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Karatana Ö, Karaman M. Relationship of sustainable development goals, holistic nursing competence, and social justice advocacy role in public health nurses. Public Health Nurs 2024. [PMID: 39248032 DOI: 10.1111/phn.13418] [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: 05/15/2024] [Revised: 07/13/2024] [Accepted: 08/28/2024] [Indexed: 09/10/2024]
Abstract
OBJECTIVE This study was conducted to examine the relationship between public health nurses' holistic nursing and social justice advocacy competencies in terms of their attitudes toward sustainable development goals. DESIGN Cross-sectional survey. SAMPLE The study sample consisted of 384 public health nurses. MEASUREMENTS Data were collected with the personal information form, the Attitudes toward Sustainable Development Scale, the Holistic Nursing Competence Scale, and the Social Justice Advocacy Scale. RESULTS The sub-dimensions of environment, public, education, and economy were found to significantly affect social justice advocacy, and the indirect effects of 0.191, 0.222, 0.205, and 0.201 were found to be statistically significant with the inclusion of holistic nursing competence in the model, respectively. It was found to explain 32%, 30%, 29%, and 22% of the total effect, respectively. CONCLUSION It supports the claim that developing public health nurses' holistic nursing competence and social justice advocacy skills is an important criterion for achieving sustainable development goals.
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Affiliation(s)
| | - Mesut Karaman
- Department of Business Administration, Institute of Social Sciences, Sivas Cumhuriyet University, Sivas, Turkey
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2
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Alodhialah AM, Almutairi AA, Almutairi M. Ethical and Legal Challenges in Caring for Older Adults with Multimorbidities: Best Practices for Nurses. Healthcare (Basel) 2024; 12:1585. [PMID: 39201144 PMCID: PMC11353594 DOI: 10.3390/healthcare12161585] [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: 06/29/2024] [Revised: 07/20/2024] [Accepted: 07/30/2024] [Indexed: 09/02/2024] Open
Abstract
This study explores the ethical and legal challenges faced by nurses in caring for older adults with multimorbidities, focusing on issues related to patient autonomy, polypharmacy, and end-of-life care. Through semi-structured interviews with 15 nurses in Riyadh, Saudi Arabia, the research highlights the complexities of obtaining informed consent from patients with cognitive impairments and the ethical dilemmas of balancing autonomy and safety. The management of polypharmacy emerged as a significant concern, with nurses emphasizing the importance of thorough documentation and coordination among healthcare providers to prevent adverse drug interactions. End-of-life care and advance directives posed further challenges, particularly when family members disagreed with patients' documented wishes. The study underscores the need for comprehensive strategies, including ongoing education, clear communication, and supportive institutional policies, to address these issues effectively. The findings suggest that enhancing nurses' understanding of ethical principles and legal requirements is crucial for improving patient care and ensuring compliance with regulatory standards. Future research should aim to develop evidence-based guidelines to support nursing practice in managing these ethical and legal challenges.
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Affiliation(s)
- Abdulaziz M. Alodhialah
- Department of Medical Surgical Nursing, College of Nursing, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Ashwaq A. Almutairi
- School of Nursing & Midwifery, Monash University, Melbourne, VIC 3800, Australia;
| | - Mohammed Almutairi
- Department of Medical Surgical Nursing, College of Nursing, King Saud University, Riyadh 11451, Saudi Arabia;
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3
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Slemon A, Wonsiak T, Delli Colli AR, Blanchet Garneau A, Varcoe C, Bungay V. Social justice in Canadian nursing professional documents: A Foucauldian discourse analysis. Nurs Inq 2024:e12653. [PMID: 39099253 DOI: 10.1111/nin.12653] [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: 05/02/2024] [Accepted: 06/11/2024] [Indexed: 08/06/2024]
Abstract
Social justice is widely advanced as a central nursing value, and yet conceptual understandings of social justice remain inconsistent and vague. Further, despite persistently articulated commitments to upholding social justice, the profession of nursing has been implicated in perpetuating inequities in health and health care. In this context, it is essential to establish both conceptual clarity and tangible guidance for nurses in enacting practices to advance social justice-particularly through regulatory, education and accreditation documents that shape the nursing profession. This Foucauldian discourse analysis examines how social justice is discursively positioned within nursing professional documents in Canada, and illustrates that social justice was largely discursively excluded from these texts. Where social justice discourses were invoked, we identified that four central discursive patterns obscured and de-centred this nursing value: (i) Vague language undermined professional commitments to social justice; (ii) Constructions of knowledge and awareness de-emphasized practice; (iii) Individualism discourses minimized institutional/professional responsibility; and (iv) Aspirational language obscured present action. Extending from this analysis, we contend that the nursing profession must re-examine how social justice is understood and articulated, and call for a re-conceptualization of social justice grounded in nursing practice toward remediating inequities in health and health care.
