in Nursing and HealthSt George HospitalKogarahNew South WalesAustralia,School of NursingUniversity of WollongongWollongongNew South WalesAustralia,Illawarra Health and Medical Research InstituteUniversity of WollongongWollongongAustralia
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Nursing, Commitment, and Leadership: More Nurses for a Better Health Care Model-Be a Nurse to Be a Leader. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106223. [PMID: 35627761 PMCID: PMC9141037 DOI: 10.3390/ijerph19106223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 12/04/2022]
Abstract
For the celebration of International Nurses Day in 2022, the International Council of Nurses (ICN) has proposed the slogan "Nursing, a voice to lead: Invest in nurses and respect rights for global health" [1]. [...].
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Abstract
ABSTRACT Nurses have a vital role in addressing social and health inequities to promote quality healthcare for all. This article discusses the tools to screen for social determinants of health (SDOH) and key considerations for nurses and nurse leaders to advance the integration of SDOH information into their workflows.
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Affiliation(s)
- Victoria Tiase
- Victoria Tiase is the director of Informatics Strategy at New York-Presbyterian Hospital. Cathryn DeGraff Crookston is the senior director for Provider Sales Solutions at Unite Us. Anna Schoenbaum is the vice-president of Information Services Applications at Penn Medicine and a faculty at the University of Maryland School of Nursing. Madelynn Valu is the senior manager of Public Health at Circulo Health. All authors are members of the Healthcare Information and Management Systems Society's Social Determinants of Health Task Force, with Ms. DeGraff Crookston as a co-chair
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Muirhead L, Brasher S, Broadnax D, Chandler R. A framework for evaluating SDOH curriculum integration. J Prof Nurs 2022; 39:1-9. [DOI: 10.1016/j.profnurs.2021.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 12/01/2021] [Accepted: 12/09/2021] [Indexed: 10/19/2022]
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Kiessling KA, Iott BE, Pater JA, Toscos TR, Wagner SR, Gottlieb LM, Veinot TC. Health informatics interventions to minimize out-of-pocket medication costs for patients: what providers want. JAMIA Open 2022; 5:ooac007. [PMID: 35274083 PMCID: PMC8903137 DOI: 10.1093/jamiaopen/ooac007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 12/13/2021] [Accepted: 01/31/2022] [Indexed: 11/14/2022] Open
Abstract
Objective To explore diverse provider perspectives on: strategies for addressing patient medication cost barriers; patient medication cost information gaps; current medication cost-related informatics tools; and design features for future tool development. Materials and Methods We conducted 38 semistructured interviews with providers (physicians, nurses, pharmacists, social workers, and administrators) in a Midwestern health system in the United States. We used 3 rounds of qualitative coding to identify themes. Results Providers lacked access to information about: patients’ ability to pay for medications; true costs of full medication regimens; and cost impacts of patient insurance changes. Some providers said that while existing cost-related tools were helpful, they contained unclear insurance information and several questioned the information’s quality. Cost-related information was not available to everyone who needed it and was not always available when needed. Fragmentation of information across sources made cost-alleviation information difficult to access. Providers desired future tools to compare medication costs more directly; provide quick references on costs to facilitate clinical conversations; streamline medication resource referrals; and provide centrally accessible visual summaries of patient affordability challenges. Discussion These findings can inform the next generation of informatics tools for minimizing patients’ out-of-pocket costs. Future tools should support the work of a wider range of providers and situations and use cases than current tools do. Such tools would have the potential to improve prescribing decisions and better link patients to resources. Conclusion Results identified opportunities to fill multidisciplinary providers’ information gaps and ways in which new tools could better support medication affordability for patients. Almost a quarter of Americans taking prescription medications have difficulty affording them. We asked 38 healthcare providers what they do to help patients get affordable medications. They try to reduce the number of medications that patients take, choose more affordable medication options, and connect them to free medications or financial help. But it is hard for providers to do these things because they don’t always know which patients have financial challenges, and they may not know how much medications cost patients. Healthcare providers use digital tools like ordering systems to pick medications for patients, but they do not always have clear price information and they do not help outside of healthcare visits with prescribers. It is also hard for healthcare providers to get information about what patients have difficulty affording medications, and about resources to help them. Healthcare providers want new and improved digital tools to help them choose medications, and to be able to compare exact medication price differences. They also want a visual sign for patients with financial challenges, and centralized information about cost reduction resources. Finally, they desire tools to help them talk to patients about mediation prices, and medication price reports for patients themselves.
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Affiliation(s)
| | - Bradley E Iott
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
- School of Information, University of Michigan, Ann Arbor, Michigan, USA
| | - Jessica A Pater
- Parkview Mirro Center for Research & Innovation, Parkview Health, Fort Wayne, Indiana, USA
| | - Tammy R Toscos
- Parkview Mirro Center for Research & Innovation, Parkview Health, Fort Wayne, Indiana, USA
| | - Shauna R Wagner
- Parkview Mirro Center for Research & Innovation, Parkview Health, Fort Wayne, Indiana, USA
| | - Laura M Gottlieb
- Social Interventions Research and Evaluation Network, University of California San Francisco, San Francisco, California, USA
| | - Tiffany C Veinot
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
- School of Information, University of Michigan, Ann Arbor, Michigan, USA
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Mills A, Knight A, Burdett T. Supporting student nurses to develop healthy conversation skills. Br J Community Nurs 2021; 26:554-559. [PMID: 34731034 DOI: 10.12968/bjcn.2021.26.11.554] [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: 11/11/2022]
Abstract
As advocates for health, nurses are ideally situated to deliver effective health promotion in their daily interactions with people. This work evaluates the integration of healthy conversation training, making every contact count (MECC), into a health promotion module in an undergraduate nursing degree at a higher education institute (HEI). In all, 108 students completed the online questionnaire I year after receiving healthy conversation training. 67% of students reported the regular or occasional use of healthy conversation skills and identified a wide range of scenarios where they had used the skills. 65% of students used health action planning framework in their own personal self-care. Student nurses acknowledged barriers and enablers to their use of healthy conversation skills. Having knowledgeable mentors who role modelled healthy conversations skills in their consultations was the most frequently raised factor, in addition to lack of knowledge of local resources, time and confidence. All placement settings should ensure that registered nurses, especially those undertaking mentorship responsibilities have access to healthy conversation training.
