Social Justice as a Framework for Professional Nursing

A family-centered approach to social needs awareness in the pediatric emergency department

Objective

We aimed to understand family preferences around reporting and receiving health-related social needs (HRSN) information by assessment modality during pediatric emergency department (PED) visits.

Methods

Families were randomized into paper (control), cell phone, or tablet modality groups by their child's exam room. Nurses alerted families to complete a single HRSN assessment during routine workflow. We used logistic regression and McNemar's test to assess discordance in modality preference.

Results

Forty-seven percent of families disclosed at least one HRSN across a total 611 assessments. Disclosure of HRSN was similar by modality. Twenty-three percent of those assigned tablet preferred cell phone (p < 0.001). Two-thirds of families preferred receiving digitally formatted community resources (email or text). There was no difference in preferred timing of HRSN assessment completion.

Conclusions

Assessment modality did not appear to influence family HRSN disclosure. Families were generally satisfied with all HRSN assessment modalities but demonstrated a particular preference in using personal cell phones over tablets. Digitally formatted community referrals also pose numerous advantages over conventional paper handouts.

Innovation

Use of personal cell phones is a novel, streamlined method of HRSN interventions in the clinical setting, performing similar to more conventional modalities, with a preference among families when compared to tablets.

"They bring the topic [of social justice] but stop there": Nursing students' perceptions of teaching practices that develop awareness and engagement with social justice

BACKGROUND

Pedagogical frameworks grounded in social justice, such as decolonizing and anti-racist educational practices, are essential in nursing programs. While scholars have begun to examine nurse educators' conceptualizations of social justice, there remains a lack of knowledge about student perspectives regarding nurse educators' approaches to incorporating social justice in education.

OBJECTIVE

To understand nursing students' perceptions about educational strategies that develop critical awareness and engagement with social justice and positively influence professional practice.

DESIGN

A qualitative study informed by Critical Feminist Pedagogy and guided by Interpretive Description methodology.

SETTINGS

A school of nursing in Western Canada.

PARTICIPANTS

Ten undergraduate and graduate nursing students recruited through convenience sampling.

METHODS

Students participated in one-on-one semi-structured interviews. A set of questions developed to facilitate data analysis allowed the deconstruction of the data to identify broad-based inductive categories. Contrast and comparison methods were also used. Members of the research team provided analytic insights into the categories, and subsequently, all members discussed the findings and developed the interpretive frame.

RESULTS

Student participants reported that educational strategies promoting awareness and engagement with social justice need to go beyond superficial engagement and awareness of social justice. Researchers' analysis suggests that cohesiveness between awareness and action in social justice is urgently needed within academia to adopt a decolonizing and anti-racist pedagogy in nursing and better prepare students for professional practice. From the data analysis, teaching strategies that enhance cohesiveness include: embracing personal development, creating community spaces and disrupting knowledge and curriculum hierarchies.

CONCLUSIONS

Understanding students' perceptions and incorporating their suggestions is critical to integrating socially just teaching practices that embrace a learner-centred pedagogy. Our findings offer suggestions for teaching strategies that foster critical awareness and engagement with social justice. Combined, these contribute to our understanding of signature pedagogies in nursing with the intention of increasing the adoption of anti-racist and decolonizing approaches.

A Concept Analysis of the Social Responsibility of Nursing Organizations Based on Walker and Avant's Method

Social responsibility has been a core value of the nursing profession, particularly in the area of health disparity. Nevertheless, it is unclear what is meant by social responsibility. This study examined ways to define the concept of the social responsibility of nursing organizations to understand the meaning of social responsibility in the nursing profession.

METHODS

The concept analysis process reported by Walker and Avant was used to clarify the meaning of social responsibility in nursing organizations.

RESULTS

Defining the attributes of the social responsibility of nursing organizations included accessing, educating, and practicing as approaches for strategizing the social and structural change in inequity, caring for oppressed groups suffering socially from those with privilege and power, and taking action for health policy changes in social and political unequal contexts. The antecedents of social responsibility in nursing organizations included recognizing personal characteristics, the perspective of vulnerable populations, and the social and environmental status quo, as well as educating public services on the ethical and moral reasoning of social issues. The consequences of the social responsibility of nursing organizations were achieving social justice as equal access to basic human health needed at a societal level, equal access to effective nursing practices, and the development of health promotion policies for world health administrative practices in nursing.

CONCLUSION

This study provides guidance to direct future studies by identifying conceptual attributes in the context of the social responsibility of nursing organizations.

