目的:本研究旨在分析和量化15种基础和临床护理教科书中深色肤色(DST)图像/图形的表示,以了解当前护理文本中描绘的多样性程度。
背景:美国(美国)人口在种族和种族上变得越来越多样化。护理文献很少,研究,以及有关深色肤色(DST)患者常见皮肤评估的评估和早期识别的教育材料。在教学材料中使用DST图像的人的代表性不足表明,在教育资源中遗漏这些图像可能会在医疗保健提供者的教育和实践中引入偏见。
方法:选择15本流行的基础和临床护理教材进行分析。这些教科书中的所有照片图像和绘制的图形都是根据菲茨帕特里克的皮肤照型(FSP)量表编码的,将肤色分类为(a)“轻”或Fitzpatrick量表I或II,(b)“中等”或Fitzpatrick量表III或IV,和(c)“黑暗”或Fitzpatrick刻度V或VI。在分析之前为数据收集者提供了培训,以确定良好的评分者间可靠性(对于浅肤色,科恩的kappa=0.960,Cohen\'skappa=0.899,适用于中等肤色,和Cohen\的kappa=0.913的深色肤色)。
结果:在15个基础和临床护理教科书中完成了14,192张照片图像和描绘肤色的绘制图形的分析。12.3%的照片图像和2.4%的绘制图形描绘了深色肤色,相比之下,这些教科书中60.9%的照片图像和82.8%的绘制图形显示浅色肤色。
结论:护理教科书夸大了浅肤色,而低估了深色肤色。虽然美国人口的大致种族分布是59.3%的非西班牙裔白人,13.6%黑人/非洲裔美国人,和26.6%的有色人种,肤色的图像和图形代表了68%的光,15%培养基,和9.4%的黑暗。
结论:所有医疗保健提供者都被期望并要求为日益多样化的人群提供称职的临床护理。对于教学,DST的更多视觉表示和在黑暗中期望的比较图像,中等,浅肤色可以帮助改善知识不足和增加健康公平。
OBJECTIVE: This study aimed to analyze and quantify the representation of dark skin tones (DST) images/
graphics across fifteen foundational and clinical nursing textbooks to understand the degree of portrayed diversity in current nursing texts.
BACKGROUND: The United States (U.S.) population is becoming more ethnically and racially diverse. There is a scarcity of nursing literature, studies, and educational materials on the assessment and early recognition of common skin assessment in patients with dark skin tones (DST). The underrepresentation of people with DST images in didactic material suggests that omissions of these images in educational resources may introduce bias in health care provider education and practice.
METHODS: Fifteen popular foundational and clinical nursing textbooks were selected and analyzed. All the photo images and drawn
graphics in these textbooks were coded according to Fitzpatrick\'s skin phototype (FSP) scale, which categorizes skin tone as (a) \"Light\" or Fitzpatrick scale I or II, (b) \"Medium\" or Fitzpatrick scale III or IV, and (c) \"Dark\" or Fitzpatrick scale V or VI. The training was provided for data collectors before analysis to ascertain good inter-rater reliability (Cohen\'s kappa = 0.960 for light skin tone, Cohen\'s kappa = 0.899 for medium skin tone, and Cohen\'s kappa = 0.913 for dark skin tone).
RESULTS: Analysis of 14,192 photo images and drawn
graphics depicting skin tone was completed across 15 foundational and clinical nursing textbooks. 12.3 % of photo images and 2.4 % of drawn
graphics depicted dark skin tones, compared to 60.9 % of photo images and 82.8 % of drawn
graphics that displayed light skin tones in these textbooks.
CONCLUSIONS: Nursing textbooks overrepresent light skin tones and underrepresent dark skin tones. While the approximate racial distribution of the U.S. population is 59.3 % non-Hispanic-White, 13.6 % Black/African American, and 26.6 % Person of Color, the images and graphics of skin tones represented 68 % light, 15 % medium, and 9.4 % dark.
CONCLUSIONS: All healthcare providers are expected and required to deliver competent clinical care to an increasingly diverse population. For teaching-learning, more visual representations of DST and comparative images between what to expect in dark, medium, and light skin tones can help improve knowledge deficits and increase health equity.