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Affiliation(s)
- Allie Slemon
- School of Nursing, University of Victoria, Victoria, British Columbia, Canada
| | - Tessa Wonsiak
- School of Nursing, University of Victoria, Victoria, British Columbia, Canada
| | - Anne-Renée Delli Colli
- Faculty of Nursing, Université de Montréal, Pavillon Marguerite-d'Youville, Montreal, Quebec, Canada
| | - Amélie Blanchet Garneau
- Faculty of Nursing, Université de Montréal, Pavillon Marguerite-d'Youville, Montreal, Quebec, Canada
| | - Colleen Varcoe
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Vicky Bungay
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
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4
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Unsworth J, Puthenpurakal A. The process of developing and implementing health and nursing policy: Implications of research and opportunities to influence. Int Nurs Rev 2024. [PMID: 39045618 DOI: 10.1111/inr.13022] [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: 02/29/2024] [Accepted: 06/26/2024] [Indexed: 07/25/2024]
Abstract
AIM To provide insight into the process of developing health and nursing policy and how that process can be influenced by both researchers and nursing leaders. BACKGROUND Nurses care for people across the life course from birth to death, in our communities, hospitals, care homes and schools. They have unique insight into how people live their lives and how this affects their health. Despite being well placed to influence health policy, nurses often fail to capitalise on this. At the same time, academics often struggle to identify the policy implications of their research resulting in further missed opportunities to use policy influence. SOURCES OF EVIDENCE Classical policy theory, which is predominantly drawn from economics and public administration together with a range of contemporary nursing and health policy studies, is used in this paper to discuss the policy process and opportunities to influence. DISCUSSION Researchers need to focus on realistic policy suggestions that aim to raise awareness, highlight policy problems or set the agenda. In turn, nursing leaders, from National Nursing Associations, need to harness evidence to support their efforts to influence policy. In terms of influence, a range of approaches exist, and each lends itself to different parts of the policy cycle. CONCLUSION The role nurses can play in health policy is not well developed in many countries. Nursing researchers and leaders are well placed to influence policy but must do so in a clear and pragmatic way recognising that policymakers make decisions despite being faced with conflicting evidence, competing demands and economic imperatives. IMPLICATIONS FOR NURSING PRACTICE Recognising that nurses can offer much in terms of policy development, the paper argues that a pragmatic approach based on different forms of influence at different stages is likely to be most successful. IMPLICATIONS FOR NURSING AND HEALTH POLICY The evidence reviewed in this paper suggests that nursing academics and leaders need to identify realistic policy interventions when examining their own empirical work or identifying ways to individually or collectively influence policymakers.
