Peggy L. Chinn

Theory and nursing : a systematic approach

This fourth edition covers nursing theory from a conceptual perspective and provides a foundation for understanding the nature and development of nursing theory and its links with research and practice. Theory and theory development are presented in a manner that encourages critical thinking. In order to reflect current developments this text discusses and provides a brief synopsis of mid-range (practice-based) theories.

Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning Nurses' Experiences in the Workplace

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) nurses constitute one of the largest subgroups within the profession of nursing, yet there is very little empirical research in the nursing literature and virtually no attention to issues of discrimination and exclusion in the workplace by nursing education or professional nursing organizations. This study reports the findings of an online survey of 261 LGBTQ nurses from a database of an LGBTQ health advocacy organization. The survey contained both quantitative and qualitative items and revealed that many workplaces lacked policies and procedures that would make LGBTQ nurses feel safer and more included and that many coworkers, supervisors, and patients had exhibited discriminatory behavior or verbal harassment, sometimes leading to significant consequences for the LGBTQ worker. LGBTQ nurses expressed a need for a professional organization that would educate the nursing profession and the general population about LGBTQ issues and address their advocacy and health care policy needs. Efforts to correct the current workplace climate for LGBTQ employees would involve (a) changes in workplace policies, (b) education of the health care workforce, and (c) advocacy from nursing professional organizations.

The effectiveness of feminist pedagogy in empowering a community of learners.

The purpose of this study was to determine whether a pedagogy grounded in feminist ideals has the potential to empower students to make changes consistent with those ideals in their personal and professional lives. In Phase I, qualitative data were collected through e-mail questionnaires from students in two nursing schools, one in Canada and one in the United States. Findings were used to identify an appropriate tool to measure the empowering influence of feminist pedagogy. In Phase 2, a pretest-posttest design used Barretts Power as Knowing Participation in Change Tool (PKPCT) to measure student empowerment. A clinical setting was added in a third baccalaureate nursing program. A total of 218 students participated in seven course offerings-four classroom and three clinical. One hundred one matched pairs were obtained, for an overall response rate of 46%. Repeated measures ANOVA revealed that overall empowerment scores, as measured by the PKPCT, and classroom empowerment (CE), as measured by the addition of a variable (i.e., the ability to contribute in class), increased significantly from pretest to posttest. Interaction between Sites 1 and 2 was also significant. Regression analysis indicated posttest CE scores added to pretest PKPCT and CE scores provided a strong model to predict overall empowerment scores, measured by the PKPCT at Time 2 (R2 = .703). Despite limitations related to loss of follow up and low response rates at one site, the results of this study supported both hypotheses: that empowerment would increase over the course of the class in which feminist pedagogical principles were used, and that classroom empowerment is likely to extend beyond the classroom to personal and work environments.

Sexual Issues in Special Populations: Lesbian and Gay Individuals

OBJECTIVES To provide an overview of health care needs and related sexuality issues of lesbian and gay patients. DATA SOURCES Research articles, books, clinical experience. CONCLUSION Attitudes of health professionals as well as patients impact care in relation to sexuality and sexual issues. Oncology nurses using a framework of awareness, sensitivity, and knowledge can obtain and apply the essential information needed to provide culturally appropriate nursing care to this population. IMPLICATIONS FOR NURSING PRACTICE Lesbian and gay patients need nurses as allies in their fight with cancer. This is particularly true in assessment and managing concerns about sexuality and sexual issues.

We’re All Here for the Good of the Patient: A Dialogue on Power

Two nurse scholars, whose works have centered on power and related concepts, discuss the ideas that have shaped their concepts of power. In this conversation, they reflect on factors that constrain nurses and nursing in organizations, and consider some possibilities that could lead nurses to realize their full potential and influence in the healthcare system.

Relationships and health.

How do relationships improve my health? For 75 years, Harvard University has interviewed hundreds of people to help figure out what makes us healthy and happy. The Harvard study shows that being connected to other people matters more than any other life factor (including money and power) to our health and happiness.1 Many other studies also show that relationships matter to our well-being. In fact, having strong relationships affects our body in the following ways: • Decreasing blood pressure and cholesterol2 • Keeping the heart rate low3 • Lowering levels of the stress hormone, cortisol4 • Increasing immune cells to fight infections5 • Lowering inflammation 6

Just between friends.

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Educating for Social Justice

Education serves two seemingly contradictory purposes—to sustain the culture and to challenge and change the culture. In nursing, we seem to have accomplished the fi rst very well! Students with whom I have worked over the years, and still to this day, are well-versed in reciting, even regurgitating, what is in the textbook or the printed article, but they rarely question what they fi nd there. The nursing education published literature has many strengths, but content addressing social and structural determinants of health is woefully absent. However, when I challenge students to think about what the printed word might include if social factors were to be addressed, they typically have little trouble recognizing the signifi cance of this missing element. When I challenge students to question the literature and to express their own ideas, they might be able to do this verbally, but putting their ideas in writing is a huge struggle. In addition, this awareness is relatively superfi cial, and without exposure to the substantial literature that deepens awareness and understanding of these factors, the ability of nurses to adequately address social equity remains out of reach. In my view, the defi cits in much of the nursing literature and the inability of students—who are the leaders of the future—to articulate a substantive nursing perspective related to social justice are major problems that also open the door of opportunity. Signs of steady progress are evident. The journal literature that challenges the status quo of social inequity has increased by leaps and bounds in recent years, and a text containing original writings by nurse scholars whose work has uncovered connections of social injustice and health has been recently published (Kagan, Smith, & Chinn, 2014). That text focuses on emancipatory nursing, which is an approach to nursing that seeks to address social and structural factors that infl uence health and that seeks social justice for all as a direct path to health and wellbeing. In the introduction to this new collection, the editors summarized common features that authors of the book chapters identifi ed as characteristics of emancipatory nursing. These features are:

Quality of articles published in predatory nursing journals

BACKGROUND Predatory journals exist in nursing and lack the safeguards of traditional publishing practices. PURPOSE To examine the quality of articles published in predatory nursing journals. METHOD Randomly selected articles (n = 358) were reviewed for structural content and eight quality indicators. FINDINGS Two-thirds (67.4%) of the articles were published between 2014 and 2016, demonstrating the acceleration of publications in predatory nursing journals. The majority (75.9%) of the articles were research reports. Most followed the IMRAD presentation of a research report but contained errors, or the study was not pertinent to the nursing discipline. CONCLUSIONS Nursing research published in predatory journals may appear legitimate by conforming to an expected structure. However, a lack of quality is apparent, representing inadequate peer review and editorial processes. Poor quality research erodes the scholarly nursing literature.

LGBT Health Research: Introduction to the Special Issue

The field of lesbian, gay, bisexual, and transgender (LGBT) health has emerged in fits and starts over the past 30 years. Prior to 1970, most of the articles in the health care literature were about the pathology or deviance of homosexuality and included psychiatric theories about the causes of or proposed treatments to cure homosexuality. Stereotypes about disease and contagion abounded even in the scientific literature. By the 1970s, around the time that homosexuality was removed from the Diagnostic and Statistical Manual of Mental Disorders (Drescher, 2012), a few articles began to appear about providing compassionate care to sexual minority individuals, especially adolescents, and articles that proposed homosexuality as deviance or advocated for cures declined (Snyder, 2011). Psychology led the way, though, and many more articles about mental health (depression and suicide in particular) and counseling of lesbians and gay men were published than articles about any physical health concerns, at least until the mid-1980s, with the explosion of research on HIV/AIDS. AIDS was to dominate both publication and funding of LGBT health for the next three decades and, since about 1984, articles about men who have sex with men