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1.
Artigo em Inglês | MEDLINE | ID: mdl-33821483

RESUMO

AIM: The current study is a descriptive-comparative study and aims to determine intercultural sensitivity and ethnocentrism levels among nurses and nursing students. METHOD: The study was conducted with 207 nurses working at a State Hospital and 211 nursing students studying at a University between November 30, 2019, and January 20, 2020. The data were collected using a descriptive characteristics form, the Intercultural Sensitivity Scale, and the Ethnocentrism Scale. FINDINGS: It was found that both nurses and nursing students (73.4% and 60.7%, respectively) struggled to communicate with foreign patients and experienced problems with cultural differences (49.8% and 22.7%, respectively). A statistically significant negative correlation was found for the nurses and nursing students in terms of their intercultural sensitivity and ethnocentrism scores (p < .05). PRACTICAL IMPLICATION: Nurses and student nurses should interact with people from different cultures to improve refugee health care.

2.
Nurse Educ Pract ; 51: 102960, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33529799

RESUMO

Discrimination towards individuals with disabilities is problematic within nursing. There have been calls to increase diversity in nursing and this includes embracing nurses with disabilities. Increasing diversity in nursing requires increasing diversity among nursing students; in this way, nurse educators are gatekeepers to the profession. Clinical education is a crucial element of nursing education, yet there have been very few studies related to the clinical education of nursing students with disabilities. There have been no studies of attitudes of acute care nurse preceptors toward students with disabilities in the United States. This gap is important as the majority of clinical experiences occur in the acute care environment. Utilizing a focused ethnography, semi-structured interviews were conducted with 20 acute care nurses with at least two years' experience precepting students. While positive feelings about nursing students with disabilities were shared, thoughts and behavioral intentions remained negative. Six themes emerged: safety, barriers, otherness, communicating to meet needs, disclosure, and student versus colleague. Attitudinal barriers are the primary barriers faced by individuals with disabilities in becoming and practicing as nurses. Nurses in practice and education must embrace more inclusive attitudes towards individuals with disabilities.

3.
Creat Nurs ; 27(1): 36-39, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33574170

RESUMO

In the United States, nursing education programs at mostly white institutions are led by faculty that are 80% white. This absence of diversity is a symptom of systemic racism and white supremacy, reinforced through built systems of inequity and economic constraints that influence accessibility of nursing education programs. White cultural norms drive standards of professionalism and assimilation within nursing education programs. These standards are formulated from white cultural supremacy and contribute to the unconscious biases of nursing faculty. It is necessary to examine these biases to reduce potential and realized inequities for students of color in current nursing education programs. Challenging and changing these cultural norms can contribute to the dismantling of systemic racism and white supremacy in nursing education and the profession of nursing, thereby increasing the diversity of the professional workforce.

4.
Int J Nurs Stud Adv ; 2: 100011, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33106797

RESUMO

Background: Despite widespread recognition of the undeniable impact of nurses on patient safety, important barriers relating to the organization of health systems still hinder the full expansion of the role of these professionals. In Quebec (Canada), nurses work overtime and increased adverse events are preoccupying and point to a possible lack of contemporary tools for continuous professional development. Innovative training tools should foster a more reflective practice focused on a holistic view of the patient in order to support the full scope of nursing practice and ensure continuous improvement in the quality of care. Such tools would make it possible to better understand their practice, according to their own perception, as well as its applicability in the emergence of a professional conscience which is essential to lasting safety competencies. This study's overarching goal was to propose a model and a portfolio prototype to support nurses' training. Method: Based on a humanistic and reflective perspective on patient care and safety competencies, a design approach was used to develop a portfolio prototype. Ethnography was used to collect and analyse data using shadowing observations of 10 nurse/patient dyads, followed by interviews about their care experience. The research was conducted in acute and long-term care settings of the Quebec City area. The iteration process resulted in a first version of the prototype that was then presented to various stakeholders during a co-design workshop aimed at better understanding the clinical applicability of this prototype. Findings: The INSÉPArable project is illustrated in two interrelated figures, which reflects a complete inductive representation supporting sustainable patient safety from nursing practice experience. First, nursing practice status has been depicted as an iceberg metaphor where the essence of care, the « art of nursing ¼ is hidden. Second, a sphere illustrates the direction to the full emergence of nursing practice that helps to enhance the hidden "art of nursing" by leading nurses towards optimal conditions conscience. Discussion: INSÉPArable turned out to be more than an individual reflective tool as it also highlights the need for collective awareness among nurse managers regarding their responsibility in implementing and sustaining healthy work environments, in which optimal conditions are better supported. This also implies a renewed mode of governance and the implementation of more humanistic processes that redefine the contemporary professionalism of nurses, which are closely linked to patient safety.

