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去殖民化护理教育和研究,以解决孕产妇健康中的种族差异问题。

Decolonizing nursing education and research to address racial disparities in maternal health.

机构信息

Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, Massachusetts, USA.

出版信息

J Adv Nurs. 2023 Jul;79(7):2465-2469. doi: 10.1111/jan.15624. Epub 2023 Mar 7.

Abstract

PURPOSE

In this paper, we discuss the need to move beyond theoretical explorations of social determinants of health (SDoH) to addressing systemic racism and its effect on Black maternal health outcomes. We also address the importance of connecting nursing research, education and practice and offer suggestions on how to transform the teaching, research and clinical practice specific to Black maternal health.

KNOWLEDGE DEVELOPMENT

A critical analysis of current Black maternal health teaching and research practices in nursing informed by the authors' experience in Black/African diasporic maternal health and reproductive justice.

DISCUSSION

There is a need for nursing to be more intentional in addressing the effects of systemic racism on Black maternal health outcomes. In particular, there is still a substantial focus on race rather than racism as a risk factor. The focus on racial and cultural differences rather than systems of oppression continues to pathologize racialized groups while failing to address the impact of systemic racism on the health outcomes of Black women.

CONCLUSION

Using a social determinant of health framework to examine maternal health disparities is useful; however, focusing on SDoH without challenging systems of oppression producing these disparities does not produce substantial changes. We suggest adding frameworks grounded in intersectionality, reproductive and racial justice and moving beyond biological assumptions about race that pathologize Black women. We also recommend a deliberate commitment to reshaping nursing research and education to centre anti-racist and anti-colonial practices that value community knowledge and practices.

NO PATIENT OR PUBLIC CONTRIBUTION

The discussion in this paper is based on the author's expertise.

摘要

目的

在本文中,我们讨论了将社会决定因素健康(SDoH)的理论探讨推进到解决系统性种族主义及其对黑人产妇健康结果的影响的必要性。我们还讨论了将护理研究、教育和实践联系起来的重要性,并就如何改变针对黑人产妇健康的教学、研究和临床实践提出了建议。

知识发展

以作者在黑人/非裔散居产妇健康和生殖正义方面的经验为基础,对护理中当前黑人产妇健康教学和研究实践进行批判性分析。

讨论

护理需要更加关注系统性种族主义对黑人产妇健康结果的影响。特别是,仍然有大量的注意力集中在种族而不是种族主义作为一个风险因素上。对种族和文化差异的关注而不是对压迫制度的关注,继续将种族化群体病理化,而未能解决系统性种族主义对黑人妇女健康结果的影响。

结论

使用健康差异的社会决定因素框架来检查产妇健康差异是有用的;然而,关注 SDoH 而不挑战产生这些差异的压迫制度,并不会产生实质性的变化。我们建议增加基于交叉性、生殖和种族正义的框架,并超越将黑人女性病理化的关于种族的生物学假设。我们还建议认真致力于重塑护理研究和教育,以中心反种族主义和反殖民主义的实践,重视社区知识和实践。

无患者或公众贡献

本文的讨论基于作者的专业知识。

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