Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA.
College of Nursing, University of Massachusetts Amherst, Amherst, Massachusetts, USA.
J Clin Nurs. 2021 Mar;30(5-6):892-899. doi: 10.1111/jocn.15569. Epub 2021 Jan 26.
To disrupt conflations between 'health disparities research' and critical engagement with racism, whiteness, other oppressions and our profession's ongoing roles in white supremacy.
In Oncology Nursing Society's (ONS) 2019-2023 research agenda, health disparities are highlighted as a top priority for nursing knowledge generation and intervention. The document concludes needs for increased 'minority and vulnerable population' participation in cancer clinical trials, reduced financial toxicity, behavioural interventions for risk reduction, incorporation of social determinants of health and technology to promote rural access to high-quality care.
In this critical resistive, theoretical and ethical analysis on current discourses on health disparities research in oncology nursing, we ask: (a) What forces (stated and unstated) shape current oncology nursing discourses about health disparities?; (b) What assumptions about health and power are embedded in these discourses?; (c) Are we, as nurses and scientists, asking the right questions?
Line-by-line analysis of the ONS Research Agenda for 2019-2023 'Health Disparities' section.
The health disparities described in this report are not new to the literature, nor are many of the proposed solutions. As noted, disparities such as disproportionate cancer-related morbidity and mortality across identities (gender, race and sexual orientation) have not improved and some have worsened over several decades.
That discourses on prioritising cancer-related health disparities persist while disparity-related outcomes remain largely unchanged presents challenges-both moral and pragmatic. We must ask, 'Rather than the concept of "health disparities," as presently understood in cancer nursing, what is the better approach to examine health equity and ethical nursing research practices?'
This paper offers several starting places for nurses, especially with the following questions: 'Who does this harm?' Answer then revise: 'Who might this harm now?' Answer then revise: 'Are these harms worth the activity?' And repeat this process.
打破“健康差异研究”与对种族主义、白色人种、其他压迫和我们专业在白人至上中的持续角色的批判性参与之间的混淆。
在肿瘤护理学会（ONS）2019-2023 年的研究议程中，健康差异被强调为护理知识生成和干预的首要任务。该文件得出结论，需要增加“少数民族和弱势群体”参与癌症临床试验，减少财务毒性，减少风险的行为干预，纳入健康的社会决定因素和技术，以促进农村获得高质量的护理。
在这篇关于肿瘤护理中健康差异研究当前话语的批判性抵制、理论和伦理分析中，我们提出了以下问题：(a) 是什么力量（明示和暗示的）塑造了当前肿瘤护理关于健康差异的话语？(b) 这些话语中嵌入了哪些关于健康和权力的假设？(c) 作为护士和科学家，我们是否在问正确的问题？
对 ONS 2019-2023 年“健康差异”部分研究议程进行逐行分析。
本报告中描述的健康差异在文献中并不新鲜，许多提议的解决方案也不是。如前所述，几十年来，不同身份（性别、种族和性取向）的癌症相关发病率和死亡率的差异并没有改善，有些甚至恶化了。
在癌症护理中，优先考虑与癌症相关的健康差异的论述仍然存在，而与差异相关的结果仍然基本不变，这带来了挑战——既有道德上的，也有实践上的。我们必须问：“与其说癌症护理中目前理解的‘健康差异’概念，不如说什么是更好的方法来检查健康公平和伦理护理研究实践？”
本文为护士提供了几个起点，特别是以下问题：“谁会受到伤害？”回答后修改：“现在谁可能会受到伤害？”回答后修改：“这些伤害值得吗？”然后重复这个过程。
