Reutter Linda I, Sword Wendy, Meagher-Stewart Donna, Rideout Elizabeth
Faculty of Nursing, University of Alberta, Edmonton, Alberta T6G 2G3, Canada.
J Adv Nurs. 2004 Nov;48(3):299-309. doi: 10.1111/j.1365-2648.2004.03199.x.
This paper examines baccalaureate nursing students' beliefs about the relationship between poverty and health, and the factors that influence these beliefs.
The relationship between poverty and health is well established, and poverty remains a persistent problem in many industrialized nations. Nurses' understanding of how poverty influences health will affect how they interact with individual clients as well as the strategies they employ to address poverty-related issues. No studies have examined nursing students' understandings of how poverty influences health and the factors that influence that understanding.
A cross-sectional survey of a random sample (n = 740) of basic baccalaureate nursing students was conducted in three Canadian universities in 2000. Students completed a 59-item questionnaire eliciting data on demographic variables, personal and educational exposure to poverty, beliefs about the relationship between poverty and health (myth, drift, behavioural, structural), and attitudes to poverty.
Students were most likely to adhere to a structural explanation of the relationship between poverty and health. Very little of the variance in myth and drift explanations was accounted for by course or personal exposure, programme level, age, and attitudes toward poverty. Greater course exposure and more positive attitudes toward the poor predicted support for the structural explanation. Support for the behavioural explanation was influenced by attitudes toward the poor and, to a lesser extent, by course exposure, age, and programme level.
Students would benefit from greater exposure to poverty through coursework that emphasizes the structural factors contributing to poverty and its negative health consequences. Classroom experience should be complemented with clinical placements that provide students with opportunities to interact with families living in poverty and to work collaboratively with others to address the causes and consequences of poverty at community and policy levels.
本文探讨护理学本科学生对贫困与健康关系的看法,以及影响这些看法的因素。
贫困与健康之间的关系已得到充分证实,贫困在许多工业化国家仍然是一个长期存在的问题。护士对贫困如何影响健康的理解将影响他们与个体患者的互动方式以及他们为解决与贫困相关问题所采用的策略。尚无研究考察护理专业学生对贫困如何影响健康的理解以及影响这种理解的因素。
2000年在加拿大三所大学对护理学本科基础阶段学生的随机样本(n = 740)进行了横断面调查。学生们完成了一份包含59个条目的问卷,收集有关人口统计学变量、个人和教育层面接触贫困的经历、对贫困与健康关系的看法(神话论、无关联论、行为论、结构论)以及对贫困态度的数据。
学生最倾向于坚持对贫困与健康关系的结构论解释。课程学习或个人经历、课程层次、年龄以及对贫困的态度对神话论和无关联论解释的差异影响甚微。更多的课程学习经历以及对穷人更积极的态度预示着对结构论解释的支持。对行为论解释的支持受到对穷人态度的影响,在较小程度上还受到课程学习经历、年龄和课程层次的影响。
通过强调导致贫困的结构因素及其负面健康后果的课程学习,让学生更多地接触贫困会使他们受益。课堂经验应辅以临床实习,为学生提供机会与贫困家庭互动,并与他人合作,在社区和政策层面解决贫困的成因及后果。