Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
Int Nurs Rev. 2013 Mar;60(1):52-8. doi: 10.1111/j.1466-7657.2012.01010.x. Epub 2012 Jun 24.
A multidisciplinary team of 20 researchers and research users from six countries - Canada, Jamaica, Barbados, Kenya, Uganda and South Africa - are collaborating on a 5-year (2007-12) program of research and capacity building project. This program of research situates nurses as leaders in building capacity and promotes collaborative action with other health professionals and decision-makers to improve health systems for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) nursing care. One of the projects within this program of research focused on the influence of workplace policies on nursing care for individuals and families living with HIV. Nurses are at the forefront of HIV prevention and AIDS care in these countries but have limited involvement in related policy decisions and development. In this paper, we present findings related to the barriers and facilitators for nurses' engagement in policymaking.
A participatory action research design guided the program of research. Purposive sampling was used to recruit 51 nurses (unit managers, clinic and healthcare managers, and senior nurse officers) for interviews.
Participants expressed the urgent need to develop policies related to AIDS care. The need to raise awareness and to 'protect' not only the workers but also the patients were critical reason to develop policies. Nurses in all of the participating countries commented on their lack of involvement in policy development. Lack of communication from the top down and lack of information sharing were mentioned as barriers to participation in policy development. Resources were often not available to implement the policy requirement. Strong support from the management team is necessary to facilitate nurses involvement in policy development.
The findings of this study clearly express the need for nurses and all other stakeholders to mobilize nurses' involvement in policy development. Long-term and sustained actions are needed to address gaps on the education, research and practice level.
一个由来自六个国家（加拿大、牙买加、巴巴多斯、肯尼亚、乌干达和南非）的 20 名研究人员和研究用户组成的多学科团队正在合作开展一个为期五年（2007-12 年）的研究和能力建设项目。该研究计划将护士定位为能力建设的领导者，并促进与其他卫生专业人员和决策者的合作行动，以改善艾滋病毒和获得性免疫缺陷综合征（艾滋病）护理的卫生系统。该研究计划中的一个项目侧重于工作场所政策对护理艾滋病毒感染者和艾滋病患者个人和家庭的影响。在这些国家，护士处于艾滋病毒预防和艾滋病护理的前沿，但在相关政策决策和制定方面的参与有限。在本文中，我们介绍了与护士参与决策制定的障碍和促进因素相关的研究结果。
参与式行动研究设计指导了该研究计划。采用目的抽样法招募了 51 名护士（单位经理、诊所和医疗保健经理以及高级护士官员）进行访谈。
参与者表示迫切需要制定与艾滋病护理相关的政策。提高认识和“保护”不仅是工人，而且是病人，是制定政策的关键原因。所有参与国家的护士都评论说，他们没有参与政策制定。从上级到下级缺乏沟通以及缺乏信息共享被认为是参与政策制定的障碍。实施政策要求的资源往往不可用。管理团队的大力支持对于促进护士参与政策制定是必要的。
这项研究的结果清楚地表达了护士和所有其他利益相关者都需要动员护士参与政策制定。需要采取长期和持续的行动来解决教育、研究和实践层面的差距。
