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Social justice is widely advanced as a central nursing value, and yet conceptual understandings of social justice remain inconsistent and vague. Further, despite persistently articulated commitments to upholding social justice, the profession of nursing has been implicated in perpetuating inequities in health and health care. In this context, it is essential to establish both conceptual clarity and tangible guidance for nurses in enacting practices to advance social justice-particularly through regulatory, education and accreditation documents that shape the nursing profession. This Foucauldian discourse analysis examines how social justice is discursively positioned within nursing professional documents in Canada, and illustrates that social justice was largely discursively excluded from these texts. Where social justice discourses were invoked, we identified that four central discursive patterns obscured and de-centred this nursing value: (i) Vague language undermined professional commitments to social justice; (ii) Constructions of knowledge and awareness de-emphasized practice; (iii) Individualism discourses minimized institutional/professional responsibility; and (iv) Aspirational language obscured present action. Extending from this analysis, we contend that the nursing profession must re-examine how social justice is understood and articulated, and call for a re-conceptualization of social justice grounded in nursing practice toward remediating inequities in health and health care., (© 2024 The Author(s). Nursing Inquiry published by John Wiley & Sons Ltd.)

Aim: The aim of this article was to introduce Fairclough's critical discourse analysis (CDA) in caring and nursing science, to provide a guide on how to perform such an analysis, and to describe the wider context of discourse epistemology., Design: The article is designed as a methodological paper, including (a) epistemological roots of discourse analysis, (b) an overview of discourse analytical research within caring and nursing science which points out an increased trend, and (c) a guide to conducting a CDA., Analysis: It is important that discourse analysis is available and accessible to nursing and caring researchers. Through the process of encircling discourses, valuable insight is given into fields that otherwise would be lost or would not be available., Conclusion: Our summary stance is that discourse analysis as it is presented in this article is strongly advisable for use in nursing and caring sciences., (© 2023 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.)

The history of Brazilian nurses is marked by several challenges, in part resulting from discontinuous and fragile activity boundaries among the health professions that share the same work objective in care services. A field of constant disputes, the Brazilian health system, was the target of a lawsuit filed by the Federal Council of Medicine that temporarily suspended nurses' activities in primary care. This study aimed to demonstrate the manipulative discourse present in the text of the injunction request by medical doctors against legislation by the Brazilian Federal Government in 2017. This is a qualitative and documental study that used the theoretical-methodological framework of critical discourse studies based on Teun Van Dijk's analytical categories. The results pointed to manipulative discourse through a polarization between manipulators' good qualities and intentions and the bad qualities of nurses and Brazilian primary care policies; episodic manipulation by the presentation of documental and historical evidence of the submission of nursing roles; and social manipulation marked by strong emotional appeal. The study demonstrated that manipulative discourse extrapolated linguistic categories in the form of ideology and history., (© 2021 John Wiley & Sons Ltd.)

This study critically examines the public's perception of Florence Nightingale's legacy through a critical discourse analysis (CDA) of digital media, specifically podcasts and YouTube. Nightingale, who is often remembered as "The Lady with the Lamp", holds a complex identity within modern narratives that is celebrated for her pioneering contributions to nursing and public health, even if there are some disagreements about her, given the colonialist setting that may have shaped some of her opinions and decisions. This research employed CDA to analyze 25 podcasts and 18 YouTube videos, which were systematically included according to a priori inclusion criteria. The study synthesized how these media products portray Nightingale and, by extension, shape public discourse about the nursing profession. The findings reveal five thematic representations of Nightingale: as a legendary figure, a modern feminist, a dedicated statistician, a pioneer in public health, and a pivotal STEM contributor. These portrayals challenge traditional nursing stereotypes by emphasizing Nightingale's role as a rigorous scientist and reformer, suggesting broader perceptions of nurses that encompass leadership, analytical skills, and strategic thinking. The study supports the hypothesis that digital narratives significantly influence the public's understanding and appreciation of nursing, advocating for a more nuanced professional identity that integrates traditional caregiving roles with critical and analytical capabilities. [ABSTRACT FROM AUTHOR]

