Posts from the ‘Journal Information’ Category

Call for ANS Editor

The time has arrived for me to “retire” from my role as Editor of ANS, and to engage a nurse scholar to assume this role starting in January 2023! The Call for ANS Editor is now posted ! Download PDF.

Embracing Difference Between Theoretical and Practical Knowledge

The current featured article in ANS is titled “Learning in the Third Room—A Way to Develop Praxis by Embracing Differences Between Theoretical and Practical Knowledge” authored by Elisabeth Dahlborg, PhD. You can access the article at no charge while it is featured, and we would be delighted to know your comments and ideas about this article in the comments below! Here is the abstract for the article:

Contradictions between theory and practice are well known in nursing. To this end, this article discusses a learning strategy that might facilitate the capture of the dialectic between theory and practice, equally valid components of a nurse’s competence, giving the 2 forms of knowledge equal relevance. Using a virtual platform (ie, the “third room”) decreases the power order between different forms of knowledge. Nurses, students, and teachers all contribute to a seminar using nonhierarchical structures and concepts to capture the knowledge that enables to learn the praxis of nursing. Key words: discourses, nursing education, philosophy, power order, virtual seminar, work integrated learning.

Source

Black Women’s Strength in Living with Chronic Pain

The current featured article for ANS is titled “’Be Strong My Sista’ – Sentiments of Strength From Black Women With Chronic Pain Living in the Deep South” authored by Lakeshia Cousin, PhD, APRN, AGPCNP-BC; Versie Johnson-Mallard, PhD, WHNP-BC, FAANP, FAAN; and Staja Q. Booker, PhD, RN. We welcome you to download this article at no cost while it is featured, and share your comments below in the ‘comments’ section. Here is a message that co-author Staja Booker shared about this work:

After meeting a Black woman on vacation who voluntarily shared her raw experience of living chronic
pain, it was clear that this conversation was a true representation of how many Black women feel living
with chronic pain. But more importantly, we were convinced that the story of aging Black women with
chronic pain had to be shared, but from a perspective that could (1) adequately explain the cultural
context of coping because of the gendered racial socialization that plagues us throughout our lives and
(2) realistically educate healthcare providers about Black women’s nuanced experience of living with
pain and seeking pain care in an unjust healthcare system.

The traditional connotation and expectations of “strength” have been associated with women who identify as Black for many decades. The Strong Black Woman (and its corollary The Superwoman Schema) is a unique cultural phenomenon with both paradoxically endearing positive and enduring negative characteristics. While evidence of the Strong Black Woman was robust in our sample, we also identified that women with a lived experience of chronic pain also submitted to God for strength and code-switched to counter the weaponization, misunderstanding, and implicit bias of being perceived as “strong” in healthcare encounters.

Research now and in the future must leverage the inner strength of the “sisterhood” and spirituality as cultural assets to empower Black communities to effectively manage chronic pain. We hope this work will lead to a greater appreciation of narrative inquiry of underrepresented individuals as rigorous scientific evidence that can lead to innovative and equitable health solutions that transform lives. “There is a kind of strength that is almost frightening in Black women. It’s as if a steel rod runs right through the head
down to the feet” (Dr. Maya Angelou).

An Analysis and Evaluation of the Theory of Planned Behavior Using Fawcett and DeSanto-Madeya’s Framework

The current featured ANS article is titled “An Analysis and Evaluation of the Theory of Planned Behavior Using Fawcett and DeSanto-Madeya’s Framework” authored by Sungwon Park, MSN, RN and Hyewon Shin, PhD, RN. Download your free copy of this manuscript while it is featured and share your comments here! Sungwon Park shared this message about this work for ANS readers:

The Theory of Planned Behavior (TPB) originally developed by Ajzen has long been a useful conceptual framework for my research, including my master’s thesis study and my projects early in my doctoral program. During the first year of my PhD program, I decided to analyze and evaluate this theory in a nursing theory class, and with the assistance of a colleague, I eventually developed this assignment into a publication in ANS.

Despite my generally positive evaluation of the TPB, I acknowledge that its use in nursing research and practice has been somewhat controversial, depending on individual researchers’ perspectives. I remember that I was excited to discuss how theory could advance nursing in my class, but theory testing as well as application of theories borrowed from other disciplines were debated among my classmates in 2019. At that time, I agreed that use of a borrowed theory can be beneficial for capturing nursing phenomena and for contributing to the development of nursing.

