101 results
Search Results
2. "I feel broken": Chronicling burnout, mental health, and the limits of individual resilience in nursing.
- Author
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Akoo, Chaman, McMillan, Kimberly, Price, Sheri, Ingraham, Kenchera, Ayoub, Abby, Rolle Sands, Shamel, Shankland, Mylène, and Bourgeault, Ivy
- Subjects
- *
PSYCHOLOGICAL resilience , *PSYCHOLOGICAL burnout , *MENTAL health , *SABBATICAL leave , *QUALITATIVE research , *SEX distribution , *MEDICAL care , *WORK environment , *JUDGMENT sampling , *DESCRIPTIVE statistics , *THEMATIC analysis , *NURSES' attitudes , *JOB stress , *HEALTH facilities , *DATA analysis software , *COVID-19 pandemic , *PSYCHOLOGY of nurses , *EMPLOYMENT reentry - Abstract
Healthcare systems and health professionals are facing a litany of stressors that have been compounded by the pandemic, and consequently, this has further perpetuated suboptimal mental health and burnout in nursing. The purpose of this paper is to report select findings from a larger, national study exploring gendered experiences of mental health, leave of absence (LOA), and return to work from the perspectives of nurses and key stakeholders. Given the breadth of the data, this paper will focus exclusively on the qualitative results from 53 frontline Canadian nurses who were purposively recruited for their workplace insight. This paper focuses on the substantive theme of "Breaking Point," in which nurses articulated a multiplicity of stress points at the individual, organizational, and societal levels that amplified burnout and accelerated mental health LOA from the workplace. These findings exemplify the complexities that underlie nurses' mental health and burnout and highlight the urgent need for multipronged individual, organizational, and structural interventions. Robust and timely interventions are needed to restore the health of the nursing profession and sustain its future. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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- View/download PDF
3. Code poverty: An adaptation of the social‐ecological model to inform a more strategic direction toward nursing advocacy.
- Author
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Hodge, Lesley and Raymond, Christy
- Subjects
HEALTH policy ,ASSOCIATIONS, institutions, etc. ,WORK environment ,SOCIAL determinants of health ,MATHEMATICAL models ,SOCIAL values ,PRACTICAL politics ,INCOME ,SOCIOECONOMIC factors ,NURSES ,THEORY ,CONSUMER activism ,GOVERNMENT policy ,POVERTY ,NURSES' associations - Abstract
The purpose of this discussion paper is to explore how nurses can be strategically poised to advocate for needed policy change in support of greater income equality and other social determinants of health. We adapted Bronfenbrenner's social‐ecological model to highlight how four broad pervasive subsystems shape the opportunities that nurses have to engage in advocacy at the policy level. These subsystems include organizations (the microsystem), professional bodies (the mesosystem), public policies (the exosystem), and societal values (the macrosystem). On the basis of this adapted model, we recommend changes among modifiable elements of the microsystem and mesosystem that can help position nurses (ecologically and collectively) to advocate for public policy change and use examples from a Canadian context to illustrate these points. We believe that the ideas arising from this model can be widely used where policy action on the social determinants of health is needed to inform, guide, and frame change efforts and advocacy work. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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4. Decolonial, intersectional pedagogies in Canadian Nursing and Medical Education.
- Author
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Bhandal, Taqdir K., Browne, Annette J., Ahenakew, Cash, and Reimer‐Kirkham, Sheryl
- Subjects
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DIVERSITY & inclusion policies , *TEACHER-student relationships , *SCHOOL environment , *TEACHING methods , *SPIRITUALITY , *RESEARCH methodology , *CURRICULUM , *SOCIAL justice , *INTERVIEWING , *NURSING education , *EXPERIENCE , *ETHNOLOGY research , *CONCEPTUAL structures , *INTERSECTIONALITY , *STUDENTS , *PSYCHOLOGICAL adaptation , *PARTICIPANT observation , *JUDGMENT sampling , *EMOTIONS , *MEDICAL education , *EDUCATIONAL outcomes - Abstract
Our intention is to contribute to the development of Canadian Nursing and Medical Education (NursMed) and efforts to redress deepening, intersecting health and social inequities. This paper addresses the following two research questions: (1) What are the ways in which Decolonial, Intersectional Pedagogies can inform Canadian NursMed Education with a focus on critically examining settler‐colonialism, health equity, and social justice? (2) What are the potential struggles and adaptations required to integrate Decolonial, Intersectional Pedagogies within Canadian NursMed Education in service of redressing intersecting health and social inequities? Briefly, Decolonial, Intersectional Pedagogies are philosophies of learning that encourage teachers and students to reflect on health through the lenses of settler‐colonialism, health equity, and social justice. Drawing on critical ethnographic research methods, we conducted in‐depth interviews with 25 faculty members and engaged in participant observation of classrooms in university‐based Canadian NursMed Education. The research findings are organized into three major themes, beginning with common institutional features influencing pedagogical approaches. The next set of findings addresses the complex strategies participants apply to integrate Decolonial, Intersectional Pedagogies. Lastly, the findings illustrate the emotional and spiritual toll some faculty members face when attempting to deliver Decolonial, Intersectional Pedagogies. We conclude that through the application of Decolonial, Intersectional Pedagogies teachers and students can support movements towards health equity, social justice, and unlearning/undoing settler‐colonialism. This study contributes new knowledge to stimulate dialog and action regarding the role of health professions education, specifically Nursing and Medicine as an upstream determinant of health in settler‐colonial nations such as Canada, United States, Australia, and New Zealand. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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5. Nurses as agents of disruption: Operationalizing a framework to redress inequities in healthcare access among Indigenous Peoples.
- Author
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Horrill, Tara C., Martin, Donna E., Lavoie, Josée G., and Schultz, Annette S. H.
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TRAUMA-informed care ,CULTURAL identity ,PSYCHIATRIC nursing ,HEALTH services accessibility ,TRANSCULTURAL medical care ,MEDICAL office nursing ,EMOTIONAL trauma ,DOMESTIC violence ,HEALTH status indicators ,CONCEPTUAL structures ,PRIMARY health care ,NURSING practice ,NURSE-patient relationships ,ABORIGINAL Canadians ,INTERPERSONAL relations ,MEDICAL care of indigenous peoples ,REFLECTION (Philosophy) - Abstract
Health equity is a global concern. Although health equity extends far beyond the equitable distribution of healthcare, equitable access to healthcare is essential to the achievement of health equity. In Canada, Indigenous Peoples experience inequities in health and healthcare access. Cultural safety and trauma‐ and violence‐informed care have been proposed as models of care to improve healthcare access, yet practitioners lack guidance on how to implement these models. In this paper, we build upon an existing framework of equity‐oriented care for primary healthcare settings by proposing strategies to guide nurses in operationalizing cultural safety and trauma‐ and violence‐informed care into nursing practice at the individual level. This component is one strategy to redress inequitable access to care among Indigenous Peoples in Canada. We conceptualize barriers to accessing healthcare as intrapersonal, interpersonal, and structural. We then define three domains for nursing action: practicing reflexivity, prioritizing relationships, and considering the context. We have applied this expanded framework within the context of Indigenous Peoples in Canada as a way of illustrating specific concepts and focusing our argument; however, this framework is relevant to other groups experiencing marginalizing conditions and inequitable access to healthcare, and thus is applicable to many areas of nursing practice. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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6. Relational ethics of delirium care: Findings from a hospice ethnography.
- Author
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Wright, David Kenneth, Brajtman, Susan, and Macdonald, Mary Ellen
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DELIRIUM ,ETHICS ,HOSPICE care ,INTERVIEWING ,RESEARCH methodology ,NURSE-patient relationships ,NURSING ethics ,NURSING specialties ,ETHNOLOGY research ,HOSPICE nurses ,SOCIAL support ,THERAPEUTICS - Abstract
Delirium, a common syndrome in terminally ill people, presents specific challenges to a good death in end‐of‐life care. This paper examines the relational engagement between hospice nurses and their patients in a context of end‐of‐life delirium. Ethnographic fieldwork spanning 15 months was conducted at a freestanding residential hospice in eastern Canada. A shared value system was apparent within the nursing community of hospice; patients’ comfort and dignity were deemed most at stake and therefore commanded nurses’ primary attention. This overarching commitment to comfort and dignity shaped all of nursing practice in this hospice, including practices related to end‐of‐life delirium. The findings of this study elaborate the ways in which hospice nurses interpreted and responded to the discomfort of their patients in delirium, as well as the efforts they made to understand their patients’ subjective experiences and to connect with them in supportive ways. In addition to what is already known about clinical assessment and treatment of delirium in palliative care settings, the findings of this study offer points of reflection for nurses anywhere who are contending with the relational challenges that delirium presents in end‐of‐life care. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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7. A very human being: Sister Marie Simone Roach, 1922-2016.
