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Osborne Chambers C, Thompson JA. Shedding new light for nurses: Enhancing pressure injury prevention across skin tones with sub-epidermal moisture assessment technology. J Adv Nurs 2024; 80:2801-2812. [PMID: 38243619 DOI: 10.1111/jan.16040] [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: 09/25/2023] [Revised: 11/30/2023] [Accepted: 12/17/2023] [Indexed: 01/21/2024]
Abstract
AIM(S) To assess the effectiveness of sub-epidermal moisture (SEM) assessment technology in the detection of early-stage pressure damage in a critical care unit (CCU) and dark skin tone patients and its impact on hospital-acquired pressure injury (HAPI) incidence. DESIGN Quality improvement study employing Kurt Lewin's change model emphasizing planning, implementation, evaluation and sustainable change. METHODS The study evaluated 140 adult patients admitted to the CCU over a 24-week period, from July to December 2022. Retrospective analysis of standard PI care pathways was performed in 90 patients admitted during a 12-week pre-implementation period. Fifty patients were admitted through the subsequent 12-week implementation period. SEM assessments were performed daily at the sacrum and heels and interventions were applied based on SEM assessments; SEM delta ≥0.6 indicating localized oedema or persistent focal oedema. Statistical analyses were performed on anonymized data. RESULTS Pre-implementation HAPI incidence was 8.9% (N = 8/90). All eight patients were African American with varying skin tones. A 100% reduction in HAPI incidence was achieved in the implementation period which included 35 African American patients. The relative risk of HAPI incidence was 1.6 times higher in the pre-implementation group. CONCLUSION Implementing SEM assessment technology enabled equitable PI care for all population types and resulted in a 100% reduction of PIs in our CCU. Objective SEM assessments detected early-stage PIs, regardless of skin tone and enabled providing interventions to specific anatomies developing tissue damage as opposed to universal preventive interventions. IMPLICATIONS PI care pathways relying on visual and tactile skin assessments are inherently biased in providing equitable care for dark skin tone patients. Implementing SEM assessments empowers healthcare practitioners in driving objective clinical interventions, eliminates bias and enables positive PI health outcomes. IMPACT Implementing SEM assessment technology had three main effects: it detected early tissue damage regardless of skin tone (detection effect), enabled anatomy-specific interventions (treatment effect) and prevented PIs across all population types (prevention effect). The authors have adhered to the Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. What does this paper contribute to the wider global clinical community? Addressing health inequities in pressure injury prevention; Demonstrated effectiveness across patient populations; Resource optimization and enhanced patient safety.
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Pittman J, Otts JA, Mulekar M. Enhanced Skin Assessment Methodology to Detect Early Tissue Damage and Prevent Pressure Injuries. J Wound Ostomy Continence Nurs 2024; 51:191-198. [PMID: 38820216 DOI: 10.1097/won.0000000000001076] [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: 06/02/2024]
Abstract
PURPOSE The purpose of this study was to evaluate a skin assessment technique, subepidermal moisture (SEM) assessment, to assess, identify, and prevent pressure injuries (PIs) in critically ill adults. DESIGN This was a retrospective, descriptive, comparative research study. SUBJECTS AND SETTING The sample comprised 69 critically ill adults; their mean age was 58.8 years (SD 18.1 years). The majority were male (n = 40, 58%), 29 (42%) were African American (AA), and 36 (52%) were White. The study setting was a surgical trauma intensive care unit (STICU) in a southern US Gulf Coast academic level I trauma hospital. Data were collected from September to November 2021. METHODS We conducted a retrospective medical record review of subjects who had undergone SEM assessment. We also collected demographic and pertinent clinical information, including Braden Scale cumulative scores and subscale scores, documented PI