Tangled pasts, healthier futures: Nursing strategies to improve American Indian/Alaska Native health equity.

American Indian/Alaska Native (AI/AN) populations in the United States continue to experience overall health inequity, despite significant improvement in health status for nearly all other racial-ethnic groups over the past 30 years. Nurses comprise the bulk of healthcare providers in the U.S. and are in an optimal position to improve AI/AN health by transforming both nursing education and practice. This potential is dependent, however, on nurses' ability to recognize the distinct historical and political conditions through which AI/AN health inequities have been produced and sustained. Nurse providers, educators, and leaders must in turn recognize how the sustained conditions of marginalization and expropriation that underpin current AI/AN health inequities continue to shape contemporary AI/AN health outcomes. This manuscript builds upon the extant literature of AI/AN historical health policy and utilizes decolonial theorizations of nursing and a cultural safety framework to propose a series of immediately actionable steps for nursing intervention into AI/AN health inequity. Ultimately, we suggest that it is crucial for nurses to collaborate with AI/AN individuals and communities across educational and clinical settings to further refine these approaches in alignment with the disciplinary obligation of promoting social justice within healthcare.

Looking Inward: Philosophical and Methodological Perspectives on Phenomenological Self-Reflection.

Engaging in early and ongoing self-reflection during interpretive phenomenological research is critical for ensuring trustworthiness or rigor. However, the lack of guidelines and clarity about the role of self-reflection in this methodology creates both theoretical and procedural confusion. The purpose of this article is to describe key philosophical underpinnings, characteristics, and hallmarks of the process of self-reflection in interpretive phenomenological investigation and to provide a list of guidelines that facilitate this process. Excerpts from an interpretive phenomenological study are used to illustrate characteristics of quality self-reflection. The guidelines are intended to be particularly beneficial for novice researchers who may find self-reflective writing to be daunting and unclear. Facilitating use of self-reflection may strengthen both the interpretive phenomenological body of work as well as that of all qualitative research.