Bakgrunn: Endrede politiske og organisatoriske rammebetingelser aktualiserer spørsmål om omprioriteringer, omorganiseringer, nye arenaer og nytt innhold i den kommunale ergoterapitjenesten. I studien undersøker vi hvordan ergoterapi fremstilles i helsepolitiske styringsdokumenter. Vi utforsker spesifikt hvilke roller ergoterapeuter tilskrives i fremtidens primærhelsetjeneste, og hva kommuneergoterapeuter bes om å løse for hvem. Metode: Studien har et diskursanalytisk design, og vi har valgt ut tre stortingsmeldinger og én NOU (Norges offentlige utredninger), som samlet sett representerer sentrale styringssignaler for fremtidens kommunale helse- og omsorgstjenester. Resultat: Vi finner stor variasjon i måten ergoterapi fremstilles på i styringsdokumentene. Det er i forbindelse med tverrfaglig samhandling, velferdsteknologi og proaktive borgere at ergoterapi særlig nevnes. Videre finner vi at det er innenfor tjenestediskursene proaktive tjenester og aktiv omsorg at ergoterapeutene ses på som en del av løsningen i fremtidens helsetjenester. Konklusjon: Selv om ergoterapi kobles til sentrale politiske virkemidler for fremtidens tjenesteutforming, synes ikke profesjonen å ha fått en endret posisjon eller tydeligere funksjon i de utvalgte stortingsmeldingene. Skal ergoterapi som profesjon inngå som en del av det politiske virkemiddelapparatet, kreves det mer inngående analyser og reelle diskusjoner om rekruttering og dimensjonering av ergoterapi i kommunehelsetjenesten. Det trengs en tydeligere konkretisering av hvordan ergoterapi skal organiseres, hvilke kompetanser som skal utvikles, og hvilke oppgaver som skal prioriteres i de kommunale helse- og omsorgstjenestene.

The nursing profession in Greenland, particularly in rural and remote areas, faces challenges due to geographical limitation and a lack of interdisciplinary collaboration. The registration process and status of internationally educated nurses (IENs) in Greenland are unclear. This article aimed to analyze existing policies and propose recommendations for an independent registration process for IENs in Greenland. A qualitative discourse analysis was used to critically discuss existing policies and regulations governing nursing registration in Greenland. Relevant legislation, government reports, and official documents were reviewed. Legislative regulations protect the title of registered nurse in both Greenland and Denmark. To work in Greenland, an IEN must have a residence permit. With recent health agreements between Greenland and Denmark, both countries have streamlined the permit acquisition process for foreign healthcare professionals, making it more accessible. However, the process of acquiring a license to work as a registered nurse for IENs lacks clarity. Policy reform is needed to establish a group of diverse nurse experts under the National Board of Health responsible for the assessment and registration of IEN qualifications. There is also a need for a bridging education program or national licensure examination which could facilitate faster IEN recognition. Mutual recognition of nurse licenses between Greenland and Denmark should be established to ensure efficient healthcare delivery and maintain professional standards. Embracing IENs can address nursing shortages and improve healthcare services in Greenland. [ABSTRACT FROM AUTHOR]

This article uses critical discourse analysis to investigate artificial intelligence (AI) generated images of aged care nurses and considers how perspectives and perceptions impact upon the recruitment and retention of nurses. The article demonstrates a recontextualization of aged care nursing, giving rise to hidden ideologies including harmful stereotypes which allow for discrimination and exploitation. It is argued that this may imply that nurses require fewer clinical skills in aged care, diminishing the value of working in this area. AI relies on existing data sets, and thus represent existing stereotypes and biases. The discourse analysis has highlighted key issues which may further impact upon nursing recruitment and retention, and advocates for stronger ethical consideration, including the use of experts in data validation, for the way that aged care services and nurses are depicted and thus valued. [ABSTRACT FROM AUTHOR]

Aim: To improve the effectiveness of nursing clinical handover through a qualitative, tailored communication intervention. Design: A multisite before and after intervention using qualitative ethnography combined with discourse analysis of nursing handover interactions. Methods: We implemented a tailored ward‐based intervention to redesign nursing handover practice with co‐constructed recommendations for organisational and cultural change on seven wards across three affiliated metropolitan hospitals between February 2020 and November 2022. The intervention was informed by pre‐implementation interviews and focus groups with nursing, medical and allied health staff and patients (n = 151) and observed and/or audio‐recorded handover events (n = 233). Post‐intervention we conducted interviews and focus groups (n = 79) and observed and/or audio‐recorded handover events (n = 129) to qualitatively evaluate impact. Results: Our translational approach resulted in substantial changes post‐intervention. Nurses conducted more shift‐to‐shift handovers at the bedside, with greater patient interaction and better structured and more comprehensive information transfer, supported by revised handover documentation. Redesigned group handovers were focused and efficient, communicating critical patient information. Conclusion: Contextualised training combined with changes to ward‐level systemic factors impeding communication results in improved nursing handovers. Practice change requires strong executive leadership and project governance, combined with effective ward‐level leadership, collaboration and mentoring. The speed and degree of change post‐intervention demonstrates the power of interdisciplinary collaborative research between hospital executive, ward leadership and communication specialists. Relevance to Clinical Practice: Nurses are more likely to conduct efficient group handovers and informative, patient‐centred bedside handovers in line with policy when they understand the value of handover and have practical strategies to support communication. Communication training should be combined with broader ward‐level changes to handover practice tailored to the ward context. A multilevel approach results in more effective practice change. Reporting Method: We adhered to the COREQ guidelines. Patient or Public Contribution: We interviewed patients on study wards pre and post intervention. [ABSTRACT FROM AUTHOR]

