Dahlke Sherry, Hunter Kathleen F
Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada.
Int J Older People Nurs. 2025 Jul;20(4):e70040. doi: 10.1111/opn.70040.
For decades, healthcare systems have enacted cost containment, which has led to nurses working within increasingly thinly resourced healthcare services influenced by political ideologies and often just trying to get through their shift. They may not have enough energy, support or background knowledge about what is behind the challenges they face or how they could effectively advocate for older people.
In this discussion paper, we provide an overview of three underlying political ideologies; discuss how these ideologies influence health and social care among western countries, examine how workplaces influenced by political ideology (e.g., resource allocation) can perpetuate ageism in healthcare decisions; explore advocacy and activism in nursing and suggest opportunities for nurses to disrupt negative practices.
We found common challenges among countries with the three ideologies-increasing older people, the need to spend money efficiently and older people's desire to age-in-place. Thus, there is critical importance of health and social community supports and informal caregivers. Although not perfect, a social democratic ideology appears to be more likely than the other ideologies to work towards valuing people of all ages, with greater potential for equitable access and to support people throughout their lifespan.
Nurses have an important role to play in suggesting improvements in health and social care. Nurses that work together through professional gerontological associations could be proactive in informing the public that their current political ideology could be perpetuating ageism in health and social care systems.
Nurses need to educate themselves about the political ideology in their country and critically examine how it influences the health and social care of older people. Also necessary that nurses take an advocacy/activist role for older people's health and social care needs.
几十年来，医疗保健系统一直在实施成本控制，这导致护士在资源日益稀缺的医疗保健服务中工作，这些服务受到政治意识形态的影响，而且护士往往只是努力完成轮班工作。他们可能没有足够的精力、支持或背景知识来了解他们所面临挑战背后的原因，或者如何有效地为老年人争取权益。
在这篇讨论文件中，我们概述了三种潜在的政治意识形态；讨论这些意识形态如何影响西方国家的健康和社会护理，研究受政治意识形态影响的工作场所（如资源分配）如何在医疗保健决策中使年龄歧视长期存在；探讨护理中的倡导和行动主义，并为护士提供打破消极做法的机会。
我们发现，在这三种意识形态的国家中存在共同的挑战——老年人数量增加、有效使用资金的必要性以及老年人原地养老的愿望。因此，健康和社会社区支持以及非正式护理人员至关重要。虽然并不完美，但社会民主意识形态似乎比其他意识形态更有可能努力重视所有年龄段的人，在公平获得服务和支持人们一生方面具有更大的潜力。
护士在建议改善健康和社会护理方面可发挥重要作用。通过专业老年学协会共同努力的护士可以积极主动地告知公众，他们当前的政治意识形态可能会使健康和社会护理系统中的年龄歧视长期存在。
护士需要了解本国的政治意识形态，并批判性地审视其如何影响老年人的健康和社会护理。护士为满足老年人的健康和社会护理需求发挥倡导/行动主义作用也很有必要。
