The paper challenges the hegemonic discourse of reflection in nursing. It argues that new conceptualizations of reflection that acknowledge and value a diversity of perspectives, contexts and dimensions are needed.

This review critically examined the barriers to breast and cervical cancer screening services for women with physical disability and discussed ways forward to change practice. When compared to the rest of the community, women with disability were less likely to use preventive health screening services for multiple reasons. Moreover, women with disability live longer than in previous years, and as age is linked to an increased risk of developing cancer, it is imperative that the barriers to screening for these women become a focus of discussion. We designed an integrative literature review to investigate this. Multiple databases were systematically searched for literature published between 2001 and 2013. Search terms used were a combination (AND/OR) of key terms. After excluding duplicates and articles not meeting the eligibility criteria, twenty-five articles were systematically and critically reviewed. Sociodemographic factors were associated with less access to preventive health screening for women with disability. The literature reviewed indicated that this was complicated further by three prominent barriers: health insurance, health care workers, and physical barriers. Sociodemographic, health insurance, health workers, and physical barriers impair access for disabled women to breast and cervical cancer screening, which are vital measures in the timely detection of breast and cervical cancers and preventable morbidity and mortality. Measures are needed to address these limiting factors for women with disability so that they can be active participants in health care, rather than being marginalized because of their disability.

By exploring experiences of women with physical disabilities of breast cancer screening, nurses and other health-care professionals can use this to develop and implement optimal approaches, such as collaborative models of care which empower women with disabilities.

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The characterization of specialization in nursing varies across different time periods, contexts, persons, groups, and institutions. Therefore, it may be viewed as a discourse. The expression of this discourse is subject to contextual influences and social interests. For example, its perceived congruence or antagonism to other major discourses, such as specialization, medicine, and nursing, will impact on its expression and legitimization. This article explores the discourse of specialization in nursing, especially as it is expressed in the Australian and North American context, and focuses on the power and knowledge issues that relate to, and constitute, the discourse.