Nursing Inquiry最新文献_第5页

"But I Love the Colored": Unpacking White Emotional Defensiveness and Racial Harm in Nursing Academia. “但我爱有色人种”：拆解护理学术界的白人情感防御和种族伤害。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70139

Kechi Iheduru-Anderson, Kaija Freborg, LaTonia Clark Chalmers

{"title":"\"But I Love the Colored\": Unpacking White Emotional Defensiveness and Racial Harm in Nursing Academia.","authors":"Kechi Iheduru-Anderson, Kaija Freborg, LaTonia Clark Chalmers","doi":"10.1111/nin.70139","DOIUrl":"10.1111/nin.70139","url":null,"abstract":"This paper examines the discursive, emotional, and institutional dynamics embedded in the racially defensive statement, \"But I love the Colored,\" voiced by a white nurse leader in academia. The phrase \"the Colored,\" a US-specific designation rooted in Jim Crow-era segregation, is deliberately retained to surface how segregationist vocabulary can be effectively reactivated in contemporary academic settings. While seemingly well-intentioned, such language reveals the enduring mechanisms of whiteness in nursing academia, including benevolent racism, white emotionality, and the rhetorical deflection of accountability. Through historical, theoretical, and linguistic analyses, this paper argues that these racial speech acts function as institutional behaviors that retraumatize racialized faculty and students, cause increased workload and fatigue, silence dissent, and reproduce racial hierarchies under the guise of care. This discursive analysis, which draws on critical whiteness studies, calls for faculty to engage in racial literacy training, self-inquiry, emotional self-regulation, and racial accountability. Rather than relying on performative policies, the paper urges antiracist transformation rooted in critical reflective practice, courageous dialogue, and structural change. While the specific linguistic signifiers analyzed here are particular to the United States, the broader phenomena may manifest in distinct forms across other national contexts. Ultimately, this analysis reveals that equity must address white emotional defensiveness within nursing education and the racial harm it produces as the future of the discipline depends not on white comfort, but on institutional transformation.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70139"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472993","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

Navigating Conflicts of Duty in Contexts of Compassionate Care: Utilitarian Reasoning as a Practice-Oriented Framework. 在富有同情心的护理背景下导航责任冲突：功利推理作为一个实践导向的框架。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70138

Ricardo Ayala, Daniela Castillo, Pierre Pariseau-Legault

{"title":"Navigating Conflicts of Duty in Contexts of Compassionate Care: Utilitarian Reasoning as a Practice-Oriented Framework.","authors":"Ricardo Ayala, Daniela Castillo, Pierre Pariseau-Legault","doi":"10.1111/nin.70138","DOIUrl":"10.1111/nin.70138","url":null,"abstract":"Compassionate nursing practice frequently requires nurses to navigate competing obligations, conflicting patient needs and constrained resources. While compassion motivates responsiveness to suffering, it does not always provide sufficient guidance for determining how such conflicts should be resolved. We argue that contemporary forms of utilitarianism may offer a useful framework for structuring compassionate practice in nursing within ethically pluralistic clinical environments. Drawing on contemporary utilitarian thought, particularly preference utilitarianism, the paper examines how attentiveness to suffering, preservation of dignity and responsiveness to patient vulnerability may be reframed around ethical deliberation under competing demands. Through clinical examples, we explore how compassionate nursing practice often involves the weighing of competing preferences, the prioritisation of morally significant needs and the allocation of finite professional attention. We argue that preference utilitarianism can fruitfully provide a structured ethical resource for evaluating actions according to their capacity to reduce and prevent suffering while respecting individual preferences and circumstances. The paper does not propose a foundational moral theory for nursing. Rather, it argues that preference utilitarianism can function as a complementary ethical resource alongside care ethics, virtue-based approaches and other relational perspectives, particularly in situations where nurses must navigate conflicting ethical duties. It therefore demonstrates how compassionate actions can be morally justified and systematically assessed, supporting a move from isolated acts of care towards more sustained and context-sensitive ethical practices within healthcare systems.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70138"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537681","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

Beyond Horizontal Expansion: Structural, Educational, and Leadership Pathways to Nursing Professional Empowerment. 超越横向扩张：结构，教育和领导途径护理专业授权。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70136

