Vers des stratégies de plaidoyer structurel : une étude sur le processus de plaidoyer chez les infirmières en santé communautaire
Bibliographic record
Abstract
In order to reduce social inequities in health, nurses need to move from patient advocacy to policy advocacy. Literature reports many barriers when nurses try to address the structural level of policy advocacy. Very little empirical research exists to show how nurses respond to these barriers and the resulting impact on the effectiveness of policy advocacy. This study characterized the types and the process of advocacy practiced by community health nurses. A collaborative ethnography with 21 nurses showed that their policy advocacy was often dismissed, leading to negative consequences such as less policy advocacy attempts, changes in their clinical evaluation with patients and personal experiences of moral distress. We argue that structural change will only occur when collective advocacy will be supported by organizations, therefore reducing inequities that affect both community health and working conditions of nurses. Afin de réduire les iniquités sociales de santé, les infirmières doivent dépasser le plaidoyer axé sur les individus en investissant des stratégies de plaidoyer ciblant les structures et les politiques. Dans cet article, nous soutenons que de ne pas exercer de plaidoyer structurel peut amener des conséquences néfastes pour les infirmières elles-mêmes et les communautés qu’elles desservent. Cette étude caractérise les types et le processus de plaidoyer exercés par les infirmières en santé communautaire. Une ethnographie collaborative avec 21 infirmières montre que leurs tentatives de plaidoyer structurel étaient ignorées, décourageant les tentatives futures, entraînant des changements dans leur évaluation clinique et des expériences de détresse morale. Nous argumentons que le changement structurel surviendra seulement lorsque les stratégies de plaidoyer seront collectivisées et soutenues par les organisations de santé, réduisant ainsi les iniquités affectant à la fois la santé communautaire et les conditions de travail des infirmières.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.021 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.005 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".