Several challenges exist to providing effective, formalized end-of-life education for undergraduate nursing students. The purpose of this study was to determine whether the addition of a discourse intervention to the End-of-Life Nursing Education Consortium Undergraduate Nursing Modules effectively improved junior-level prelicensure bachelor of science in nursing students' knowledge and attitudes toward end-of-life care. This quasi-experimental 2-group comparison, pretest/posttest design consisted of a sample of 135 enrolled in a medical-surgical nursing class. Applying Mezirow's transformational learning theory, a 2-hour discourse intervention that included a self-reflective journal, an unfolding case study focused on loss, and a discussion with question-and-answer session was implemented at the completion of the Undergraduate Nursing Modules for the intervention group. Knowledge and attitude toward end-of-life care were measured before and after the intervention with the Palliative Care Quiz for Nurses and the Frommelt Attitude Toward Care of the Dying. The findings indicated increased knowledge and positive attitude changes. This study supports the value of theory-based educational interventions, like a discourse intervention, to enhance effective pedagogy when addressing emotionally laden content such as end-of-life care. This study may have also given a glimpse of how a global pandemic may affect end-of-life knowledge and attitudes. [ABSTRACT FROM AUTHOR]

Abstract Background Intensive care unit (ICU) nurses working in South Korea report experiencing uncertainty about how to care for patients undergoing withdrawal of life-sustaining treatments (WLT). A lack of consensus on care guidelines for patients with WLT contributes to uncertainty, ambiguity, and confusion on how to act appropriately within current law and social and ethical norms. To date, little has been discussed or described about how ICU nurses construct meaning about their roles in caring for dying patients in the context of wider social issues about end-of-life care and how this meaning interacts with the ICU system structure and national law. We aimed to better understand how ICU nurses view themselves professionally and how their perceived roles are enabled and/or limited by the current healthcare system in South Korea and by social and ethical norms. Methods This qualitative descriptive study was conducted using in-depth, semi-structured interviews and discourse analysis using Gee’s Tools of Inquiry. Purposive sampling was used to recruit ICU nurses (n = 20) who could provide the most insightful information on caring for patients undergoing WLT in the ICU. The interviews were conducted between December 2021 and February 2022 in three university hospitals in South Korea. Results We identified four categories of discourses: (1) both “left hanging" or feeling abandoned ICU nurses and patients undergoing WLT; (2) socially underdeveloped conversations about death and dying management; (3) attitudes of legal guardians and physicians toward the dying process of patients with WLT; and (4) provision of end-of-life care according to individual nurses’ beliefs in their nursing values. Conclusion ICU nurses reported having feelings of ambiguity and confusion about their professional roles and identities in caring for dying patients undergoing WLT. This uncertainty may limit their positive contributions to a dignified dying process. We suggest that one way to move forward is for ICU administrators and physicians to respond more sensitively to ICU nurses’ discourses. Additionally, social policy and healthcare system leaders should focus on issues that enable and limit the dignified end-of-life processes of patients undergoing WLT. Doing so may improve nurses’ understanding of their professional roles and identities as caretakers for dying patients.

Aims: This paper explores two critical feminist methodologies for nursing research: feminist political economy and feminist critical discourse analysis. The aim was to appreciate varied methodological approaches available for nurses to understand complexities in healthcare environments, above and beyond socially normative ways of knowing. Design: Discursive paper. Data Sources: Published articles from nursing databases (CINAHL and ProQuest; no date restrictions) and interdisciplinary databases (Women's Studies International, Sociological Abstracts and Ovid MEDLINE; publication dates between 2017 and 2022). Methods: A discursive paper exploring and critically synthesizing the literature on feminist political economy and feminist critical discourse analysis to demonstrate how each methodological approach can be used in nursing. Results: The findings of this discursive paper suggest there is an opportunity to draw on interdisciplinary studies for creative insights into how these methodologies may be helpful for nurses' scholarship and programmes of research. Although few nursing studies explicitly name a feminist political economy or feminist critical discourse analysis approach, several studies apply principles of these methodological approaches. Conclusion: There is an opportunity for these methodologies to be applied within the same project when there is a fit between the research questions and aims of both methodologies (studies where notions of gender and power are considered central and there are potential insights from exploring social progress, structures and the material, along with the social relations of discourses). Implications for the Profession and/or Patient Care: Feminist political economy and feminist critical discourse analysis offer novel options for methodological analyses. Impact: Application of these methodologies may benefit critical nursing scholars looking for diverse critical methodological avenues to explore and to broaden nursing's methodological toolbox towards meeting social justice aims. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Introduction: Fever stands out as the predominant clinical indicator in infancy. Pediatricians encounter fever routinely in their daily practice, playing a crucial role in their interactions with children and families. Objective: The aim is to examine pediatricians' viewpoints, understanding, and approaches regarding childhood fever in two healthcare settings: pediatric hospitalization (emergency and inpatient ward) and primary care. Methods: A qualitative study was conducted using an ethnomethodological approach. Pediatricians working in the specified pediatric settings participated in in-depth interviews where theoretical clinical cases were presented for analysis. Results: Following the examination of the discourses, the codes were organized into eight categories: Understanding of fever, Significance ascribed to fever, Therapeutic strategies, Engagement with the evidence, Family apprehensions regarding fever, Influence of the COVID-19 Pandemic, Inter- and intra-professional relationships, and Suggestions for change: Conclusions: Pediatricians acknowledge the importance of addressing discomfort in the treatment of fever, but express challenges in implementing these recommendations. Pediatricians in inpatient settings emphasize the need for enhanced parental education from primary care, while those in primary care recognize the potential for improvement. Inpatient pediatricians are open to implementing changes in their daily practices, particularly concerning the administration of antipyretics. [ABSTRACT FROM AUTHOR]