prevention interventions, and PI occurrence and characteristics if developed within 7 days of SEM measurement. We also evaluated whether PI prevention interventions were appropriate. To examine nurse perception of the SEM device, we conducted a web-based survey of nurses providing care in our facility's STICU. Comparison of responses was done using Fisher's test or Chi-square test, and the mean responses from groups were compared using t test. RESULTS Thirty-five (57%) subjects had a sacral SEM delta ≥0.6; 14 (40%) were AA; 20 (57%) were White; and 11 (31%) had a hospital-acquired PI (HAPI) or present-on-admission (POA) PI. Among the 14 HAPI and POA PI subjects with sacral SEM delta, 11 (79%) had sacral SEM delta ≥0.6. Among 26 AA subjects with sacral SEM delta, 5 had a HAPI or POA PI, and of those, 4 (80%) had sacral SEM delta ≥0.6. A significant and negative correlation was observed between cumulative Braden Scale scores on day 2 and sacral SEM delta (r = -0.28, P = .03) and R heel delta (r = -0.29, P = .03) scores, indicating higher PI risk. Of the 35 patients with a sacral SEM delta ≥0.6, 24 (69%) subjects did not have appropriate PI prevention interventions. Nurses (n = 13) indicated that the SEM device was easy to use and helped them perform an accurate skin assessment on patients with darker skin tones. CONCLUSIONS This study demonstrates that SEM technology is beneficial to address racial disparities in skin assessment, enhance skin assessment accuracy beyond existing PI care, improve the accuracy of risk assessment, and promote appropriate location-specific PI prevention interventions.
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Affiliation(s)
- Joyce Pittman
- Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, Mobile, Alabama
- Jo Ann Otts, DNP, RN, NEA-BC, College of Nursing, University of South Alabama, Mobile, Alabama
- Madhuri Mulekar, PhD, Department of Mathematics, University of South Alabama, Mobile, Alabama
| | - Jo Ann Otts
- Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, Mobile, Alabama
- Jo Ann Otts, DNP, RN, NEA-BC, College of Nursing, University of South Alabama, Mobile, Alabama
- Madhuri Mulekar, PhD, Department of Mathematics, University of South Alabama, Mobile, Alabama
| | - Madhuri Mulekar
- Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, Mobile, Alabama
- Jo Ann Otts, DNP, RN, NEA-BC, College of Nursing, University of South Alabama, Mobile, Alabama
- Madhuri Mulekar, PhD, Department of Mathematics, University of South Alabama, Mobile, Alabama
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Markey K, Prosen M. Integrating inclusivity and skin tone diversity in nurse education materials and resources. Evid Based Nurs 2023:ebnurs-2023-103861. [PMID: 38123964 DOI: 10.1136/ebnurs-2023-103861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Kathleen Markey
- Department of nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Mirko Prosen
- Faculty of Health Sciences, University of Primorska College of Health Care, Izola, Slovenia
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Vernon E, White P. Assessing and documenting dark skin tones in stoma care. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:S22-S26. [PMID: 38060390 DOI: 10.12968/bjon.2023.32.22.s22] [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: 12/18/2023]
Abstract
The stoma care nurse (SCN) assesses peristomal skin during each patient intervention. Living in a diverse multicultural society, the SCN needs to consider dark skin tones and how these are documented. This article looks at how the literature on peristomal skin assessment and available tools discuss skin colour, and compare this with the tissue viability literature. Stoma care and peristomal skin literature features very little about skin colour. Registered nurses are often unaware of the differences when assessing light skin tones versus dark skin tones. The article discusses how to assess for, identify and document problems around peristomal skin with patients who have dark skin tones. The differences in skin breakdown between light skin tones and dark skin tones are highlighted. There needs to be further research and development of tools to assist clinicians in identification and documentation relating to skin tone, thus providing consistency in assessment.