- Author
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Villeneuve, Michael J, Tschudin, Verena, Storch, Janet, Fowler, Marsha D M, and Peter, Elizabeth
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LEADERS ,NURSES ,CARING ,SCHOLARLY method ,MEDICAL research personnel ,HISTORY of nursing ,PHILOSOPHY of nursing ,NURSING ethics ,HISTORY - Abstract
Sister (Sr.) Marie Simone Roach, of the Sisters of St. Martha of Antigonish, Nova Scotia, died at the Motherhouse on 2 July 2016 at the age of 93, leaving behind a rich legacy of theoretical and practical work in the areas of care, caring and nursing ethics. She was a humble soul whose deep and scholarly thinking thrust her onto the global nursing stage where she will forever be tied to a central concept in nursing, caring, through her Six Cs of Caring model. In Canada, she was the lead architect of the Canadian Nurses Association's first code of ethics, and her influence on revisions to it is still profound more than 35 years later. In this paper, four global scholars in nursing and ethics are invited to reflect on Sr. Simone's contribution to nursing and health‐care, and we link her work to nursing and health‐care going forward. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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8. Resistance, mobilization and militancy: nurses on strike.
- Author
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Briskin, Linda
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HISTORY of strikes & lockouts ,STRIKES & lockouts ,CARING ,DISMISSAL of employees ,HEALTH care reform ,NEWSPAPERS ,NURSES ,PUBLIC opinion ,RESEARCH funding ,SEXISM ,LABOR unions ,QUALITATIVE research ,PROFESSIONALISM ,THEMATIC analysis - Abstract
BRISKIN L. Nursing Inquiry 2012; 19: 285-296 Resistance, mobilization and militancy: nurses on strike Drawing on nurses' strikes in many countries, this paper explores nurse militancy with reference to professionalism and the commitment to service; patriarchal practices and gendered subordination; and proletarianization and the confrontation with healthcare restructuring. These deeply entangled trajectories have had a significant impact on the work, consciousness and militancy of nurses and have shaped occupation-specific forms of resistance. They have produced a pattern of overlapping solidarities - occupational solidarity, gendered alliances and coalitions around healthcare restructuring - which have supported, indeed promoted, militancy among nurses, despite the multiple forces arrayed against them. The professional commitments of nurses to the provision of care have confronted healthcare restructuring, nursing shortages, intensification of work, precarious employment and gendered hierarchies with a militant discourse around the public interest, and a reconstitution and reclamation of 'caring', what I call the politicisation of caring. In fact, nurses' dedication to caring work in the late twentieth and early twenty-first centuries may encourage rather than dissuade them from going on strike. This paper uses a trans-disciplinary methodology, qualitative material in the form of strike narratives constructed from newspaper archives, and references to the popular and scholarly literature on nursing militancy. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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9. Social inclusion/exclusion as matters of social (in)justice: a call for nursing action.
- Author
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Yanicki, Sharon M, Kushner, Kaysi E, and Reutter, Linda
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CITIZENSHIP ,CONCEPTUAL structures ,HEALTH services accessibility ,HEALTH status indicators ,NURSES ,NURSING ethics ,SOCIAL justice ,OCCUPATIONAL roles - Abstract
Social inclusion/exclusion involves just/unjust social relations and social structures enabling or constraining opportunities for participation and health. In this paper, social inclusion/exclusion is explored as a dialectic. Three discourses - discourses on recognition, capabilities, and equality and citizenship - are identified within Canadian literature. Each discourse highlights a different view of the injustices leading to social exclusion and the conditions supporting inclusion and social justice. An Integrated Framework for Social Justice that incorporates the three discourses is developed and used to critique the dominant focus on distributive justice within foundational Canadian nursing documents. We propose a broader conceptualization of social (in)justice that includes both relational and structural dimensions. Opportunities for multilevel interventions to promote social justice are identified. This framework is congruent with nursing's moral imperative to promote health equity and with the multiple roles played by nurses to promote social justice in everyday practice. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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10. Applying a Foucauldian lens to the Canadian code of ethics for registered nurses as a discursive mechanism for nurses professional identity.
- Author
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Purvis JK
- Subjects
- Humans, Codes of Ethics, Canada, Ethics, Nursing, Nurses
- Abstract
This study examines the Canadian Code of Ethics for Registered Nurses as a discursive mechanism for shaping nurses' professional identity using a Foucauldian lens. Nurses are considered essential in healthcare, yet the nursing profession has struggled to be recognized for its discipline-specific knowledge and expertise and, as such, has remained the subject of and subject to the dominant discourses within healthcare and society generally. Developing a professional identity in nursing begins after the necessary education and training are achieved and embodies the profession's history, values, code of ethics, and expectations of the profession that distinguish it from other professions. Since nurses' professional identity is shaped through discourse, it raises the question of whether there are spaces to reconceptualize nurses' subject position within health care. Since professional identity is considered the embodiment of knowledge and practice, the code of ethics bears examination both for its effect on nurses' professional identity and as a potential site from which to challenge hegemonic assumptions. This article discusses the concept of professional identity in nursing and its development through the discursive formations in the code of ethics. The sources of power/knowledge are examined as both mechanisms of control and as spaces for change., (© 2022 John Wiley & Sons Ltd.)
- Published
- 2023
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11. Understanding access to healthcare among Indigenous peoples: A comparative analysis of biomedical and postcolonial perspectives.
- Author
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Horrill, Tara, McMillan, Diana E., Schultz, Annette S. H., and Thompson, Genevieve
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COMPARATIVE studies ,HEALTH services accessibility ,INDIGENOUS peoples ,MEDICAL quality control ,TRANSCULTURAL medical care ,MEDICAL care of indigenous peoples ,CULTURAL identity - Abstract
As nursing professionals, we believe access to healthcare is fundamental to health and that it is a determinant of health. Therefore, evidence suggesting access to healthcare is problematic for many Indigenous peoples is concerning. While biomedical perspectives underlie our current understanding of access, considering alternate perspectives could expand our awareness of and ability to address this issue. In this paper, we critique how access to healthcare is understood through a biomedical lens, how a postcolonial theoretical lens can extend that understanding, and the subsequent implications this alternative view raises for the nursing profession. Drawing on peer‐reviewed published and gray literature concerning healthcare access and Indigenous peoples to inform this critique, we focus on the underlying theoretical lens shaping our current understanding of access. A postcolonial analysis provides a way of understanding healthcare as a social space and social relationship, presenting a unique perspective on access to healthcare. The novelty of this finding is of particular importance for the profession of nursing, as we are well situated to influence these social aspects, improving access to healthcare services broadly, and among Indigenous peoples specifically. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
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12. Rationing nurses: Realities, practicalities, and nursing leadership theories.
- Author
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Fast, Olive and Rankin, Janet
- Subjects
BUDGET ,COST control ,DISCOURSE analysis ,HOSPITALS ,WORKING hours ,INTERVIEWING ,LABOR productivity ,LEADERSHIP ,RESEARCH methodology ,NURSE administrators ,NURSING services administration ,RESPONSIBILITY ,TECHNOLOGY ,ETHNOLOGY research - Abstract
In this paper, we examine the practicalities of nurse managers’ work. We expose how managers’ commitments to transformational leadership are undermined by the rationing practices and informatics of hospital reform underpinned by the ideas of new public management. Using institutional ethnography, we gathered data in a Canadian hospital. We began by interviewing and observing frontline leaders, nurse managers, and expanded our inquiry to include interviews with other nurses, staffing clerks, and administrators whose work intersected with that of nurse managers. We learned how nurse managers’ responsibility for staffing is accomplished within tightening budgets and a burgeoning suite of technologies that direct decisions about whether or not there are enough nurses. Our inquiry explicates how technologies organize nurse managers to put aside their professional knowledge. We describe professionally committed nurse leaders attempting to activate transformational leadership and show how their intentions are subsumed within information systems. Seen in light of our analysis, transformational leadership is an idealized concept within which managers’ responsibilities are shaped to conform to institutional purposes. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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13. Factors influencing the performance of English as an Additional Language nursing students: instructors’ perspectives.
