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Campinha-Bacote J. Promoting Health Equity Among Marginalized and Vulnerable Populations. Nurs Clin North Am 2024; 59:109-120. [PMID: 38272576 DOI: 10.1016/j.cnur.2023.11.009] [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] [Indexed: 01/27/2024]
Abstract
This article calls for a closer examination of health equity regarding the disparities and inequities in health care among marginalized and vulnerable populations. A review of strategies to improve culturally responsive care to these populations will be examined. This examination includes a discussion of the need for structural competence and the ongoing debate around the concepts of cultural competence and cultural humility. Cultural competemility, a new paradigm of thought regarding the relationship between cultural competence and cultural humility, will be proposed. This article culminates with downstream, midstream, and upstream approaches reducing the magnitude of inequity among marginalized and vulnerable populations.
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2
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Williams EM. Overcoming Career Advancement Barriers to Executive Leadership Roles of Nurses From Racial and Ethnic Minority Backgrounds. Nurs Adm Q 2024; 48:71-79. [PMID: 38079298 DOI: 10.1097/naq.0000000000000619] [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: 12/18/2023]
Abstract
There is underrepresentation of nurses with racial and ethnic minority backgrounds in executive nursing leadership positions as compared with the general population. The management problem is that even when academically prepared, nurses with racial and ethnic minority backgrounds perceive that they face both singular and systemic barriers to promotional opportunities to executive nurse positions. A literature gap exists as to why this phenomenon persists. The purpose of this qualitative narrative inquiry study was to explore the personal stories and lived experiences of executive nurses with racial and ethnic minority backgrounds concerning the barriers they faced and overcame on their pathway to an executive leadership position. The conceptual framework combined the intersectionality of race and internal and external capabilities. Data collected through semistructured interviews underwent a 3-dimensional-space narrative structure and thematic analysis process. Eleven themes in 3 major categories emerged: (a) facing the challenges; (b) overcoming barriers; and (c) where my help came from. The social change implications include new knowledge for multiple stakeholders in supporting and developing nurses from racial and ethnic minority backgrounds to assist them in achieving executive nursing leadership positions, thereby increasing the number of these nurses in executive roles.
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3
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"I'm not going there": Student refusal in clinical learning. J Prof Nurs 2023; 45:A1-A3. [PMID: 36889899 DOI: 10.1016/j.profnurs.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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4
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Cooper Brathwaite A, Varsailles D, Haynes D. Building Solidarity with Black Nurses to Dismantle Systemic and Structural Racism in Nursing. Policy Polit Nurs Pract 2023; 24:5-16. [PMID: 36300199 DOI: 10.1177/15271544221130052] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Systemic and structural racism in nursing have profound impacts on Black People, Indigenous Peoples, and People of Color. They contributed to underrepresentation in faculty, senior nurse executives, and presidents' positions in academic and healthcare organizations, physical and mental health issues in racialized groups. This quality improvement study described ways in which the Black Nurses Task Force of the Registered Nurses Association of Ontario can build solidarity with nursing and government organizations to dismantle systemic and structural racism in nursing. This study used a structured online survey, comprised of quantitative and qualitative questions. The qualitative data were analyzed using interpretative thematic analysis and the quantitative data were analyzed with descriptive statistics. Findings showed that 88% of participants experienced racism and 63% said racism affected their mental health. Three themes emerged from the qualitative data: Social support for Black nurses, accountability of leaders and solidarity with Black nurses. These findings demonstrated the urgent need to dismantle systemic and structural racism in nursing.
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Affiliation(s)
| | - Dania Varsailles
- Registered Nurses Association of Ontario (RNAO), Toronto, ON, Canada
| | - Deborah Haynes
- Registered Nurses Association of Ontario (RNAO), Toronto, ON, Canada
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Odzakovic E, Huus K, Ahlberg BM, Bradby H, Hamed S, Thaper-Björkert S, Björk M. Discussing racism in healthcare: A qualitative study of reflections by graduate nursing students. Nurs Open 2023; 10:3677-3686. [PMID: 36692244 PMCID: PMC10170953 DOI: 10.1002/nop2.1619] [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: 03/07/2022] [Revised: 11/02/2022] [Accepted: 01/13/2023] [Indexed: 01/25/2023] Open
Abstract
AIM The aim is to illustrate and analyse reflections from graduate nursing students over their experience of discussing racism in healthcare in an educational intervention. DESIGN A qualitative, descriptive design was adopted. METHODS Data were collected through written reflections and analysed through content analysis. In total, 81 students participated in the intervention; 39 paediatric and 42 public health care nursing students. Of those, 27 participants gave consent to have their written reflections included in the study. RESULTS Three main categories were developed in the content analysis of student reflections: (a) the implicit embeddedness of racism in healthcare organization; (b) the effect of racism on interactions with patients; and (c) a growing awareness of one's own understanding of racism. This study indicates that student nurses discussed racism as relevant to understanding good clinical practice for the benefit of patients and work-based wellbeing of staff. This recognition of the organizational nature of racism warrants nursing leaders and managers to include racism as a social determinant of health in the undergraduate and graduate curricula to educate the next generation of nursing about racism.
