Award Date

5-15-2025

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Committee Member

Andrew Reyes

Second Committee Member

Clariana Ramos de Oliveira

Third Committee Member

Mary Bondmass

Fourth Committee Member

Elizabeth Lawrence

Number of Pages

212

Abstract

Problem & Significance: Research has demonstrated that individual health outcomes depend highly on social determinants of health (SDOH). Further, COVID-19 highlighted the need for healthcare professionals to be knowledgeable about SDOH. As such, the nursing profession has been called to address SDOH in all practice areas. Nursing faculty are called to prepare nursing students to enter the profession ready to tackle the needs of the patient populations they will encounter. Integrating SDOH in nursing education prepares students to provide holistic, patient-centered care, enhancing patient trust and satisfaction. It also equips them to develop targeted interventions that address SDOH, ultimately improving health outcomes. However, nursing programs have been slow to integrate SDOH into their curricula. Review of Literature: Previous research on curricular change has identified faculty buy-in as the most significant barrier, with resistance stemming from a lack of motivation, understanding, time, knowledge, or confidence in teaching the new content. Studies on SDOH in nursing education have primarily focused on teaching strategies and faculty perceptions but have not examined the role of institutional, academic, and faculty culture in shaping decisions to integrate SDOH concepts. Given the potential influence of these cultural factors, a study exploring how the nursing faculty culture impacts the integration of SDOH is needed to address existing gaps and support more effective curricular change. To date, no studies have examined how these cultures influence faculty decisions toward integrating SDOH. Methodology: This qualitative, focused ethnographic study used Leininger’s Cultural Care Diversity and Universality Theory to investigate the nursing faculty’s values, beliefs, and practices within a school of nursing to understand facilitators and barriers to curricular adoption of SDOH content. Sixteen undergraduate nursing faculty members from a university in the southwestern United States participated in this study. Data collection methods included in-depth interviews, observations in classrooms, clinical learning environments, and curriculum development meetings. Additionally, an in-depth review of pertinent documents was conducted. Data analysis procedures were performed based on Leininger's four phases of data analysis. The interpretation of data was conducted with a focus on the social structure factors, identified by Leininger, that influenced the development of faculty decisions and actions within the school of nursing. Results: The data analysis identified three major themes influencing the integration of SDOH into the curriculum: Experiencing Change, The Value of Time, and Perceiving the Significance of the SDOH. The first theme, Experiencing Change, highlighted how faculty navigated multiple institutional shifts, including curricular revisions and leadership changes, which either facilitated or hindered SDOH integration. The second theme, The Value of Time, emerged as a significant barrier, with faculty expressing insufficient time to incorporate SDOH content effectively. The third theme, Perceiving the Significance of the SDOH, demonstrated that faculty with personal or professional experiences with SDOH were more intentional and confident in integrating SDOH into their teaching. These themes, influenced by cultural and social structure factors, shaped faculty decisions and actions regarding the integration of SDOH within nursing education. The findings from this focused ethnographic study had major implications for nursing education, nursing faculty, and administrators within schools of nursing.

Keywords

Curriculum; Nursing Education; Nursing Faculty; Social Determinants of Health

Disciplines

Nursing

File Format

pdf

File Size

3100 KB

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

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Available for download on Wednesday, May 15, 2030


Included in

Nursing Commons

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