Social Literacy: Nurses' Contribution Toward the Co-Production of Self-Management.

We share findings from a larger ethnographic study of two urban complex care management programs in the Western United States. The data presented stem from in-depth interviews conducted with 17 complex care management RNs and participant observations of home visits. We advance the concept of social literacy as a nursing attribute that comprises an RN’s recognition and responses to the varied types of hinderances to self-management with which patients must contend in their lived environment. It is through social literacy that complex care management RNs reconceptualize and understand health literacy to be a product born out of the social circumstances in which patients live and the stratified nature of the health care systems that provide them care. Social literacy provides a broader framework for health literacy—one that is situated within the patient’s social context through which complex care management RNs must navigate for self-management goals to be achieved.

我们分享了对美国西部两个城市综合护理管理项目进行的一项更广泛的民族志研究的结果。所呈现的数据来自对17名综合护理管理注册护士的深度访谈以及对家访的参与式观察。我们提出社会素养这一护理属性的概念，它包括注册护士对患者在其生活环境中必须应对的各种自我管理障碍的认识和反应。正是通过社会素养，综合护理管理注册护士重新概念化并理解健康素养是患者所生活的社会环境以及为其提供护理的医疗保健系统的分层性质所产生的产物。社会素养为健康素养提供了一个更广泛的框架——一个位于患者社会背景内的框架，综合护理管理注册护士必须通过这个框架来实现自我管理目标。