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Santos ACPDO, de Camargo CL, Vargas MADO, Araújo CNVD, Whitaker MCO, Zilli F, Martins RD, Gomes NP. A critical perspective on institutional violence against hospitalized children: Testimonies by health professionals and family members. Nurs Inq 2024:e12665. [PMID: 39138913 DOI: 10.1111/nin.12665] [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: 12/28/2022] [Revised: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 08/15/2024]
Abstract
The purpose of this study is to understand institutional violence (IV) in the relationships between health professionals, hospitalized children, and family members. This is a qualitative study developed at the pediatric inpatient unit of a university hospital in the city of Salvador, Bahia, Brazil. The research participants consisted of 39 health professionals who specialized in pediatrics and 10 family members of hospitalized children. Semi-structured interviews were the method used for data collection. Using discourse analysis as a basis and taking a Foucauldian perspective, the researchers observed that the expressions of IV could be traced to abusive power relations within the system. We found four discursive forms within the data set: communication problems as IV, violence through inattention and neglect, violence as an action and consequent materialization on the body, and psychological violence as a submission mechanism. Based on these findings, we argue that professionals, managers, the scientific community, and users might be able to better guarantee the safety of children by recognizing IV and effectively intervening in it.
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Affiliation(s)
| | | | | | | | | | - Francielly Zilli
- Federal University of Santa Catarina, R. Delfino Conti, S/N - Trindade, Florianópolis, SC, Brazil
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Zinter KE, Tull P, Greeson MR, Hoffman EE, Wegrzyn A. The Working Relationship Between Emergency Room Nurses and Medical Rape Victim Advocates: A Qualitative Examination of Nurses' Perceptions of the Influence of Nurse Training and Experience on Nurse-Advocate Interactions. Violence Against Women 2023; 29:2891-2914. [PMID: 37605545 DOI: 10.1177/10778012231196058] [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: 08/23/2023]
Abstract
Nurses and medical advocates respond to sexual assault survivors seeking hospital services. Ideally, both providers work collaboratively. However, this does not always happen. Extant research on the nurse-advocate relationship focuses on Sexual Assault Nurse Examiners (SANEs). This study examines how ER nurses perceive their training and experience influence the working relationships between emergency room (ER) nurses (not exclusively SANEs) and medical advocates. Key findings indicate nurses perceive increased training improves (a) role understanding, (b) trust, (c) respect, (d) rapport, and (e) appreciation. Less training was associated with poorer role understanding and trust.
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Ma L, Wang X, Zou S, Lin M, Qiu S, Li W. A structural equation modelling analysis: interprofessional team collaboration, organizational career management, and post competency of community nurses. BMC Health Serv Res 2023; 23:327. [PMID: 37005581 PMCID: PMC10067220 DOI: 10.1186/s12913-023-09303-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 03/17/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND With the advent of an ageing society and an increase in the prevalence of chronic diseases, the role of primary health care has become increasingly important and reliant on multidisciplinary collaboration. As members of this interprofessional cooperative team, community nurses play a dominant role. Thus, the post competencies of community nurses study deserve our attention. In addition, organizational career management can affect nurses in some ways. This study aims to examine the current situation and relationship among interprofessional team collaboration, organizational career management and post-competency of community nurses. METHODS A survey was conducted among 530 nurses in 28 community medical institutions from November 2021 to April 2022 in Chengdu, Sichuan Province, China. Descriptive analysis was used for analysis, and a structural equation model was used to hypothesize and verify the model. A total of 88.2% of respondents met the inclusion criteria and did not meet the exclusion criteria. The main reason nurses gave for not participating was that they were too busy. RESULTS Among the competencies on the questionnaire, ensuring quality and helping roles scored the lowest. The teaching-coaching and diagnostic functions played a mediating role. Nurses with greater seniority and those who were transferred to administrative departments had lower scores, and the difference was statistically significant (p < 0.05). In the structural equation model, CFI = 0.992 and RMSEA = 0.049, which shows that the model fit well, suggesting that organizational career management had no statistically significant effect on post competency (β = -0.006, p = 0.932) but that interprofessional team collaboration had a statistically significant effect on post competency (β = 1.146, p < 0.001) and organizational career management had a statistically significant effect on interprofessional team collaboration (β = 0.684, p < 0.001). CONCLUSIONS Attention should be given to the improvement of community nurses' post competency in ensuring quality and performing helping, teaching-coaching, and diagnostic roles. Moreover, researchers should focus on the decline in community nurses' abilities, particularly for those with greater seniority or in administrative roles. The structural equation model shows that interprofessional team collaboration is a complete intermediary between organizational career management and post competency.