- Author
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Donnelly, Tam Truong, McKiel, Elaine, and Hwang, Jihye
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IMMIGRANT students ,ENGLISH as a foreign language ,NURSING students ,NURSING education - Abstract
The increasing number of immigrants in Canada has led to more nursing students for whom English is an additional language (EAL). Limited language skills, cultural differences, and a lack of support can pose special challenges for these students and the instructors who teach them. Using a qualitative research methodology, in-depth interviews with fourteen EAL nursing students and two focus group interviews with nine instructors were conducted. In this paper, the instructors' perspectives are presented. Data acquired from the instructors suggest that the challenges experienced by EAL students and instructors reside in a lack of awareness and support at the institutional and structural levels rather than solely on capacities of individual EAL students or instructors. From this study, identification of supportive activities for nurse educators and education sector decision makers emerged. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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14. Gender, power, nursing: a case analysis.
- Author
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Ceci C
- Subjects
PEDIATRIC nursing ,CARDIAC surgery ,CHILD care ,NURSING practice ,NURSES ,MEDICAL care - Abstract
This paper is concerned with events that were the subject of an inquest into the deaths of 12 children who died while undergoing or shortly after having undergone cardiac surgery at the Winnipeg Health Sciences Centre, Manitoba, Canada, during 1994. A notable finding of the Sinclair Inquest was that nurses involved with the pediatric cardiac surgery program were concerned about the competence of the surgeon and made sustained efforts throughout 1994 to have these concerns addressed. That the nurses' concerns were not taken seriously is the central problem of this paper. Essentially, the position articulated is that gendered and gendering discourses constituted a form of power that structured the field of nurses' possible actions. These discourses constituted a resource to make nurses knowable, to produce them as certain forms of the person, and were therefore part of what governed nurses everyday conduct. Though neither simply good nor bad in themselves, in this case, these discourses had constraining effects on how nurses were able to conduct themselves. [ABSTRACT FROM AUTHOR]
- Published
- 2004
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15. Human agency and the process of healing: lessons learned from women living with a chronic illness — ‘re-writing the expert’.
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Tang, Sannie Y S, Anderson, Joan M, and Tang, Sannie
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MEDICAL care ,WOMEN'S health - Abstract
In this paper we examine the notion of human agency in the context of women experiencing a chronic illness. Based on two qualitative studies conducted with Canadian women of Chinese- and Anglo-descent living with diabetes, we unmask the complex power relations inherent in patient–practitioner interactions, and problematize the privileging of healthcare providers as knowers and experts on the patient’s body. Specifically, we analyse the meanings that women ascribe to their illness experience. We discuss how women experience the loss of agency in healthcare encounters, how they resist patienthood by reclaiming agency, and how healthcare providers foster agency in their interactions with women. Rather than suggesting that biomedical experts should be ‘written out’, we propose to rewrite healthcare providers as ‘reflexive practitioners’ through the construction of transformative knowledge. We argue that praxis-oriented practice, which is based on transformative knowledge, will provide the space for women and healthcare providers to enter into a new dialogue and a relation in which women can sustain a sense of self, and begin the journey of healing. [ABSTRACT FROM AUTHOR]
- Published
- 1999
- Full Text
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16. Palliative sedation and medical assistance in dying: Distinctly different or simply semantics?
- Author
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Booker, Reanne and Bruce, Anne
- Subjects
ANESTHESIA ,ASSISTED suicide ,BEREAVEMENT ,CAREGIVERS ,CONSCIOUSNESS ,MEDICAL care ,PALLIATIVE treatment ,PATIENTS ,QUALITY assurance ,SEMANTICS ,TERMINAL care ,PATIENT autonomy - Abstract
Medical assistance in dying (MAiD) and palliative sedation (PS) are both legal options in Canada that may be considered by patients experiencing intolerable and unmanageable suffering. A contentious, lively debate has been ongoing in the literature regarding the similarities and differences between MAiD and PS. The aim of this paper is to explore the propositions that MAiD and PS are essentially similar and conversely that MAiD and PS are distinctly different. The relevance of such a debate is apparent for clinicians and patients alike. Understanding the complex and multi‐faceted nuances between PS and MAiD allows patients and caregivers to make more informed decisions pertaining to end‐of‐life care. It is hoped that this paper will also serve to foster further debate and consideration of the issues associated with PS and MAiD with a view to improve patient care and the quality of both living and dying in Canada. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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17. ‘Health equity through action on the social determinants of health’: taking up the challenge in nursing.
- Author
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Reutter, Linda and Kushner, Kaysi Eastlick
- Subjects
COMMUNITY health nursing ,HEALTH services accessibility ,HEALTH policy ,NURSES ,PUBLIC administration ,SOCIAL justice ,SOCIAL role ,SOCIOECONOMIC factors ,NURSES' associations ,CONSUMER activism - Abstract
REUTTER L and KUSHNER KE. Nursing Inquiry 2010; 17: 269–280 ‘Health equity through action on the social determinants of health’: taking up the challenge in nursing Reducing health inequities is a priority issue in Canada and worldwide. In this paper, we argue that nursing has a clear mandate to ensure access to health and health-care by providing sensitive empowering care to those experiencing inequities and working to change underlying social conditions that result in and perpetuate health inequities. We identify key dimensions of the concept of health (in)equities and identify recommendations to reduce inequities advanced in key global and Canadian documents. Using these documents as context, we advocate a ‘critical caring approach’ that will assist nurses to understand the social, political, economic and historical context of health inequities and to tackle these inequities through policy advocacy. Numerous societal barriers as well as constraints within the nursing profession must be acknowledged and addressed. We offer recommendations related to nursing practice, education and research to move forward the agenda of reducing health inequities through action on the social determinants of health. [ABSTRACT FROM AUTHOR]
- Published
- 2010
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18. Challenges in providing breast and cervical cancer screening services to Vietnamese Canadian women: the healthcare providers’ perspective.
- Author
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Donnelly, Tam Truong
- Subjects
MEDICAL screening ,BREAST cancer ,CERVICAL cancer ,CANCER in women ,WOMEN'S health ,VIETNAMESE Canadians - Abstract
Breast cancer and cervical cancer are major contributors to morbidity and mortality among Vietnamese Canadian women. Vietnamese women are at risk because of their low participation rate in cancer-preventative screening programmes. Drawing from the results of a larger qualitative study, this paper reports factors that influence Vietnamese women's participation in breast and cervical cancer screening from the healthcare providers’ perspectives. The women participants’ perspective was reported elsewhere. Semistructured interviews were conducted with six healthcare providers. Analysis of these interviews reveals several challenges which healthcare providers encountered in their clinical practice. These include the physicians’ cultural awareness about the private body, patient's low socioeconomic status, the healthcare provider–patient relationship, and limited institutional support. This is the first Canadian study to identify the healthcare providers’ perspective on giving breast and cervical cancer preventive care to the Vietnamese immigrant women. The insight gained from these healthcare providers’ experiences are valuable and might be helpful to healthcare professionals caring for immigrant women of similar ethno-cultural backgrounds. Recommendations for the promotion of breast cancer and cervical cancer screening among Vietnamese women include: (i) effort should be made to recruit Vietnamese-speaking female healthcare professionals for breast and cervical health-promotion programmes; (ii) reduce woman–physicians hierarchical relationship and foster effective doctor–patient communication; (iii) healthcare providers must be aware of their own cultural beliefs, values and attitudes that they bring to their practice; and (iv) more institutional support and resources should be given to both Vietnamese Canadian women and their healthcare providers. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
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19. The impact of the re-engineered world of health-care in Canada on nursing and patient outcomes.
- Author
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Shannon, Valerie and French, Susan
- Subjects
NURSING ,NURSE-patient relationships ,NURSING services ,HEALTH outcome assessment ,MEDICAL care - Abstract
SHANNON V and FRENCH S. Nursing Inquiry 2005; 12: 231–239 The impact of the re-engineered world of health-care in Canada on nursing and patient outcomes The healthcare environment is knowledge driven and knowledge and human resource dependent. Despite the paucity of evidence on which to shape and evaluate organizational change, health-care in Canada has undergone many changes in the last 15 years. In the pursuit of enhanced productivity, healthcare administrators have turned to industrial and engineering models. Using available Canadian research and policy reports, and where necessary, American literature, this paper describes the impact of re-engineering on nursing and on the relationship between nursing and patient outcomes. It also identifies emerging trends and ways forward. [ABSTRACT FROM AUTHOR]
- Published
- 2005
- Full Text
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20. Making room for grief: walking backwards and living forward.