Aims: To explore the effects of power dynamics and hospital organizational structure upon neonatal intensive care nurses' experiences caring for infants and families from a substance‐exposed pregnancy (SEP). Design: This secondary data analysis further investigated the results of a primary study after the original analysis suggested differences in work environments may impact relationship‐building opportunities between nurses and mothers/families. Critical discourse analysis served as both the theoretical lens and analytic technique. Method: Nine (9) nurses from the southeast region of the United States (U.S.) were interviewed in 2019. Fifty‐one (51) stories of caregiving experiences were analysed with a focus on narratives related to organizational structure and care delivery. Results: Study findings revealed nurses experienced challenges providing high‐quality, family‐centered care for patients in the neonatal intensive care unit (NICU) affected by substances during pregnancy. Nurses described the central challenge of workload, exacerbated by power imbalances and structural constraints within the hospital's organizational structure. Findings suggest workload issues may endorse stigma by inhibiting opportunities to build relationships. Nurses report manageable workloads can support healthcare teams and recipients of care. Conclusion: The study suggests power imbalances between nurses, families and adjacent healthcare professionals can inhibit the delivery of high‐quality care. Supporting healthcare teams and recipients of care while centering the role of organizational structure is critical. Questions emerged about workload demands impacting the potential production of stigma in clinical environments. Impact: This study examines the intersection of nurses' care experiences and hospital organizational structure. It identifies how the unique needs of caring for infants and families from a SEP increase the complexity of power imbalances and organizational constraints to further increase workload demands. Findings have implications for global healthcare organization leaders who build and maintain the structural integrity of clinical environments and nurse leaders who advocate and guide clinical teams to provide high‐quality care in stressful healthcare environments. Reporting Method: EQUATOR guidelines were followed, using the COREQ checklist. Patient or Public Contribution: NICU nurses were interviewed about their care‐provision experiences. Interviews were analysed in the primary study and the current analysis of secondary data. [ABSTRACT FROM AUTHOR]

Nurses working in correctional and forensic mental health settings face unique challenges in the provision of care to patients within custodial settings. The subjectivities of both patients and nurses are subject to the power relations, discourses and abjection encountered within these practice milieus. Using a poststructuralist approach using the work of Foucault, Kristeva, and Deleuze and Guattari, this paper explores how both patient and nurse subjectivities are produced within the carceral logic of this apparatus of capture. Recognizing that subjectivities are fluid and dynamic, and capable of change, Deleuze and Guattari's concept of deterritorialization will illustrate opportunities for resistance, where nurses can begin to practice outside the dominant carceral logic (and restrictions) of the system. [ABSTRACT FROM AUTHOR]

American institutions of nursing education have integrated cultural competence as a pillar approach to addressing health disparities. The theoretical frameworks, priorities, and solutions that national organizations pursue and endorse have far-reaching implications. The American Association of Colleges of Nursing (AACN) is one such organization. The purpose of this project was to critically analyze the AACN's Tool Kit of Resources for Cultural Competent Education for Baccalaureate Nurses to excavate dynamics related to language, power, and inequality. Findings of this critical discourse analysis indicate: (1) the centrality of the AACN's assumed authority and lack of relationality with readers, (2) nursing insularity and narrow theorization of culture and power, and (3) the harm of whiteness and colonialism as pedagogy. Accountability and repair include transparency, taking note of resources and viewpoints available and endorsed on organization websites, and updating (or refuting) outdated and harmful approaches. [ABSTRACT FROM AUTHOR]