Qian Yang, Juanjin Wang, Yuzhou Xu, Wenli Lu, Rongqing Hu, Chunsheng Feng, Jiayi Song, Xueyu Niu, Peihua Xiao, Huan Du

{"title":"Beyond Horizontal Expansion: Structural, Educational, and Leadership Pathways to Nursing Professional Empowerment.","authors":"Qian Yang, Juanjin Wang, Yuzhou Xu, Wenli Lu, Rongqing Hu, Chunsheng Feng, Jiayi Song, Xueyu Niu, Peihua Xiao, Huan Du","doi":"10.1111/nin.70136","DOIUrl":"10.1111/nin.70136","url":null,"abstract":"The horizontal growth of nursing education globally over recent decades has not been matched by a corresponding vertical breakthrough in professional autonomy. Nurses remain structurally subordinated within clinical governance, resource allocation, and institutional decision-making. This discursive paper argues that this gap persists because three mutually reinforcing mechanisms remain intact: historically entrenched institutional path dependence, operational deficits in competency-based evaluation frameworks, and persistent gaps in how leadership translates structural and educational reforms into clinical authority. Applying a historical institutionalist lens, we trace how early critical junctures locked nursing into a doctor-led, nurse-subordinate configuration that subsequent reforms have failed to disrupt. We then examine how the absence of structured entrustment-supervision scales prevents competency standards from conferring genuine decision-making power. Finally, we analyze how conceptual overlap among leadership constructs, and unaddressed measurement threats like social desirability bias, weaken the evidence base for leadership interventions. To resolve this, the paper contributes an integrated analytical framework proposing that institutional restructuring, educational framework enhancement, and leadership development must operate synergistically, not in isolation. This coordinated pathway offers a strategy for achieving sustainable nursing empowerment.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70136"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563432","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

Making Nursing Visible in General Practice: Responsible Action Research as an Approach to Developing Nurse-Sensitive Metrics. 使护理在全科实践中可见：负责任的行动研究作为开发护士敏感指标的方法。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70130

Orla Loftus Moran, Mary Casey

{"title":"Making Nursing Visible in General Practice: Responsible Action Research as an Approach to Developing Nurse-Sensitive Metrics.","authors":"Orla Loftus Moran, Mary Casey","doi":"10.1111/nin.70130","DOIUrl":"10.1111/nin.70130","url":null,"abstract":"This critical discussion paper argues that the development of nurse-sensitive metrics in general practice is not simply a technical task of selecting indicators, but an ethical and methodological process through which nursing contribution becomes known, named and represented. Although health systems increasingly prioritise measurement, accountability and performance data, important dimensions of nursing practice remain poorly captured, particularly in community and primary care contexts. In general practice, nursing care is characterised by generalist, relational, preventive and cumulative forms of care, making the direct transfer of metrics developed outside this context problematic. General practice nurses represent a substantial workforce, yet their contribution remains only partially visible within existing healthcare data systems. This paper advances a Responsible Action Research approach to developing nurse-sensitive metrics grounded in everyday practice. Drawing on Action Research, implemented through Appreciative Inquiry and informed by the Quality Action Research Checklist, the paper considers how collaborative inquiry can support general practice nurses to articulate dimensions of nursing quality that may otherwise remain tacit. Inclusion of perspectives from general practitioners, patients and practice administrators further situates this inquiry within the broader ecology of care. The paper argues that responsible metric development requires attention not only to what is eventually measured, but to the transparency, reflexivity and accountability of the process through which potential indicators are generated. By reframing metric development as a practice-engaged process of knowledge generation, it offers a methodological contribution to debates on how nursing work can be made visible without reducing its complexity.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70130"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347128","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

Whose Language Is Nursing? Multilingualism, Ubuntu and the Politics of Voice in Nursing Education. 谁的语言是护理？多语言、乌班图与护理教育中的话语权政治。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70116