- Author
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Moules NJ, Simonson K, Prins M, Angus P, and Bell JM
- Subjects
GRIEF ,BEREAVEMENT ,SUFFERING ,NURSING ,FAMILIES ,PATHOLOGICAL psychology ,PSYCHOTHERAPY - Abstract
In this paper, the authors describe an aspect of a program of research around grief and clinical practice. The first phase of the study involves examination of experiences of grief with attention to troublesome or problematic beliefs that fuel the extent of suffering in the bereaved. The data, obtained from a review of videotaped clinical interviews with families seen in the Family Nursing Unit at the University of Calgary, were analyzed according to philosophical hermeneutic tradition. Findings suggest that grief is an experience that is ongoing, that changes in nature over time, but that involves a continuing relationship with the deceased; it is a graceful, periodic, deliberate walk backwards while keeping a sure foot in living forward. [ABSTRACT FROM AUTHOR]
- Published
- 2004
- Full Text
- View/download PDF
21. ‘Patient satisfaction’: knowledge for ruling hospital reform — An institutional ethnography.
- Author
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Rankin, Janet M.
- Subjects
PATIENT satisfaction ,HOSPITALS - Abstract
‘Patient satisfaction’: Knowledge for ruling hospital reform — An institutional ethnography Driven by funding restraint, Canadian health-care has undergone over a decade of significant reform. Hospitals are being restructured, as text-based practices of accountability bring a new business-orientation into hospital and clinical management. New forms of knowledge, generated through records of various sorts, are a necessary resource for managing care in the new environment. This paper's research uses Canadian sociologist Dorothy E. Smith's institutional ethnographic methodology to critically analyse one instance of text-based management. I analyse information about ‘patient satisfaction’ as it is generated through a patient survey (in which I was implicated through my involvement with a hospitalized family member). Subsequently, I have studied the management environment into which that information would be entered. I argue that in the instance analysed, the information becomes part of a dominant consumer oriented healthcare discourse that subordinates concerns about ‘what actually happened’ as a professional caregiver would have known it. On this basis, I contend that this sort of taken-for-granted approach to making decisions about quality care in hospitals may be seriously, even dangerously, flawed. [ABSTRACT FROM AUTHOR]
- Published
- 2003
- Full Text
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22. Toward evidence-based policy decisions: a case study of nursing health human resources in Ontario, Canada.
- Author
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O'Brien-Pallas L and Baumann A
- Subjects
NURSE supply & demand ,HUMAN capital ,DECISION making ,GOVERNMENT policy - Abstract
This paper reflects how health services research 'evidence' was used to influence decisions in the province of Ontario, Canada. The process involved interaction among a variety of stakeholders and decision-makers with researchers to reduce uncertainty and to substantiate emerging service provision issues in the province. The issues presented here focus specifically on an analysis of the nursing situation completed in 1998 for the Minister of Health's Nursing Task Force, which examined key issues in service delivery. The issues were: restructured work environments; nurse supply and declining enrollments; labour trends and utilization of the nursing workforce; patient acuity and complexity of work environments and the influence on workload; and the paucity of reliable and valid data bases for analysis of nursing's contribution to the health system. Ontarians can be confident that the Task Force recommendations were born from solid research-based evidence and now the challenge becomes to monitor the implementation of these resolutions over time. [ABSTRACT FROM AUTHOR]
- Published
- 2000
- Full Text
- View/download PDF
23. The hierarchy of evidence in advanced wound care: The social organization of limitations in knowledge.
- Author
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Waters, Nicola and Rankin, Janet M.
- Subjects
CHRONIC wounds & injuries ,CLINICAL medicine ,DECISION making ,HEALTH facility administration ,HEALTH services administrators ,INTELLECT ,INTERVIEWING ,LABOR productivity ,EVALUATION of medical care ,NURSES ,PARTICIPANT observation ,POLICY sciences ,RESEARCH funding ,SOCIAL case work ,WOUND healing ,TRAUMATOLOGY diagnosis ,WOUND care ,ETHNOLOGY research ,EVIDENCE-based medicine ,SOCIAL services case management ,PATIENT-centered care ,PSYCHOLOGICAL factors ,THERAPEUTICS - Abstract
In this article, we discuss how we used institutional ethnography (Institutional ethnography as practice, Rowman & Littlefield, Lanham, MD and 2006) to map out powerful ruling relations that organize nurses' wound care work. In recent years, the growing number of people living with wounds that heal slowly or not at all has presented substantial challenges for those managing the demands on Canada's publicly insured health‐care system. In efforts to address this burden, Canadian health‐care administrators and policy‐makers rely on scientific evidence about how wounds heal and what treatments are most effective. Advanced wound care exemplifies the growing authorization of particular forms of evidence that change the ways in which nurses come to know about and conduct their work. The focus of this paper's nursing inquiry is a critique of registered nurses' wound work as it arises within the established uptake of scientific evidence. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
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24. Beyond technology, drips, and machines: Moral distress in PICU nurses caring for end‐of‐life patients.
- Author
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Gagnon, Michelle and Kunyk, Diane
- Subjects
DEATH & psychology ,INTENSIVE care units ,ETHICS ,INTENSIVE care nursing ,NURSES' attitudes ,JOB stress ,PEDIATRICS ,PEDIATRIC nursing ,DESCRIPTIVE statistics ,DATA analysis software ,CONTENT analysis ,PSYCHOLOGICAL distress ,SECONDARY analysis ,CHILDREN - Abstract
Moral distress is an experience of profound moral compromise with deeply impactful and potentially long‐term consequences to the individual. Critical care areas are fraught with ethical issues, and end‐of‐life care has been associated with numerous incidences of moral distress among nurses. One such area where the dichotomy of life and death seems to be at its sharpest is in the pediatric intensive care unit. The purpose of this study was to understand the moral distress experiences of pediatric intensive care nurses when caring for pediatric patients at the end of life. A secondary analysis was undertaken of seven transcripts from registered nurses across six Canadian pediatric intensive care units and produced three themes: under prioritization of child patient dignity, burden of insider knowledge, and environmental constraints on nursing roles and responsibilities. When caring for patients at the end of life, nurses experienced moral distress when a dignified death was not realized. Furthermore, despite interprofessional collaboration efforts in Canada, the concept of silo mentality persists and contributes to moral distress. Organizational involvement is needed to address moral distress in pediatric intensive care nurses both to achieve a dignified death for child patients and in addressing silo mentality. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
25. Toward a moral commitment: Exposing the covert mechanisms of racism in the nursing discipline.
- Author
-
Louie‐Poon, Samantha, Hilario, Carla, Scott, Shannon D., and Olson, Joanne
- Subjects
RACISM ,ETHICS ,SOCIAL justice ,CRITICAL theory ,PHILOSOPHY of nursing ,COMMITMENT (Psychology) - Abstract
Recent Canadian and international events have sparked dialogue and action to address racism within the nursing discipline. While the urgency to seek and implement antiracist solutions demands the attention of nurses, we contend that a contemporary analysis of the mechanisms that continue to perpetuate racism within nursing's theoretical foundation is required first. This study reconsiders the perceived functions of racism within the current state of nursing concepts and theories. In particular, we expose the role that covert racism plays by inadvertently sustaining racism through nursing's theoretical foundation, and how this process strengthens white supremacy. We argue that, in the absence of exposing these covert mechanisms, the development of solutions will be futile in dismantling racism. By making visible the covert mechanisms of racism within nursing's theoretical foundation, we attempt to establish an opportunity for the nursing discipline to dismantle its racist foundation and engage in sustained antiracist action. Lastly, this study demonstrates the need to equip the discipline with a moral commitment to antiracism in an effort to emancipate nursing from its racist legacies. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
26. "Go back to your country": Exploring nurses' experiences of workplace conflict involving patients and patients' family members in two Canadian cities.
- Author
-
Boateng, Godfred O. and Brown, Kyrah K.
