Nursing Department, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA.
Sue & Bill Gross School of Nursing, University of California, Irvine, California, USA.
Nurs Forum. 2021 Apr;56(2):313-321. doi: 10.1111/nuf.12549. Epub 2021 Jan 23.
Nursing organizations and leaders adopted the social determinants of health (SDOH) as essential to the delivery of health care, but little is known about working registered nurses' (hereafter nurses) views on the SDOH. The purpose of this study was to (1) explore nurses' perceptions of how SDOH affect patient care and (2) describe nurses' ideas about how SDOH can be addressed to improve outcomes and services. Thirteen registered nurses with a baccalaureate in nursing beginning their online graduate advanced practice educational program were interviewed. This qualitative descriptive study used constant comparative analysis for data analysis. The analysis found two major themes: (1) SDOH are integrated into the nurses' care. The SDOH experienced by patients challenges the nurses to provide care at the patient's level and to provide usable patient education, and (2) health-care delivery change is needed to achieve equity and to provide health care to those in need. The nurses recommended more organized, seamless health-care delivery and interdisciplinary advocacy to achieve these needed changes. Nurse educators and nurse leaders can harness the frustration and ingenuity of nurses to help the nurses advocate for health-care change that integrates the SDOH.
护理组织和领导者将健康的社会决定因素(SDOH)视为提供医疗保健的必要条件,但对于注册护士(以下简称护士)对 SDOH 的看法知之甚少。本研究的目的是:(1)探讨护士对 SDOH 如何影响患者护理的看法;(2)描述护士关于如何解决 SDOH 以改善结果和服务的想法。13 名具有护理学士学位的注册护士开始参加在线研究生高级实践教育计划,对他们进行了访谈。这项定性描述性研究使用恒定比较分析进行数据分析。分析发现了两个主要主题:(1)SDOH 已融入护士的护理中。患者所经历的 SDOH 使护士面临挑战,要求他们根据患者的水平提供护理,并提供可用于患者教育的信息;(2)需要进行医疗保健提供方式的变革,以实现公平,并为有需要的人提供医疗保健。护士建议提供更有组织、更无缝的医疗保健服务,并进行跨学科的宣传,以实现这些必要的变革。护士教育者和护士领导者可以利用护士的挫折感和创造力,帮助护士倡导将 SDOH 纳入医疗保健变革。