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Affiliation(s)
- Emma Vernon
- Nurse Manager (South), SecuriCare (Medical) Ltd
| | - Pamela White
- Head of Clinical Governance and Regulatory Affairs, CliniMed and SecuriCare (Medical) Ltd
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De D, Heaslip V, Gunowa NO. Calling for wider skin tone representation in simulation-based learning. NURSE EDUCATION TODAY 2023; 131:105950. [PMID: 37683298 DOI: 10.1016/j.nedt.2023.105950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/02/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023]
Affiliation(s)
- Diana De
- School of Healthcare Sciences, Cardiff University, United Kingdom of Great Britain and Northern Ireland.
| | - Vanessa Heaslip
- School of Nursing and Society, University of Salford, United Kingdom of Great Britain and Northern Ireland
| | - Neesha Oozageer Gunowa
- School of Health Sciences, University of Surrey, United Kingdom of Great Britain and Northern Ireland
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Irving SY, Berry KG, Morgan S, Seiple SM, Nagle ML, Stetzer M, Tabatabaei N, Murphy S, Srinivasan V, Mascarenhas M. Nutrition association with skin integrity and pressure injury in critically ill pediatric patients. Nutr Clin Pract 2023; 38 Suppl 2:S125-S138. [PMID: 37721464 DOI: 10.1002/ncp.11063] [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: 06/29/2023] [Revised: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND Current research highlights the positive impact of nutrition therapy, particularly enteral nutrition, in critical illness. However, little attention is given to the impact of nutrition on skin integrity during critical illness. Skin integrity is at risk in critically ill children owing to necessary clinical therapies and challenges of providing nutrition therapy. METHODS We conducted a narrative literature review with three main thematic concepts to drive our literature search: the association of nutrition therapy with (1) skin integrity; (2) injury, wounds, and wound healing; and (3) differences of skin color. Using pertinent search and subject terms, PubMed, CINAHL, EMBASE, and SCOPUS databases were searched, yielding 316 articles. After removal of duplicates, articles were reviewed based on inclusion and exclusion criteria defined by the authors; only eight articles met the defined criteria to inform this review. RESULTS Large and important gaps exist in the current literature regarding an association between nutrition therapy, skin injury, and wound healing. Little to no attention was found for associations with skin color. The resulting narrative review addresses these topics and subtopics with additional references included that are independent of the original search strategy. CONCLUSIONS A dearth of evidence exists describing associations between nutrition and disruption of skin integrity in pediatric critical illness. Children with dark skin are at increased risk, as manifestation and identification of disruption to skin integrity may not be recognized. Research is needed to describe these associations and the impact of nutrition on skin integrity, including differences of skin color.
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Affiliation(s)
- Sharon Y Irving
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
- Department of Nursing and Clinical Care Services, Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Katarina G Berry
- Department of Clinical Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Sherry Morgan
- Holman Biotech Commons, Robert Wood Johnson Pavilion, Philadelphia, Pennsylvania, USA
| | - Stephanie M Seiple
- Department of Clinical Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Monica L Nagle
- Department of Clinical Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Molly Stetzer
- Wound Ostomy and Vascular Access Services, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Neeka Tabatabaei
- Department of Clinical Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Sara Murphy
- Department of Clinical Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Vijay Srinivasan
- Division of Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Maria Mascarenhas
- Department of Clinical Nutrition, Division of Gastroenterology and Nutrition, Philadelphia, Pennsylvania, USA