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Affiliation(s)
- Elzana Odzakovic
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Karina Huus
- CHILD Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Beth Maina Ahlberg
- Department of Sociology, Uppsala University, Uppsala, Sweden.,Skaraborg Institute for Research and Development, Skövde, Sweden
| | - Hannah Bradby
- Department of Sociology, Uppsala University, Uppsala, Sweden
| | - Sarah Hamed
- Department of Sociology, Uppsala University, Uppsala, Sweden
| | | | - Maria Björk
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,CHILD Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Wilson D, Werk A, Hemmer B. A Nursing School on Reservation Land. Am J Nurs 2022; 122:49-55. [PMID: 36384796 PMCID: PMC10311005 DOI: 10.1097/01.naj.0000904096.09348.6a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
ABSTRACT An associate degree in nursing program was established six years ago at the tribal college of the Fort Belknap Indian Reservation, home of the Aaniiih and Nakoda people. As this program continues to evolve and grow, it offers a successful example of how to increase diversity in nursing and potentially improve the health outcomes of Native Americans living on and nearby reservation communities.
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Affiliation(s)
- Deborah Wilson
- Deborah Wilson is a doctoral candidate at the Johns Hopkins University School of Nursing in Baltimore, MD, and a member of the teaching faculty at Aaniiih Nakoda College on the Fort Belknap Indian Reservation, MT. Alicia Werk is an enrolled member of the Aaniiih Tribe, an MSN student at the Johns Hopkins University School of Nursing, and a former nurse education instructor at Aaniiih Nakoda College, where Brigit Hemmer is the director of the Grow Our Own nursing program. Contact author: Deborah Wilson, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Salomon RE, Dobbins S, Harris C, Haeusslein L, Lin CX, Reeves K, Richoux S, Roussett G, Shin J, Dawson-Rose C. Antiracist symptom science: A call to action and path forward. Nurs Outlook 2022; 70:794-806. [PMID: 36400578 PMCID: PMC10916506 DOI: 10.1016/j.outlook.2022.07.014] [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: 04/06/2022] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 11/17/2022]
Abstract
Nurse scientists recognize the experience of racism as a driving force behind health. However, symptom science, a pillar of nursing, has rarely considered contributions of racism. Our objective is to describe findings within symptom science research related to racial disparities and/or experiences of racism and to promote antiracist symptom science within nursing research. In this manuscript, we use an antiracist lens to review a predominant symptom science theory and literature in three areas of symptom science research-oncology, mental health, and perinatal health. Finally, we make recommendations for increasing antiracist research in symptom science by altering (a) research questions, (b) recruitment methods, (c) study design, (d) data analysis, and (e) dissemination of findings. Traditionally, symptom science focuses on individual level factors rather than broader contexts driving symptom experience and management. We urge symptom science researchers to embrace antiracism by designing research with the specific intent of dismantling racism at multiple levels.
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Affiliation(s)
- Rebecca E Salomon
- The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Sarah Dobbins
- San Francisco Department of Public Health, San Francisco, California
| | | | | | - Chen-Xi Lin
- University of California, San Francisco, San Francisco, California
| | - Katie Reeves
- University of California, San Francisco, San Francisco, California
| | - Sarah Richoux
- University of California, San Francisco, San Francisco, California
| | - Greg Roussett
- University of California, San Francisco, San Francisco, California
| | - Joosun Shin
- University of California, San Francisco, San Francisco, California
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A Concept Analysis of Structural Competency. ANS Adv Nurs Sci 2022; 46:188-198. [PMID: 36036684 PMCID: PMC10153664 DOI: 10.1097/ans.0000000000000442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Structural competency is a concept that offers a way to understand and respond to health inequities and work toward antiracism in health care. This article undertakes a concept analysis of structural competency using Rodgers' evolutionary method. Based on this analysis, structural competency refers to the ability to recognize and act on structural inequities, skill development, multidisciplinary collaboration, and the reproduction of inequity over time. The meanings and use of this concept differ among disciplines. Multidisciplinary applications of structural competency offer insight into how this concept can foster health equity and antiracism in nursing care, education, research, and health services delivery.