- Subjects
PREVENTION of violence in the workplace ,WORK environment ,VIOLENCE in the workplace ,NURSES' attitudes ,WORK ,DISCRIMINATION (Sociology) ,MEDICAL personnel ,INTERVIEWING ,NURSE-patient relationships ,PATIENTS' families ,CONFLICT (Psychology) ,PHENOMENOLOGY ,QUALITATIVE research ,STEREOTYPES ,CONFLICT management ,EXPERIENTIAL learning ,PATIENT-family relations ,NURSES ,SEX crimes ,PSYCHOLOGICAL adaptation ,ETHNIC groups ,AGGRESSION (Psychology) - Abstract
This study explores nurses' experiences of workplace conflict with patients and their family members, how it differs by ethnic/racial identity, and highlights the coping strategies engaged to lessen these conflicts. Using a qualitative research design, this study draws on phenomenology and in‐depth interviews of 66 registered nurses and registered practical nurses from multiple sites in two Canadian cities to explore the experiences of nurses with multiple marginalized identities in relation to nurse–patient and nurse–patient's family member conflicts in direct care practice. The results show that horizontal conflicts, especially, ones involving nurses, patients, and their family members are quite pervasive in the nursing profession. Direct care nurses, especially, ethnic minorities relative to majority groups experience excessive physical assaults, verbal aggressive behaviors, racial stereotyping and discrimination, and sexual harassment from patients and patients' family members. Institutional support through policies and practices designed to de‐escalate aggressive behavior from patients and their family members were identified as important support systems. We conclude that policies aimed at creating a safe and strong health‐care system call for holding patients and th'eir family members legally responsible for uncivil and aggressive behavior against caregivers. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
27. A critical exploration of nurses' perceptions of access to oncology care among Indigenous peoples: Results of a national survey.
- Author
-
Horrill, Tara C., Martin, Donna E., Lavoie, Josée G., and Schultz, Annette S. H.
- Subjects
TUMOR treatment ,PREVENTION of racism ,ONCOLOGY nursing ,OCCUPATIONAL roles ,NURSES' attitudes ,HEALTH services accessibility ,SOCIAL determinants of health ,RESEARCH methodology ,COMMUNICATION barriers ,HEALTH status indicators ,EARLY detection of cancer ,SOCIOECONOMIC factors ,NURSE-patient relationships ,ABORIGINAL Canadians ,NURSES ,RESEARCH funding ,DISCOURSE analysis ,DESCRIPTIVE statistics ,DATA analysis software ,MEDICAL care of indigenous peoples ,CANCER patient medical care ,TRANSPORTATION ,HEALTH promotion - Abstract
Inequities in access to oncology care among Indigenous peoples in Canada are well documented. Access to oncology care is mediated by a range of factors; however, emerging evidence suggests that healthcare providers, including nurses, play a significant role in shaping healthcare access. The purpose of this study was to critically examine access to oncology care among Indigenous peoples in Canada from the perspective of oncology nurses. Guided by postcolonial theoretical perspectives, interpretive descriptive and critical discourse analysis methodologies informed study design and data analysis. Oncology nurses were recruited from across Canada to complete an online survey (n = 78). Nurses identified a range of barriers experienced by Indigenous peoples when accessing oncology care, yet located these barriers primarily at the individual and systems levels. Nurses perceived themselves as mediators of access to oncology care; however, their efforts to facilitate access to care were constrained by the dominance of biomedicine within healthcare. Nurses' constructions of access to oncology care highlight the embedded narrative of individualism within nursing practice and the relative invisibility of racism as a determinant of equitable access to care among Indigenous peoples. This suggests a need for oncology nurses to better understand and incorporate structural determinants of health perspectives. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
28. Examining the potential of nurse practitioners from a critical social justice perspective.
- Author
-
Browne, Annette J. and Tarlier, Denise S.
- Subjects
NURSE practitioners ,SOCIAL justice ,MEDICAL quality control ,NURSING practice - Abstract
Nurse practitioners (NPs) are increasingly called on to provide high-quality health-care particularly for people who face significant barriers to accessing services. Although discourses of social justice have become relatively common in nursing and health services literature, critical analyses of how NP roles articulate with social justice issues have received less attention. In this study, we examine the role of NPs from a critical social justice perspective. A critical social justice lens raises morally significant questions, for example, why certain individuals and groups bear a disproportionate burden of illness and suffering; what social conditions contribute to disparities in health and social status; and what social mandate NPs ought to develop in response to these realities. In our analysis, we draw on lessons learned from the initial Canadian experience with the introduction of NPs in the 1970s to consider the renewed and burgeoning interest in NPs in Canada, Australia and elsewhere. As we argue, a critical social justice perspective (in addition to the biomedical foci of NP practice) will be essential to sustaining long-term, socially responsive NP roles and achieving greater equity in health and health-care. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
29. Writing activities and the hidden curriculum in nursing education.
- Author
-
Mitchell, Kim M., McMillan, Diana E., Lobchuk, Michelle M., and Nickel, Nathan C.
- Subjects
SCHOOL environment ,CURRICULUM ,INTERVIEWING ,BACCALAUREATE nursing education ,NURSING education ,QUALITATIVE research ,CLINICAL medicine ,QUESTIONNAIRES ,RESEARCH funding ,WRITTEN communication ,NURSING students - Abstract
Nursing programs are complex systems that articulate values of relationality and holism, while developing curriculums that privilege metric‐driven competency‐based pedagogies. This study used an interpretive approach to analyze interviews from 20 nursing students at two Canadian Baccalaureate programs to understand how nursing's educational context, including its hidden curriculums, impacted student writing activities. We viewed this qualitative data through the lens of activity theory. Students spoke about navigating a rigid writing context. This resulted in a hyper‐focus on "figuring out" the teacher with minimal focus on the act of writing. Students used a form of behavioral "code‐switching" to maximize their grade while considering how their "valuing" of the assignment fit within their writing motives. Hidden curriculum messages taught students that academic success was assured whether their writing mirrored instructor preferences. Instructional practices of rigidity reinforced unequal social conditions for some minority students. Faculty can counteract the impact of the hidden curriculum through encouragement of choice and independent thinking about writing activities. Acknowledging power relationships and their influence on how students navigate writing assignments and nursing discourse may relieve pressures on students who fear penalties for countering norms and result in a more flexible learning environment. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
30. Nurses' engagement with power, voice and politics amidst restructuring efforts.
- Author
-
McMillan, Kim and Perron, Amélie
- Subjects
ACADEMIC medical centers ,CONTROL (Psychology) ,INTERVIEWING ,PHENOMENOLOGY ,PSYCHOLOGY of nurses ,ORGANIZATIONAL change ,PRACTICAL politics ,RESEARCH funding ,HUMAN voice - Abstract
Change is inevitable, and increasingly rapid and continuous in healthcare as organizations strive to adapt, improve and innovate. Organizational change challenges healthcare providers because it restructures how and when patient care delivery is provided, changing ways in which nurses must carry out their work. The aim of this doctoral study was to explore frontline nurses' experiences of living with rapid and continuous organizational change. A critical hermeneutic approach was utilized. Participants described feeling voiceless, powerless and apolitical amidst rapid and continuous organizational changes which fuelled apathy, cynicism and disengagement from the organization. However, critical analysis of the data showed that nurses actively engaged with power, voice and politics through resistant and transgressive behaviours in micro‐ethical moments of practice. There is a need to reconceptualize the concepts of voice, power and politics in nursing as there is dissonance between nurses' beliefs about these concepts and what they are enacting in practice. Recognizing their enactment of power, voice and political agency at the micro‐level may empower nurses. Empowerment would mitigate the high levels of reports of powerlessness experienced in practice during organizational changes. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
31. Caring for indigenous families in the neonatal intensive care unit.
- Author
-
Wright, Amy L., Ballantyne, Marilyn, and Wahoush, Olive
- Subjects
ABORIGINAL Canadians ,CONCEPTUAL structures ,INTERVIEWING ,RESEARCH methodology ,MEDICAL care ,MEDICAL personnel ,NEONATAL intensive care ,NURSES ,PATIENTS ,RESEARCH funding ,QUALITATIVE research ,OCCUPATIONAL roles ,THEMATIC analysis ,NEONATAL intensive care units ,PATIENTS' families ,DESCRIPTIVE statistics - Abstract
Inequitable access to health care, social inequities, and racist and discriminatory care has resulted in the trend toward poorer health outcomes for Indigenous infants and their families when compared to non‐Indigenous families in Canada. How Indigenous mothers experience care during an admission of their infant to the Neonatal Intensive Care Unit has implications for future health‐seeking behaviors which may influence infant health outcomes. Nurses are well positioned to promote positive health care interactions and improve health outcomes by effectively meeting the needs of Indigenous families. This qualitative study was guided by interpretive description and the Two‐Eyed Seeing framework and aimed to understand how Indigenous mothers experience accessing and using the health care system for their infants. Data were collected by way of interviews and a discussion group with self‐identifying Indigenous mothers of infants less than two years of age living in Hamilton, Ontario, Canada. Data underwent thematic analysis, identifying nursing strategies to support positive health care interactions and promote the health and wellness of Indigenous infants and their families. Building relationships, providing holistic care, and taking a trauma‐informed approach to the involvement of child protection services are three key strategies that nurses can use to positively impact health care experiences for Indigenous families. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
32. 'No other alternative than to compromise': Experiences of midwives/nurses providing care in the context of scarce resources.