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Barcelona V, Condon EM, Jacoby SF. Leveraging biosocial methods to examine and address structural determinants of health and promote health equity. Nurs Outlook 2024; 72:102195. [PMID: 38810533 PMCID: PMC11330731 DOI: 10.1016/j.outlook.2024.102195] [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: 01/14/2024] [Revised: 03/26/2024] [Accepted: 04/28/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Biosocial approaches in nursing research have largely focused on the ways that social determinants of health influence individual-level outcomes, including symptom management, family and social support, and educational interventions. PURPOSE Theoretical, methodological, and practical strategies are needed to expand current biosocial methods for nursing science and focus on upstream, structural determinants of health and the policies that underlie health inequities. METHODS This paper summarizes presentations given at the 2023 Council for the Advancement of Nursing Science Advanced Methods Conference, Biosocial Methods to Advance Health Equity, in a panel titled "Individual, community, systems and policy related to biosocial methods." DISCUSSION Nurses are uniquely positioned to examine upstream, structural determinants of health by leveraging expertise in biosocial methods, collaborating with interdisciplinary researchers and community members, and advocating for policy change. By conducting theory-grounded biosocial research, nurse researchers can significantly advance scientific knowledge and promote health equity for individuals and communities. CONCLUSION Nurse scientists are conducting research using biosocial methods and provide recommendations for expansion of this approach in the field.
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Affiliation(s)
| | - Eileen M Condon
- University of Connecticut School of Nursing, Storrs, CT; Department of Pediatrics, University of Connecticut School of Medicine, Storrs, CT
| | - Sara F Jacoby
- Department of Family and Community, University of Pennsylvania School of Nursing, Philadelphia, PA
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6
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Mccready G, Laperrière H. The advocacy process in Canadian community health nursing: A collaborative ethnography. J Adv Nurs 2024; 80:2847-2859. [PMID: 37837207 DOI: 10.1111/jan.15896] [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: 02/28/2023] [Revised: 08/09/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023]
Abstract
AIMS To shed light on the process of advocacy in the context of community health nursing, through a methodology inspired by the epistemologies of the South. DESIGN We conducted a collaborative ethnography in a community health centre in Canada. METHODS de Sousa Santos' epistemologies of the South, a typology of advocacy and main themes from historic research informed the methodology. Data were collected between 2016 and 2018 through 420 h of fieldwork observations and three group discussions, including a collective process to co-construct interpretations with participants. Twenty-one nurses participated in the study. RESULTS Nurses had sufficient work flexibility to practice advocacy actions focused on individuals and groups. They also engaged in attempts at policy reform in the form of defending access to appropriate care and changing the mode of care organization. However, these were curbed by bureaucracy and administrative rules, resulting in the eventual dismissal of health promotion actions and experiences of moral distress. CONCLUSION Despite the political climate of their work environment impeding social justice agendas, nurses' advocacy practices showed a persistence of moral values and ideals in coherence with the regional nursing legacy. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Acting at the organizational level and involving field nurses in decision making are potential avenues for increasing policy advocacy efficacy. IMPACT Examining contexts through another epistemic lens and methods of research drawing on history and anthropology has shed light on a process of advocacy. This research shows that organizations need to equip themselves with mechanisms to promote the sharing of realities between nurses, thereby building collective advocacy. REPORTING METHOD The research adheres to the EQUATOR guidelines with SRQR and COREQ methods. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Geneviève Mccready
- Health Science Department, University of Quebec at Rimouski, Rimouski, Quebec, Canada
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Li L, Fan J, Qiu L, Li C, Han X, Liu M, Zhao S, Wang Y. Prevalence and factors associated with job burnout among nurses in China: A cross-sectional study. Nurs Open 2024; 11:e2211. [PMID: 38858855 PMCID: PMC11164709 DOI: 10.1002/nop2.2211] [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: 11/24/2023] [Revised: 03/23/2024] [Accepted: 05/29/2024] [Indexed: 06/12/2024] Open
Abstract
AIM Many people see nursing as a high-pressure, high-risk profession. Therefore, job burnout among nursing staff has become an important topic of study and has received widespread attention worldwide. This research intended to evaluate the frequency of and variables related with work burnout among nurses in public hospitals in China. DESIGN Using a multistage random sample procedure, a cross-sectional survey was carried out in the eastern, central and western areas of China. METHODS The Maslach Inventory-Human Service Survey and demographic information made up the two sections of the questionnaire. Of the 5250 questionnaires sent, 4865 were deemed legitimate, yielding an effective response rate of 92.67%. A linear regression analysis was performed to investigate the variables linked to nursing work burnout. RESULTS Among the 4865 nurses, women accounted for 97.4% of the survey respondents, most of whom were aged 26-35 years. Results showed that the total scores of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA) were 20.02 ± 12.04, 4.78 ± 5.54 and 34.42 ± 10.32 respectively. 50.7% of subjects obtained high or moderated scores on EE, 32.8% of subjects obtained high or moderated scores on DP and 80.4% of subjects obtained low or moderated scores on PA. Age, department, position, post-establishment, work shift type in recent months, overtime times in recent months and night shift frequency in recent months were negatively correlated with EE, and child status, monthly income, working days per week and sleep quality in recent 1 month were positively correlated with it (F = 141.827, P < 0.01, R2 = 0.243). Age, gender, department, post-establishment, overtime hours in recent months and night shift frequency in recent months were negatively correlated with DP, and child status and sleep quality in the last 1 month were positively correlated with it (F = 78.794, p < 0.01, R2 = 0.115). Child status, years of nursing work and sleep quality in the last 1 month were negatively correlated with PA, whereas age, position, work shift type in recent months and night shift frequency in recent months were positively correlated with it (F = 67.981, p < 0.01, R2 = 0.089).