IntroductionThe power of action research to create change by anchoring research results in practice was challenged in an action research project at a specialized rehabilitation unit for persons with acquired spinal cord injury. Despite the co-researchers' new insights, approaches, and actions supporting patient participation, it was not possible to change the basic conditions for the practicing of nursing. We aimed to raise awareness of the mechanisms that govern barriers by exploring these barriers as experienced by nurses in their effort to change their practice to improve patient participation.MethodWe used Fairclough's critical discourse analysis drawing on Foucault's practical systems; ethics (identity, relation to oneself), power (action, relation to others), and knowledge (representation, aspects of the world), which he combines with discourse-analytical concepts.ResultsOur discourse analysis of the empirical data at micro-level uncovers the nature of barriers to change in practice. In addition, our analysis at macro-level unveils how these practices are embedded in larger historical, societal, and institutional discourses. This identified two current discourses: a biomedical discourse and a biopsychosocial discourse. In the light of these two discourses, the nurses at micro-level saw themselves as strong agents for the best rehabilitation by acting in accordance with the biopsychosocial discourse. But they were unable to find the time and space to do so due to tasks, structures, and practices specified by an organization dominated by the biomedical discourse.

Copyright of Revista de Enfermagem e Atenção à Saúde (REAS) is the property of Revista de Enfermagem e Atencao a Saude - Reas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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. [ABSTRACT FROM AUTHOR]

Background: Quality of care depends on the information shared orally during shift handovers and documented in the clinical records. Objective: To analyze the verbal and written information shared in shift handovers and its impact on clinical decision-making in nursing and the continuity of care in a pediatric emergency ward, as well as identify the emerging paradigm for care. Methodology: Qualitative approach, based on Yin's case study process, using three methods: transcription of the shift handover, documented process, and process carried out by the expert. Results: The results show increased sharing of information about unintentional body processes, especially in oral transmission. Although documented data includes more detailed information about adaptive processes, it is incipient for a structured and intentional conception of nursing care. Conclusion: The verbal and written information shared in shift handovers mainly focuses on the disease rather than the individual as a whole. Autonomous nursing information does not address the dimension of the person, the human responses to transitions, and the life processes. [ABSTRACT FROM AUTHOR]

Critical discourse analysis is a set of theoretical and methodological devices used to analyze and challenge how we construct reality by looking for meaning behind words. The process of conducting critical discourse analysis is complex and, in the field of nursing research, is often carried out without regarding the different dimensions entwined in discourse. In this vein, the dimension that concerns the linguistic characteristics of texts is a highly informative one, but all too often left out of study results by researchers in nursing. This article aims to present some methodological notes of our experience conducting an analysis of linguistic characteristics within a critical discourse analysis doctoral research. We discuss the theoretical and methodological reasons why these characteristics should be widely recognized as a fundamental dimension in the framework of critical discourse analysis. We propose general recommendations to make this dimension of analysis more easily accessible and encourage other critical researchers to include the analysis of linguistic characteristics of texts in their research. [ABSTRACT FROM AUTHOR]

Objective: to identify in the discourse of managers aspects related to barriers to access and treatment of people with tuberculosis in Primary Health Care services. Method: this is a qualitative study, with the participation of six coordinating managers of the tuberculosis control program. Data collection was performed using the interview and for data analysis was used the theoretical-methodological basis in French Discourse Analysis. Results: barriers that have hindered the access of patients are organizational, lack of professional, service hours, active search, delay in marking and delivery of tests. Information: lack of awareness of symptoms and stigma. In addition, the geographical accessibility that makes it difficult to move to health services. Final considerations: access to the diagnosis of tuberculosis in Primary Health Care services has weaknesses. It is necessary to make aware all those involved in the actions of care for tuberculosis, to turn their eyes to the aggravation. [ABSTRACT FROM AUTHOR]

Objective: to know the discourses attributed by students entering the Bachelor's course in Nursing to the epistemic units health and disease. Method: exploratory-descriptive, qualitative approach. The research was conducted with 29 beginners of the Bachelor's degree in Nursing at a public university located in the city of Boa Vista, Roraima state. The strategy for data production was the Dramatic Play using the image inducer. The raw data were recorded by scribes during class and analyzed according to the speech. Results: known discourses involved health, social determinants of health, diseases, nursing performance in health-disease processes and expanded discourses on the Unified Health System. Final considerations: through the dramatic play, the nursing freshmen highlighted discourses on health promotion, disease prevention, social elements in health interface, nursing know-how and expanded reflections on health system. [ABSTRACT FROM AUTHOR]

Objective: to understand the use of light technologies by nursing professionals in the care of hospitalized patients with covid-19. Method: qualitative study, developed with 23 nursing professionals, from reference hospitals for care of people with covid-19, between May and June 2021. The data collection technique used was semi-structured interview. The theoretical-analytical framework of Discourse Analysis, of French matrix, was used. Results: the discursive training of health needs of people hospitalized with covid-19 was developed from the perspective of nursing professionals; nursing care for hospitalized patients with covid-19 and technologies used; difficulties faced in nursing care for hospitalized patients with covid-19. Final considerations: nursing professionals could not identify the light technologies in their care practices, although their discourses revealed traces of the use of these technologies in their daily work. [ABSTRACT FROM AUTHOR]