Teaching strategies to develop skills to address social inequalities in nursing education: A scoping review

OBJECTIVES

to identify teaching strategies for developing skills to address social inequalities in nursing education.

DESIGN

Following the Joanna Briggs Institute and PRISMA-ScR guidelines, a scoping review was performed to answer the following research question: "What are the teaching strategies employed to develop nurses' skills to address social inequalities?"

DATA SOURCES

Bibliographical search was conducted seven electronic databases until December 29, 2020, and updated on March 25, 2022. Papers published in Portuguese, English, and Spanish on competence and professional practice, social inequality, education/training, and nursing were included.

REVIEW METHODS

Seven reviewers screened the articles by reading titles and abstracts. Studies on teaching strategies used to develop nurses' skills to address social inequalities were included. Of the 1137 articles found, 61 were selected by the first screening, and 23 were included in the final sample. Data were analyzed and summarized as a narrative.

RESULTS

The included papers were published between 2000 and 2020, predominantly in the United States. Curricular and learning strategies, including service, experience, and interactive, were the most common, followed by university programs and civil society initiatives. Courses, classes, debates, and practical activities predominated as teaching activities. Teaching techniques focus on resources such as posters, videos, workshops, and seminars.

CONCLUSIONS

This review identified teaching strategies used to develop nurses' skills to address social inequalities. Curricular initiatives, learning strategies, university programs and civil society initiatives can expand students' understanding of social inequalities and be used to develop skills.

Health equity knowledge development: A conversation with Black nurse researchers

Can the institutional systems that prepare Black nurse researchers question the ways their systemic pathways have impacted health equity knowledge development in nursing? We invite our readers to keep this question in mind and engage with our conversation as Black nurse researchers, scholars, educators, and clinicians. The purpose of our conversation, and this article, is to explore the transactional impact of knowledge development pathways and Black faculty retention pathways on the state of health equity knowledge in nursing today. Over a series of conversations, we discuss the research exploitation of communities of color, deficit research funding, knowledge capitalization, the marginalization of diversity as a continuous process, a lack of sociocultural authority, and our thoughts on solutions. We conclude by using the wisdom of a generation to answer our initial question.

Applying a Nursing Perspective to Address the Challenges Experienced by Cisgender Women in the HIV Status Neutral Care Continuum: A Review of the Literature

ABSTRACT

The field of HIV research has grown over the past 40 years, but there remains an urgent need to address challenges that cisgender women living in the United States experience in the HIV neutral status care continuum, particularly among women such as Black women, who continue to be disproportionately burdened by HIV due to multiple levels of systemic oppression. We used a social ecological framework to provide a detailed review of the risk factors that drive the women's HIV epidemic. By presenting examples of effective approaches, best clinical practices, and identifying existing research gaps in three major categories (behavioral, biomedical, and structural), we provide an overview of the current state of research on HIV prevention among women. To illustrate a nursing viewpoint and take into account the diverse life experiences of women, we provide guidance to strengthen current HIV prevention programs. Future research should examine combined approaches for HIV prevention, and policies should be tailored to ensure that women receive effective services that are evidence-based and which they perceive as important to their lives.

Strategies to establish and maintain trust when working in immigrant communities

The nursing profession has historically advocated a strong commitment to social justice. As immigration issues have become increasingly politicized, nurses are being called upon to integrate principles of social justice when caring for immigrant populations. Nurse researchers have a particular challenge in winning and maintaining trust in immigrant communities. Data from several studies suggest that erosion of trust in the health care system, due to fears of detention and deportation, is resulting in adverse health outcomes among immigrants. The purpose of this article is to discuss a variety of strategies to establish and maintain trust in immigrant communities. These strategies were developed to maintain an academic-community partnership focused around obesity prevention among Mexican immigrant families. Strategies included: (a) Conceptualize trust as a dynamic continuum; (b) recognize the scope and impact of the stressors; (c) separate fact versus fiction; (d) identify deportation-related stressors and community responses; (e) manage trust and mistrust issues; (f) build bridges; and (g) establish a positive presence. Nurses are well poised to intervene to repair the damaged trust between immigrant communities and the health care system, using community-based participatory methods.

A Theoretical Framework for Emancipatory Nursing With a Focus on Environment and Persons' Own and Shared Lifeworld

By giving a brief overview of the metaconcepts in nursing, with a focus on environment, we sketch a theoretical framework for an emancipatory perspective in nursing care practice. To meet the requirements of equality in care and treatment, we have in our theoretical framework added a critical lifeworld perspective to the antioppressive practice, to meet requirements of equity in health care encounter. The proposed model of emancipatory nursing goes from overall ideological structures to ontological aspects of the everyday world. Based on the model, nurses could identify what kind of theoretical critical knowledge and thinking they require to conduct equal care and encounter the person behind the patient role.