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Affiliation(s)
- Lei Li
- The Second Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Jing Fan
- The First Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Lili Qiu
- The Second Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Chunyan Li
- The Second Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Xuanye Han
- The Second Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Ming Liu
- Shenzhen Luohu Hospital Group Luohu People's Hospital/the Third Affiliated Hospital of Shenzhen UniversityShenzhenChina
| | - Shihong Zhao
- The Six Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Ying Wang
- The Second Affiliated Hospital of Harbin Medical UniversityHarbinChina
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Turale S, Thummathai K. Addressing the global shortage of nurses: A call to arms. Nurs Health Sci 2024; 26:e13130. [PMID: 38804106 DOI: 10.1111/nhs.13130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 05/06/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024]
Affiliation(s)
- Sue Turale
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
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Pate K, Linder JM. National Association of Clinical Nurse Specialists Affiliate Support for Professional Growth of Clinical Nurse Specialist Students. CLIN NURSE SPEC 2024; 38:75-79. [PMID: 38364067 DOI: 10.1097/nur.0000000000000800] [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: 02/18/2024]
Abstract
PURPOSE/OBJECTIVES The purpose of this article was to describe how a National Association of Clinical Nurse Specialists affiliate partnered with a local university to engage clinical nurse specialist (CNS) students, enhance its mission and activities, and create succession planning opportunities, while providing mentorship and professional growth opportunities. DESCRIPTION OF THE PROJECT Academic preparation of CNS students endeavors to instill professionalism. A 3-pronged partnership incorporating the inclusion of a student liaison on the board, presentation of student clinical work at the affiliate's annual conference, and development of a student scholarship was implemented. OUTCOMES Membership in professional nursing organizations for a CNS student provides exposure and access to professional development resources, socialization to the role, rewarding networking opportunities with peers and colleagues, and leadership development. Anecdotal feedback demonstrated a better understanding of the CNS role, increased confidence, and enhanced knowledge on topics such as legislative advocacy as well as experiences of sharing clinical challenges with CNS colleagues. CONCLUSION Partnership with the local university allowed the affiliate to maintain the influx of new CNSs, which sustains membership, nurtures the growth of new CNSs, and ensures the influx of new ideas. Furthermore, membership in professional nursing organizations is imperative to address the opportunities that exist in healthcare.