- Author
-
Boakye PN
- Subjects
- Pregnancy, Female, Humans, Morals, Africa, Canada, Qualitative Research, Midwifery, Nurse Midwives
- Abstract
Midwives and nurses play a critical role in safeguarding the lives of women in resource-constrained African countries. Working within the context of scarce resources may undermine their moral agency and hinder their ability to care. The purpose of this paper is to understand the influence of resource scarcity on midwifery and nursing care and practice. A critical ethnography was conducted in the obstetric department of three tertiary-level facilities in Ghana. Purposive sampling was used to recruit 30 midwives and nurses and semistructured interviews, field notes and documentary materials were used to generate in-depth understanding. Ethical approval was granted from Canada and Ghana and written, and ongoing informed consent was obtained from the participants. Five conceptual themes depicting the impact of scarce resources on midwifery and nursing care were discovered: compromised care, constrained care, dehumanized care, missed care and disengaged care. Improving the maternal health of women and averting avoidable maternal morbidity and mortality require governments and institutions to invest in health infrastructure that will support the delivery of ethical and safe midwifery care for women in their most vulnerable period., (© 2022 John Wiley & Sons Ltd.)
- Published
- 2022
- Full Text
- View/download PDF
33. Bedside nurses’ roles in discharge collaboration in general internal medicine: Disconnected, disempowered and devalued?
- Author
-
Goldman, Joanne, MacMillan, Kathleen, Kitto, Simon, Wu, Robert, Silver, Ivan, and Reeves, Scott
- Subjects
ACADEMIC medical centers ,COMMUNICATION ,CONTENT analysis ,HEALTH care teams ,INTERPROFESSIONAL relations ,INTERVIEWING ,LEADERSHIP ,RESEARCH methodology ,MEDICAL quality control ,PATIENT safety ,RESEARCH funding ,ETHNOLOGY research ,DISCHARGE planning ,HOSPITAL nursing staff - Abstract
Collaboration among nurses and other healthcare professionals is needed for effective hospital discharge planning. However, interprofessional interactions and practices related to discharge vary within and across hospitals. These interactions are influenced by the ways in which healthcare professionals’ roles are being shaped by hospital discharge priorities. This study explored the experience of bedside nurses’ interprofessional collaboration in relation to discharge in a general medicine unit. An ethnographic approach was employed to obtain an in‐depth insight into the perceptions and practices of nurses and other healthcare professionals regarding collaborative practices around discharge. Sixty‐five hours of observations was undertaken, and 23 interviews were conducted with nurses and other healthcare professionals. According to our results, bedside nurses had limited engagement in interprofessional collaboration and discharge planning. This was apparent by bedside nurses’ absence from morning rounds, one‐way flow of information from rounds to the bedside nurses following rounds, and limited opportunities for interaction with other healthcare professionals and decision‐making during the day. The disconnection, disempowerment and devaluing of bedside nurses in patient discharge planning has implications for quality of care and nursing work. Study findings are positioned within previous work on nurse–physician interactions and the current context of nursing care. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
34. Textually mediated discourses in Canadian news stories: Situating nurses’ salaries as the problem.
- Author
-
Urban, Ann‐Marie
- Subjects
DISCOURSE analysis ,HOSPITALS ,MASS media ,NEWSPAPERS ,NURSING career counseling ,OCCUPATIONAL prestige ,WAGES - Abstract
The aim of this article is to elucidate how nurses are positioned in Canadian news stories regarding their salaries. While the image of nursing in mass media has been widely studied, few studies explore how nurses are constructed in news stories. Drawing on ideas from institutional ethnography together with discourse analysis, this discussion highlights public textual discourses about nurses’ salaries in Canadian news stories. The media discourse was found to distort the issues by focusing attention on nurses. Recognizing how these textual distortions mediate and construct messages is important in understanding how nurses and their work are constructed in the media. This discussion seeks to inform readers about how nurses are situated within commonly circulated discourses in the media. It also seeks to contribute to the literature about the nurse's image and how nurses and their work are portrayed in the public realm. It concludes by recommending increased awareness about how nurses are talked about in mass communication and the need to disrupt these messages and their underlying assumptions. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
35. The influence of democratic racism in nursing inquiry.
- Author
-
Hilario, Carla T., Browne, Annette J., and McFadden, Alysha
- Subjects
DENIAL (Psychology) ,NURSING ,CULTURAL pluralism ,PRACTICAL politics ,RACISM ,HEALTH equity - Abstract
Neoliberal ideology and exclusionary policies based on racialized identities characterize the current contexts in North America and Western Europe. Nursing knowledge cannot be abstracted from social, political and historical contexts; the task of examining the influence of race and racial ideologies on disciplinary knowledge and inquiry therefore remains an important task. Contemporary analyses of the role and responsibility of the discipline in addressing race‐based health and social inequities as a focus of nursing inquiry remain underdeveloped. In this article, we examine nursing's engagement with ideas about race and racism and explore the ways in which nursing knowledge and inquiry have been influenced by race‐based ideological discourses. Drawing on Henry and Tator's framework of
democratic racism , we consider how strategic discursive responses—the discourses of individualism, multiculturalism, colour‐blindness, political correctness and denial—have been deployed within nursing knowledge and inquiry to reinforce the belief in an essentially fair and just society while avoiding the need to acknowledge the persistence of racist discourses and ideologies. Greater theoretical, conceptual and methodological clarity regarding race, racialization and related concepts in nursing inquiry is needed to address health and social inequities. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
36. 'Philosophy Lost': Inquiring into the effects of the corporatized university and its implications for graduate nursing education.
- Author
-
Springer, Rusla Anne and Clinton, Michael Edward
- Subjects
ORGANIZATIONS & ethics ,CONFLICT of interests ,CORPORATE culture ,CORPORATIONS ,CRITICAL thinking ,ENDOWMENT of research ,SCHOLARLY method ,MEDICAL teaching personnel ,MEDICAL practice ,PHILOSOPHY of nursing ,NURSING research ,NURSING school faculty ,PHARMACEUTICAL industry ,RESEARCH ethics ,TEACHING ,UNIVERSITIES & colleges ,GRADUATE nursing education ,INTELLECTUAL freedom - Abstract
Drawing on a comprehensive, pan-national analysis of the corporatization of Canadian universities, as well as the notions of 'parrhesiastic' mentorship and practice, the authors examine the effects of the corporatized university, its implications for graduate nursing education and nursing's relative silence on the subject. With the preponderance of business interests, the increasing dependence of universities on industry funding, cults of efficiency, research intensivity, and the pursuit of profit so prevalent in today's corporatized university, we argue that philosophical presuppositions so crucial to critical teaching, research, and reflection on nursing as a discipline are troublingly losing ground. We lament the erosion and fragmentation of philosophy, politics, and ethics as foundations for graduate education, which are increasingly perceived as less valuable, problematic, and in some cases, even burdensome. The effect of corporatization is the suppression of the critical engagement required of faculty in the everyday workings of institutions. We argue that, when the ideals of intellectual freedom, academic responsibility, duty, and obligation, as supported by philosophical thought, are smothered by the normalizing power of corporatized research agendas, philosophical approaches to inquiry and knowledge development become marginalized as scholars find themselves floundering in the face of a seeming 'philosophy lost'. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