Parents' reasons for not attending parental education groups in antenatal and child health care: A qualitative study

AIMS AND OBJECTIVES

To explore expectant and new parents' reasons not to participate in parental education (PE) groups in antenatal care or child health care.

BACKGROUND

In Sweden, expectant and new parents are offered PE groups in antenatal care and in child health care. Although many parents feel unprepared for parenthood, an urgent task is to attract parents to attend the PE groups.

DESIGN

A total of 915 parents with children aged 0 to 21 months answered a web questionnaire with open questions about (a) reasons not to participate; (b) anything that could change their mind; and (c) parenting support instead of PE groups. This was analysed using content analysis. The study follows the SRQR guidelines.

RESULTS

Parents expressed private reasons for not attending PE groups. Some parents also asked for more heterogeneity regarding content and methods, as well as accommodation of parents' different interests. Other parents asked for like-minded individuals who were in similar situation to themselves. Lack of information or invitations from antenatal care or child health care, or that PE groups were unavailable, were additional reasons for not participating in groups.

CONCLUSIONS

Reasons for not attending PE groups were multifaceted from personal, self-interested and norm-critical reasons, to that the groups were not available or that the parents were not aware of their existence.

RELEVANCE TO CLINICAL PRACTICE

Parents of today are a diverse group with different interests and needs. Nevertheless, all parents need to feel included in a way that makes participation in PE groups relevant for them. Thus, it is important for leaders to be aware of structures and norms, and to be able to create a group climate and a pedagogy of acceptance where group members value each other's differences. However, to attract parents to participate in PE groups, it is necessary for clinical practice to work on individual, group and organisational levels.

A pedagogy of social justice for resilient/vulnerable populations: Structural competency and bio-power

BACKGROUND

Nursing schools frequently assert the importance of social justice curriculum, but little information is available about specifics for such a class.

PURPOSE

The purpose of this article is to describe a class that builds a foundation for the understanding of social justice and the pedagogical frameworks on which it rests.

METHODS

The authors develop a class grounded in bio-power and structural competency.

DISCUSSION

Described are topics presented to students, the rationale for their selection along with class activities and implementation challenges. Highlighted is the use of praxis as students incorporate the components of structural competency and bio-power. The focus is on the potential for public health and advanced practice registered nurses to recognize and evaluate structural factors in patient and population-based care.

CONCLUSION

Faculty meet substantive challenges in teaching social justice, including lack of recognition of societal forces which affect student's ability to provide care. Focused effort incorporating newer structural and philosophical frameworks in a social justice class may improve the provision of health services. The frameworks of structural competency and bio-power provide a critical paradigm salient in social justice pedagogy.

Libraries on the frontlines: neutrality and social justice

Purpose

The purpose of this paper is to examine libraries’ responsibility to engage with and support communities of color as they challenge systemic racism, engage in the political process, and exercise their right to free speech. Many libraries have ignored the Black Lives Matter (BLM) movement, citing the need to maintain neutrality. Despite extensive scholarship questioning the validity of this concept, the framing of library neutrality as nonpartisanship continues. This paper examines librarianship’s engagement with, and disengagement from black communities through the lens of the BLM movement. It also explores the implications of education, engagement, and activism for people of color and libraries today.

Design/methodology/approach

The authors have engaged the topic from a critical race perspective as a practice in exercising voice – telling stories, presenting counterstories, and practicing advocacy (Ladson-Billings, 1998).

Findings

The assertion that libraries have been socially and politically neutral organizations is ahistorical. When libraries decide not to address issues relevant to people of color, they are not embodying neutrality; they are actively electing not to support the information and service needs of a service population. In order for libraries to live up to their core values, they must engage actively with communities, especially when those communities are in crisis.

Originality/value

As a service field, librarianship has an ethos, values, and history that parallel those of many other service fields. This paper has implications for developing understanding of questions about equitable service provision.

Contested Practice: Political Activism in Nursing and Implications for Nursing Education

Canadian nurses have a social mandate to address health inequities for the populations they serve, as well as to speak out on professional and broader social issues. Although Canadian nursing education supports the role of nurses as advocates for social justice and leadership for health care reform, little is known about how nurse educators understand activism and how this translates in the classroom. A comparative life history study using purposeful sampling and a critical feminist lens was undertaken to explore political activism in nursing and how nurse educators foster political practice among their students. Findings from interviews and focus groups with 26 Ontario nurse educators and nursing students suggested that neoliberal dynamics in both the practice setting and in higher education have constrained nurses' activist practice and favour a technical rational approach to nursing education. Implications and strategies to inspire political action in nursing education are discussed.