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Affiliation(s)
- Kimberly Pate
- Author Affiliations: Director of Policy and Professional Development (Dr Pate), Atrium Health's Carolinas Medical Center, Charlotte; and Associate Clinical Professor, East Carolina University School of Nursing (Dr Linder), Greenville, North Carolina
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Ibrahim AM. Nurses' ethical responsibilities: Whistleblowing and advocacy in patient safety. Nurs Ethics 2024:9697330241235306. [PMID: 38415609 DOI: 10.1177/09697330241235306] [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: 02/29/2024]
Abstract
BACKGROUND In the dynamic landscape of healthcare, nurses play a crucial role as ethical stewards, responsible for whistleblowing, nurse advocacy, and patient safety. Their duties involve ensuring patient well-being through ethical practices and advocacy initiatives. AIM This study investigates the ethical responsibilities of nurses regarding whistleblowing and advocacy in reporting concerns about patient safety. RESEARCH DESIGN A cross-sectional study utilized cluster and simple random sampling to gather a representative sample of actively practicing registered nurses. Data collection involved a demographic form, Nurse Whistleblowing Intentions Scale, Nursing Advocacy Scale, and Clinical Decision-Making Scale. PARTICIPANTS AND RESEARCH CONTEXT The study utilizing a robust sample size determination formula for reliable findings included 96 diverse nurses, predominantly females. Engaged actively in direct patient care across various outpatients clinics. The recruitment process specifically sought individuals with expertise in safety protocols and reporting, contributing to a nuanced understanding of the study's focus. ETHICAL CONSIDERATIONS Ethical approval was obtained from the ethics committee of the university and the hospitals involved. Written consent was obtained from the participants. A thorough ethical review was conducted to guarantee participant protection and adherence to ethical principles. RESULTS Surveyed nurses demonstrated positive whistleblowing (Overall Mean Score: 3.58), high advocacy (Overall Mean Score: 12.2), and nuanced ethical decision-making for patient safety (Overall Mean Score: 15.78). Demographic factors, such as nationality and ethical training, significantly impacted whistleblowing intentions, while age, gender, and ethical training correlated with nursing advocacy behavior. Associations with experience and qualification emerged in ethical decision-making. CONCLUSION The gained insights foster targeted interventions, improving ethical practices, advocacy, and informed decision-making in nursing. This study explores the intricate link between demographics and ethical considerations among surveyed nurses, acting as a catalyst for ongoing initiatives to strengthen the ethical foundation in healthcare sector.
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Pappas S, Brosius W, Hayes R, Lawrence M, McMichael B, Zimmermann D, McCauley L. Maximizing the potential value of the nursing workforce. Nurs Outlook 2024; 72:102016. [PMID: 37574395 DOI: 10.1016/j.outlook.2023.102016] [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: 03/09/2023] [Revised: 06/11/2023] [Accepted: 06/21/2023] [Indexed: 08/15/2023]
Abstract
This panel paper is the fifth installment in a six-part Nursing Outlook special edition based on the 2022 Emory Business Case for Nursing Summit. The 2022 summit convened national nursing, health care, and business leaders to explore possible solutions to nursing workforce crises, including the nursing shortage. Each of the summit's four panels authored a paper in this special edition on their respective topic, and this panel paper focuses on maximizing the potential value of the nursing workforce. It addresses topics including the need to create a nursing-inclusive federal health care billing system improve nursing salaries by designing/testing nurse-informed compensation models, and strengthen nursing's national professional infrastructure.
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Affiliation(s)
| | | | - Rose Hayes
- Emory University School of Nursing, Atlanta, GA.
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12
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Wood RE, Matthews EE, Bourgault A, Rice M, Hershberger PE, Voss JG, Loerzel V, Henderson WA, Talsma A, Kinser PA. Strategies to Strengthen Nursing PhD Enrollment: An Ecological Systems Perspective. J Nurs Educ 2023; 62:669-678. [PMID: 38049303 DOI: 10.3928/01484834-20231006-05] [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: 12/06/2023]
Abstract
BACKGROUND Nurses with a Doctor of Philosophy (PhD) degree are essential to developing nursing knowledge, promoting health outcomes, and educating the next generation of nurses. Declining enrollment in nursing PhD programs calls for purposeful action. Guided by Bronfenbrenner's Ecological Systems Framework, this article outlines barriers and facilitators, and offers strategies to increase PhD enrollment. METHOD Extant literature and the authors' cumulative experiences in PhD education and research were reviewed to identify strategies to increase PhD enrollment. RESULTS Multilevel influences impede or facilitate enrollment in PhD programs. Strategies addressing individual and interpersonal influences included intentional personalized recruiting and early outreach to students at various levels of education. Institutional and organizational strategies included research partnerships and programs, and financial and infrastructure support. Sociocultural strategies included image branding and a positive social media presence supporting nurse scientists. CONCLUSION Strategies to enhance PhD enrollment across all levels can spark interest in nursing science and PhD enrollment. [J Nurs Educ. 2023;62(12):669-678.].