Objective: to analyze nurses' discourse about the potentialities in using information technologies as organizational support for the COVID-19 coping actions in Primary Health Care. Method: a qualitative and exploratory study conducted in the Family Health Strategy units from the city of João Pessoa, Paraíba, Brazil. Data collection was carried out from September to November 2021 with 26 nurses selected through the snowball technique, resorting to a semi-structured interview script. The empirical material was organized in the Atlas.ti 9 software and grounded on the theoretical- methodological contribution of Discourse Analysis, French Line. Results: three discursive blocks were evidenced: innovation based on social media; health education actions; resoluteness in organizational actions, presenting the relevance of the WhatsApp®, Instagram® and Facebook® apps as strategic resources, in order to collaborate in the Primary Health Care are with the organization of health actions against COVID-19 by nurses. Conclusion: health units have the potential to strengthen the assistance provided through digital organizational devices; however, they need political support that invests in the structure and strategies to enhance organization of the health actions. [ABSTRACT FROM AUTHOR]

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This perspective paper aims to present a personal viewpoint on the impact of psychiatric discourse on the principles of recovery in mental health care. Mental health services espouse these principles, yet psychiatric discourse remains the dominant model. A critical analysis will examine how psychiatry maintains this dominance. The aim is to examine how psychiatric discourse constructs both the nature of mental distress and its treatment, and how it maintains its power as the dominant authority and its relationship to recovery principles. The paper concludes that psychiatric discourse is the antithesis of recovery principles and that its authority is perpetuated through co‐opting a medical explanatory model, claiming expertise in the ability to predict social risk, and maintaining a tightly controlled echo chamber. A way forward involves the dismantling of the hierarchical service delivery model based on psychiatric discourse and replacing it with a more horizontal service delivery model in which the lived experience of mental distress is central. Regular audit of services needs to prioritize recovery principles. The implications for mental health nursing are considered. [ABSTRACT FROM AUTHOR]

Background: Communication about managing medications during transitions of care can be a challenging process for older patients since they often have complex medication regimens. Previous studies highlighted that links between communication breakdowns and medication incidents in older patients occur mainly at discharge or in the post‐discharge period. Little attention has been paid to exploring communication strategies facilitating patient‐centred medication communication at transitions of care from a discourse‐analytic perspective. Objectives: To explore, through a discursive lens, strategies that enable patient‐centred medication communication at transitions of care. Design: A focused ethnographic study was employed for this study. The study was reported according to the COREQ checklist. Methods: Interviews, observations and focus groups were analysed utilising Critical Discourse Analysis and the Medication Communication Model following thematic analysis. Data collection was undertaken in eight wards across two metropolitan hospitals in Australia. Results: Patient preferences and beliefs about medications were identified as important characteristics of patient‐centred communication. Strategies included empathetic talk prioritising patients' medication needs and preferences for medications; informative talk clarifying patients' concerns; and encouraging talk for enhancing shared decision‐making with older patients. Challenges relating to the use of these strategies included patients' hearing, speech or cognitive impairments, language barriers and absence of interpreters or family members during care transitions. Relevance to clinical practice: To enhance medication communication, nurses, doctors and pharmacists should incorporate older patients' preferences, previous experiences and beliefs, and consider the challenges faced by patients across transitions. Strategies encouraging patients' contribution to decision‐making processes are crucial to patient‐centeredness in medication communication. Nurses need to engage in informative talk more frequently when administering the medications to ensure older patients' understanding of medications prescribed or altered in hospital settings. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Enfermagem e Atenção à Saúde (REAS) is the property of Revista de Enfermagem e Atencao a Saude - Reas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study uses a Foucauldian discourse analysis to explore media reporting on the role of nurses as being consistently positioned 'heroes' during COVID‐19. In so doing, it highlights multiple intersecting discourses at play, with the caring discourse acting as a central one in negatively impacting nurses' ability to advocate for safe working conditions during a public health emergency. Drawing on media reports during the outbreak of COVID‐19 in Ontario, Canada in the spring of 2020 and on historical information from SARS, this study seeks to establish caring as a discourse and examine if the caring discourse impedes nurses' ability to protect themselves from harm. The results of this analysis explicate how public media discourses that position nurses as caring, sacrificial and heroic may have impacted their ability to maintain their personal safety as a result of the expectations put upon the nursing profession. [ABSTRACT FROM AUTHOR]

