School of Health and Life Sciences, University of the West of Scotland, Paisley, United Kingdom.
School of Education, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, United Kingdom.
Policy Polit Nurs Pract. 2021 May;22(2):134-145. doi: 10.1177/1527154421994069. Epub 2021 Mar 11.
In the United Kingdom, significant ongoing inconsistency exists in wound care nursing education provision and practice. Health economists have identified this to be a major cause of the burgeoning economic and personal cost of successfully, and equitably, healing chronic wounds. While numerous wound care educational resources exist, policies intended to implement a program of reform or change are for some reason not filtering down to, or being implemented by, those who need them most. Policy making processes do not appear to be operating as efficiently as they should, and this merits further scrutiny. A critical discourse analysis of two UK professional body wound care policies provided an innovative insight into the effect of policy production to the research problem. The overarching construct of "Aspiration and Resolution" and its subconstructs were identified. Links between data, analysis, and conclusions were established using Greckhamer and Cilesiz's (2014) framework to address criticisms over lack of transparency in critical discourse analysis methodology. Findings indicate wound care policy makers must adopt an active, not passive, approach to policy making. An active position, compared with the inertia that appears to currently exist, would take into consideration the capacity to implement policy and not merely increase awareness or disseminate. Wound healing policy making agencies need to make decisions on how to disseminate and implement policy. Active policy making would also adopt target audiences' decisions to implement policy, instigate activities to improve knowledge and skills, facilitate change, and ensure continued use of policy as part of organizational operations.
在英国，伤口护理护理教育的提供和实践存在着持续的、显著的不一致。卫生经济学家已经确定这是成功、公平地治愈慢性伤口的经济和个人成本不断增加的主要原因之一。虽然有许多伤口护理教育资源，但出于某种原因，旨在实施改革或变革计划的政策并没有传达给或由最需要的人实施。政策制定过程似乎没有像应该的那样高效运作，这值得进一步审查。对英国两个专业机构伤口护理政策的批判性话语分析，为研究问题提供了一个创新的视角，了解政策制定的效果。确定了“愿望和决心”的总体结构及其子结构。使用 Greckhamer 和 Cilesiz（2014）的框架建立了数据、分析和结论之间的联系，以解决批判性话语分析方法缺乏透明度的批评。研究结果表明，伤口护理政策制定者必须对政策制定采取积极的、而不是被动的方法。与当前似乎存在的惯性相比，积极的立场将考虑到实施政策的能力，而不仅仅是提高认识或传播。伤口愈合政策制定机构需要就如何传播和实施政策做出决策。积极的政策制定还将采纳目标受众实施政策的决定，发起活动以提高知识和技能，促进变革，并确保将政策继续作为组织运作的一部分加以利用。