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Njie H, Dale E, Gopinathan U. Procedural fairness in decision-making for financing a National Health Insurance Scheme: a case study from The Gambia. Health Policy Plan 2023; 38:i73-i82. [PMID: 37963076 PMCID: PMC10645046 DOI: 10.1093/heapol/czad063] [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: 10/11/2022] [Revised: 03/29/2023] [Accepted: 07/27/2023] [Indexed: 11/16/2023] Open
Abstract
Achieving universal health coverage (UHC) involves difficult policy choices, and fair processes are critical for building legitimacy and trust. In 2021, The Gambia passed its National Health Insurance (NHI) Act. We explored decision-making processes shaping the financing of the NHI scheme (NHIS) with respect to procedural fairness criteria. We reviewed policy and strategic documents on The Gambia's UHC reforms to identify key policy choices and interviewed policymakers, technocrats, lawmakers, hospital chief executive officers, private sector representatives and civil society organizations (CSOs) including key CSOs left out of the NHIS discussions. Ministerial budget discussions and virtual proceedings of the National Assembly's debate on the NHI Bill were observed. To enhance public scrutiny, Gambians were encouraged to submit views to the National Assembly's committee; however, the procedures for doing so were unclear, and it was not possible to ascertain how these inputs were used. Despite available funds to undertake countrywide public engagement, the public consultations were mostly limited to government institutions, few trade unions and a handful of urban-based CSOs. While this represented an improved approach to public policy-making, several CSOs representing key constituents and advocating for the expansion of exemption criteria for insurance premiums to include more vulnerable groups felt excluded from the process. Overload of the National Assembly's legislative schedule and lack of National Assembly committee quorum were cited as reasons for not engaging in countrywide consultations. In conclusion, although there was an intent from the Executive and National Assembly to ensure transparent, participatory and inclusive decision-making, the process fell short in these aspects. These observations should be seen in the context of The Gambia's ongoing democratic transition where institutions for procedural fairness are expected to progressively improve. Learning from this experience to enhance the procedural fairness of decision-making can promote inclusiveness, ownership and sustainability of the NHIS in The Gambia.
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Affiliation(s)
- Hassan Njie
- Department of Community Medicine and Global Health, University of Oslo, Postboks 1130 Blindern, Oslo 0318, Norway
| | - Elina Dale
- Cluster for Global Health, Norwegian Institute of Public Health, Sandakerveien 24C, Oslo 0473, Norway
| | - Unni Gopinathan
- Cluster for Global Health, Norwegian Institute of Public Health, Sandakerveien 24C, Oslo 0473, Norway
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14
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Haney B. Influencing health policy: A vital aspect of the APRN role. Nurse Pract 2023; 48:9-13. [PMID: 37751608 DOI: 10.1097/01.npr.0000000000000094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Affiliation(s)
- Beth Haney
- Beth Haney is a faculty member in the NP program at University of Southern California; City Councilwoman of Yorba Linda, Calif.; and CEO/Owner/NP at Luxe Aesthetic Center, Yorba Linda, Calif
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15
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Marye S, Atav S. The Affordable Care Act and child asthma: Lowering health care barriers by raising our voices. Nurs Outlook 2023; 71:102025. [PMID: 37494843 DOI: 10.1016/j.outlook.2023.102025] [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: 02/24/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND This policy discussion addresses the provisions of the Affordable Care Act (ACA) that impact children with asthma. PURPOSE The purpose of this policy paper is to inform health care professionals and lawmakers about ACA provisions affecting pediatric asthma care and provide recommendations for policy changes that can improve equitable care for children with asthma. METHODS The issues addressed involve discrimination, Medicaid policy oversight, quality improvement stategy, data collection, school-based health care funding, accountable care organization reimbursement, and the extension of dependent coverage. DISCUSSION Health care policy development that focuses on human rights, and not market valuation, could reduce health inequity among children with asthma. CONCLUSION Policy recommendations are presented to improve asthma care for a population that is largely vulnerable due to age, socioeconomic status, and discrimination.
