Nursing Inquiry最新文献_第2页

The Disciplined Body: A Genealogy of Naturalized Discipline in Nursing Education. 学科主体：护理教育归化学科谱系。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70124

R Colin Blenis

{"title":"The Disciplined Body: A Genealogy of Naturalized Discipline in Nursing Education.","authors":"R Colin Blenis","doi":"10.1111/nin.70124","DOIUrl":"10.1111/nin.70124","url":null,"abstract":"Punitive culture in nursing education has been documented for over four decades. Interventions have proliferated, yet the problem persists. This paper argues that persistence is not an implementation failure but an epistemic one. Drawing on nursing's own critical tradition, particularly Roberts's application of Freire's oppressed group behavior model and the Foucauldian scholarship of Gastaldo, Holmes, and their successors, I trace three historically specific disciplinary logics that converge in a professional epistemology experienced as natural rather than constructed: religious moral formation, which naturalized obedience as virtue; biomedical hierarchical subordination, which naturalized hierarchy as scientific authority; and gendered labor discipline, which naturalized self-sacrifice as caring. These logics persist through what Bourdieu termed habitus: durable dispositions transmitted through intergenerational socialization, the hidden curriculum, and clinical evaluation structures. Behavioral interventions fail because they target outputs without making the generating logics visible. What is needed is not better behavioral management but genealogical consciousness: the capacity to recognize the profession's disciplinary inheritance as historical construction rather than natural order.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70124"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What We Owe: A Liberatory Ethics of Harm Reduction. 我们所欠的：减少伤害的解放伦理。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70137

R Colin Blenis

{"title":"What We Owe: A Liberatory Ethics of Harm Reduction.","authors":"R Colin Blenis","doi":"10.1111/nin.70137","DOIUrl":"10.1111/nin.70137","url":null,"abstract":"Needle exchange programs and other harm reduction interventions are typically defended on utilitarian grounds or through appeals to liberal autonomy. These defenses are valid but insufficient. They reduce persons to cost calculations or presuppose an unencumbered agent abstracted from the conditions under which people arrive at the encounter. I argue that trauma-informed care principles, Freirean critical pedagogy, and the concept of epistemic injustice provide a more ethically coherent foundation for harm reduction. The argument proceeds in four stages. First, I establish that trauma-informed care principles constitute ethical demands of just encounter under conditions of power asymmetry and institutional violation, not technical responses to a presumed etiology. Second, I reframe harm reduction as problem-posing public health praxis in which people who inject drugs are recognized as knowing subjects, not passive recipients of expert intervention. Third, I reconceive the communitarian objection to needle exchange as a form of hermeneutical injustice requiring expansion of the moral community. Finally, I articulate implications for nursing ethics, education, and practice. The resulting framework shifts the moral question from permissibility to obligation. Trial Registration: Not applicable.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70137"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Impact of Anti-Black Racism on Black Undergraduate Nursing Students in Canada. 反黑人种族主义对加拿大黑人护理本科学生的影响。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70110

Florence Luhanga, Delasi Essien, Kamogelo Amanda Matebekwane, Sithokozile Maposa, Vivian Puplampu, Eunice Abudu, Olufunke Oba, Andrew Ansah, Crystal Garvey, Keisha Jefferies, Oluwabukola Salami

{"title":"The Impact of Anti-Black Racism on Black Undergraduate Nursing Students in Canada.","authors":"Florence Luhanga, Delasi Essien, Kamogelo Amanda Matebekwane, Sithokozile Maposa, Vivian Puplampu, Eunice Abudu, Olufunke Oba, Andrew Ansah, Crystal Garvey, Keisha Jefferies, Oluwabukola Salami","doi":"10.1111/nin.70110","DOIUrl":"10.1111/nin.70110","url":null,"abstract":"The graduation rate of Black undergraduate students in nursing programs remains lower than that of their peers despite a notable increase in enrollment. Without disaggregated data, anecdotal and emerging evidence suggests student attrition rates are associated with unreasonable demands and unmet learning needs. Black nursing students experience systemic anti-Black racism from instructors, nurses, peers, and patients, which also contributes to their slow progress. These experiences impact equity, diversity, and inclusion in higher education and nursing. We explored the experiences of Black students in the two undergraduate nursing programs in Saskatchewan, Canada, to deepen our understanding of their needs and inform strategies for addressing anti-Black racism in nursing education. Using focused ethnography grounded in critical race theory and intersectionality, N = 26 individual interviews with current and former Black students from Saskatchewan nursing programs were analyzed using thematic analysis. Racist experiences reported by study participants were more prominent in clinical than classroom settings. Five main themes were identified. This paper focuses on Theme 1, \"Racism is part of the culture in nursing,\" and its subthemes, namely racial microaggressions, racial stereotyping and accent bias, isolation and exclusion, unfavorable environment, and impact on mental health and well-being. Support and accountability measures in nursing education are needed to facilitate social justice.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70110"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148037143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Moral Distress as Subordination by Design: Silence, Containment and the Ethical Erosion of Nursing. 设计从属的道德困境：护理的沉默、遏制和伦理侵蚀。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70123