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Affiliation(s)
- Li Ma
- Institute of Hospital Management, Outpatient Department, West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xinwei Wang
- School of Business, Sichuan University, Chengdu, Sichuan, China
| | - Shiyue Zou
- The First People's Hospital of Longquanyi District, Chengdu, Sichuan, China
| | - Min Lin
- The First People's Hospital of Longquanyi District, Chengdu, Sichuan, China
| | - Shi Qiu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Weimin Li
- Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, Frontiers Science Center for Disease-Related Molecular Network/Precision Medicine Research Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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López Gabeiras MDP. La importancia de la comunicación médico-paciente: un estudio en Argentina. PERSONA Y BIOÉTICA 2023. [DOI: 10.5294/pebi.2022.26.2.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Objetivo: Analizar la importancia de la comunicación en la relación médico-paciente y recopilar información sobre la percepción durante su práctica. Método: Se realiza una revisión bibliográfica y una encuesta (participaron 105 médicos en Argentina). Resultados: Los resultados muestran que la mayoría de los profesionales refiere dificultades en la comunicación y que estas dificultan la atención. Los médicos manifestaron dificultades para comunicar malas noticias, mayormente en las áreas clínicas, y que la habilidad de ponerse en el lugar del paciente es fundamental para la comunicación de dichas noticias. Los jóvenes consideran de manera significativa que la comunicación de malas noticias depende de la práctica. Conclusiones: Las habilidades comunicativas son indispensables. Existe evidencia para sugerir que es necesario profundizar en la adquisición de competencias comunicativas y valores éticos.
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Endris Y, W/Selassie M, Edmealem A, Ademe S, Yimam W, Zenebe Y. Nurse-Physician Inter-Professional Collaboration and Associated Factors at Public Hospitals in Dessie City, Amhara, Northeastern Ethiopia, 2021. J Multidiscip Healthc 2022; 15:1697-1708. [PMID: 35971397 PMCID: PMC9375560 DOI: 10.2147/jmdh.s373599] [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: 05/20/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Nurse–physician collaboration is an integral part of quality improvement in health care. Collaboration enables individuals to work together to achieve defined and common health purposes. There is limited evidence related to nurse–physician inter-professional collaboration and its associated factors in Ethiopia, particularly in Dessie city public hospitals. Objective To assess nurse–physician inter-professional collaboration and associated factors at public hospitals in Dessie city, Ethiopia, 2021. Methods An institutional-based cross-sectional study was conducted among nurses and physicians at public hospitals in Dessie city. A self-administered questionnaire was used for data collection. Stratified simple random sampling techniques were used to select study participants proportional to the sample size allocation. The final sample size was 260 and allocated proportionally to Dessie Comprehensive Specialized Hospital and Boru Meda General Hospital. The data were entered and analyzed using EPI-data version 4.6 and SPSS version 26 software respectively. During analysis, p-values less than 0.25 in binary logistic regression were entered into multivariable logistic regression. Finally, p-values less than 0.05 in multi-variable logistic regression were considered statically significant. Results The mean score for inter-professional collaboration was 97.40 ± 19.6SD. In this study, inter-professional collaboration among nurses and physicians was 44.2%. This study showed that favorable attitude [AOR=3.205; CI: 1.781–5.766], respondents working in the gynecological department [AOR=0.210; CI: 0.052–0.849], satisfied organizational support [AOR=2.062; CI: 1.140–3.729] and urban residents [AOR=3.996; CI: 1.069–14.931] were factors associated with nurse–physician inter-professional collaboration. Conclusion In this study, nurse–physician inter-professional collaboration was low. Training on the importance of health teamwork, timely monitoring and evaluation of organizational support, and professional empowerment towards a favorable attitude of nurse–physician inter-professional collaboration shall be provided at hospital levels. Routine assessment and timely intervention of the gynecological department for nurse–physician inter-professional collaboration shall be done at hospital levels. Moreover, both quantitative and qualitative research shall be performed for future research.