6.
Ciênc. Saúde Colet ; 25(1): 47-56, jan. 2020. tab
Artigo em Português | LILACS | ID: biblio-1055782

RESUMO

Resumo A formação do enfermeiro no Brasil, ainda se apresenta como um desafio para as universidades, face as diversidades étnicas e as particularidades regionais existentes. Assim, o objetivo do estudo foi identificar os desafios no processo de formação de enfermeiros indígenas em Mato Grosso, Brasil. Trata-se de estudo exploratório e qualitativo, junto a 11 enfermeiros indígenas. A análise dos dados, baseou-se na interculturalidade de Paulo Freire. Verificou-se que todos participantes, buscam a integração dos saberes tradicionais indígenas com os conhecimentos técnico científicos, durante suas práticas, o que facilita a interação satisfatória com a comunidade. Durante a graduação de Enfermagem tiveram pouco ou nenhum contato com conteúdos relacionados à saúde indígena e ao término da formação vislumbravam despreparo para atender as variadas demandas em saúde. Historicamente, apresentam-se subalternizados em relação aos não indígenas, o que reflete em desvantagens no processo de ensino-aprendizagem, tanto relacionados aos aspectos técnicos/tecnológicos como sociais.


Abstract The training of nurses in Brazil remain a challenge for the university, given the existing ethnic diversity and regional particularities. Thus, the aim of this study was to identify the challenges in the training process of indigenous nurses in Mato Grosso, Brazil. It is an exploratory and qualitative study, carried out with 11 indigenous nurses. Data analysis was based on Paulo Freire's interculturality. It was verified that both participants sought the integration of indigenous traditional knowledge with scientific technical knowledge during their practices, which facilitates a satisfactory interaction with the community. During nursing undergraduate school, they had little or no contact with contents related to indigenous health and at the end of the training they observed they were not prepared to meet the diverse health demands. Historically, they are subordinated in relation to non-indigenous people, which manifests as disadvantages in the teaching-learning process, related to technical / technological as well as social aspects.


Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Índios Sul-Americanos/educação , Educação em Enfermagem/organização & administração , Brasil , Pessoa de Meia-Idade
7.
Cien Saude Colet ; 25(1): 47-56, 2020 Jan.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31859854

RESUMO

The training of nurses in Brazil remain a challenge for the university, given the existing ethnic diversity and regional particularities. Thus, the aim of this study was to identify the challenges in the training process of indigenous nurses in Mato Grosso, Brazil. It is an exploratory and qualitative study, carried out with 11 indigenous nurses. Data analysis was based on Paulo Freire's interculturality. It was verified that both participants sought the integration of indigenous traditional knowledge with scientific technical knowledge during their practices, which facilitates a satisfactory interaction with the community. During nursing undergraduate school, they had little or no contact with contents related to indigenous health and at the end of the training they observed they were not prepared to meet the diverse health demands. Historically, they are subordinated in relation to non-indigenous people, which manifests as disadvantages in the teaching-learning process, related to technical / technological as well as social aspects.


Assuntos
Educação em Enfermagem/organização & administração , Índios Sul-Americanos/educação , Adulto , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
8.
Surgery ; 167(3): 661-667, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31653491

RESUMO

BACKGROUND: This investigation was undertaken to define the factors determining the optimal and most productive relationship among indigenous communities, surgeons, and providers of surgical services. METHODS: A systematic literature review was conducted to identify studies reporting on the experience of indigenous communities with surgeons, medical practitioners, and the providers of surgical and other health services. The databases searched were MEDLINE, EMBASE, PubMed, Web of Science, and Google Scholar, including all literature available until the search date of April 3, 2019. The reference lists of all included articles and related review articles were searched manually to identify further relevant studies. An inductive approach was used to identify common themes. RESULTS: Thirty-three publications discussed the experiences of New Zealand Maori (n = 2), Aboriginal and Torres Strait Islanders (n = 20), North American First Nation (n = 10), and Indigenous Latin Americans (n = 1). Across all indigenous peoples, 6 themes emerged: accessible health services, community participation and community governance, continuous quality improvement, a culturally appropriate and clinically skilled workforce, a flexible approach to care, and holistic healthcare. CONCLUSION: To provide medical and surgical services in indigenous communities successfully requires a diverse range of skills and core technical and academic competencies. Many skills lie within the definition of professionalism and advocacy as well as the ability to undertake and operationalize community consultation and empowerment. If surgical services serving Indigenous communities are to be successful in addressing health disparity, specific training in these skills will need to be developed and made available.