37. Structural impact on gendered expectations and exemptions for family caregivers in hospice palliative home care.
- Author
-
Sutherland, Nisha, Ward‐Griffin, Catherine, McWilliam, Carol, and Stajduhar, Kelli
- Subjects
CAREGIVERS ,DECISION making ,DISCOURSE analysis ,FEMINIST criticism ,HOME care services ,HOME nursing ,HOSPICE care ,INTERVIEWING ,MANAGEMENT ,SCIENTIFIC observation ,PALLIATIVE treatment ,PAMPHLETS ,RESEARCH evaluation ,RESEARCH funding ,SEX distribution ,ETHNOLOGY research ,THEMATIC analysis ,FAMILY attitudes - Abstract
Evidence of gender differences in the amount and type of care provided by family caregivers in hospice palliative home care suggests potential inequities in health and health care experiences. As part of a larger critical ethnographic study examining gender relations among clients with cancer, their family caregivers and primary nurses, this article describes gendered expectations and exemptions for family caregivers within the sociopolitical context of end‐of‐life at home. Data were collected from in‐depth interviews (n = 25), observations of agency home care visits (n = 9) and analyses of policy and home care agency documents (n = 12). Employing a critical feminist lens, a gender‐based analysis revealed that structural discourses emphasizing an artificial divide between public and private spheres constructed end‐of‐life at home as private and apolitical. Associated with care of home and family, women were most impacted by these public/private discourses underpinning neoliberal values of cost‐efficiency. Findings suggest that a critical perspective is needed to assist policy makers and healthcare providers to view how caregiver experiences are shaped by structures that control the availability of resources. Thus, instead of focusing on caregivers' deficits, interventions should be directed at the social, political and economic conditions that shape gendered experiences. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
38. Challenging 'girls only' publicly funded human papillomavirus vaccination programmes.
- Author
-
Law, Victoria G and Gustafson, Diana L
- Subjects
HEALTH policy ,SEXUAL health ,SEXISM ,SOCIAL justice ,GOVERNMENT aid ,HUMAN papillomavirus vaccines ,THEORY - Abstract
This analysis examines the ‘girls only’ policy for publicly funded human papillomavirus (HPV) vaccination programmes. Current funding policy in most Canadian provinces covers ‘girls only’ with the goal of reducing mortality and morbidity rates of HPV‐related cervical cancer. Recent studies indicate increasing rates of other HPV‐related cancers among cisgender men and women. The HPV vaccine is proving effective against some of these cancers. Statistics on HPV vaccine uptake among individuals with different gender expressions are scarce. Critics argue that a ‘girls only’ HPV vaccine policy is inequitable. We add to this critique by reflecting on the gender binary embedded in such policies and produced through epidemiological studies that attend differentially to females, reinforcing exclusionary practices that leave out those who form their gender identities across the spectrum. We then draw on deontological (duties‐based) and utilitarian (utility‐based) frameworks to show that these gendered policies are also unethical. These challenges to the assumptions underlying ‘girls only’ immunization programmes have implications for nurses and the healthcare system. If we are to advance equitable and ethical health outcomes, we entreat nurses as a collective to mobilize the public to lobby federal, provincial and territorial governments to fund more inclusive HPV vaccination policies. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
39. Disciplining virtue: investigating the discourses of opioid addiction in nursing.
- Author
-
Kunyk, Diane, Milner, Margaret, and Overend, Alissa
- Subjects
PROFESSIONS ,ANALGESICS ,CHARACTER ,CORRUPTION ,DISCOURSE analysis ,DRUG addiction ,ETHICS ,LABOR discipline ,MASS media ,CASE studies ,NARCOTICS ,NURSES ,ORGANIZATIONAL behavior ,LEGAL procedure ,PUBLIC opinion ,RESEARCH funding ,PROFESSIONAL standards ,THEMATIC analysis ,NURSES' associations ,IMPAIRED medical personnel - Abstract
Two nurses diagnosed with opioid addiction launched legal action after being found guilty of unprofessional conduct due to addiction‐related behaviors. When covered by the media, their cases sparked both public and legal controversies. We are curious about the broader discursive framings that led to these strong reactions, and analyze the underlying structures of knowledge and power that shape the issue of opioid addiction in the profession of nursing through a critical discourse analysis of popular media, legal blogs and hearing tribunals. We argue that addiction in nursing is framed as personal choice, as a failure in the moral character of the nurses, as decontextualized from addiction as disease arguments, and as an individualized issue devoid of contextual factors leading to addiction. Our investigation offers a critical case study of a nursing regulatory body that upheld popular assumptions of addiction as an autonomous, rational choice replete with individual‐based consequences – a framing that is inconsistent with evidence‐based practice in health‐care. We put forth this critical interrogation to open up possibilities for counterdiscourses that may promote more nuanced and effective responses to the issue of addiction in nursing. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
40. Conference Review.
- Author
-
Lauzon, Sylvie and Lawler, Jocalyn
- Subjects
SCIENCE conferences ,CONFERENCES & conventions - Abstract
This congress meets annually for the purpose of bringing Francophone scholars together to discuss and debate their work. It is a major event on the annual calendar of French speaking scholars from around the globe, but the congress is always held in Canada, and generally in a Francophone university in the Province of Québec. This year the conference was held at the Université de Montréal and the nursing section was organised by one member of academic staff (Dr Jacinthe Pépin) and two doctoral students (Francine Major and Alain Legault) from the Faculté des sciences infirmières at the Université de Montréal. [ABSTRACT FROM AUTHOR]
- Published
- 2000
- Full Text
- View/download PDF
41. The business of managing nurses' substance-use problems.
- Author
-
Ross CA, Jakubec SL, Berry NS, and Smye V
- Subjects
- Anthropology, Cultural, Canada, Health Knowledge, Attitudes, Practice, Humans, Evidence-Based Practice standards, Nurses psychology, Substance-Related Disorders therapy
- Abstract
Nurses' experiences in, and the overall effectiveness of, widely used alternative-to-discipline programs to manage nurses' substance-use problems have not been adequately scrutinized. We uncovered the conflicted official and experiential ways of knowing one such alternative-to-discipline program in a Canadian province. We explicated this conflict through an institutional ethnography analysis. Ethnographic data from interviews with 12 nurses who were enrolled in an alternative-to-discipline treatment program and three program administrators, as well as institutional texts, were analyzed to explore how institutional practices and power relations co-ordinated and managed nurses' experiences. Analysis revealed the acritical acceptance of a standardized program not based on current norms of practice. Potential and actual conflicts of interest, power imbalances, and prevailing corporate interests were rife. Nurses were not afforded the same rights to quality ethical health care as other citizens. 'Expert' physicians' knowledge was privileged while nurses' knowledge was subordinated. Conclusions were that regulatory bodies cannot rely on the taken-for-granted standardized treatment model in widespread use. Individualized treatment alternatives reflecting current, scientific evidence must be offered to nurses, and nurses' knowledge, expertise, and experiences need to be included in decision-making processes in these programs., (© 2019 John Wiley & Sons Ltd.)
- Published
- 2020
- Full Text
- View/download PDF
42. Your blues ain't like mine: considering integrative antiracism in HIV prevention research with black men who have sex with men in Canada and the United States.
- Author
-
Nelson, LaRon E., Walker, Ja'Nina J., DuBois, Steve N., and Giwa, Sulaimon
- Subjects
HIV prevention ,GAY men ,CINAHL database ,PSYCHOLOGY information storage & retrieval systems ,MEDLINE ,RACISM ,RELIGION ,SPIRITUALITY ,SYSTEMATIC reviews - Abstract
Evidence-based interventions have been developed and used to prevent HIV infections among black men who have sex with men ( MSM) in Canada and the United States; however, the degree to which interventions address racism and other interlocking oppressions that influence HIV vulnerability is not well known. We utilize integrative antiracism to guide a review of HIV prevention intervention studies with black MSM and to determine how racism and religious oppression are addressed in the current intervention evidence base. We searched CINAHL, PsychInfo, MEDLINE and the CDC compendium of evidence-based HIV prevention interventions and identified seventeen interventions. Three interventions targeted black MSM, yet only one intervention addressed racism, religious oppression, cultural assets and religious assets. Most interventions' samples included low numbers of black MSM. More research is needed on interventions that address racism and religious oppression on HIV vulnerability among black MSM. Future research should focus on explicating mechanisms by which multiple oppressions impact HIV vulnerability. We recommend the development and integration of social justice tools for nursing practice that aid in addressing the impacts of racism and other oppressions on HIV vulnerability of black MSM. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