Returning to the Profession's Roots: Social Justice in Nursing Education for the 21st Century

This article reviews the history of social justice in nursing and argues that education needs to be redesigned to allow nurses to return to the profession's social justice roots. A review of social justice literature in nursing practice and education was conducted. Although social justice is a recurring theme in the literature, definitions are abstract, calls to action are ambiguous, and theoretical frameworks continue to emphasize the individual nurse-patient dyad. Nursing education needs to be redesigned to incorporate social justice concepts throughout the entire curriculum. By educating the current and future nursing workforce, the profession can return to its roots of social justice to address structural inequalities and social injustices that manifest as health inequities in the United States.

A critical review of social and health inequalities in the nursing curriculum

CONTEXT

Social and health inequalities are a reality around the world and one of the most important challenges in the current age. Nurse educators can respond to these challenges by incorporating curricular components to identify and intervene in social and health inequalities.

OBJECTIVE

To examine how social and health inequalities have been addressed in the nursing curriculum.

DESIGN

Informed by the work of Paulo Freire, a critical literature review was performed to examine how social and health inequalities have been addressed in the nursing curriculum.

DATA SOURCES AND REVIEW METHODS

In July 2015, we searched for articles published from 2000 to 2015 in ERIC, CINAHL, Web of Science, Scielo, MEDLINE and LILACS databases. Main search terms included "disparity" or "inequality" and "curriculum" and "nursing." We included studies published in academic journals in English, Portuguese and Spanish.

RESULTS

A total of 20 articles were included in this review. Most of the articles (15) were from the United States and described educational experiences in implementing courses in nursing undergraduate curricula. Limited experiences with graduate nursing education were identified. Social and health inequalities were approached in these articles through elements such as social justice, cultural competence, cultural safety, and advocacy. A concern to reduce social and health disparities was noted. We identified three major themes in the articles included in this review: 1) elements in the curricula that can contribute to reducing social and health inequalities; 2) educational and research strategies used to address the theme of inequalities; 3) a focus on socially vulnerable populations to increase awareness on social and health inequalities.

CONCLUSION

Findings suggest that nursing education initiatives align with the recommendations from the World Health Organization to address disparities. There is also a need to identify existing conceptual and practical content on inequalities in the nursing curriculum through future research.

"They treated me like crap and I know it was because I was Native": The healthcare experiences of Aboriginal peoples living in Vancouver's inner city

There is growing evidence that Aboriginal peoples often experience healthcare inequalities due to racism. However, research exploring the healthcare experiences of Aboriginal peoples who use illicit substances is limited, and research rarely accounts for how multiple accounts of stigma intersect and contribute to the experiences of marginalized populations. Our research aimed to explore the healthcare experiences of Aboriginal peoples who use illicit drugs and or illicit alcohol (APWUID/A) living in Vancouver's inner city. Using Indigenous methodologies, a community research team comprised of APWUID/A led the study design, data collection and analysis. Peer-facilitated talking circles explored community members' experiences accessing healthcare services and patient-provider encounters. Using an intersectionality framework, our research demonstrated how healthcare inequalities among Aboriginal peoples are perpetuated by systemic racism and discrimination. Stigmatizing racial stereotypes were perceived to negatively influence individual attitudes and clinical practice. Participants' experiences of medical dismissal often resulted in disengagement from care or delay in care. The findings suggest healthcare providers must understand the structural and historical forces that influence racial disparities in healthcare and personal attitudes in clinical practice. Adequate clinical protocols for pain management within the context of illicit substance use are urgently needed. The valuation of Aboriginal peoples and cultures within healthcare is paramount to addressing the health gap between Aboriginal and non-Aboriginal Canadians.

Cultural Background and Societal Influence on Coping Strategies for Physical Activity Among Immigrant Women

PURPOSE

The aim of the study was to examine, from an intersectional perspective, how immigrant women with prolonged illness experience the conditions for physical activity.

METHOD

Focus groups were used. Twenty-two women from primary care representing 14 countries were included. Systematic text condensation was applied for analysis.

RESULTS

Five conditions were identified: Dual cultures to relate to, Isolation an invisible danger, Keys to physical activity, Physical activity for whom, The power to decide the agenda.

DISCUSSION AND CONCLUSION

This study shows the importance of raising the intersectional perspective for immigrant women's possibilities to perform physical activity. Immigrant women's vulnerability to power relations and their adjustment to society's expectations are significant considerations to be aware of.