Assuntos
Acesso aos Serviços de Saúde/organização & administração , Necessidades e Demandas de Serviços de Saúde , Serviços de Saúde do Indígena/organização & administração , Disparidades em Assistência à Saúde/organização & administração , Especialidades Cirúrgicas/organização & administração , Competência Clínica , Participação da Comunidade , Assistência à Saúde Culturalmente Competente/organização & administração , Saúde Global , Humanos , Povos Indígenas , América Latina/etnologia , Nova Zelândia/etnologia , América do Norte/etnologia , Melhoria de Qualidade , Cirurgiões , Recursos Humanos/organização & administração
9.
BMC Nurs ; 18: 63, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31827389

RESUMO

Background: Students studying in a country where another language is spoken face multiple challenges including their ability to fully integrate with peers and academic pressures in trying to obtain an undergraduate nursing degree. The aim of the study was to explore the lived experiences of students, from varying cultural and ethnic backgrounds, undertaking an undergraduate nursing degree. Methods: The study adopted a qualitative design and eight individual semi-structured interviews were conducted. The interviews were analysed using manifest content analysis according to Graneheim and Lundman. Results: Students reported feelings of isolation and the lack of opportunities to integrate with native students within academia and practice. The need for personal support was a crucial factor that was independent of gender and students reported challenges related to both language and culture during the programme. Conclusions: Suggestions arising from this study includes appropriate support systems within academia and practice. It is imperative that universities and practice settings promote and integrate cultural awareness within academia and practice in meeting the needs of students and providing culturally appropriate nursing care, thereby providing opportunities for all students to become competent and professional practitioners.

10.
Hum Resour Health ; 17(1): 88, 2019 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-31752896

RESUMO

BACKGROUND: In recent years, the number of students from Asian and African countries to study medicine in China has been on the rise. This study investigated the migration intentions of China-educated international medical students (IMSs) after graduation and the factors that influence the migration intentions. METHODS: The cross-sectional, questionnaire-based study involved the IMSs from the 2nd to the 6th year of degree course at Xuzhou Medical University, China, conducted from April to July of 2018. The self-administrated questionnaire asked questions on students' migration destinations for short-term stay and permanent stay. The influence of gender, continent of origin, academic performance, and family socioeconomic background on the migration intentions was analyzed. Chi-square tests were used for statistical analysis. RESULTS: Among 266 valid responses, 124 (46.62%) students intended to return to their home countries. This intention to return was associated with Asian citizenship, lower academic performance, and middle/lower family socioeconomic status. The remaining 142 students desired to stay temporarily or permanently outside their home countries. The starting time for them to stay outside home countries was immediately after graduation or some time later. Among them, 88 (61.97%) expected to migrate to a high-income country. The intention to migrate to high-income countries was associated with female gender and higher academic grades. For students who intended to stay outside their home countries, the most popular destination for short-term stay was China, and that for permanent stay was the USA. CONCLUSION: IMSs with characteristics of Asian citizenship, lower academic performance, or middle/lower family socioeconomic status are more likely to return to their home countries after graduation, and those with characteristics of female gender or higher academic grades are more likely to migrate to high-income countries. These results suggest that China-educated IMSs constitute a potential resource of healthcare workforce not only for their home countries, but also for the recipient countries. Our findings provide important information on healthcare workforce planning for the governments of the relevant countries.