43. Fostering excellence: development of a course to prepare graduate students for research on migration and health.
- Author
-
Ogilvie, Linda, Higginbottom, Gina, Burgess-Pinto, Elizabeth, and Murray, Christina
- Subjects
LEGISLATION ,CONCEPTUAL structures ,DEVELOPMENTAL psychobiology ,CURRICULUM ,EMIGRATION & immigration ,HEALTH services accessibility ,IMMIGRANTS ,INFANT mortality ,LIFE expectancy ,MORTALITY ,MATERNAL mortality ,NURSING research ,REFUGEES ,GRADUATE nursing education ,GOVERNMENT policy ,DOCTORAL programs ,CULTURAL competence ,BEHAVIORAL objectives (Education) - Abstract
Canada is an immigrant-receiving nation and many graduate students in nursing and other disciplines pursue immigrant health research. As these students often start with inadequate understanding of the policy, theoretical, and research contexts in which their work should be situated, we became concerned that the theses and dissertations were less sophisticated than were both possible and desirable. This led to development of a PhD-level course titled Migration and Health in the Canadian Context. In this study, we provide an analytic overview including course description, objectives, assignments, and specific class topics. Areas of focus include historical and theoretical considerations; determinants of immigrant health; refugee health; cultural competence and cultural safety; research challenges, approaches, and skills; policy-relevant research; and educational imperatives in the health and related disciplines. Salient research is introduced in each of these classes. While Canada is the main focus, comparative data are provided and there is relevance for nurse-researchers in other immigrant-receiving countries. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
44. Beyond greener pastures: exploring contexts surrounding Filipino nurse migration in Canada through oral history.
- Author
-
Ronquillo, Charlene, Boschma, Geertje, Wong, Sabrina T, and Quiney, Linda
- Subjects
EMIGRATION & immigration & psychology ,CULTURE ,INTERVIEWING ,NURSES ,NURSES' attitudes ,ORAL history ,RESEARCH funding ,STATISTICAL sampling ,FILIPINOS ,FAMILY relations ,NARRATIVES ,FOREIGN nurses ,PSYCHOLOGY - Abstract
RONQUILLO C, BOSCHMA G, WONG ST and QUINEY L. Nursing Inquiry 2011; 18: 262-275 Beyond greener pastures: exploring contexts surrounding Filipino nurse migration in Canada through oral history The history of immigrant Filipino nurses in Canada has received little attention, yet Canada is a major receiving country of a growing number of Filipino migrants and incorporates Filipino immigrant nurses into its healthcare workforce at a steady rate. This study aims to look beyond the traditional economic and policy analysis perspectives of global migration and beyond the push and pull factors commonly discussed in the migration literature. Through oral history, this study explores biographical histories of nine Filipino immigrant nurses currently working in British Columbia and Alberta, Canada. Narratives reveal the instrumental role of the deeply embedded culture of migration in the Philippines in influencing Filipino nurses to migrate. Additionally, the stories illustrate the weight of cultural pressures and societal constructs these nurses faced that first colored their decision to pursue a career in nursing and ultimately to pursue emigration. Oral history is a powerful tool for examining migration history and sheds light on nuances of experience that might otherwise be neglected. This study explores the complex connections between various factors motivating Filipino nurse migration, the decision-making process, and other pre-migration experiences. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
45. Constructing mentally ill inmates: nurses' discursive practices in corrections.
- Author
-
Perron, Amélie and Holmes, Dave
- Subjects
ATTITUDE (Psychology) ,DISCOURSE analysis ,INTERVIEWING ,MENTAL illness ,NURSE-patient relationships ,NURSES' attitudes ,NURSING specialties ,POWER (Social sciences) ,PRISON nurses ,PSYCHIATRIC nursing ,RESEARCH funding ,QUALITATIVE research ,CRIMINALS with mental illness - Abstract
PERRON A and HOLMES D. Nursing Inquiry 2011; 18: 191-204 Constructing mentally ill inmates: nurses' discursive practices in corrections The concepts of discourse, subjectivity and power allow for innovative explorations in nursing research. Discourse take many different forms and may be maintained, transmitted, even imposed, in various ways. Nursing practice makes possible many discursive spaces where discourses intersect. Using a Foucauldian perspective, were explored the ways in which forensic psychiatric nurses construct the subjectivity of mentally ill inmates. Progress notes and individual interviews constitute discursive spaces within which nurses construct patients' subjectivities. Progress notes provide a written (and permanent) form of discourse, while interviews set the space for a more fluid and contextual form of discourse. We identified five types of subjectivities - the (in)visible patient, the patient as risk, the deviant patient, the disturbed patient and the disciplined patient. These subjectivities were rooted in various types of discourses circulating in the selected setting. Despite the multiple discursive dimensions of forensic psychiatric nursing, progress notes remain the main formal source of information regarding nursing care even though it is not representative of the care provided nor is it representative of nurses' complex discursive practices in corrections. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
46. Examining our privileges and oppressions: incorporating an intersectionality paradigm into nursing.
- Author
-
Van Herk KA, Smith D, and Andrew C
- Subjects
FIRST Nations of Canada ,CANADIAN Inuit ,ATTITUDE (Psychology) ,CULTURE ,HEALTH services accessibility ,INTERVIEWING ,MEDICAL personnel ,METROPOLITAN areas ,PARADIGMS (Social sciences) ,POWER (Social sciences) ,RACE ,RACISM ,RESEARCH funding ,SEX distribution ,SEXISM ,SOCIAL classes ,SOCIAL justice ,SOCIAL values ,THEORY ,JUDGMENT sampling ,SECONDARY analysis ,SOCIOECONOMIC factors ,THEMATIC analysis ,FIELD notes (Science) - Abstract
VAN HERK KA, SMITH D and ANDREW C. Nursing Inquiry 2011; : 29-39 An intersectionality paradigm is a means by which nurses can attend to issues of oppression and privilege within their practice and profession. Intersectionality is introduced as an essential theory to help debunk the hegemony of the 'white, middle class' perspective that often directs nursing research, practice, and education. The values and benefits of using an intersectionality paradigm in nursing are shown through recent research done with Aboriginal women. These findings contribute to an increased understanding of the importance and necessity of attending to the power relations that dominate nursing care encounters and influence the way nurses provide care. By acknowledging and responding to the presence of privilege and oppression and the associated power dynamics within the therapeutic encounter, nursing can strive further in helping to alleviate social injustices and health disparities that arise from unequal power relations. [ABSTRACT FROM AUTHOR]
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- 2011
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47. Using participatory research to challenge the status quo for women's cardiovascular health L Young and J Wharf Higgins Women's cardiovascular health.
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Young, Lynne and Higgins, Joan Wharf
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ACTION research ,CARDIOVASCULAR diseases ,CARDIOVASCULAR diseases risk factors ,FOCUS groups ,HEALTH promotion ,INTERVIEWING ,HEALTH policy ,MOTHERS ,REFLECTION (Philosophy) ,SELF-efficacy ,SINGLE parents ,SURVEYS ,WOMEN'S health ,QUALITATIVE research ,CASE studies ,MULTIPLE regression analysis ,QUANTITATIVE research ,SECONDARY analysis ,SOCIOECONOMIC factors - Abstract
YOUNG L, and WHARF HIGGINS J. Nursing Inquiry 2010; : 346-358 Cardiovascular health research has been dominated by medical and patriarchal paradigms, minimizing a broader perspective of causes of disease. Socioeconomic status as a risk for cardiovascular disease is well established by research, yet these findings have had little influence. Participatory research (PR) that frames mixed method research has potential to bring contextualized clinically relevant findings into program planning and policy-making arenas toward developing meaningful health and social policies relevant to primary prevention. In this article we provide an overview of a PR program that included two quantitative and one qualitative studies and then we discuss lessons learned. The PR process we found was empowering for lone mothers, and transformative for lone mothers and researchers. Further, PR as an approach to research opened spaces in practice and policy-making arenas to raise upstream issues relevant to the health of low income lone mothers. We conclude that while PR is an effective approach to social determinants research, as a time-intensive endeavor, and one that does not easily align with research tradition, researchers must consider the strengths and drawbacks of PR when planning to implement such an approach. [ABSTRACT FROM AUTHOR]
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- 2010
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- View/download PDF
48. Withdrawal from Weihui: China missions and the silencing of missionary nursing, 1888-1947.
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Grypma S
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HOSPITALS ,EMPLOYMENT in foreign countries ,HISTORY of nursing ,HISTORICAL research ,PRACTICAL politics ,ACQUISITION of data ,MISSIONARY medicine ,RESEARCH funding ,MEDICAL records ,ARCHIVES ,RELIGION - Published
- 2007
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49. Accommodation and resistance to the dominant cultural discourse on psychiatric mental health: oral history accounts of family members.
- Author
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Boschma G
- Subjects
MENTAL health ,PSYCHIATRY ,ORAL history ,MENTAL health services - Published
- 2007
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50. An examination of nervios among Mexican seasonal farm workers.
- Author
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England M, Mysyk A, and Gallegos JA
- Subjects
MIGRANT agricultural workers ,MEXICANS ,IRRITABILITY (Psychology) ,MENTAL depression ,DESPAIR - Published
- 2007
- Full Text
- View/download PDF
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