IMPLICATIONS FOR PRACTICE

Our findings emphasize the significance of collaborating in biomedical and psychosocial issues, considering that the obstacles are more comprehensive than society assumes regarding prior knowledge, isolation, and cultural rules.

Political representation for social justice in nursing: lessons learned from participant research with destitute asylum seekers in the UK

The concept of social justice is making a revival in nursing scholarship, in part in response to widening health inequalities and inequities in high-income countries. In particular, critical nurse scholars have sought to develop participatory research methods using peer researchers to represent the 'voice' of people who are living in marginalized spaces in society. The aim of this paper is to report on the experiences of nurse and peer researchers as part of a project to explore the experiences of people who find themselves destitute following the asylum process in the UK. In seeking to explore social injustice, three challenges are identified: lack of a robust political theory, institutional/professional constraints and an absence of skills to engage with the politics of social (in)justice. Each challenge is presented, opposing voices outlined and some possible solutions are suggested. The work of political theorist Nancy Fraser is used as a conceptual framework, in particular her focus on mis/framing and political representation for social justice. In addition, it is suggested that social justice needs to be further embedded in nursing policy and curriculum. Finally, nurses are encouraged to develop practical political skills to engage with both politics and the media in a neoliberal globalizing world.

Questioning Photovoice Research: Whose Voice?

Photovoice is an important participatory research tool for advancing health equity. Our purpose is to critically review how participant voice is promoted through the photovoice process of taking and discussing photos and adding text/captions. PubMed, Scopus, PsycINFO, and Web of Science databases were searched from the years 2008 to 2014 using the keywords photovoice, photonovella, photovoice and social justice, and photovoice and participatory action research. Research articles were reviewed for how participant voice was (a) analyzed, (b) exhibited in community forums, and (c) disseminated through published manuscripts. Of 21 studies, 13 described participant voice in the data analysis, 14 described participants' control over exhibiting photo-texts, seven manuscripts included a comprehensive set of photo-texts, and none described participant input on choice of manuscript photo-texts. Photovoice designs vary in the advancement of participant voice, with the least advancement occurring in manuscript publication. Future photovoice researchers should expand approaches to advancing participant voice.

The Association of HIV Stigma and HIV/STD Knowledge With Sexual Risk Behaviors Among Adolescent and Adult Men Who Have Sex With Men in Ghana, West Africa

Ghanaian men who have sex with men (MSM) have a high HIV seroprevalence, but despite a critical need to address this public health concern, research evidence has been extremely limited on influences on sexual risk behavior among MSM in Ghana. To investigate associations between HIV/STD knowledge, HIV stigma, and sexual behaviors in a sample of MSM in Ghana, we conducted a secondary data analysis of cross-sectional survey data from a non-probability sample of Ghanaian MSM (N = 137). Nearly all the men (93%) had more than one current sex partner (M = 5.11, SD = 7.4). Of those reported partners, the average number of current female sexual partners was 1.1 (SD = 2.6). Overall, knowledge levels about HIV and STDs were low, and HIV stigma was high. There was no age-related difference in HIV stigma. Younger MSM (≤25 years) used condoms less often for anal and vaginal sex than did those over 25. Relative frequency of condom use for oral sex was lower in younger men who had higher STD knowledge and also was lower in older men who reported high HIV stigma. Knowledge and stigma were not associated with condom use for anal or vaginal sex in either age group. These descriptive data highlight the need for the development of intervention programs that address HIV/STD prevention knowledge gaps and reduce HIV stigma in Ghanaian communities. Intervention research in Ghana should address age-group-specific HIV prevention needs of MSM youth.

Public health nurse educators' conceptualisation of public health as a strategy to reduce health inequalities: a qualitative study

BACKGROUND

Nurses have long been identified as key contributors to strategies to reduce health inequalities. However, health inequalities are increasing in the UK despite policy measures put in place to reduce them. This raises questions about: convergence between policy makers' and nurses' understanding of how inequalities in health are created and sustained and educational preparation for the role as contributors in reducing health inequalities.

AIM

The aim of this qualitative research project is to determine public health nurse educators' understanding of public health as a strategy to reduce health inequalities.

METHOD

26 semi-structured interviews were conducted with higher education institution-based public health nurse educators.

FINDINGS

Public health nurse educators described health inequalities as the foundation on which a public health framework should be built. Two distinct views emerged of how health inequalities should be tackled: some proposed a population approach focusing on upstream preventive strategies, whilst others proposed behavioural approaches focusing on empowering vulnerable individuals to improve their own health.