Aims: To increase the quality and safety of patient care, many hospitals have mandated that nursing clinical handover occur at the patient's bedside. This study aims to improve the patient‐centredness of nursing handover by addressing the communication challenges of bedside handover and the organizational and cultural practices that shape handover. Design: Qualitative linguistic ethnographic design combining discourse analysis of actual handover interactions and interviews and focus groups before and after a tailored intervention. Methods: Pre‐intervention we conducted interviews with nursing, medical and allied health staff (n = 14) and focus groups with nurses and students (n = 13) in one hospital's Rehabilitation ward. We recorded handovers (n = 16) and multidisciplinary team huddles (n = 3). An intervention of communication training and recommendations for organizational and cultural change was delivered to staff and championed by ward management. After the intervention we interviewed nurses and recorded and analyzed handovers. Data were collected from February to August 2020. Ward management collected hospital‐acquired complication data. Results: Notable changes post‐intervention included a shift to involve patients in bedside handovers, improved ward‐level communication and culture, and an associated decrease in reported hospital‐acquired complications. Conclusions: Effective change in handover practices is achieved through communication training combined with redesign of local practices inhibiting patient‐centred handovers. Strong leadership to champion change, ongoing mentoring and reinforcement of new practices, and collaboration with nurses throughout the change process were critical to success. Impact: Ineffective communication during handover jeopardizes patient safety and limits patient involvement. Our targeted, locally designed communication intervention significantly improved handover practices and patient involvement through the use of informational and interactional protocols, and redesigned handover tools and meetings. Our approach promoted a ward culture that prioritizes patient‐centred care and patient safety. This innovative intervention resulted in an associated decrease in hospital‐acquired complications. The intervention has been rolled out to a further five wards across two hospitals. [ABSTRACT FROM AUTHOR]

To understand power relations, it is important to consider that power is an attribute, and whoever has it at a given moment is in the condition of dominant and whoever is under its exercise is dominated. Moreover, we must consider that these positions are interchangeable, changing when relations of force change. Power relations represent the pursuit of supremacy through knowledge, with struggles for better positioning in the social structure. In this study, we analyze the effects of disciplinary power on daily practices of nurses and physicians in the hospital environment, more specifically in intensive care units. From the perspective of disciplines, power is exercised in a discreet, modest, calculated and permanent way, through the establishment of rules and norms. In this context, despite the strong appreciation of a medical‐centered model, it is observed that nurses gain visibility through knowledge and the defense of institutional norms and rules, which can generate tensions in daily professional practices. [ABSTRACT FROM AUTHOR]

Internationally, primary health care has in recent years gained a more central position in political priorities to ensure sustainable health care for the population. Thus, more people receive health care locally and in their own homes, where home‐care nursing plays a large role. In this article, we investigate how home‐care nursing is articulated and made visible in contemporary Norwegian policy documents. The study is a Fairclough‐inspired critical discourse analysis seeking to uncover the position of nursing in the prevailing political ideologies on current primary health care. In the documents, we identified several complementary and conflicting understandings about home‐care nursing. Home‐care nursing is presented as a basic part of a municipality's health services, but at the same time, its content and contribution are unclear and almost invisible. We argue that the absence of nursing leads to significant perspectives being left out and tie this to the fact that some patient groups and tasks seem to be disadvantaged. The political placement of home‐care nursing in the health‐care landscape is thus not just about nursing as a professional practice but also concerns fundamental care values in our society in relation to disadvantaged groups and work tasks. [ABSTRACT FROM AUTHOR]

Bedside handovers in clinical nursing are crucial communicative events fostering involvement of patients in their care. Communication challenges between nurses and patients threaten quality of care and hinder patient involvement. Knowledge and in-depth understanding of how these specialised interactions are co-constructed discursively is limited, but necessary to inform English for specific purposes training and to improve patient participation. We trace the interpersonal discursive features of communication between nurses and patients across four case studies of bedside handovers recorded at two metropolitan Australian hospitals. Handovers were selected for contextual factors: patients' language background (native or non-native English speaking (NES/NNES)) and presence of family/carers. By applying a deductive framework of discursive approachability features, combined with an inductive analysis of discourse features in context, we describe which communication behaviours facilitate or hinder patient participation. We discovered that incoming and outgoing nurses used different discursive strategies during handover. Outgoing nurses made fewer efforts at being approachable to patients and family/carers, impeding patient involvement. Incoming nurses were more approachable, inviting patient participation and building interpersonal connections. NES patients and carers were more involved in handover despite outgoing nurses' disengaging communication behaviours. Findings can inform reflective practice and communication skills training among practicing and trainee nurses. • A new framework of discursive approachability features guided handover analysis. • Outgoing nurses displayed more negatively geared approachability features. • Outgoing nurses discursively impede patient participation in bedside handovers. • Incoming nurses displayed more positively geared approachability features. • Incoming nurses discursively invite patient participation and foster relationships. [ABSTRACT FROM AUTHOR]