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Waddell-Henowitch CM, Kruth ML, Stephen HM. Reiterating a Need for Antiracism Praxis in Nursing and Psychiatric Nursing Education. J Nurs Educ 2022; 61:439-446. [PMID: 35944198 DOI: 10.3928/01484834-20220602-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The reemergence of the Black Lives Matter movement in 2020 reinforced the need for antiracist and decolonizing praxis in all areas, including nursing education, the burden for which has fallen predominantly on visible minorities. To enact the needed change within health care systems and nursing education, White nurses must recognize their privilege and become active participants in the conversations and change. METHOD This two-phase qualitative study explored nursing and psychiatric nursing students' experiences of racism and antiracism education at a small western Canadian university. RESULTS Anonymous qualitative surveys (n = 24) and structured interviews (n = 9) with nursing and psychiatric nursing students highlighted the difficulties and complexities of recognizing racism and a present lack of antiracism praxis in educational and health care settings. CONCLUSION Nursing educators must reevaluate structural and behavioral aspects of nursing education to support genuine antiracism praxis. [J Nurs Educ. 2022;61(8):439-446.].
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10
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Advancing Diversity in Nursing Education: A Groundwater Approach. J Prof Nurs 2022; 41:140-148. [DOI: 10.1016/j.profnurs.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/06/2022] [Accepted: 05/10/2022] [Indexed: 11/18/2022]
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11
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Brown JS, Waller MN. Enhancing diversity in nursing education: Implementing inclusive practices to create a bias-free learning environment. NURSE EDUCATION TODAY 2022; 113:105358. [PMID: 35428010 DOI: 10.1016/j.nedt.2022.105358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 02/09/2022] [Accepted: 04/01/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Jami S Brown
- College of Nursing, University of Tennessee Health Science Center, Memphis, TN, USA.
| | - Melody N Waller
- College of Nursing, University of Tennessee Health Science Center, Memphis, TN, USA
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12
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Browne NT, Hodges EA, Small L, Snethen JA, Frenn M, Irving SY, Gance-Cleveland B, Greenberg CS. Childhood obesity within the lens of racism. Pediatr Obes 2022; 17:e12878. [PMID: 34927392 DOI: 10.1111/ijpo.12878] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/28/2021] [Accepted: 12/03/2021] [Indexed: 11/30/2022]
Abstract
Despite decades of research and a multitude of prevention and treatment efforts, childhood obesity in the United States continues to affect nearly 1 in 5 (19.3%) children, with significantly higher rates among Black, Indigenous, and People of Colour communities. This narrative review presents social foundations of structural racism that exacerbate inequity and disparity in the context of childhood obesity. The National Institute of Minority Health and Health Disparities' Research Framework guides the explication of structurally racist mechanisms that influence health disparities and contribute to childhood obesity: biologic and genetic, health behaviours, chronic toxic stress, the built environment, race and cultural identity, and the health care system. Strategies and interventions to combat structural racism and its effects on children and their families are reviewed along with strategies for research and implications for policy change. From our critical review and reflection, the subtle and overt effects of societal structures sustained from years of racism and the impact on the development and resistant nature of childhood obesity compel concerted action.
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Affiliation(s)
| | - Eric A Hodges
- UNC-Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA
| | - Leigh Small
- Michigan State University College of Nursing, East Lansing, Michigan, USA
| | - Julia A Snethen
- University of Wisconsin-Milwaukee, College of Nursing, Milwaukee, Wisconsin, USA
| | - Marilyn Frenn
- Marquette University College of Nursing, Milwaukee, Wisconsin, USA
| | - Sharon Y Irving
- Pediatric Nursing, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA.,Pediatric Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | - Cindy Smith Greenberg
- College of Health and Human Development, California State University, Fullerton, California, USA
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13
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Heitkemper EM, Thurman W. Social justice informatics: A critical approach for the future. Nurs Outlook 2022; 70:374-376. [DOI: 10.1016/j.outlook.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 01/13/2022] [Accepted: 02/15/2022] [Indexed: 10/18/2022]
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14
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Qureshi Z, Suleman M, Richards A, Sheather J, Bishop H. Addressing racist parents in a paediatric setting: the nuance of zero tolerance policies. BMJ 2021; 375:n3067. [PMID: 34903521 DOI: 10.1136/bmj.n3067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Zeshan Qureshi
- London School of Paediatrics
- Department of Sociology, University of Cambridge
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15
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A Vision for the Future of Nursing Leadership in the Lactation Field. J Perinat Neonatal Nurs 2021; 35:302-304. [PMID: 34726646 DOI: 10.1097/jpn.0000000000000607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Emami A, de Castro B. Confronting racism in nursing. Nurs Outlook 2021; 69:714-716. [PMID: 34330527 DOI: 10.1016/j.outlook.2021.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/01/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Azita Emami
- University of Washington School of Nursing, Seattle, WA
| | - Butch de Castro
- Equity, and Inclusion, University of Washington School of Nursing, Seattle, WA
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