ANS. Advances in nursing science
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The Middle-Range Theory of Self-Care of Chronic Illness has been used widely since it was first published in 2012. With the goal of theoretical refinement in mind, we evaluated the theory to identify areas where the theory lacked clarity and could be improved. The concept of self-care monitoring was determined to be underdeveloped. ⋯ Also, the manner in which self-care monitoring and self-care management are associated was thought to need refinement. As both of these issues relate to symptoms, we decided to enrich the Middle-Range Theory with knowledge from theories about symptoms. Here, we propose a revision to the Middle-Range Theory of Self-Care of Chronic Illness where symptoms are clearly integrated with the self-care behaviors of self-care maintenance, monitoring, and management.
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By seeking answers to ontological and epistemological questions, nursing scholars explored the foundations of nursing and articulated the meaning of nursing science from various philosophical perspectives. This ongoing search for advancement and development of nursing aligns with the concept of "normal science" by Thomas Kuhn. ⋯ Despite this influence, Kuhn's science's relevance for nursing science received a little scrutinization. This article presents a critical analysis of Kuhn's science and its influence on and relevance for nursing discipline and suggests implications for nursing knowledge development.
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Review Historical Article
Words Matter: An Integrative Review of Institutionalized Racism in Nursing Literature.
In health care, as in society, racism operates on multiple levels and contributes greatly to health and social inequities experienced by black Americans. In addressing racism, however, health care has primarily focused on interpersonal racism rather than institutionalized forms of racism that are deeply entrenched and contribute to racial inequities in health. ⋯ A systematic search of relevant nursing literature published since 2008 yielded 29 journal articles that focused on black Americans' experience of institutionalized racism in health and health care; the articles explicitly named racism as institutionalized, institutional, systemic, systematic, or structural. This review summarizes author-identified implications of institutionalized racism for nursing education, research, and practice, and offers suggestions for use by the nursing profession to dismantle racist policies, practices, and structures.
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Lesbian, gay, bisexual, transgender, and queer (LGBTQ) health disparities persist and reflect larger structural inequities that negatively impact the health of historically marginalized communities. By way of using queer phenomenology, the author analyzes a personal experience that was harmful to her as a lesbian patient who required emergency medical attention. Also a registered nurse, the author draws on her lived experiences to reveal heteronormativity as a prevalent, but largely unacknowledged, source of structural harms for LGBTQ patients. This aims to bring about an appreciation among nurses and other health care professionals to locate themselves within systems of privilege and oppression and gain an awareness on how they might better respond to ongoing structural harms that are disproportionately experienced by vulnerable patient populations.
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Many nursing theorists claim caring as the aspect of nursing that differentiates it from other health care professions. Newman et al defined the focus of nursing as "the study of caring in the human health experience," yet there is little consensus among nurses about the validity of this statement. The purpose of this article is to explore the concept of caring as it has been defined by various nursing scholars and to determine whether the focus of nursing knowledge development can appropriately be defined as "the study of caring in the human health experience."