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Harrison J. A scoping review exploring the confidence of healthcare professionals in assessing all skin tones. Br Paramed J 2023; 8:18-28. [PMID: 37674918 PMCID: PMC10477824 DOI: 10.29045/14784726.2023.9.8.2.18] [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: 09/08/2023] Open
Abstract
Background Health inequalities and poorer outcomes have been identified for patients with dark skin tones. The reasons are multi-factorial, but may include delayed treatment due to a lack of recognition of early clinical signs of physiological deterioration. Within the medical literature there is a light skin tone bias, leading to healthcare professionals having insufficient knowledge regarding the assessment of patients with different skin tones, which may result in reduced confidence and create patient safety issues. The aim of this scoping review was to explore the confidence levels of healthcare professionals when assessing patients of different skin tones. Methods The methodology followed scoping review frameworks set out by Arksey and O'Malley (2005), the Joanna Briggs Institute (Peters et al., 2020) and the PRISMA extension for Scoping Reviews (PRISMA-ScR) (Tricco et al., 2018). Searches for literature were performed between February and June 2022 using electronic databases EBSCO (Academic Search Complete, the Allied Complementary Medicine Database, e-journals, MEDLINE, CINAHL), British Nursing Index (ProQuest), Scopus, Web of Science, Zetoc, UpToDate, Google Scholar, NICE Evidence, ResearchGate, Opengrey and the British Association of Dermatologists. No date range was specified, expanders were left on and the findings were screened using inclusion and exclusion criteria. Included papers were synthesised using narrative synthesis. Results Thirteen papers were identified, and the extracted data charted by the paper's origin, sample size, profession and confidence levels. Our synthesis revealed reduced confidence in assessing, managing and diagnosing skin conditions in dark skin tones. A lack of training was cited by different health professionals, but undertaking tailored training and experiential learning increased confidence. Conclusions There is a safety issue for patients with dark skin tones, as healthcare professionals lack clinical confidence in managing and treating all ethnicities equally. Tangible diversity within healthcare training is required, supported by inclusive skin tone imagery and appropriate terminology within medical literature.
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Black J, Cox J, Capasso V, Bliss DZ, Delmore B, Iyer V, Massaro J, Munro C, Pittman J, Ayello EA. Current Perspectives on Pressure Injuries in Persons with Dark Skin Tones from the National Pressure Injury Advisory Panel. Adv Skin Wound Care 2023; 36:470-480. [PMID: 37590446 DOI: 10.1097/asw.0000000000000032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
BACKGROUND Pressure injury (PI) development is multifactorial. In patients with dark skin tones, identifying impending PIs by visual skin assessment can be especially challenging. The need for improved skin assessment techniques, especially for persons with dark skin tones, continues to increase. Similarly, greater awareness of the need for inclusivity with regard to representation of diverse skin colors/tones in education materials is apparent. OBJECTIVE To provide current perspectives from the literature surrounding skin assessment and PI development in patients with dark skin tones. METHODS The following elements will be discussed through the lens of skin tone: (1) historical perspectives of PI staging from the National Pressure Injury Advisory Panel, (2) epidemiology of PI, (3) anatomy and physiology of the skin, (3) skin tone assessment and measurement, (4) augmented visual assessment modalities, (5) PI prevention, (6) PI healing, (7) social determinants of health, and (8) gaps in clinician education. CONCLUSIONS This article highlights the gap in our clinical knowledge regarding PIs in patients with dark skin tones. Racial disparities with regard to PI development and healing are especially clear among patients with dark skin tones. Skin tone color assessment must be standardized and quantifiable in clinical education, practice, and research. This work is urgently needed, and support from private and governmental agencies is essential.