CONCLUSION

Despite upstream interventions to reduce inequalities in health being proved to have more leverage than individual behavioural interventions in tackling the fundamental causes of health inequalities, some nurses have a better understanding of individual interventions than take population approaches.

Understanding inequalities in access to health care services for aboriginal people: a call for nursing action

We present findings from an Access Research Initiative to reduce health disparities and promote equitable access with Aboriginal peoples in Canada. We employed Indigenous, interpretive, and participatory research methodologies in partnership with Aboriginal people. Participants reported stories of bullying, fear, intimidation, and lack of cultural understanding. This research reveals the urgent need to enhance the delivery of culturally appropriate practices in emergency. As nurses, if we wish to affect equity of access, then attention is required to structural injustices that act as barriers to access such as addressing the stigma, stereotyping, and discrimination experienced by Aboriginal people in this study.

Discourses of social justice: examining the ethics of democratic professionalism in nursing

This essay provides a critical exploration of discourses of social justice in nursing. It examines commitments to social justice in the work of international nursing scholars and in professional codes of ethics in international nursing organizations. The analysis touches on salient conversations in philosophy, relating these ways of knowing to social justice as an ethical pattern in nursing practice. On the basis of this analysis, the discussion explores questions of professional formation in nursing, noticing when commitments to social justice are taken up or evaded in different models of professionalism. In concluding comments, implications of democratic professionalism are explored for professional formation in nursing, arguing for teaching, learning, and knowledge projects that contribute to social justice in our democracy.

Evaluation of the validity and reliability of the Korean version of the Nursing Professional Values Scale-Revised

BACKGROUND

The development of professional values is a significant factor in improving nursing practice. It is important to develop nursing curricula for establishing and investigating nursing students' professional values. Professional values of Korean nursing students may differ from those of nursing students in other countries, and research on the professional values of Koreans using a validated scale is needed.

OBJECTIVES

The purpose of this study was to test the validity and reliability of the Korean version of the Nursing Professional Values Scale-Revised.

METHODS

Convenience samples of 1077 baccalaureate nursing students were recruited from four universities in Korea. Construct validity and internal consistency reliability using explanatory factor analysis were examined.

RESULTS

The validity was obtained using a principle component analysis of a five-factor structure (variance explained 58.90%). The five factors were labeled human dignity, professionalism, innovation, contribution, and advocacy. The Cronbach's alphas were .93 for the total scale and .89-.62 for the subscales.

CONCLUSIONS

The overall Korean version of the Nursing Professional Values Scale-Revised was valid and reliable for measuring nursing professional values. Criterion-related validation of the Korean version of the Nursing Professional Values Scale-Revised and the development of items congruent with Korean culture are needed to support the validity and reliability of the Korean version of the Nursing Professional Values Scale-Revised.

Health inequalities as a foundation for embodying knowledge within public health teaching: a qualitative study

INTRODUCTION

Recent U.K. health policies identified nurses as key contributors to the social justice agenda of reducing health inequalities, on the assumption that all nurses understand and wish to contribute to public health. Following this policy shift, public health content within pre-registration nursing curricula increased. However, public health nurse educators (PHNEs) had various backgrounds, and some had limited formal public health training, or involvement in or understanding of policy required to contribute effectively to it. Their knowledge of this subject, their understanding and interpretation of how it could be taught, was not fully understood.

METHODOLOGY

This research aimed to understand how public health nurse educators' professional knowledge could be conceptualised and to develop a substantive theory of their knowledge of teaching public health, using a qualitative data analysis approach. Qualitative in-depth semi-structured interviews (n=26) were conducted with eleven university-based PHNEs.

RESULTS

Integrating public health into all aspects of life was seen as central to the knowing and teaching of public health; this was conceptualised as 'embodying knowledge'. Participants identified the meaning of embodying knowledge for teaching public health as: (a) possessing a wider vision of health; (b) reflecting and learning from experience; and (c) engaging in appropriate pedagogical practices.

CONCLUSION

The concept of public health can mean different things to different people. The variations of meaning ascribed to public health reflect the various backgrounds from which the public health workforce is drawn. The analysis indicates that PHNEs are embodying knowledge for teaching through critical pedagogy, which involves them engaging in transformative, interpretive and integrative processes to refashion public health concepts; this requires PHNEs who possess a vision of what to teach, know how to teach, and are able to learn from experience. Their vision of public health is influenced by social justice principles in that health inequalities, socioeconomic determinants of health, epidemiology, and policy and politics are seen as essential areas of the public health curriculum. They believe in forms of teaching that achieve social transformation at individual, behavioural and societal levels, while also enabling learners to recognise their capacity to effect change.