To comprehensively analyze a nursing theory, the author’s intentions in disseminating the theory need to be systematically examined, as do later theory revisions. Our manuscript analyzed and evaluated the TPB, which originated in the social psychology field, using Fawcett and DeSanto-Madeya’s framework, which was intended to be applied to nursing theory. A theory borrowed from another discipline will not fully reflect the values and concerns of nursing. However, rather than simply dismissing theories such as the TPB from consideration for the nursing discipline, I contend that different criteria should be employed for evaluation of borrowed theories.

In our case, we could not fully apply some of the elements of Fawcett and DeSanto-Madeya’s framework in our paper. For example, the TPB does not fully incorporate the nursing metaparadigm or include philosophical statements about nursing. Consequently, our paper recommended consideration of additional criteria for evaluation of borrowed theories. I believe that among other potential benefits, use of borrowed theories in nursing raises important questions such as “what are nursing phenomena?” and “what is the definition of nursing?”

I favor the definition of holistic nursing care, and a prerequisite for holistic care is to understand the human being and everything that surrounds the human experience. Consequently, describing the scope of holistic care is extremely challenging, but the new perspectives offered by a borrowed theory can facilitate understanding of such care.

Considering that all efforts from theory development and testing to application in various practice situations contribute to the advancement of nursing, what is your opinion of using the TPB for nursing advancement?

Properties of Situation Specific Theories

This blog is contributed by Eun-Ok Im, PhD, MPH, RN, CNS, FAAN. Dr. Im is author of the current ANS featured article titled Properties of Situation-Specific Theories and Neo-pragmatism (download at no cost while the article is featured). Here Dr. Im describes her journey in the evolution and development of situation-specific theory.

This article was initiated from a PhD theory class that I taught about 4 years ago.  The class was discussing the philosophical bases of situation specific theories that I wrote more than 20 years ago.  When I wrote the first paper on situation specific theories in the late 1990s, the main focus on philosophical bases of nursing was given to social critical theories, feminism, and hermeneutics, especially on the west coast of the U.S.  Most of my colleagues admired these three specific philosophical bases for the future direction of philosophical bases for nursing discipline, and we were deeply impressed by the qualitative research paradigms at that time.  Most of us were critical on positivism and its great influences on biomedical science in general, and we thought nursing approaches should be different from the mainstream biomedical approaches. Due to this great influence of the time, my first paper on situation specific theories focused on these philosophical bases as the philosophical bases of situation specific theories. However, honestly speaking, even at that time, I was thinking something was missing in the list of philosophical bases for situation specific theories.

 Going back to the class that I taught about 4 years ago, the students in the class asked me how these specific philosophical bases were chosen as the philosophical bases of situation specific theories, and I mentioned about the background of the time when the paper was written.  Then, I suddenly thought I’d better revisit the philosophical bases of situation specific theories because I myself had also been wondering if I missed something in the original paper. Then, in a subsequent literature review, neo-pragmatism was identified as an additional philosophical basis for situation specific theories.  Indeed, looking back on it, the raison d’être of situation specific theories was highly practical.  Nursing needs a theoretical basis that could be easily adopted in nursing practice and research with high specificity. Yet, I was not sure if neo-pragmatism actually fits with the properties of situation specific theories in the literature. Thus, a systematic integrated literature review was firstly conducted to identify the properties of situation specific theories in the literature and examined the properties from a neo-pragmatic perspective.

The literature review and subsequent examination of the properties of situation specific theories using a neo-pragmatic perspective revealed that the properties of situation specific theories that I found in the literature review were congruent with the philosophical stance of neo-pragmatism. For instance, neo-pragmatism’s declination of the universal truth and representationalism and its definition of truth were consistent with situation specific theories’ support for diversities and multiplicities of truths. Also, neo-pragmatism’s support for multiple truths and objection on the representationalism supports the necessity of different conceptualization and theorization based on contextual understanding, which was another property of situation specific theories that I found from the recent literature review.  Despite this paper on the updated philosophical bases of situation specific theories, I still feel like that something is missing in the paper.  Maybe, about 10 years later, I would look back on this paper, reflect on what was missing, and decide to do another review on the philosophical bases of situation specific theories. Continuous reflection and repeated revisits on our own thoughts may be essential for further development of our theoretical bases.