Alan Ramsay, Kris McBain-Rigg, Peter Hartin

{"title":"Moral Distress as Subordination by Design: Silence, Containment and the Ethical Erosion of Nursing.","authors":"Alan Ramsay, Kris McBain-Rigg, Peter Hartin","doi":"10.1111/nin.70123","DOIUrl":"10.1111/nin.70123","url":null,"abstract":"Moral distress has become one of the most prominent ethical constructs in contemporary nursing, widely used to describe nurses' experiences of constraint, frustration and ethical unease. While moral distress scholarship continues to retain important ethical and structural dimensions, the broader operationalisation of moral distress within healthcare organisations and professional discourse may influence how ethical conflict is understood and managed within healthcare organisations. This paper argues that such framings can have unintended consequences for nursing's moral authority and professional standing. Adopting a critical theoretical and conceptual synthesis, and drawing on feminist theory, Foucauldian analyses of power and contemporary nursing scholarship, this paper reconceptualises moral distress as functioning within conditions of subordination by design, understood as organisational, discursive and material arrangements that may systematically constrain nursing authority while influencing the conditions under which ethical dissent is manageable and non-disruptive. Within this framework, this paper advances three related concepts: moral containment, referring to organisational responses that absorb and redirect ethical dissent; ethical erosion, describing the cumulative diminishment of nurses' moral agency over time, and ethical laundering, naming the institutional process through which ethical harm may be acknowledged yet rendered politically inert. Rather than rejecting moral distress scholarship, the paper situates moral distress within a broader architecture of organisational power, contributing to contemporary debates regarding nursing voice, professional authority and the structural conditions under which nursing ethics can be meaningfully enacted.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70123"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Generative AI in Qualitative Health Research: What the Emerging Evidence Shows. 定性健康研究中的生成人工智能：新出现的证据显示了什么。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70140

Pallavi Gupta, Maxim Topaz, Kathryn A Connell, Hyunmin Yu, Laura-Maria Peltonen

引用次数: 0

Beyond Deskilling: Reframing Skill Disruption Among Internationally Educated Nurses as a Problem of Skill Governance. 超越技能：将国际教育护士的技能中断作为技能治理问题进行重构。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70127

Daniel Joseph E Berdida

{"title":"Beyond Deskilling: Reframing Skill Disruption Among Internationally Educated Nurses as a Problem of Skill Governance.","authors":"Daniel Joseph E Berdida","doi":"10.1111/nin.70127","DOIUrl":"10.1111/nin.70127","url":null,"abstract":"Internationally educated nurses are increasingly central to healthcare systems facing persistent workforce shortages, ageing populations, and rising care demands. Yet research continues to show that migration and workforce entry are often accompanied by significant disruption to professional practice. Although these experiences are commonly described through the language of deskilling, post-migration skill change is still often framed as a linear process of adaptation and eventual professional equivalence. In this discursive paper, I argue that linear accounts of post-migration skill adjustment are analytically limited because they obscure how host healthcare systems shape what counts as legitimate nursing competence. I propose instead that deskilling, upskilling, unskilling, and mis-skilling should be understood as overlapping and sometimes contradictory outcomes of how these systems regulate, recognize, and reorganize nursing labor. Drawing on nursing workforce scholarship, professional regulation literature, migration studies, and the sociology of work, I reframe skill disruption as a structural effect of skill governance, shaped by risk management, selective recognition, and the preservation of professional hierarchies. A conceptual model of skill governance is presented to show how prior expertise is filtered through regulatory and organizational processes, producing uneven forms of professional incorporation. This reframing has implications for workforce policy, regulatory practice, and nursing leadership by shifting attention from individual adaptation to system accountability and more equitable forms of workforce integration.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70127"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Antiracist Nursing Pedagogy and Decolonising Curriculum Design: Fostering Critical Consciousness for Equity in Nurse Education. 反种族主义护理教育学和非殖民化课程设计：培养护士教育公平的批判意识。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70128

Mynesha Sankar, Agness Tembo, Calvin Moorley

引用次数: 0

The Reciprocal Insecurity Paradox: A Phenomenological Analysis of the Crisis Encounter Between the Mental Health Nurse and Service User With Complex Emotional Needs. 相互不安全感悖论：心理健康护士与复杂情感需求服务使用者危机遭遇的现象学分析。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70125