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Affiliation(s)
- Joyce Black
- Joyce Black, PhD, RN, FAAN, is President, National Pressure Injury Advisory Panel, and Florence Niedfelt Professor of Nursing, College of Nursing, University of Nebraska, Lincoln, USA. Jill Cox, PhD, RN, APN-C, CWOCN, FAAN, is Member, Board of Directors, National Pressure Injury Advisory Panel; Clinical Professor, Rutgers University School of Nursing, New Jersey; and Wound/Ostomy/Continence Advanced Practice Nurse, Englewood Health, New Jersey. Virginia Capasso, PhD, CNP, CNS, CWS, FAAN, is Member, Board of Directors, National Pressure Injury Advisory Panel; Instructor in Surgery, Harvard Medical School, Boston, Massachusetts; and Advanced Practice Nurse and Nurse Scientist, Massachusetts General Hospital, Boston. Donna Z. Bliss, PhD, RN, FAAN, is School of Nursing Foundation Professor of Nursing Research, and Chair, Adult and Gerontological Health Cooperative, University of Minnesota School of Nursing, Minneapolis. Barbara Delmore, PhD, RN, CWCN, MAPWCA, IIWCC, FAAN, is Alumna, Board of Directors, National Pressure Injury Advisory Panel, and Senior Nurse Scientist and Clinical Assistant Professor, NYU Langone Health, New York. Vignesh Iyer, MS, is Director, Medical Affairs, Bruin Biometrics, Los Angeles, California. Jacqueline Massaro, MSN, RN, CWOCN, is Wound/Ostomy/Continence Nurse, Brigham and Women's Hospital, Boston, Massachusetts. Cassendra Munro, PhD, RN, CNOR, is Nurse Scientist, Office of Research Patient Care Services, Stanford Health Care, Palo Alto, California. Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, is Alumna, Board of Directors, National Pressure Injury Advisory Panel, and Associate Professor, College of Nursing, University of South Alabama, Mobile. Elizabeth A. Ayello, PhD, RN, CWON, MAPWCA, FAAN, is Alumna, Board of Directors, and Past President, National Pressure Injury Advisory Panel, and President, Ayello, Harris & Associates, Inc, New York
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9
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Abstract
ABSTRACT There is a scarcity of nursing literature, studies, and educational materials on the assessment and early recognition of both common and serious integumentary and general health issues in people with dark skin tones. Nurses must be exposed to such learning resources to be adequately prepared to care for patients with diverse skin tones and to help reduce health disparities and promote health equity. This article provides faculty, nursing students, and clinicians with basic information about the assessment of dark skin tone and calls for action in academia and professional practice to ensure nurses and nursing students can effectively perform skin assessments in all patients.
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Protecting peristomal skin: A two-pronged approach in stoma patients. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S1-S8. [PMID: 37733640 DOI: 10.12968/bjon.2022.31.sup6.s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
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Oozageer Gunowa N, Hutchinson M, Brooke J, Aveyard H, Jackson D. Pressure injuries and skin tone diversity in undergraduate nurse education: Qualitative perspectives from a mixed methods study. J Adv Nurs 2021; 77:4511-4524. [PMID: 34245169 DOI: 10.1111/jan.14965] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/20/2021] [Accepted: 06/21/2021] [Indexed: 02/02/2023]
Abstract
AIMS To, firstly, explore student and academic nurse perceptions of classroom content about the assessment and identification of pressure injuries across skin tone diversity and, secondly, to describe the impact of classroom content on student nurse understanding of pressure injury in people with dark skin tones. DESIGN Qualitative case study employing focus groups and semi-structured interviews. METHODS Five higher education institutions in the United Kingdom were purposively chosen. At each of the five-case sites, one focus group with student nurses and one semi-structured interview with a nurse academic were conducted between May 2018 and April 2019. The participants' narratives were transcribed verbatim and analysed via thematic analysis. RESULTS Classroom learning was predominately framed through a white lens with white normativity being strongly reinforced through teaching and learning activities. This reinforcement of white normativity was evidenced through two main themes: (i) dominance of whiteness in the teaching and learning of pressure injuries in undergraduate nurse education and (ii) the impact and implications for student nurses of whiteness as the norm in pressure injury teaching. CONCLUSION Nurses responsible for the design and delivery of teaching and learning experiences for nursing students need to ensure meaningful teaching and learning experiences. This learning should assist future nurses to interrogate their complicity in a system of white dominance. IMPACT Nurse education delivered today influences and shapes nurses of the future. Nurses are the cornerstone of healthcare and play a significant role in the delivery of equitable healthcare. Nurse academics have a duty of care to inform and highlight health inequities in nursing and ultimately to enhance equity in care.