Vhothusa Edward Matahela

{"title":"Whose Language Is Nursing? Multilingualism, Ubuntu and the Politics of Voice in Nursing Education.","authors":"Vhothusa Edward Matahela","doi":"10.1111/nin.70116","DOIUrl":"10.1111/nin.70116","url":null,"abstract":"In multilingual nursing education, English-medium practices often dominate teaching, assessment and documentation, positioning students' home languages as informal or inappropriate for legitimate academic participation. This qualitative, descriptive, exploratory and contextual study investigates how nurse educators conceptualise the role of students' home languages in teaching and assessment, and what these conceptualisations disclose about language ideologies, recognition and the politics of voice in professional formation. Across five focus groups with 44 nurse educators, participants framed home language as a pathway to epistemic access, enabling comprehension, conceptual clarity and participation when English constrained expression. They also described multilingual responsiveness as a practice of dignity and cultural recognition, in which respectful communication and non-humiliating feedback enact humanising pedagogy. At the same time, educators highlighted structural tensions in which English operates as a gatekeeping regime in assessment and professional communication, producing moments where students 'know' content yet struggle to demonstrate competence in sanctioned discourse. Communication was further expanded beyond linguistic proficiency to include cultural nuance, nonverbal meaning and relational conduct, linking language to clinical readiness and patient care. The article argues for structured multilingual pedagogies and language-aware assessment that maintain standards while widening voice, belonging and equitable participation.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70116"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145098","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

Exploring the Social and Cultural Influences on Advance Care Planning Engagement for Patients Living With Cancer: A Hermeneutic Phenomenology Study. 探讨社会和文化对癌症患者预先护理计划参与的影响：一项解释学现象学研究。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70109

Cheng-Pei Lin, Chih-Yun Huang, Jen-Kuei Peng, Hsiao-Ting Chang

{"title":"Exploring the Social and Cultural Influences on Advance Care Planning Engagement for Patients Living With Cancer: A Hermeneutic Phenomenology Study.","authors":"Cheng-Pei Lin, Chih-Yun Huang, Jen-Kuei Peng, Hsiao-Ting Chang","doi":"10.1111/nin.70109","DOIUrl":"10.1111/nin.70109","url":null,"abstract":"Guided by Leininger's Theory of Culture Care, this hermeneutic phenomenological study explored how social and cultural contexts shape engagement in advance care planning (ACP) among people living with cancer in Taiwan. Semi-structured interviews were conducted with 26 stakeholders, including 8 patients, 7 family caregivers, and 11 healthcare providers, recruited from oncology and ACP outpatient clinics, inpatient wards, and home care services at a tertiary medical center. Data were audio-recorded, transcribed verbatim, and analyzed using Naeem's six-step approach. Six interrelated influences on ACP engagement were identified: socioeconomic circumstances, prior experiences and personal background, religious beliefs and life values, relational dynamics with family and significant others, wider social norms, and political and legal requirements. These factors shaped whether ACP was seen as acceptable, when it was introduced, who was involved in decision-making, and how discussions were negotiated within families and with healthcare professionals. The findings show that ACP engagement in Taiwan is a relational, culturally embedded process. Culturally congruent, nurse-led ACP approaches that address relational, socioeconomic, and legal structural influences are needed to support family-centered cancer care.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70109"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965166","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 Self-Care Paradox: From Nursing Theory to Neoliberal Subjectivity. 自我照顾悖论：从护理理论到新自由主义主体性。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70117

Hyo-do Kim, Hyunjung Lee

{"title":"The Self-Care Paradox: From Nursing Theory to Neoliberal Subjectivity.","authors":"Hyo-do Kim, Hyunjung Lee","doi":"10.1111/nin.70117","DOIUrl":"10.1111/nin.70117","url":null,"abstract":"Self-care occupies a central, often taken-for-granted and normatively privileged position in contemporary nursing discourse, consistently framed as a marker of empowerment, autonomy and responsible health behaviour. Although critical scholarship has contested this framing through work on relational care, feminist critiques of individualism and the neoliberal responsibilisation of health, the normative work self-care performs within nursing's own conceptual frameworks remains insufficiently examined. This paper offers a theoretical analysis of self-care as a subject-forming discourse. It revisits Orem's Self-Care Deficit Nursing Theory as a conceptual baseline in which vulnerability and dependence are ethically acceptable conditions that legitimately call forth nursing intervention, and traces how neoliberal health discourse has reconfigured self-care from capacity into obligation. Building on existing structural critiques, the paper argues that a further, subjective transformation warrants attention: self-care discourse contributes to the formation of subject positions in which responsibility is internalised, vulnerability experienced as inadequacy and care-seeking as personal failure. These subject positions are unevenly taken up across class, gender, age and health status, and may be resisted or reinterpreted. Drawing on Byung-Chul Han's account of the achievement subject, the paper conceptualises this dynamic here as the self-care paradox and considers what it asks of nursing theory.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70117"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200869","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