Critical service learning in community health nursing: enhancing access to cardiac health screening

Critical service learning (CSL) offers promise for preparing community health nursing students to be advocates for social justice and social change. The purpose of this article is to describe a community based CSL project designed to provide cardiac health screening to an underserviced population, wherein nursing's role in social justice is integrated into nursing practice. First, the relationship between social justice and CSL is explored. Then, the CSL approach is examined and differentiated from the traditional service learning models frequently observed in the nursing curriculum. The CSL project is described and the learning requisites, objectives, requirements, and project outcomes are outlined. While not a panacea for system reform, CSL offers nursing students avenues for learning about social justice and understanding the social conditions that underlie health inequalities. Nurse educators may benefit from the new strategies for incorporating social justice into nursing curriculum; this paper suggests that CSL offers one possibility.

Putting the world as classroom: an application of the inequalities imagination model in nursing and health education

This article focuses on the description of an educational initiative, the Interdisciplinary Population Health Project (IPHP) conducted in the academic year of 2006-2007 with a group of nursing and health care students. Inspired by population health, community development, critical pedagogy, and the inequalities imagination model, students participated in diverse educational activities to become immersed in the everyday life of an underserved urban neighborhood. A sample of convenience composed of 158 students was recruited from 4 health disciplines in a Western Canadian university. Data were collected using a modified version of the Parsell and Bligh's Readiness of Health Care Students for Interprofessional Learning Scale. A one group pretest-posttest design was used to assess the outcomes of the IPHP. Paired t tests and one-way analyses of variance were used to compare the responses of students from different academic programs to determine if there were differences across disciplines. Findings suggest that students' readiness to work in interprofessional teams did not significantly change over the course of their participation in the IPHP. However, the inequalities imagination model may be useful to enhance the quality and the effectiveness of fieldwork learning activities as a means of educating culturally and socially conscious nurses and other health care professionals of the future.

Public Policy Analysis to Redress Urban Environmental Health Inequities

Public policies may not have been designed to disadvantage certain populations, but the effects of some policies create unintended health inequities. The nature of community health nurses’ daily work provides a privileged position to witness the lived experiences and effects of policy-produced social and health inequities. This privileged position requires policy competence including analytical skills to connect lived experiences to public policy. The purpose of this article is to present an example of an urban ethnography that explicates inequity-producing effects of public policy and is intended to inform necessary policy changes. This study sheds light on how issues of childcare, housing, nutrition, and urban infrastructure in the context of poverty are fundamental to the larger issues of environmental health. This policy analysis documents how the Day Care Act of Nova Scotia, Canada explicates patriarchal and neoliberal gender and class assumptions that have implications for mothers’ health decisions.

How has liberation theology influenced my practice?

In this paper, I would like to share with readers some concepts from liberation theology in relation to Christian nursing. First, I present liberation theology to explore its concepts and how they can shed light on Christian nursing. I introduce liberation theology and discuss the three concepts of relevance to Christian nursing: emancipatory knowing, contextual mindedness and socioeconomic inequality. Two case studies will be described to revisit the importance of building a rapport, learning the patient's story in a humble and respectful way, and addressing the social inequality and heath disparity of which we should be aware in a patient-nurse encounter. The possibility for collaboration between theologians and Christian nurses should be further explored in the future.

Psychometric evaluation of the perceived prejudice in health care scale-modified (PPHC-M) among baccalaureate student nurses

PURPOSE

Discrepancy in quality of health care for patients with diverse backgrounds contributes to health outcome disparities. BSN students reveal surprise regarding the presence of health care disparities. Critical social theory guided this study. The psychometric properties of the Perception of Prejudice in Health Care Scale–Modified (PPHC-M) were evaluated,and the relationship between perceived discrimination in health care delivery and cultural sensitivity awareness was explored.

DESIGN

A descriptive, cross-sectional survey of 146 Midwest BSN students was conducted using Cultural Competence Assessment (CCA), PPHC-M, and the Marlowe–Crowne Social Desirability Scale.

RESULTS

PPHC-M demonstrated reliability(α = .781.) Cronbach’s alphas for General Perception of Prejudice (GPP) and Personal Experience of Prejudice (PEP) were.759 and .756, respectively. Construct validity was supported by contrasted groups. The PPHC was not significantly correlated with the CCA scores.

DISCUSSION/CONCLUSION

PPHC-M shows promise in measuring perceived prejudice in health care.