Michael Haslam, Mick McKeown, Emma Jones, Gary Lamph, Karen Wright

{"title":"The Reciprocal Insecurity Paradox: A Phenomenological Analysis of the Crisis Encounter Between the Mental Health Nurse and Service User With Complex Emotional Needs.","authors":"Michael Haslam, Mick McKeown, Emma Jones, Gary Lamph, Karen Wright","doi":"10.1111/nin.70125","DOIUrl":"10.1111/nin.70125","url":null,"abstract":"While research is emerging, there remains an inadequate focus upon the experiences of those delivering and receiving care specifically for service users with complex emotional needs (CEN) within Crisis Resolution and Home Treatment (CRHT) settings. This study therefore utilised hermeneutic phenomenology to examine the lived experience of both those providing and receiving care within CRHT settings. Data were gathered via semi-structured interviews with 14 participants (seven mental health nurses working within CRHT settings and seven service users with CEN who have received CRHT intervention). Transcripts were analysed using van Manen's hermeneutic phenomenological reflective method. A synthesis of participant accounts revealed several areas of convergence across the two groups, thus highlighting those 'core structures' of mental health crisis care as lived by participants in these encounters. Fears arising from structural vulnerabilities were illuminated as the eidos (or the 'essence') of the crisis encounter in CRHT settings, and at the heart of the crisis encounter, a central phenomenon of reciprocal insecurity is illuminated, whereby both parties' attempts to achieve a sense of personal safety inadvertently threatens that of the other. Findings highlight an urgent need for hermeneutic mediators; structures that provide the space and containment necessary for both parties to feel safe.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70125"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Ongoing "Doctor-Nurse Game": Power, Knowledge, and Advocacy Through the Lens of Nursing Standpoint Theory. 正在进行的“医生-护士游戏”：从护理立场理论的角度看权力、知识和倡导。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70129

Kathleen Shearer, Steven Hall

{"title":"The Ongoing \"Doctor-Nurse Game\": Power, Knowledge, and Advocacy Through the Lens of Nursing Standpoint Theory.","authors":"Kathleen Shearer, Steven Hall","doi":"10.1111/nin.70129","DOIUrl":"10.1111/nin.70129","url":null,"abstract":"There is ongoing tension in healthcare where certain types of knowledge are privileged above others to the detriment of patient outcomes. This hierarchy marginalizes nursing knowledge and patient perspectives, reinforcing systemic inequities in care delivery. Revisiting Stein's (1967) \"doctor-nurse game,\" in which nurses were expected to influence care indirectly while preserving physician authority, this paper examines how hierarchical patterns of communication and knowledge recognition continue to shape practice. Nursing standpoint theory serves as a framework for critically examining power dynamics within the healthcare setting, providing a means to critically examine how power operates within healthcare structures and interprofessional relationships. Applying nursing standpoint theory reveals how systemic power imbalances shape provider interactions and affect the ability of nurses to advocate for patients. The analysis demonstrates that nurses' embeddedness in patient care positions them uniquely to recognize and respond to gaps in care. Understanding the ways nurses and physicians are situated in relation to power helps explain persistent tensions and offers a path toward more equitable care delivery. Rather than treating advocacy as an individual reactive task, centering the nursing standpoint reframes it as a relational and structural practice that depends on reciprocal recognition of professional knowledge. Empowering nurses to navigate and reshape power relations is therefore essential to improving outcomes. This theoretical reorientation benefits patients, teams, and health systems by shifting the \"game\" from deference to deliberation in support of patient-centered care.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70129"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Person-Centred Approach to Severe Mental Illness: The Individual Symptom Complex as Guiding Principle. 以人为本的方法来治疗严重的精神疾病：以个体症状复杂为指导原则。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70114

Saskia Bollen, Philippe Delespaul, Gina Rossi, Sebastiaan Van Alphen

{"title":"A Person-Centred Approach to Severe Mental Illness: The Individual Symptom Complex as Guiding Principle.","authors":"Saskia Bollen, Philippe Delespaul, Gina Rossi, Sebastiaan Van Alphen","doi":"10.1111/nin.70114","DOIUrl":"10.1111/nin.70114","url":null,"abstract":"People with long-term psychiatric disorders often display complex behaviours that cannot be fully explained by existing categories in diagnostic classification systems. As a result, translating such symptom profiles into truly person-centred and recovery-oriented care remains a challenge. This article explores how symptom-focused observation through transdiagnostic dimensions can be integrated within person-centred psychiatric nursing, and oriented toward meaning-making and recovery. A narrative literature approach was used, based on an analysis of theoretical frameworks such as the Research Domain Criteria and practical insights from psychiatric nursing. Structuring behaviour along symptom dimensions such as affect regulation or social cognition provides tools for understanding so-called 'challenging behaviour'. Nurses play a key role in this process, as they interpret symptoms based on individual context, values and needs. Symptom-based approaches only become meaningful when linked to idiographic interpretation. This enhances a recovery-oriented and relational model of person-centred care. Observation instruments such as the Neuropsychiatric Inventory Questionnaire may support nurses in interpreting symptoms, provided they are embedded within relational attunement. Nurses should be recognised as key actors in translating symptom profiles into person-centred interventions within multidisciplinary teams. The analysis is theoretical in nature; practical application requires further empirical validation.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70114"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148037072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0