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Biomedical subjects

Colleen Varcoe

Publications and source records attributed to Colleen Varcoe.

16 recordsLinked to original sources
PubMed2006

Doing participatory action research in a racist world.

This exploration of the racial power dynamics in a participatory action research project with women who had experienced intimate partner violence discusses the challenges inherent in doing participatory action with antiracist intent and offers suggestions for overcoming these challenges. To engage in this type of research, explicit commitment to the goals of an antiracist intent needs to be shared as widely as possible. Fostering such shared commitment demands that the social locations of all involved be interrogated continuously. Such interrogation, however, needs to be prefaced with understanding that individuals are not representative of particular power positions or social identities or locations and with critical attention to how language and social structures shape racism and other forms of dominance. Being inclusive must be understood as complex and the influence of diverse agendas and perspectives acknowledged and taken into account. In the face of such complexity, "success" in research may need redefinition.

Anthropology, Cultural↗
PubMed2006

The "hard spots" of family nursing: connecting across difference and diversity.

The focus of this discussion is how nurses might more effectively work within the "hard spots" of family nursing to connect across difference. Taking a pragmatic stance toward knowledge, the practical consequences of ideas and theories informing definitions of family and family nursing practice are examined. The authors propose that the provision of competent, ethical, and culturally safe nursing care could be greatly enhanced by a relational view. In particular it is suggested that understanding family as a relational experience, understanding nursing and culture as relational processes and conceptualizing difference as a basis for connection can provide a foundation for more effectively working across differences. Using this relational view the authors outline processes that have the potential to foster more equitable, just, and compassionate family nursing practice.

Adaptation, Psychological↗
PubMed2006

Critical cultural perspectives and health care involving Aboriginal peoples.

Despite a growing body of critical scholarship in nursing, the concept of culture continues to be applied in ways that diminish the significance of power relations and structural constraints on health and health care. In this paper, we take a critical look at how assumptions and ideas underpinning conceptualizations of culture and cultural sensitivity can influence nurses' perceptions of Aboriginal peoples and Aboriginal health. Drawing on examples from our research, we examine how popularized assumptions about culture can shape nurses' views of Aboriginal patients. These assumptions and perceptions require closer scrutiny because of their potential to influence nurses' practice with Aboriginal patients. Our specific aims are to: (a) consider some of the limitations of cultural sensitivity in relation to health care involving Aboriginal peoples; (b) explore how ideas about culture have the potential to become problematic in nursing practice with Aboriginal peoples; and (c) explore the relevance of a 'critical cultural approach' in extending our understanding of culture in relation to Aboriginal peoples' health. We discuss a critical cultural perspective as one way of broadening nurses' understandings about the complexities of culture and the many facets of culture that require critical consideration. In relation to Aboriginal health, this will require nurses to develop greater critical awareness of culture as a relational process, and as necessarily influenced by issues of racism, colonialism, historical circumstances, and the current political climate in which we live.

Cultural Characteristics↗
PubMed2006

Toward a safer moral climate.

The authors define moral climate in the context of health care as the implicit and explicit values that drive health-care delivery and shape the workplaces in which care is delivered. Over the past six years, their research has focused on describing the moral climates of nurses' workplaces and improving them. In this article, the authors argue that nurses in direct care delivery roles have the insights, expertise and interpersonal skills required to create a much safer moral climate for practice. To make this happen, nurses require opportunities for self-reflection and for true collaboration with their colleagues in management and administration and other health-care disciplines.

Attitude of Health Personnel↗
PubMed2005

The relevance of postcolonial theoretical perspectives to research in Aboriginal health.

The authors critically examine the relevance of postcolonial theoretical perspectives to nursing research in the area of Aboriginal health. They discuss key theoretical underpinnings of postcolonial theory, citing differences and commonalities in postcolonial theory, postcolonial indigenous thinking, and other forms of critical theory. Drawing on insights from Aboriginal scholars, they critique the relevance of postcolonial discourses to issues of concern to Aboriginal peoples, and the potential limitations of those discourses. They then consider the implications of conducting research that is informed by postcolonial perspectives. They argue that postcolonial perspectives provide direction for research with Aboriginal communities in 4 interrelated ways. These are focused on (a) issues of partnership and "voice" in the research process, (b) a commitment to engaging in praxis-oriented inquiry, (c) understanding how continuities from the past shape the present context of health and health care, and (d) the colonizing potential of research. The authors draw attention to the concept of cultural safety as an instrument for incorporating postcolonial perspectives into the realm of nursing. To illustrate applications of postcolonial theory, they give examples from recent research conducted in partnership with Aboriginal communities. Although postcolonial theories are relatively new in nursing discourses, they provide a powerful analytical framework for considering the legacy of the colonial past and the neocolonial present as the context in which health care is delivered.

Attitude to Health↗
PubMed2005

Turning around the intergenerational impact of residential schools on Aboriginal people: implications for health policy and practice.

This paper reports on the first wave of results from a study exploring the views and experiences of community-based stakeholders on improving care for pregnant and parenting Aboriginal people in Canada. The issue of poor access to prenatal care by Aboriginal women and families is viewed through a post-colonial lens within a historical and social location. This case study was guided by participatory research principles. Data were collected through exploratory interviews and small-group discussions. The sample comprised purposively selected community leaders, providers, and community members affiliated with 2 Aboriginal health-care organizations in a mainly rural region. Participants from all 3 stakeholder groups expressed the view that care should be based on an understanding of the priorities and experiences of the pregnant and parenting Aboriginal women and families themselves. Therefore the research question What are Aboriginal parents' views of the importance of pregnancy and parenting? was added to highlight the views and life experiences of Aboriginal parents. "Turning around" the intergenerational impact of residential schools was identified as pivotal to care. The results suggest that pregnancy and parenting must be understood as reflecting both the unique individual and family experiences of Aboriginal people and the intergenerational impact of residential schools as an instrument of collective violence and as a key factor in Aboriginal Canadians' inequitable health status and access to health services.