Assuntos
Educação Médica , Emigração e Imigração/estatística & dados numéricos , Intenção , Área de Atuação Profissional/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , África/etnologia , Ásia/etnologia , China , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos e Questionários
11.
Aust J Prim Health ; 25(5): 389-394, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31619320

RESUMO

A central strategy in addressing health disparities experienced by Indigenous people has been based on a concern with workforce improvement. In this paper, the Indigenous Australian healthcare workforce literature since 1977 is reviewed and its scope of concern, as being often limited to questions of 'supply', is critiqued. The pipeline metaphor, whether used explicitly or implied, regularly focuses attention on closing the gap on Indigenous representation within the health workforce. The exception though is the discourse concerning Indigenous Health Workers (IHWs), where questions concerning the legitimacy of the role continue to abound within a workforce hierarchy where community knowledge, though shown to be crucial to culturally safe health service provision, is trumped by the other health professions whose knowledges and legitimacy are not in question. This contrast exemplifies the need to examine the working of power not just 'supply'. The pipeline metaphor is disrupted with concerns about a range of other 'gaps' - gaps in the recognition of Indigenous knowledges, in organisational structures, in governance and in self-awareness by the health professions of their whiteness. As the health system continues to measure workforce development in terms of pipeline capacity, our study questions what happens beyond the pipeline.


Assuntos
Mão de Obra em Saúde , Grupo com Ancestrais Oceânicos , Atenção Primária à Saúde , Austrália , Mão de Obra em Saúde/organização & administração , Disparidades em Assistência à Saúde , Humanos , Grupo com Ancestrais Oceânicos/educação , Atenção Primária à Saúde/organização & administração
13.
J Anesth Hist ; 5(2): 44-48, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-31400835

RESUMO

The space race began in the summer of 1955 when the United States and the Soviet Union pledged to launch artificial satellites. The race culminated in 1969 when the United States landed the first humans on the moon. After completing his training in anesthesiology, Dr. Cloid Green forged his career as one of the physician-scientists who played an integral role by evaluating the effects of space flight on human physiology. Family members of Dr. Green were interviewed and university and society archives, literature and periodicals were reviewed. Dr. Cloid Green received his medical training at the University of Minnesota. He earned his MD in 1946 before moving to South Dakota and working as a general practitioner. A combination of professional curiosity and the military's request for further service led Dr. Green to complete an anesthesia residency at the University of Iowa. After training, he was assigned as the physician in charge of a bomber wing at a base near Austin, Texas, in 1957. Due to his research on the effects of high altitude on pilots, he was recruited to the Brooks Air Force Base. Dr. Green was the ranking medical official overseeing early space flights involving monkeys. After leaving the USAF, Dr. Green practiced anesthesiology at the University of Virginia before moving to Newfoundland, Canada. He became the first chair of Anesthesiology at the Memorial University of Newfoundland in 1969. Dr. Cloid Green's career grew alongside the specialty of anesthesiology in the 1950s. His training in anesthesiology proved to be a versatile and profoundly useful skill set as the specialty became fully recognized. Dr. Green's long and fruitful career is the perfect example of the diverse opportunities afforded by anesthesiology training.


Assuntos
Anestesiologia/história , Medicina Militar/história , Voo Espacial/história , Anestesiologistas/história , Anestesiologia/educação , Canadá , História do Século XX , Humanos , Estados Unidos
14.
Health Equity ; 3(1): 395-402, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31406953

RESUMO

Purpose: This piece details the evaluation and implementation of a student-led educational intervention designed to train health professionals on the impact of racism in health care and provide tools to mitigate it. In addition, this conference, cosponsored by medical, nursing, and social work training programs, facilitates development of networks of providers with the knowledge and skills to recognize and address racism in health care. Methods: The conference included 2 keynote speakers, an interprofessional panel, and 15 workshops. Participants (n=220) were asked to complete a survey assessing perceptions of conference content and impact. We compared responses pre- and postconference using Wilcoxon signed-rank tests. Results: Of the survey respondents (n=44), 45.5% were medical students, 13.6% nursing students, and 9% social work students; 65.9% self-identified as a race/ethnicity other than non-Hispanic white; and 63.6% self-identified as female. We found that 47.7% respondents reported they were more comfortable discussing how racism affects health (p<0.001), 36.4% had better understanding of the impact of racism on an individual's health (p<0.001), and 54.5% felt more connected to other health professionals working to recognize and address racism in medicine (p<0.001). Conclusion: These findings suggest that a student-organized conference could potentially be an effective strategy in addressing a critical gap in racism training for health care professionals.

