Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
Faculty of Nursing, MacEwan University, Edmonton, Alberta, Canada.
Nurs Inq. 2023 Jan;30(1):e12511. doi: 10.1111/nin.12511. Epub 2022 Jul 8.
The purpose of this discussion paper is to explore how nurses can be strategically poised to advocate for needed policy change in support of greater income equality and other social determinants of health. We adapted Bronfenbrenner's social-ecological model to highlight how four broad pervasive subsystems shape the opportunities that nurses have to engage in advocacy at the policy level. These subsystems include organizations (the microsystem), professional bodies (the mesosystem), public policies (the exosystem), and societal values (the macrosystem). On the basis of this adapted model, we recommend changes among modifiable elements of the microsystem and mesosystem that can help position nurses (ecologically and collectively) to advocate for public policy change and use examples from a Canadian context to illustrate these points. We believe that the ideas arising from this model can be widely used where policy action on the social determinants of health is needed to inform, guide, and frame change efforts and advocacy work.
本文旨在探讨护士如何能够战略性地倡导必要的政策变革，以支持更大的收入平等和其他健康的社会决定因素。我们借鉴了 Bronfenbrenner 的社会生态模型，强调了四个广泛存在的子系统如何塑造护士在政策层面进行倡导的机会。这些子系统包括组织（微系统）、专业团体（中系统）、公共政策（外系统）和社会价值观（宏系统）。基于这个改编的模型，我们建议在微系统和中系统的可修改元素中进行改变，这可以帮助护士（从生态和集体的角度）定位，以倡导公共政策的改变，并以加拿大的例子来说明这些观点。我们相信，在需要采取政策行动来影响、指导和构建变革努力和倡导工作的健康的社会决定因素方面，这一模式所产生的想法可以得到广泛应用。