Considering drastically changing nursing environments with high complexities, I think the necessity of situation specific theories in nursing would keep increasing. The beauty of situation specific theories would be with their philosophical plurality, through which diversities and complexities in nursing could be addressed with high specificity and contextual understanding. Indeed, I am getting more and more inquiries on situation specific theories from nursing scholars across the globe, and nursing is definitely recognizing the importance of considerations on diversities in nursing phenomenon. Neo-pragmatism could provide an essential philosophical basis for our theoretical bases, especially situation specific theories that aim to address diversities and complexities in nursing phenomenon and to be easily applied to nursing research and practice.

The below pictures show the evolution of flowers blooming at my backyard, which would reflect my feelings about situation specific theories. During the past decades, situation specific theories have grown as a new type of nursing theories by the level of abstraction with an increasing number of situation specific theories that nursing scholars have developed.  Situation specific theories started from one theory that I developed under the mentorship of my life-time mentor, Dr. Afaf Meleis.  Then, a few situation specific theories began to emerge in the literature.  Then, now, we are witnessing an increasing number of situation specific theories that nursing scholars are developing. However, at the same time, many aspects of situation specific theories are not fully unfolded, and the refinement of situation specific theories as a theoretical basis of nursing needs to be continuously done. At this moment of blooming, I think this paper would be a good addition to our thoughts on situation specific theories. Again, I think we need to remember the practical reason we started situation specific theories; we need a theoretical basis that could be directly linked to nursing practice and research. What works for nursing is what nursing needs.  Before finishing this blog, I want to give my special thanks to Dr. Chinn for her continuous strong support for situation specific theories, and also want to say how much I appreciate this thoughtful opportunity to reflect on why I started this article and to have a dialogue with my respected colleagues. Have a great start of beautiful fall~

Impulsivity: A central concept into human behaviors

The current ANS featured article is titled “A Review of the Concept of Impulsivity: An evolutionary perspective,” authored by Mohammed M. Al-Hammouri, Ph.D., IBA, CHPE, RN; Jehad Rababah, PhD, RN; and Celeste Shawler, PhD, PMHCNS-BC. While the article is featured, you can download and read it at no cost! Here is a message about this work from the primary author, Mohammed Al-Hammouri:

As a certified behavior analyst and an associate professor at Jordan University of Science and technology-Faculty of Nursing,  I believe that nursing is privileged to deal with complex human behavior. Thus, my current work is to bring the attention of the nursing community to an important concept relevant to human behaviors. Impulsivity is a central concept of various behavior modification theories and models such as Hot/Cool System model and the Acceptance and Commitment Therapy (ACT). These theories and models were extensively used for positive behavioral change in other fields. However, they were overlooked by the nursing scientific community despite their relevance to health-related practices. I feel committed to bringing such interesting and valuable concepts to expand the literature and scientific knowledge in behavior modification. 

The concept is readily applicable to the nursing practice in all settings and human behavior phenomena. I guarantee that reading the article will be an eye-opener for nursing researchers and practitioners for innovative and creative ideas. During the review process of our article, the reviewer themselves proposed novel applications of the concept within the field of nursing. Our concept analysis paper offers a practical definition of the concept of impulsivity in relevance to the nursing practice. We hope that our article will be an important step toward the advent of nursing research in this area.

Family Satisfaction in Adult Intensive Care

The current ANS featured article is titled “Family Satisfaction in the Adult Intensive Care Unit: A Concept Analysis” authored by Cristobal Padilla Fortunatti, MSN; Joseph P. De Santis, PhD, APRN, ACRN, FAAN and Cindy L. Munro, PhD, RN, ANP-BC, FAAN, FAANP, FAAAS. The article is available for download at no cost while it is featured, and we welcome you comments here about this work. Here is the message for ANS readers from the authors about this work:

            In the context of family-centered care, the concept of family satisfaction has received increased attention as a construct that attempts to encompass the evaluation of salient experiences by family members while navigating the critical illness of a loved one. This concept analysis provides an initial framework for family satisfaction in the adult ICUs that includes attributes such as adequate communication with health care providers, emotional support, closeness to the patient, comforting environment, decision-making involvement, and nursing care of the patient. In light of this work, some of the challenges that remain in the understanding, conceptualization, and measurement of family satisfaction in the ICU are:

• Studies on family satisfaction in the ICU studies only assessed a single-family member rather than the entire family. The use of the concept of “family satisfaction” may incorrectly suggest that the satisfaction of all the members of the family is measured.
• Fulfilling ICU family members´ needs and expectations fall on healthcare providers. ICU’s stressful nature, high workload, and lack of communication skills training may prevent them, particularly nurses, to have more frequent and meaningful interactions with family members.
• Current family satisfaction in the ICU questionnaires does not involve the evaluation of the expectations regarding the items/topics measured. Thus, higher family satisfaction levels may be the reflection of lower expectations and conversely, lower family satisfaction may be attributed to higher expectations.
• Within family satisfaction in the ICU literature, the use of the concept “dissatisfaction” or to classify family members as satisfied v/s dissatisfied based on arbitrary cut-off scores may not have enough theoretical support. Furthermore, it oversimplifies the complex nature of family satisfaction, leading to an inaccurate picture of the quality of care delivered to ICU family members.
• Incentives for healthcare institutions to improve family satisfaction in the ICU are almost non-existent. The high costs of the ICUs and the absence of incentives to support and improve the experiences of family members in current reimbursement schemes represent a significant barrier to the improvement of family satisfaction.

Identifying Coping Mechanisms for Veterans Suffering Moral Injury

The current ANS featured article is titled “Moral Injury in Veterans: Application of the Roy Adaptation Model to Improve Coping” authored by Michael Cox, DNP, MHA, RN; Vonda Skjolsvik, DNP, RN, CHSE; Becki Rathfon, MS, CCMHC; and Ellen Buckner, PhD, RN, CNE, AE. We invite you to download this article at no cost while it is featured, and return here to leave your comments and questions! Dr. Cox has shared his personal reflections about this article for ANS readers:

The concept that one’s morally transgressive behavior may result in lasting harm to the individual’s well-being is thoroughly documented in historical literature, as ancient cultures struggled to explain and cope with warrior reintegration. In more modern times, Civil War soldiers were diagnosed with “soldiers’ heart” or profound melancholy. In WWI, the condition was described as “shell shock.” WWII introduced the term “battle fatigue,” and the Vietnam Veterans were diagnosed with Post Traumatic Stress Disorder (PTSD). However, mental health professionals are beginning to understand that these terms do not fully capture war’s moral and ethical implications. As a result, they fail to fully capture the soldiers’ challenges as they transition into civil society.

Shortly after the start of the wars in Afghanistan and Iraq, my military colleagues and I began to recognize the harmful effects of deployment. The concerns about our comrades’ psychological well-being escalated as current treatment modalities proved to be ineffective. The inability to explain our observations prompted us to refer to these soldiers “as broken.” Currently, 22 veterans commit suicide each day in the United States, and the rate of suicide among veterans 18 to 34 years of age has risen 80% compared to the civilian population.

Acknowledgment that the suffering of these soldiers does not resolve upon exiting the military; prompted our team to explore the concept of moral injury (MI) in relation to veteran suicide. MI is the damage done to one’s conscience or moral compass when the person perpetrates, witnesses, or fails to prevent acts that transgress one’s own moral beliefs, values, or ethical code of conduct. Our study describes the struggles veterans face as they try to reassemble their lives post-war.

Breaching moral boundaries has created dissonance between the veterans’ conscience and subconscious thoughts regarding right and wrong, resetting the individual’s fundamental identity and impeding their ability to develop relationships and maintain group identity. This inner struggle helps explain the previously determined feelings of betrayal, guilt, and irredeemablity frequently seen in veterans with MI. Unfortunately, I feel like I am reliving the past as the trauma experienced by our health care providers due to Covid-19 is manifesting in the same manner that we witnessed in those returning from deployment. It creates an environment where clinicians, similar to our veterans, struggle to reconcile the incongruence between their perceived ethical standards and those they are witnessing daily. Exploring the implications of this moral discord may be necessary to avert a similar crisis in our healthcare professionals.