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Affiliation(s)
- Neesha Oozageer Gunowa
- Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR), Oxford Brookes University, Oxford, UK
| | - Marie Hutchinson
- School of Health and Human Sciences, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Joanne Brooke
- Health and Related Research, Birmingham City University, Birmingham, UK
| | - Helen Aveyard
- Faculty of Health & Life Sciences - Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR), Oxford Brookes University, Oxford, UK
| | - Debra Jackson
- Susan Wakil School of Nursing, University of Sydney Australia, Sydney, NSW, Australia
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Gazaway SB, Barnett MD, Bowman EH, Ejem D, Harrell ER, Brown CJ, Bakitas M. Health Professionals Palliative Care Education for Older Adults: Overcoming Ageism, Racism, and Gender Bias. CURRENT GERIATRICS REPORTS 2021; 10:148-156. [PMID: 34745842 PMCID: PMC8556773 DOI: 10.1007/s13670-021-00365-7] [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] [Accepted: 07/23/2021] [Indexed: 12/03/2022]
Abstract
Purpose of review Most aging Americans lack access to specialist palliative care aimed at those experiencing serious illness and/or high symptom burden at end of life. The curricula used by training programs for all healthcare professions should focus on helping learners develop the primary palliative care skills and competencies necessary to provide compassionate bias-free care for adults with serious illness. We believe there is much opportunity to improve this landscape via the incorporation of palliative care competencies throughout generalist healthcare professional programs. Recent findings Several recent publications highlight multiple issues with recruitment and retention of diverse students and faculty into healthcare professional training programs. There are also concerns that the curricula are reinforcing age, race, and gender biases. Due to these biases, healthcare professionals graduate from their training programs with socialized stereotypes unquestioned when caring for older adult minority patients and caregivers. Summary Important lessons must be incorporated to assure that bias against age, race, and gender are discovered and openly addressed in healthcare professional’s education programs. This review highlights these three types of bias and their interrelationships with the aim of revealing hidden truths in the education of healthcare professionals. Ultimately, we offer targeted recommendations of focus for programs to address implicit bias within their curricula.
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Affiliation(s)
- Shena B. Gazaway
- School of Nursing Center for Palliative and Supportive Care, University of Alabama, 1720 2nd Avenue South, AL 35294-1210 Birmingham, USA
| | - Michael D. Barnett
- Associate Professor of Medicine & Pediatrics, Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, USA
| | - Ella H. Bowman
- Professor of Medicine, Section Chief of Geriatric Medicine, University of Alabama at Birmingham, Alabama VA Health Care System, Birmingham, USA
| | - Deborah Ejem
- Assistant Professor School of Nursing, University of Alabama Birmingham, Birmingham, USA
| | - Erin R. Harrell
- Assistant Professor Department of Psychology, University of Alabama, Tuscaloosa, USA
| | - Cynthia J. Brown
- Professor and Chair Department of Internal Medicine, Louisiana State University Health Sciences Center, New Orleans , USA
| | - Marie Bakitas
- Professor and Associate Dean for Research and Scholarship School of Nursing Center for Palliative and Supportive, University of Alabama, Birmingham, USA
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Rosenstock Gonzalez YR, Williams D, Herbenick D. Skin Color and Skin Tone Diversity in Human Sexuality Textbook Anatomical Diagrams. JOURNAL OF SEX & MARITAL THERAPY 2021; 48:285-294. [PMID: 34647496 DOI: 10.1080/0092623x.2021.1989533] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Little is known about skin tone and skin color representation within sexuality education materials. A content analysis was performed to assess skin tone and skin color diversity among anatomical images (n = 182) within eight contemporary, college-level human sexuality textbooks. Of these images, 1.1% represented dark skin tones while 83.5% represented light skin tones. Skin colors commonly associated with Black and Brown people were underrepresented in comparison to colors generally associated with white or white-presenting people such as conch, which comprised 42.3% (n = 77) of anatomical images. We encourage sex therapists to use racially conscious and inclusive imagery and educational materials when serving clients.
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Affiliation(s)
- Yael R Rosenstock Gonzalez
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, Indiana, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, Indiana, USA
| | - Deana Williams
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, Indiana, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, Indiana, USA
| | - Debby Herbenick
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, Indiana, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, Indiana, USA
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