Perceptions of Clinical Trial Participation in African American Cancer Survivors and Caregivers.

PURPOSE: To explore the perceptions of African American survivors and caregivers about participation in clinical trials. PARTICIPANTS & SETTING: 13 participants were enrolled and participated in one of the focus groups, and 11 participated in two focus groups. METHODOLOGIC APPROACH: A qualitative descriptive study using a community-based participatory research approach. Focus groups guided by Freire's dialogic model explored the perceptions of African American patients with cancer about participation in clinical trials. Focus groups were audio recorded and transcribed. FINDINGS: The analysis identified three main themes. IMPLICATIONS FOR NURSING: The under- representation of African American patients in clinical trials contributes to racial health disparity by negatively affecting health outcomes and quality of care delivered to this population. Oncology nurses are at the forefront of cancer care and in the best position to advocate for individuals with cancer, particularly those who face health inequalities. Findings from this study guided the recommendations.

The Lived Experience of Black Nurse Faculty in Predominantly White Schools of Nursing.

PURPOSE: This study explored the experiences of Black nurse faculty employed in predominantly White schools of nursing. High attrition rates of this group were noted in previous literature. Understanding their experiences is important to increase nurse diversity. DESIGN: Hermeneutic phenomenology was used to explore the experiences of 15 Black nurse faculty using interviews. FINDINGS: Four themes were extracted as the following: cultural norms of the workplace, coping with improper assets, life as a "Lone Ranger," and surviving the workplace environment. DISCUSSION: The study provided insight to understand the meaning that Black faculty members give to their experiences working in predominantly White schools of nursing. Findings exemplify the need to improve culturally competent work environments and mentoring programs. IMPLICATIONS FOR PRACTICE: Results suggest that better communication and proper respect from students, colleagues, and administrators are necessary. The limited research on this topic illustrates that Black nurse faculty remain under investigated; research is necessary to determine effective change strategies.

The Workplace Environment for African-American Faculty Employed in Predominately White Institutions.

Diversity in academia requires attention, especially with the expected increase in minority populations in the United States (American Association of Colleges of Nursing, (AACN) 2014). Despite theoretical papers that suggest that several challenges are encountered by minority faculty employed in predominately White institutions, a dearth of research on this topic has been published. The purpose of this literature review was to analyze the published research that addressed the workplace environment of African-American faculty employed in predominately White institutions. In utilizing the keywords in various combinations, 236 articles were retrieved through multiple databases. After applying inclusion and exclusion criteria, 15 studies were reviewed with only three related to nursing. Two themes were extracted from the review: 1) the cultural climate of the workplace environment and, 2) underrepresentation of African-American faculty. It is apparent from this review that additional research is needed to understand the experiences of this group of faculty to target effective recruitment and retention strategies.

Application of the Symphonological approach to faculty-to-faculty incivility in nursing education.

The nature of ethical interactions among nurse educators is crucial in modeling ethically based relationships for nursing students. This article focuses on the issue of uncivil faculty-to-faculty relationships in nursing education and is supported by a literature review of incivility in academic settings and the experiential reflections of seasoned nurse educators. The bioethical practice-based theory of symphonology provides a new perspective for framing these reviews and reflections. This theory can facilitate decision making in difficult interactions and sustain a focus on the central agreements that are foundational to nursing education. Incivility exemplars are explored within the context of autonomy, freedom, objectivity, beneficence, and fidelity, and the integration of academia and ethics is discussed as essential to nursing education and human caring.

Patient-provider race-concordance: does it matter in improving minority patients' health outcomes?

OBJECTIVE: To understand if patient-provider race-concordance is associated with improved health outcomes for minorities. DESIGN: A comprehensive review of published research literature (1980-2008) using MEDLINE, HealthSTAR, and CINAHL databases were conducted. Studies were included if they had at least one research question examining the effect of patient-provider race-concordance on minority patients' health outcomes and pertained to minorities in the USA. The database search and data analysis were each independently conducted by two authors. The review was limited to data analysis in tabular and text format. A meta-analysis was not possible due to the discrepancy in methods and outcomes across studies. RESULTS: Twenty-seven studies met the inclusion criteria. Combined, the studies were based on data from 56,276 patients and only 1,756 providers. Whites/Caucasians (37.6%) and Blacks/African Americans (31.5%), followed by Hispanics/Latinos (13.3%), and Asians/Pacific Islanders (4.3%) comprised the majority of the patient sample. The median sample of providers was only 16 for African Americans, 10 for Asians and two for Hispanics. The review presented mixed results. Of the 27 studies, patient-provider race-concordance was associated with positive health outcomes for minorities in only nine studies (33%), while eight studies (30%) found no association of race-concordance with the outcomes studied and 10 (37%) presented mixed findings. Analysis suggested that having a provider of same race did not improve 'receipt of services' for minorities. No clear pattern of findings emerged in the domains of healthcare utilization, patient-provider communication, preference, satisfaction, or perception of respect. CONCLUSIONS: There is inconclusive evidence to support that patient-provider race-concordance is associated with positive health outcomes for minorities. Studies were limited to four racial/ethnic groups and generally employed small samples of minorities. Further research is needed to understand what health outcomes may be more sensitive to cultural proximity between patients and providers, and what patient, provider and setting-level variables may moderate or mediate these outcomes.