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Affiliation(s)
- Yimer Endris
- Department of Adult Health Nursing, Tropical College of Medicine, Dessie, Ethiopia
| | - Mulugeta W/Selassie
- Department of Pediatrics and Child Health Nursing, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
| | - Afework Edmealem
- Department of Comprehensive Nursing, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
| | - Sewunet Ademe
- Department of Comprehensive Nursing, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
| | - Wondwossen Yimam
- Department of Comprehensive Nursing, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
| | - Yosef Zenebe
- Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
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Poder interprofissional em cuidados intensivos: reflexão filosófica a partir de perspectivas foucaultianas e críticas. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ar0245345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Santos ACPDO, Camargo CLD, Vargas MADO. Hospital structure elements demarcating (in)visibilities of institutional violence against children. Rev Bras Enferm 2022; 75:e20200785. [PMID: 35043933 DOI: 10.1590/0034-7167-2020-0785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 09/05/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to analyze the hospital structure elements that demarcate (in)visibilities of institutional violence in hospitalized children. METHODS this is a descriptive-exploratory qualitative study that used approaches with Foucault's thinking. Ten companions and 39 healthcare professionals from a university hospital in Salvador, Bahia participated. Data collection took place from November 2018 to June 2019 through semi-structured interviews. The discourse analysis method was used. The study was approved by the Institutional Review Board. RESULTS institutional violence was understood in the violations and invisibilities of the structure of health services through the problems: in infrastructure (physical structure, lack of human and material resources, scrapping of equipment); administrative and management; pilgrimage. FINAL CONSIDERATIONS it is necessary to realize the invisibilities of the infrastructure to act in confronting institutional violence to hospitalized children.
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Mattar E Silva TW, McLean D, Velloso IC. Disciplinary power on daily practices of nurses and physicians in the hospital. Nurs Inq 2021; 29:e12455. [PMID: 34414630 DOI: 10.1111/nin.12455] [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: 12/28/2020] [Revised: 08/03/2021] [Accepted: 08/07/2021] [Indexed: 11/30/2022]
Abstract
To understand power relations, it is important to consider that power is an attribute, and whoever has it at a given moment is in the condition of dominant and whoever is under its exercise is dominated. Moreover, we must consider that these positions are interchangeable, changing when relations of force change. Power relations represent the pursuit of supremacy through knowledge, with struggles for better positioning in the social structure. In this study, we analyze the effects of disciplinary power on daily practices of nurses and physicians in the hospital environment, more specifically in intensive care units. From the perspective of disciplines, power is exercised in a discreet, modest, calculated and permanent way, through the establishment of rules and norms. In this context, despite the strong appreciation of a medical-centered model, it is observed that nurses gain visibility through knowledge and the defense of institutional norms and rules, which can generate tensions in daily professional practices.
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Affiliation(s)
- Tauana W Mattar E Silva
- Graduate Program, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Donna McLean
- Department of Nursing Foundations, Faculty of Nursing, MacEwan University, Edmonton, Alberta, Canada
| | - Isabela C Velloso
- Department of Applied Nursing, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Byrne AL, Harvey C, Baldwin A. Health (il)literacy: Structural vulnerability in the nurse navigator service. Nurs Inq 2021; 29:e12439. [PMID: 34237182 DOI: 10.1111/nin.12439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/30/2021] [Accepted: 06/02/2021] [Indexed: 12/29/2022]
Abstract
Health literacy is a contemporary term used in health services, often used to describe individuals requiring additional support to access, understand and implement health service information. It is used as a measure of self-efficacy in chronic disease models of care such as the nurse navigator service. The aim of the research was to investigate the concept of health literacy in the nurse navigator service, particularly in relation to the defined role objective of person-centred care. Fairclough's critical discourse analysis was used to analyse the experiential, relational and expressive elements of texts, investigating the hidden truths which are represented in discourse. Texts from a variety of health service micro-, meso- and macro-hierarchical sources were selected for analysis using the nurse navigator evaluation data set and other associated texts. Health literacy in the nurse navigator service is a technology of government used to increase participation of individuals in their own health and well-being. The discourse suggests that health literacy responsibilises both individuals and nurses and is discursively formed within a matrix of rational choice. In this context, health literacy contributes to structural vulnerability.