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Affiliation(s)
- Stacey Marye
- Department of Nursing, University of North Carolina at Greensboro, Greensboro, NC.
| | - Serdar Atav
- Decker College of Nursing and Health Science, Binghamton University, State University of New York, Binghamton, NY.
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16
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Hardin-Fanning FD, Hartson K, Lynette G, Gesler R, Kern N. Socioecological Analysis of a Nursing Advocacy Skills-Building Activity. J Nurs Educ 2023; 62:509-515. [PMID: 37672499 DOI: 10.3928/01484834-20230712-07] [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: 09/08/2023]
Abstract
BACKGROUND Advocacy is an expectation of the nursing profession. Nursing curricula should include opportunities for advocacy skills building at multiple levels of potential effect. Analyses of student performances during these advocacy exercises provide insight into how well students understand the multifactorial nature of most public health issues. METHOD A socioecological model was used to evaluate nursing students' advocacy responses to food-insecurity scenarios during a guided online discussion activity aimed at advocacy skills building. RESULTS Student recommendations were categorized as individual, interpersonal, organizational, community, and policy interventions, with subcategories at each socioecological level. CONCLUSION Recommendations are given for future educational research specific to advocacy skills building. Implications for nursing education at each socioecological level also are discussed. [J Nurs Educ. 2023;62(9):509-515.].
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17
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Chiu P, Thorne S, Schick-Makaroff K, Cummings GG. Lessons from professional nursing associations' policy advocacy responses to the COVID-19 pandemic: An interpretive description. J Adv Nurs 2023. [PMID: 36876739 DOI: 10.1111/jan.15625] [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: 12/01/2022] [Revised: 01/30/2023] [Accepted: 02/19/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Professional nursing associations across jurisdictions engaged in significant policy advocacy during the COVID-19 pandemic to support nurses, the public and health systems. While professional nursing associations have a long history of engaging in policy advocacy, scholars have rarely critically examined this important function. PURPOSE The purpose of this study was twofold: (a) to examine how professional nursing associations engage in the process of policy advocacy and (b) to develop knowledge specific to policy advocacy in the context of a global pandemic. METHODS This study was conducted using interpretive description. A total of eight individuals from four professional nursing associations (two local, one national and one international) participated. Data sources included semi-structured interviews conducted between October 2021 and December 2021 and internal and external documents produced by organizations. Data collection and analysis occurred concurrently. Within-case analysis was conducted prior to cross-case comparisons. FINDINGS Six key themes were developed to illustrate the lessons learned from these organizations including their organization's role in supporting a wide audience (professional nursing associations as a compass); the scope of their policy priorities (bridging the gaps between issues and solutions), the breadth of their advocacy strategies (top down, bottom up and everything in between), the factors influencing their decision-making (looking in and looking out), their evaluation practices (focus on contribution, not attribution) and the importance of capitalizing on windows of opportunity. CONCLUSIONS This study provides insight into the nature of policy advocacy carried out by professional nursing associations. IMPACT The findings suggest the need for those leading this important function to think critically about their role in supporting a wide range of audiences, the breadth and depth of their policy priorities and advocacy strategies, the factors that influence their decision-making, and the ways in which their policy advocacy work can be evaluated to move towards greater influence and impact.