15.
J Strength Cond Res ; 33(12): 3295-3301, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31453934

RESUMO

Hurley, E, Comstock, BA, Haile, L, and Beyer, KS. Relative age effect in collegiate soccer: influence of nationality, playing position, and class. J Strength Cond Res 33(12): 3295-3301, 2019-The purpose of this study was to evaluate the existence of relative age effects (RAEs) in collegiate soccer. In addition, the impact of nationality, position, class, and National Collegiate Athletic Association (NCAA) tournament qualification status on the prevalence of RAEs was assessed. Birth dates from male NCAA Division I soccer athletes (n = 4,082) from the 2017/2018 season were categorized into quarters based on calendar and scholastic quarters. All athlete birth-date distributions were compared with the expected birth-date distributions for the United States. International-born athletes (INT) displayed a significant difference in birth-date distribution when assessed with calendar quarters, whereas American-born athletes (USA) showed a significant difference in birth-date distributions when assessed with scholastic quarters. Furthermore, INT showed significant RAEs for midfielders and defenders, whereas USA showed significant RAEs midfielders and goalkeepers. In terms of class, INT had significant RAEs for all classes, whereas USA had significant RAEs only for freshmen and sophomores. All INT had significant RAEs regardless of tournament qualification status; however, USA had significant RAEs only for nontournament teams. In summary, significant RAEs exist in male Division I college soccer; however, the presence of RAEs is influenced by nationality, position, class, and NCAA tournament qualification status. Coaches should be aware of RAEs during the recruitment process to avoid potential selection bias.


Assuntos
Grupos Étnicos , Seleção de Pessoal , Futebol , Universidades , Fatores Etários , Humanos , Masculino , Viés de Seleção , Estados Unidos
16.
Contemp Nurse ; 55(2-3): 156-170, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31288623

RESUMO

Background: As the largest professional group employed within the health care system, the capacity for nurses to contribute to improving the health of Australian Indigenous people is substantial. Cultural safety has recently been incorporated into the national codes of conduct for nurses. Nurse academics have a key role in ensuring graduates are culturally safe practitioners. Staff capacity is a crucial consideration if cultural safety is to be embedded effectively within nursing curriculum. Aims: The aim of this study was to explore capability in relation to cultural safety with Nurse Academics at a regional university in New South Wales, Australia. Design: Mixed methods approach incorporating a survey and individual interviews. Methods: Casual and permanent nurse academics involved in teaching the undergraduate nursing program were eligible to participate. Results: Fifteen staff completed the survey and eight participated in an interview. Although the importance of cultural safety was recognised, there was a lack of comprehensive understanding and lack of confidence to teach the philosophy and practices of cultural safety. There was strong support cultural safety and anti-racism professional development. Impact statement: Building staff capacity is a crucial consideration if cultural safety is to be embedded within nursing curriculum. Conclusions: Cultural safety professional development is a starting point for nurses to develop their skills in providing culturally safe care and an essential step towards shifting the institutional and professional culture of the nursing profession. Research findings are clear it is time for Nurse Academics to "Step up" to effectively embed cultural safety in undergraduate nursing curriculum.


Assuntos
Competência Cultural , Assistência à Saúde Culturalmente Competente/organização & administração , Assistência à Saúde Culturalmente Competente/estatística & dados numéricos , Bacharelado em Enfermagem/organização & administração , Povos Indígenas/estatística & dados numéricos , Estudantes de Enfermagem/psicologia , Estudantes de Enfermagem/estatística & dados numéricos , Adulto , Austrália , Currículo , Feminino , Humanos , Masculino , Adulto Jovem
20.
J Health Care Poor Underserved ; 30(2): 442-455, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31130529

RESUMO

Rural American Indian and Alaska Native (AI/AN) communities face physician vacancy rates over 25%. A variety of programs aim to address those gaps, from early-life STEM initiatives for AI/ANs to physician loan repayment programs. However, unfilled clinical positions and underrepresentation of AI/AN physicians persist. We review existing workforce initiatives, then demonstrate that three recently developed clinical fellowship programs fill an important gap. The fellowships, led by faculty at large academic health centers, place fellows in clinical positions in rural AI/AN communities in partnership with tribal health systems and/or the Indian Health Service. In addition to providing clinical care, the fellowships seek to enhance health systems' capacity development through community-centered initiatives that include training and health promotion. Other academic health centers should consider working together with tribal communities to assess whether replication of the models could reduce local physician staffing gaps and health disparities.


Assuntos
Bolsas de Estudo , Índios Norte-Americanos , Médicos/provisão & distribução , Educação de Pós-Graduação em Medicina/organização & administração , Educação de Graduação em Medicina/organização & administração , Educação Pré-Médica/organização & administração , Humanos , Médicos/organização & administração , Serviços de Saúde Rural/organização & administração , População Rural
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