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Affiliation(s)
- Amy-Louise Byrne
- Midwifery and Social Science, Central Queensland University School of Nursing, Townsville, QLD, Australia
| | - Clare Harvey
- Midwifery and Social Science, Central Queensland University School of Nursing, Townsville, QLD, Australia.,School of Nursing, Massey University, Palmerston North, New Zealand
| | - Adele Baldwin
- Midwifery and Social Science, Central Queensland University School of Nursing, Townsville, QLD, Australia
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Ewuoso C, Hall S, Dierickx K. How do healthcare professionals respond to ethical challenges regarding information management? A review of empirical studies. Glob Bioeth 2021; 32:67-84. [PMID: 33897255 PMCID: PMC8023626 DOI: 10.1080/11287462.2021.1909820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim This study is a systematic review that aims to assess how healthcare professionals manage ethical challenges regarding information within the clinical context. Method and Materials We carried out searches in PubMed, Google Scholar and Embase, using two search strings; searches generated 665 hits. After screening, 47 articles relevant to the study aim were selected for review. Seven articles were identified through snowballing, and 18 others were included following a system update in PubMed, bringing the total number of articles reviewed to 72. We used a Q-sort technique for the analysis of identified articles. Findings This study reveals that healthcare professionals around the world generally employ (to varying degrees) four broad strategies to manage different types of challenges regarding information, which can be categorized as challenges related to confidentiality, communication, professional duty, and decision-making. The strategies employed for managing these challenges include resolution, consultation, stalling, and disclosure/concealment. Conclusion There are a variety of strategies which health professionals can adopt to address challenges regarding information management within the clinical context. This insight complements current efforts aimed at enhancing health professional-patient communication. Very few studies have researched the results of employing these various strategies. Future empirical studies are required to address this. Abbreviations CIOMS: Council of International Organization of Medical Sciences; WHO: World Health Organization; AMA: American Medical Association; WMA: World Medical Association; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analysis; ISCO: International Standard Classification of Occupations; ILO: International Labour Office; SPSS: The Statistical Package for the Social Sciences
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Affiliation(s)
| | - Susan Hall
- Center for Applied Ethics, Stellenbosch University, Western-Cape, South Africa
| | - Kris Dierickx
- Centre for Biomedical Ethics and Law, Katholieke Universiteit Leuven, Leuven, Belgium
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Byrne AL, Baldwin A, Harvey C. Whose centre is it anyway? Defining person-centred care in nursing: An integrative review. PLoS One 2020; 15:e0229923. [PMID: 32155182 PMCID: PMC7064187 DOI: 10.1371/journal.pone.0229923] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 02/18/2020] [Indexed: 11/19/2022] Open
Abstract
AIM The aims of this literature review were to better understand the current literature about person-centred care (PCC) and identify a clear definition of the term PCC relevant to nursing practice. METHOD/DATA SOURCES An integrative literature review was undertaken using The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Scopus and Pubmed databases. The limitations were English language, full text articles published between 1998 and 2018 within Australian, New Zealand, Canada, USA, Europe, Ireland and UK were included. The international context off PCC is then specifically related to the Australian context. REVIEW METHODS The review adopted a thematic analysis to categorise and summarise themes with reference to the concept of PCC. The review process also adhered to the Preferred Reporting System for Meta-Analysis (PRISMA) and applied the Critical Appraisal Skills Programme (CASP) tools to ensure the quality of the papers included for deeper analysis. RESULTS While definitions of PCC do exist, there is no universally used definition within the nursing profession. This review has found three core themes which contribute to how PCC is understood and practiced, these are People, Practice and Power. This review uncovered a malalignment between the concept of PCC and the operationalisation of the term; this misalignment was discovered at both the practice level, and at the micro, meso and micro levels of the healthcare service. CONCLUSION The concept of PCC is well known to nurses, yet ill-defined and operationalised into practice. PCC is potentially hindered by its apparent rhetorical nature, and further investigation of how PCC is valued and operationalised through its measurement and reported outcomes is needed. Investigation of the literature found many definitions of PCC, but no one universally accepted and used definition. Subsequently, PCC remains conceptional in nature, leading to disparity between how it is interpreted and operationalised within the healthcare system and within nursing services.
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Affiliation(s)
- Amy-Louise Byrne
- Central Queensland University School of Nursing, Midwifery and Social Science, Townsville, Queensland, Australia
| | - Adele Baldwin
- Central Queensland University School of Nursing, Midwifery and Social Science, Townsville, Queensland, Australia
| | - Clare Harvey
- Central Queensland University School of Nursing, Midwifery and Social Science, Townsville, Queensland, Australia
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