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Affiliation(s)
- Patrick Chiu
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sally Thorne
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Greta G Cummings
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Hodge L, Raymond C. Code poverty: An adaptation of the social-ecological model to inform a more strategic direction toward nursing advocacy. Nurs Inq 2023; 30:e12511. [PMID: 35801387 DOI: 10.1111/nin.12511] [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: 01/16/2021] [Revised: 06/14/2022] [Accepted: 06/18/2022] [Indexed: 01/25/2023]
Abstract
The purpose of this discussion paper is to explore how nurses can be strategically poised to advocate for needed policy change in support of greater income equality and other social determinants of health. We adapted Bronfenbrenner's social-ecological model to highlight how four broad pervasive subsystems shape the opportunities that nurses have to engage in advocacy at the policy level. These subsystems include organizations (the microsystem), professional bodies (the mesosystem), public policies (the exosystem), and societal values (the macrosystem). On the basis of this adapted model, we recommend changes among modifiable elements of the microsystem and mesosystem that can help position nurses (ecologically and collectively) to advocate for public policy change and use examples from a Canadian context to illustrate these points. We believe that the ideas arising from this model can be widely used where policy action on the social determinants of health is needed to inform, guide, and frame change efforts and advocacy work.
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Affiliation(s)
- Lesley Hodge
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Christy Raymond
- Faculty of Nursing, MacEwan University, Edmonton, Alberta, Canada
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De Raeve P, Bolzonella F, Davidson PM. A Theoretically Derived Approach to Impact: Implementing Policy Influence Strategies. Policy Polit Nurs Pract 2022; 23:150-161. [PMID: 35656783 DOI: 10.1177/15271544221100164] [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: 11/16/2022]
Abstract
Advocacy is an intentional act of influencing government and an important precondition for successful policy change in society. Drawing from an existing framework on policy influence, we propose an approach to quantifying the impact of policy influence efforts, specifically within the context of European Public Health (EPH) advocacy. The analysis hinges on the article "Moving from tokenism" which provides a starting point to conceptualize strategies to quantify impact. An exploratory case study approach allowed to integrate literature on advocacy evaluation in parallel with the internal documentation of a EPH advocacy organization We provide recommendations to advocacy organizations that aim to create an infrastructure towards quantifying the impact of their efforts. The framework is mostly tailored to the needs of EPH advocacy, but it can also have resonance beyond the scope of a specific sector.
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Affiliation(s)
- Paul De Raeve
- Secretary General European Federation of Nurses Associations, Brussels, Belgium
| | - Francesco Bolzonella
- 120669Maastricht University, School of Business and Economics, Maastricht, Netherlands
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van Wijk M, Lalleman PCB, Cummings GG, Engel J. Public Opinion Leadership in Nursing Practice: A Rogerian Concept Analysis. Policy Polit Nurs Pract 2022; 23:67-79. [PMID: 35040669 PMCID: PMC8804936 DOI: 10.1177/15271544211071099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the Dutch nursing context, work remains in strengthening the voice of nurses serving as frontline health care providers and board members alike. Conceptual clarity of Public Opinion Leadership (POL) in nursing practice is needed to provide attributes, antecedents and consequences for nurses and nurse leaders so they can contribute in the public debate and policy making processes. Using Rodgers’ method of evolutionary concept analysis and the key words “POL,” “lobbying” and “public affairs,” we searched PubMed (including MEDLINE), CINAHL, PsycINFO and Cochrane Library for articles written in English, published between January 1999 and May 2020, which resulted in a final selection of seven studies. In addition, transcripts of an expert panel discussion regarding POL were analyzed. Attributes of POL are credibility, accessibility, altruism, dynamic networking and sense of systemness. Antecedents are a clinical background, authentic authority, policy and political awareness and strategic skills. The main consequences of POL entail influencing those who are involved in policy making processes, a new generation of public opinion leaders, and the raising of bottom-up political leaders. POL is a relatively new concept for nursing, with increasing interest given the need to ensure quality of care by increasing the use of evidence in clinical practice. POL in nursing practice is defined as the action of influencing public debate regarding policy making processes by maintaining dynamic (social) networks, having a high sense of systemness, and being (clinically) credible, altruistic and accessible to peers and a wide variety of stakeholders.
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Affiliation(s)
- M van Wijk
- 8119HU University of Applied Sciences, Utrecht, The Netherlands
| | - P C B Lalleman
- 3158University of Alberta, Edmonton, Canada.,3158Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | | | - J Engel
- 8119HU University of Applied Sciences, Utrecht, The Netherlands
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