Critical Pragmatism as a Paradigm for Nursing Research. 批判实用主义：护理研究的范式。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70120

Renée Gordon, Marjan Kekanovich, Aleksandra Zuk, Marian Luctkar-Flude, Danielle Macdonald

引用次数: 0

Emancipatory Theory of Compassion in Action: Power, the Unspeakable, and Compassionate Resistance in Nursing Ethics. 行动中同情的解放理论：护理伦理中的力量、不可言说和同情抵抗。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70107

Joshua B Hardin

{"title":"Emancipatory Theory of Compassion in Action: Power, the Unspeakable, and Compassionate Resistance in Nursing Ethics.","authors":"Joshua B Hardin","doi":"10.1111/nin.70107","DOIUrl":"10.1111/nin.70107","url":null,"abstract":"Decisions about limiting directives and Do Not Resuscitate orders in perianesthesia settings raise enduring ethical questions about power, responsibility, and compassion in clinical practice. This article advances the emancipatory theory of compassion for nursing by using these tensions to explore how the theory's core concepts operate within everyday clinical decision-making. The inquiry uses qualitative data from interviews, observations, and artifact reviews involving 27 participants, including patients, family members, and clinicians in a tertiary surgical services department. The results illustrate how distance, free-floating responsibility, and the zoe/bios dichotomy shape interactions between patients and clinicians. Together, these dynamics can normalize the suspension of limiting directives, rendering ethically troubling practices unspeakable within routine clinical work. At the same time, moments emerge when clinicians or family members insist that patient preferences be addressed, interrupting these patterns and creating space for more compassionate forms of practice. By demonstrating how these theoretical concepts illuminate the ethical dynamics of perianesthesia care, the analysis contributes to the continuing development of emancipatory nursing theory while highlighting how attention to relational power may help create more equitable and compassionate clinical encounters.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70107"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943528","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

When Advance Care Planning Is Not Yet an Option: Preconditions for Participation and the Relational Work of Nursing. 当预先护理计划还不是一种选择：参与和护理相关工作的先决条件。

IF 3.2 4区医学

Nursing Inquiry Pub Date : 2026-07-01 DOI: 10.1111/nin.70143

Takashi Iwashiro

{"title":"When Advance Care Planning Is Not Yet an Option: Preconditions for Participation and the Relational Work of Nursing.","authors":"Takashi Iwashiro","doi":"10.1111/nin.70143","DOIUrl":"10.1111/nin.70143","url":null,"abstract":"Advance care planning (ACP) non-initiation is commonly attributed to information deficits or low motivation. I argue here that a more fundamental barrier exists: ACP may not yet have become cognitively and relationally available as a meaningful option within a person's everyday horizon. Drawing on a concept-oriented review of the theoretical and empirical literature, I develop a participatory framework built on four linked preconditions. First, decision readiness describes the pre-decisional state, in which future care becomes sufficiently thinkable to enter dialogue. Second, the cognitive repertoire reconceptualises ACP learning as the formation of latent resources -values, questions and interpretive frames-that can be activated when life circumstances make future care salient. Third, self-disclosure highlights that, even when internal readiness exists, participation depends on relational and emotional conditions that make concerns speakable. Fourth, supportive nudging describes the deliberate design of environmental and relational conditions that allow already-existing concerns to surface without compromising autonomy. Altogether, these preconditions suggest that ACP non-initiation is better understood as a problem of option accessibility than one of information transfer. This reframing has direct implications for how ACP interventions are designed and evaluated and extends to the broader questions of patient and public participation in future-oriented care.","PeriodicalId":49727,"journal":{"name":"Nursing Inquiry","volume":"33 3","pages":"e70143"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498332","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