Background: Self-management skills among nurses are in rising demand. Such skills promise to improve the efficiency of nurses. Aim: This study explores how the self-managing nurse is constructed in reports guiding the future of Danish healthcare. Furthermore, it explores in which way identified discourses affect the self-managing intensive care nurse in clinical practice. Method: Foucaultdian discourse analysis and qualitative interview. Findings: Articulation of quality, knowledge and motivation affects the nurse in such a manner that she herself articulates these concepts as a natural and self-evident part of her daily tasks. The informants accept these truths and thereby adopt the self-management discourses. Conclusion: Awareness of which skills the self-managing nurse and other healthcare professionals are expected to hold may contribute to greater match of expectations. This can create awareness of opportunities and risks associated with self-management. A knowledge that extends far beyond the healthcare professionals in Denmark. [ABSTRACT FROM AUTHOR]

Research Objective: The aim of this article is to report a study that explores how spirituality is understood to be represented in the current Australian Nursing and Midwifery Board of Australia (NMBA) Registered Nurse (RN) standards for practice. Research Design: Fairclough's approach to critical discourse analysis was applied in the examination of participant interview texts for the language used in relation to spirituality as well as power mechanisms which influenced the way the participants viewed spirituality's representation in the RN Standards for Practice. Participants: Three members of the RN Standards for Practice research and development team. Results: Findings indicate three discourses shaped the way participants viewed how spirituality is presently represented in the RN Standards for Practice. Discourses are (1) spirituality as part of holistic care, (2) spirituality as part of person-centered care, and (3) the professionalization of nursing. Conclusions: Participant interviews revealed these discourses exerted power over how spirituality was represented within the RN Standards for Practice. This has implications for the inclusion of spirituality in the practice standards and the practice of spiritual care. [ABSTRACT FROM AUTHOR]

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]

Objective: to understand the perspective of health professionals on the concepts of Clinical Economics and Patient Advocate. Method: a qualitative study with health professionals. Data were collected in June/2017 from the question: What is your perception of the concept of Clinical Economics and Patient Advocate? Qualitative data were analyzed using the Collective Subject Discourse. Results: the speeches pointed out that it deals with innovative, challenging and applicable proposals for nursing and health care. Patient Advocate and the Clinical Economics concept can support the decisions of the health team/service managers. The ideas can enhance the integration of the teams, resolve conflicts, bring together different professional categories and mitigate the risks of legal, financial and ethical responsibilities regarding health care. Conclusion: the concepts was understood as fundamental and applicable, since the organization survive with adequate human, financial and material management. [ABSTRACT FROM AUTHOR]

Introduction: The educational function of the nursing role is considered an instance of link with the community. Objective: to unveil health promotion practices based on educational radio advertisements of nurses in 1983 in Chile. Material and method: qualitative perspective, with linguistically oriented discourse analysis, and review of the literature in databases: Scielo, Google scholar, Science direct, with keywords: community health nursing, role of the nurse, health education, history of nursing. Results: the education function in the nursing role shows power edges and is associated with the political context of the time. The care of the child and the family is associated with the responsibility of the woman, with explicit instructions that the mother must comply with in order to obtain optimal health for her children. Hygiene measures such as hand washing are strongly instilled in the prevention of infectious - contagious diseases. Discussion and Conclusion: Health promotion, exercised as a radio educational activity, was an alternative for linking and channeling with the most vulnerable population, to achieve states of family well-being and made it possible to make visible the educational function of the role of professional nurses. [ABSTRACT FROM AUTHOR]

Objective: highlight health inequalities of homeless adolescents based on the conceptual framework of social determinants of health. Method: this is a convergent parallel mixed-methods study. The population consisted of adolescents who are homeless, with purposeful sampling and data saturation. Quantitative data were obtained with a questionnaire and qualitative data through semi-structured interviews. Results: 19 homeless adolescents participated in the study, 13 (68.4%) aged 16 to 19 years; 11 (57.9%) were male, 3 (15.8%) were female, and 5 (26.3%) were transgender adolescents. Participants experienced different levels of exposure and vulnerabilities to conditions that affect health and were directly related to intermediate determinants of health. Conclusion: this study provides an understanding of the inequalities related to the health of homeless adolescents and shows evidence that supports strategies to promote equity and dignity in health care. [ABSTRACT FROM AUTHOR]

Purpose: To explore the caregiving dynamic between NICU nurses and mothers with a substance-exposed pregnancy (SEP) by examining how nurses view these mothers compared to mothers without an SEP. Design: A qualitative design using interviews with NICU nurses who care for infants and families with an SEP. Sample: The sample (n = 9) was all female, with an average of approximately 10 years of nursing experience in the NICU, with two-thirds having achieved a Bachelor of Science in Nursing (BSN) or higher. Main outcome variable: Perceptions of nurses working with families affected by an SEP. Results: Stigmatized views and trust issues shaped nurses' views of mothers with an SEP as different from other mothers. Empathy levels toward mothers differed related to nurses' views of substance use as either a moral decision or chronic disease. These viewpoints shaped the nurse's judgment of the mother's potential to provide a safe environment and independently care for the infant at home. Nurses described personal distress when caring for these families. [ABSTRACT FROM AUTHOR]

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