Smeltzer Suzanne C, Robinson-Smith Gale, Dolen Mary Anne, Duffin Janice M, Al-Maqbali Majid
Center for Nursing Research, Villanova University, Villanova, Pennsylvania, USA.
Nurs Educ Perspect. 2010 May-Jun;31(3):148-55.
Although the American with Disabilities Act in 1990 mandated that people with disabilities (PWDs) have equal access to facilities and services, men and women with disabilities continue to report receiving inadequate health care. The need to address disability in health professions education, including nursing, has been identified by the U.S. Surgeon General, researchers, and the disability community. This study examined how disability issues are integrated in textbooks commonly used in nursing programs and differences in coverage by seven textbook categories (e.g., medical-surgical, pediatrics). A total of 33 textbooks used in undergraduate nursing curricula were systematically reviewed for inclusion of disability content using a review grid developed with the input of PWDs. Two researchers independently reviewed each textbook and at least three members of the team developed consensus ratings for each of 224 content items for each textbook. Sums of consensus ratings were calculated for each topic, each textbook, and all seven categories of textbooks. Ratings of each category of disability-related content were calculated and ranked from highest to lowest. Two investigators reviewed the consensus ratings for each category of book as well as written comments provided during the initial steps of the review. Analysis revealed that disability-related content was largely absent from textbooks and categories of textbooks. Although disabling conditions were discussed, issues related to lifelong or preexisting disability were often not addressed. Abuse, a major issue for PWDs, was barely addressed in detail in any of the textbooks. There were significant differences (p = .005) in inclusion of disability-related content by type of textbook; the highest ranked category was community health. Topics that would be expected in specific categories were often addressed infrequently or not at all. The results of this study suggest the need for faculty members to address disability in their nursing curricula in creative ways until textbook authors and publishers begin to address this issue. The large and growing population of 60 million individuals with disabilities mandates this action.
尽管1990年的《美国残疾人法案》规定残疾人有权平等使用设施和服务，但残疾男性和女性仍报告称获得的医疗保健不足。美国卫生局局长、研究人员以及残疾人群体已经认识到在包括护理在内的卫生专业教育中解决残疾问题的必要性。本研究调查了残疾问题是如何融入护理专业常用教科书的，以及七个教科书类别（如内科-外科、儿科）在覆盖范围上的差异。使用在残疾人参与下制定的审查网格，对本科护理课程中使用的33本教科书进行了系统审查，以确定是否包含残疾相关内容。两名研究人员独立审查每本教科书，团队中至少三名成员对每本教科书的224个内容项目进行共识评级。计算每个主题、每本教科书以及所有七个教科书类别的共识评级总和。计算每类残疾相关内容的评级，并从高到低进行排名。两名研究人员审查了每类书籍的共识评级以及审查初始阶段提供的书面评论。分析表明，教科书和教科书类别中基本上没有残疾相关内容。虽然讨论了致残情况，但与终身或既往残疾相关的问题往往未得到解决。虐待是残疾人面临的一个主要问题，在任何一本教科书中都几乎没有详细提及。不同类型教科书在包含残疾相关内容方面存在显著差异（p = 0.005）；排名最高的类别是社区卫生。特定类别中预期会涉及的主题往往很少被提及或根本未被涉及。本研究结果表明，在教科书作者和出版商开始解决这个问题之前，教师需要以创新方式在护理课程中讲授残疾问题。6000万庞大且不断增长的残疾人群体要求采取这一行动。
