Inequalities in the Everyday of Care: Dimensions of the Incorporation of Intersectional Theory in Nursing Practice
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作者:
Graells-Sans, Ariadna
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机构:
Hosp del Mar, Res Inst, Social Determinants & Hlth Educ Res Grp SDHEd, Barcelona, Spain
Univ Pompeu Fabra, Hosp del Mar Nursing Sch ESIHMar, Barcelona, SpainHosp del Mar, Res Inst, Social Determinants & Hlth Educ Res Grp SDHEd, Barcelona, Spain
Graells-Sans, Ariadna
[1
,2
]
Insa-Calderon, Esther
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机构:
Hosp del Mar, Res Inst, Social Determinants & Hlth Educ Res Grp SDHEd, Barcelona, Spain
Univ Pompeu Fabra, Hosp del Mar Nursing Sch ESIHMar, Barcelona, SpainHosp del Mar, Res Inst, Social Determinants & Hlth Educ Res Grp SDHEd, Barcelona, Spain
Insa-Calderon, Esther
[1
,2
]
Sanclemente-Dalmau, Montserrat
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机构:
Hosp del Mar, Res Inst, Social Determinants & Hlth Educ Res Grp SDHEd, Barcelona, Spain
Univ Pompeu Fabra, Hosp del Mar Nursing Sch ESIHMar, Barcelona, SpainHosp del Mar, Res Inst, Social Determinants & Hlth Educ Res Grp SDHEd, Barcelona, Spain
Sanclemente-Dalmau, Montserrat
[1
,2
]
Coll-Planas, Gerard
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机构:
Univ Vic, Cent Univ Catalonia, Barcelona, SpainHosp del Mar, Res Inst, Social Determinants & Hlth Educ Res Grp SDHEd, Barcelona, Spain
Coll-Planas, Gerard
[3
]
机构:
[1] Hosp del Mar, Res Inst, Social Determinants & Hlth Educ Res Grp SDHEd, Barcelona, Spain
[2] Univ Pompeu Fabra, Hosp del Mar Nursing Sch ESIHMar, Barcelona, Spain
framework;
health inequalities;
intersectionality;
nursing practice;
SOCIAL DETERMINANTS;
HEALTH;
ILLNESS;
D O I:
10.1111/jan.16821
中图分类号:
R47 [护理学];
学科分类号:
1011 ;
摘要:
AimTo offer a practical proposal regarding the implications of integrating intersectional theory into nursing practice, drawing from the experiences and narratives of nurses across diverse professional contexts.DesignQualitative Grounded theory, following the constructivist approach offered by Kathy Charmaz.MethodsData collection was conducted between 2022 and 2023 with nursing professionals from Catalonia, Spain. Following Charmaz's approach, thematic analysis was performed after theoretical sampling was saturated through 17 in-depth interviews and 2 focus groups.ResultsA total of 26 individuals participated in the study. The analysis identified five dimensions related to considerations for incorporating intersectionality into nursing practice. These dimensions are presented as a conceptual framework, organised from elements most closely related to reflexivity and professional positionality, to those more distally connected to a critique of the structural system within which nursing activities are situated.ConclusionAlthough the findings reveal widespread agreement regarding the necessity of adopting a new perspective that challenges the dominance of biomedical knowledge and facilitates alternative approaches to the social and health complexities in our environments, there exists divergence in the methods for achieving this paradigm shift. Intersectional theory provides a theoretical framework conducive to this reassessment.Implications for the Profession and/or Patient CareThe findings outlined in this study hold significant implications for both professional practice and the structuring of nursing education at the university level. Concerning professional practice, we advocate for a theoretical framework that offers lucidity and precision regarding the strategies and skill sets necessary for the integration of an intersectional perspective into nursing practice. This framework may prove beneficial not only to individual practitioners but also to managerial entities seeking to reshape institutional care paradigms. In terms of nursing education, this research provides a foundation for a critical revaluation of curricular structures and their practical execution.What were the main findings?Findings underscore the importance of aligning nursing values with principles of equality, respect, and social justice to address social health inequalities effectively.Where and on whom will the research have an impact?This study provides insights into the ambivalence surrounding the incorporation of intersectional theory in nursing practice, shedding light on its perceived value and feasibility among practitioners. A practical framework is developed which emphasises the significance of understanding power dynamics in healthcare settings and their implications for perpetuating or challenging social inequalities in health.Where and on whom will the research have an impact?This study provides insights into the ambivalence surrounding the incorporation of intersectional theory in nursing practice, shedding light on its perceived value and feasibility among practitioners. A practical framework is developed which emphasises the significance of understanding power dynamics in healthcare settings and their implications for perpetuating or challenging social inequalities in health.Reporting MethodThe manuscript is based on the Consolidated Criteria for Reporting Qualitative Research (COREQ).Patient or Public ContributionNo Patient or Public Contribution.
机构:
Univ Penn, Dept Med Eth, Nursing Ctr Bioeth, Philadelphia, PA 19104 USA
Univ Penn, Sch Nursing, New Courtland Ctr Transit & Hlth, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USAUniv Penn, Dept Med Eth, Nursing Ctr Bioeth, Philadelphia, PA 19104 USA
Ulrich, Connie M.
Taylor, Carol
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机构:
Georgetown Univ, Ctr Bioeth, Washington, DC USAUniv Penn, Dept Med Eth, Nursing Ctr Bioeth, Philadelphia, PA 19104 USA
Taylor, Carol
Soeken, Karen
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机构:
Univ Maryland, Sch Nursing, Baltimore, MD 21201 USAUniv Penn, Dept Med Eth, Nursing Ctr Bioeth, Philadelphia, PA 19104 USA
Soeken, Karen
O'Donnell, Patricia
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h-index: 0
机构:
Inova Hlth Syst, Ctr Eth, Fairfax, VA USAUniv Penn, Dept Med Eth, Nursing Ctr Bioeth, Philadelphia, PA 19104 USA
O'Donnell, Patricia
Farrar, Adrienne
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机构:Univ Penn, Dept Med Eth, Nursing Ctr Bioeth, Philadelphia, PA 19104 USA
Farrar, Adrienne
Danis, Marion
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机构:
NIH, Dept Social Work, Ctr Clin, Sect Eth & Hlth Policy, Bethesda, MD 20892 USAUniv Penn, Dept Med Eth, Nursing Ctr Bioeth, Philadelphia, PA 19104 USA
Danis, Marion
Grady, Christine
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机构:
NIH, Dept Bioeth, Ctr Clin, Sect Human Subjects Res & Acting Chief, Bethesda, MD 20892 USAUniv Penn, Dept Med Eth, Nursing Ctr Bioeth, Philadelphia, PA 19104 USA