Being and doing politics: an outdated model or 21st century reality?

AIM

This paper presents a discussion of how critical social theory can be used as a tool for research, reflection and exploration of the political role of the nurse.

BACKGROUND

Sociological theory can be used to examine ideologies within nursing systems in order to contribute to the future development of the profession. The importance of critical social theory has been identified in the literature as being directly relevant to holism which is central to the nature of nursing.

DATA SOURCES

Texts published in English were identified from 1990 to 2008 using the keywords critical social theory, community nursing, political advocacy, social justice, sociological theory, health inequalities, health democracy, equity and inequality.

DISCUSSION

Critical social theory can be used as a tool to highlight ethical ways to practise nursing. One reason for examination of the community nurse's political role is a shift in focus from the individual as patient to communities experiencing health inequalities. Nursing needs to decide whether the profession will work at the political level, and where advocacy and citizenship are located within a community role.

CONCLUSION

Nurse educators must prepare nurses for political participation, and nurse managers need to focus on national and local contexts in order to encourage policy analysis and community engagement within nursing practice. An understanding of critical social theory can aid decision-making in relation to global and local policy, enable the nursing profession to respond to social injustice, and permit nurses to work with communities in the pursuit of community health.

Cultural humility and the importance of long-term relationships in international partnerships

This article describes an education, leadership, and health professional interchange project in the Dominican Republic. It emphasizes the importance of long-term relationships and explores how over time, dialogue has led to cultural humility, self-reflection, and empowerment among nursing colleagues across national boundaries, despite differences in assumptions. The project is an example of a north-south collaboration encouraged by the World Health Organization to strengthen nursing and midwifery globally.

Social responsibility of nursing: a global perspective

This study addresses social responsibility in the discipline of nursing and implications for global health. The concept of social responsibility is explicated and its relevance for nursing is examined, grounded in the American Nurses Association Code of Ethics and the International Council of Nurses Code of Ethics. Social justice, human rights, nurse migration, and approaches to nursing education are discussed within the framework of nursing's social responsibility. Strategies for addressing nursing workforce issues and education within a framework of social responsibility are explored.

Collective knowledge sharing as a social justice strategy: the difference it made in a service project about preterm birth disparity

Knowledge about how health disparities are created and sustained from those affected is needed. Collective knowledge sharing is one way to redefine and revalue dialogue and critique processes with the aim of promoting just relationships of knowledge production. This article describes how a community service project focused on using collective knowledge sharing as a social justice strategy with health ministry volunteers produced insights about preterm birth disparity issues. Project insights related to (1) the connection between faith and health, (2) the significance of family and congregational stories, and (3) the importance of praising assets in the context of disparity recognition.

Language interpreting as social justice work: perspectives of formal and informal healthcare interpreters

The assurance that limited-English-proficient individuals have access to quality healthcare depends on the availability of competent healthcare interpreters. To further understand the complex work of interpreting, we conducted in-depth interviews with 27 formal and informal healthcare interpreters. Participants identified the technical conduit role as the professional standard. Yet they experienced considerable role dissonance and blurring. From their position "in the middle," they witnessed discrimination and bias. Having a social justice perspective encouraged expanding their role to include advocacy and cultural brokering. Implications for nursing include a shared commitment to language access and social justice.

Engaging racial autoethnography as a teaching tool for womanist inquiry

Racial autobiography, self-narratives on how one learned about the idea of race, has been underutilized as a tool to familiarize and orient students in the process of critical inquiry for nursing research. The aims of this article are to explore how racial autoethnography: (1) repositions students to effect an epistemological change, (2) challenges dominant ideology, and (3) functions as a link between the student and critical theories for use in nursing research. Students engage in and share reflective narrative about a variety of instructional materials used in the course. Reflective narratives are presented in a framework that addresses white racial identity development.

Culture care theory: a framework for expanding awareness of diversity and racism in nursing education

As American society becomes increasingly diverse, and the nursing profession does not, there has been a focus on promoting both cultural competence and diversity within the profession. Although culture and diversity are widely discussed in nursing education, the issue of racism may be avoided or suppressed. Institutionalized racism within nursing education must be acknowledged and discussed before nursing education may be transformed. Madeleine Leininger's Culture Care Theory is an established nursing theory that emphasizes culture and care as essential concepts in nursing. Theoretical frameworks abound in nursing, and Culture Care Theory may be underutilized and misunderstood within nursing education. This article examines the issue of racism in nursing education and recommends Culture Care Theory as a relevant framework for enhancing both cultural competence and diversity.