Acculturation↗
PubMed2004

Ethical practice in nursing: working the in-betweens.

BACKGROUND: While contemporary ethical theory is of tremendous value to nursing, the extent to which such theory has been informed by the concerns and practices of nurses has been limited. PURPOSE: With a view to complementing extant ethical theory, a study was undertaken to explore, from the perspective of nurses, the meaning of ethics and the enactment of ethical practice in nursing. DESIGN AND METHODS: Located in the interpretive/constructivist paradigm, using an emergent design, this inquiry employed focus groups to collect the data. Eighty-seven nurses from a wide range of practice settings were interviewed in 19 focus groups of three to nine nurses each. FINDINGS: The nurses described ethics in their practice as both a way of being and a process of enactment. They described drawing on a wide range of sources of moral knowledge in a dynamic process of developing awareness of themselves as moral agents. Enacting moral agency involved working in a shifting moral context, and working in-between their own values and those of the organizations in which they worked, in-between their own values and those of others, and in-between competing values and interests. CONCLUSIONS: Analysis of the experiences and concerns of the nurses offered new understanding of ethics in nursing and direction for the development of ethical theory pertinent to nursing practice.

Adult↗
PubMed2003

Reinterpretations across studies: an approach to meta-analysis.

The authors undertook a qualitative meta-analysis of their own studies to examine the context of health care and health care relationships. They "translated" selected concepts and metaphors from each study through those of the other studies, yielding new interpretations. In this article, they present their methods, discuss possible applications of this approach, and examine some issues that remain unresolved in the area of qualitative meta-analysis. They offer this approach, which produced broader perspectives than the individual studies afforded, as a promising way of synthesizing qualitative findings, providing a foundation for praxis, and influencing practice toward health and social justice.

Anthropology, Cultural↗
PubMed2003

Health care relationships in context: an analysis of three ethnographies.

A qualitative meta-analysis of three ethnographic studies conducted by the original investigators of those studies yielded new understandings of the dynamics of health care relationships in context. Through this analysis, the authors show that moral judgments and decision making in health care are highly relational and contextual. The use of power to compel health care providers and patients to comply with organizational practices is shown as fundamental to organizational functioning, and nurses participate in activities that often perpetuate conditions that contribute to their own moral distress. Furthermore, resistant actions often operate to sustain the practice patterns and ideologies being resisted. The authors call for an understanding of moral distress as relational and for collective strategies to counter practices that thwart ethical practice.

Anthropology, Cultural↗
PubMed2002

Navigating towards a moral horizon: a multisite qualitative study of ethical practice in nursing.

This paper reports the results of a qualitative study of nurses' ethical decision-making. Focus groups of nurses in diverse practice contexts were used as a means to explore the meaning of ethics and the enactment of ethical practice. The findings centre on the metaphor of a moral horizon--the horizon representing "the good" towards which the nurses were navigating. The findings suggest that currents within the moral climate of nurses' work significantly influence nurses' progress towards their moral horizon. All too often, the nurses found themselves navigating against a current characterized by the privileging of biomedicine and a corporate ethos. Conversely, a current of supportive colleagues as well as professional guidelines and standards and ethics education helped them to move towards their horizon. The implications for nursing practice and for our understanding of ethical decision-making are discussed.

Decision Making↗
PubMed2002

Strength in adversity: motherhood for women who have been battered.

Research into violence against women in intimate relationships has begun to uncover women's experiences of abuse. However, there is a paucity of research addressing women's mothering experiences in the context of partner abuse. The purpose of this study was to explore the experience of motherhood from the perspective of women who have been battered. The methodology used was interpretive description, a qualitative research approach in which the women's accounts could be conceptualized as constructed narratives. Five mothers who had been battered were interviewed twice. Analysis revealed that the abuse shaped their experiences of motherhood and that they faced complex mothering challenges, but that motherhood nevertheless acted as a buffer against the abuse and as a source of strength. The findings extend our understanding of the complexities of mothering in the context of abuse and provide direction for improving health-care support for mothers who have been abused.

Adaptation, Psychological↗
PubMedDate not supplied

Toward compassionate action: pragmatism and the inseparability of theory/practice.

Believing that the purpose of knowledge development and practice is compassionate action, in this article, we discuss how pragmatism can help us move toward that goal. Specifically, we show how pragmatic inquiry draws attention to the inseparability of practice/theory and the integral role practice experiences play in the ongoing development of theory. We demonstrate the utility of pragmatism to nursing by describing how we have explicitly approached theory development as a practical (and practice) activity of inquiry to attend to experiences of culture and diversity in family nursing.

Cultural Diversity↗
PubMedDate not supplied

Bringing safety and responsiveness into the forefront of care for pregnant and parenting aboriginal people.

Poor access to prenatal care for Aboriginal people is well documented, and is explicated as an unethical barrier to care resulting from colonial and neocolonial values, attitudes, and practices. A postcolonial standpoint, participatory research principles, and a case study design were used to investigate 2 Aboriginal organizations' experiences improving care for pregnant and parenting Aboriginal people. Data were collected through exploratory interviews and small-group discussions with purposefully selected community leaders, providers, and community members. The study found that safety in healthcare relationships and settings, and responsiveness to individuals' and families' unique experiences and capacities must be brought into the forefront of care. Results suggest that the intention of care must be situated within a broader view of colonizing relations to improve early access to, and relevance of, care during pregnancy and parenting for Aboriginal people.

Attitude of Health Personnel↗