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Affiliation(s)
- Anne Mills
- Senior Lecturer, Department of Medical Sciences and Public Health, Bournemouth University, Bournemouth
| | - Anneyce Knight
- Senior Lecturer, Department of Nursing Science, Bournemouth University, Bournemouth
| | - Teresa Burdett
- Principal Lecturer, Department of Nursing Science, Bournemouth University, Bournemouth
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Placzek H, Cruz S, Chapdelaine M, Carl M, Levin S, Hsu C. Intersecting systemic and personal barriers to accessing social services: qualitative interviews in northern California. BMC Public Health 2021; 21:1933. [PMID: 34689735 PMCID: PMC8542412 DOI: 10.1186/s12889-021-11981-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 10/12/2021] [Indexed: 12/02/2022] Open
Abstract
Background Addressing social risks in the clinical setting can increase patient confidence in the availability of community resources and may contribute to the development of a therapeutic alliance which has been correlated with treatment adherence and improved quality of life in mental health contexts. It is not well understood what barriers patients face when trying to connect to community resources that help address social risks. This paper aims to describe patient-reported barriers to accessing and using social needs-related resources to which they are referred by a program embedded in a safety net primary care clinic. Methods This is a qualitative assessment of patient-reported barriers to accessing and using social needs assistance programs. We conducted over 100 in-depth interviews with individuals in Northern California who participated in a navigation and referral program to help address their social needs and describe a unique framework for understanding how policies and systems intersect with an individual’s personal life circumstances. Results Individuals described two distinct domains of barriers: 1) systems-level barriers that were linked to the inequitable distribution of and access to resources, and 2) personal-level barriers that focused on unique limitations experienced by each patient and impacted the way that they accessed services in their communities. While these barriers often overlapped or manifested in similar outcomes, this distinction was key because the systems barriers were not things that individuals could control or overcome through their own initiative or by increasing individual capacity. Conclusions Respondents describe intersecting systemic and personal barriers that compound patients’ challenges to getting their social needs met; this includes both a picture of the inequitable distribution of and access to social services and a profile of the limitations created by individual life histories. These results speak to the need for structural changes to improve adequacy, availability, and accessibility of social needs resources. These findings highlight the need for advocacy to address systems barriers, especially the stigma that is faced by people who struggle with a variety of health and social issues, and investment in incentives to strengthen relationships between health care settings and social service agencies.
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Affiliation(s)
- Hilary Placzek
- Health Leads, San Francisco, CA, USA. .,Ariadne Labs, Boston, MA, USA. .,Ontrak, Inc., San Francisco, CA, USA.
| | - Stephanie Cruz
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | | | - Mary Carl
- Health Leads, San Francisco, CA, USA
| | - Sara Levin
- Contra Costa Public Health Clinical Services, Martinez, CA, USA
| | - Clarissa Hsu
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
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Fawaz M. Role of nurses in precision health. Nurs Outlook 2021; 69:937-940. [PMID: 33745686 DOI: 10.1016/j.outlook.2021.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/23/2021] [Accepted: 01/30/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Mirna Fawaz
- Nursing Department, Faculty of Health Sciences, Beirut Arab University, BEY, Lebanon.
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Schneiderman JU, Olshansky EF. Nurses' perceptions: Addressing social determinants of health to improve patient outcomes. Nurs Forum 2021; 56:313-321. [PMID: 33484172 DOI: 10.1111/nuf.12549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 12/27/2020] [Accepted: 01/03/2021] [Indexed: 01/13/2023]
Abstract
Nursing organizations and leaders adopted the social determinants of health (SDOH) as essential to the delivery of health care, but little is known about working registered nurses' (hereafter nurses) views on the SDOH. The purpose of this study was to (1) explore nurses' perceptions of how SDOH affect patient care and (2) describe nurses' ideas about how SDOH can be addressed to improve outcomes and services. Thirteen registered nurses with a baccalaureate in nursing beginning their online graduate advanced practice educational program were interviewed. This qualitative descriptive study used constant comparative analysis for data analysis. The analysis found two major themes: (1) SDOH are integrated into the nurses' care. The SDOH experienced by patients challenges the nurses to provide care at the patient's level and to provide usable patient education, and (2) health-care delivery change is needed to achieve equity and to provide health care to those in need. The nurses recommended more organized, seamless health-care delivery and interdisciplinary advocacy to achieve these needed changes. Nurse educators and nurse leaders can harness the frustration and ingenuity of nurses to help the nurses advocate for health-care change that integrates the SDOH.
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Affiliation(s)
- Janet U Schneiderman
- Nursing Department, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Ellen F Olshansky
- Sue & Bill Gross School of Nursing, University of California, Irvine, California, USA
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Imaiso J. Evaluation Items for Community-Based Health Care Focusing on Social Aspects: A Literature Review. Health (London) 2021. [DOI: 10.4236/health.2021.1312106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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