Posts from the ‘Journal Information’ Category

Unitary Appreciative Nursing Praxis

We are delighted to introduce a new feature in ANS called “Visions: Scholarship of Rogerian Nursing Science. This new section maintains the long tradition of the journal that has been produced by the Society for Rogerian Science since 1993. The first article in this section is titled “Unitary Appreciative Nursing Praxis” authored by W. Richard Cowling III, PhD, RN, AHN-BC, SGAHN, ANEF, FAAN, and it is available for no-cost download while it is featured. Here is a message from Dr. Cowling giving some background about his work, and what inspires him in his research and practice!

Last week at the Virtual Nursing Theory Week conference, during a dialogue, Jacqui Fawcett asked a question along the lines of “how do you know its nursing?”  This was in response to several participants describing what nursing was like for them and why they thought it was unique.  This made me think of my first encounters with nursing as a young 15-year-old boy who was doing volunteer work in a local hospital.  When I experienced what nurses were doing with and for patients, I fell in love with that work.  This was in 1964.  In 1979 I found myself in a course on nursing science taught by Martha Rogers, and it was then that for the first time I learned about a conceptual system that helped me make sense of nursing as I experienced and loved it.  Unitary appreciative nursing praxis (Cowling, 2023) is a culmination of the journey I have been on since those days in that class.  Unitary appreciative nursing is the embodiment of the science of unitary human beings as a praxis as I have grown to understand and know if from inquiry projects with women in despair who experienced various forms of abuse as children.  The article is an attempt to clarify the nature of a praxis of nursing that has the wholeness of human beings and their worlds as the central focus and uses patterning of that wholeness as a reference point for participating knowingly in illuminating and unlocking the emancipatory strivings of people in health care.  It offers a framework and process for the realization of ideals set forth in the Nursing Manifesto that evoked the creation of nursemanifest.com. The last paragraph of the article expresses my deepest desires for nursing and its potential for the betterment of humankind which was the intent of the science of unitary human beings:

“If ever there was a need for innovative praxis models, it is now. The people, families, groups, and communities we care for need models that demonstrate how nurses can more effectively meet anger with compassion, loneliness with love, fragmentation with wholeness, and despair with aspiration. Unitary appreciative nursing is not a remedy for all of these, but it provides the possibility for nurses and people they care for to mutually engage in this journey borne out of fear and desperation in our daily personal and societal lives using appreciation as a means for recognizing and embracing the wholeness and oneness available to us all” (p. 115).

Increase, Protect, and Support: Illuminating the Contributions of African American Nurse Scientists

Featured currently in ANS is the article title “African American Perceptions ofParticipating in Health Research Despite Historical Mistrust” authored by Marie Campbell Statler, PhD, RN; Barbra Mann Wall, PhD, RN, FAAN; Jeanita W. Richardson, PhD; Randy A. Jones, PhD, RN, FAAN; and Susan Kools, PhD, RN, FAAN. Here Dr. Statler describes her program of research and the challenges faced by African American Nurse Scientists:

‘If I can help someone on the journey, then my living will not be in vain’: African American perceptions of participating in health research despite historical mistrust. 

My program of research centers around developing participant-centered and community-based research strategies that eradicates health disparities in the hardest hit African American communities. The intersectionality between my lived Black experience and my work as a clinical research nurse led to an interest in understanding the motivational behaviors and interactions of African Americans’ participation in health research despite a legacy of research mistreatment. As a former clinical nurse researcher, I understood research as a promising approach to advancing health and its connections to eliminating health disparities. Likewise, I understood the historical undertones that profoundly impacted the health of Black communities coupled with the shared cultural experiences with my Black patients. Therefore, with amazing coauthors and mentors Dr. Susan Kools, Dr. Barbra Mann Wall, Dr. Jeanita W. Richardson, Dr. Randy A. Jones and the gracious contributions of the African American Research Participants, this study was explored. 

Qualitative description methodological approach allowed for an essential historical exploration, contextualization of relationships, and rich descriptions of new areas that motivate African American Research Participants (AARP) to research participation through a critical lens (Crenshaw et al., 1995; Green & Thorogood, 2018; Neergaard, Olesen, Andersen & Sondergaard, 2009; Sandelowski, 2000). Research highlighting the barriers to research participation is abundant, therefore, as part of a larger study that included thirty-three research participants, this study captured the perceptions of nineteen AARP that participate in health research.

Through researcher reflexivity and a deep historical reexamination, this study explored the perspectives of AARP that facilitate participation in research and provided a rich description of motivational factors, behaviors, and interactions of AARP that impact their participation in health research despite the legacy of justifiable distrust of research. In addition, utilizing community- engagement research strategies, the researcher collaborated with the Michigan Center for Urban African American Aging Research (MCUAAAR), and the Healthier Black Elders Center (HBEC) for participant recruitment and community research approval. Furthermore, this study was supported by a grant from the National Institutes of Health, 5P30 AG015281, and the Michigan Center for Urban African American Aging Research. More importantly, the findings from this study were disseminated back to the community. 

This article offers several AARP experiences with research participation, their narratives revealed salient motivational factors including altruism towards improving population health including the health of the African American community. Furthermore, the study revealed the significance behind participants feeling respected and valued by their researchers and their experiences with race concordance in the researcher-participant relationship. Conversely, when participants were asked about their research experiences, several AARP expounded on experiences of mistreatment in health care settings which led several participants to seek Black health care providers and alternative forms of health information.

This is an area that warrants a deeper understanding and developing strategies to improve patient-provider relationships. Despite a historical legacy, the participants in this study were not deterred from participating in research and balanced their decision making with healthy skepticism. Just as important, this article offers the counterstories from AARP as to why they participate in health research and offers strategies to improve participant-researcher encounters. Therefore, it is essential that African Americans that choose to participate in research are treated as experts and collaborators in joint efforts to improve population health through inclusive research.  

Crenshaw K., Gotanda N., Peller, G., & Thomas, K. (Ed.) (1995). Critical Race Theory: The Key 

Writings That Formed the Movement. New York, NY: The New Press. 

Green, J. & Thorogood, N. (2018). Qualitative Methods for Health Research: 4th Edition. Thousand Oaks, CA. SAGE. 

Neergaard, M. A, Olesen, F., Andersen, R. S., & Sondergaard, J. (2009). Qualitative description: Poor cousin of qualitative health research? BMC-Medical Research methodology, 9, 52-56. doi: 10.1186/1471-2288-9-52 

Sandelowski M. Whatever happened to qualitative description? Res Nurs Health. 2000;23(4):334- 340. doi:10.1002/1098-240x (200008)23:4334::aidnur93.0.co;2-g 

LGBTQI+ Migrants’ Experiences with Nurses in Canada

We are now featuring the ANS article titled ““Ally Theater Is a Problem:” LGBTQI+ Migrants’ Experiences With Nurses in Canada” authored by Roya Haghiri-Vijeh, PhD, RN, BN, MN, and it is available for free download while it is featured! Here is Dr. Haghiri-Vijeh’s description of her work that she shared for ANS readers!

My research and professional journey with a focus on needs of migrant 2S/LGBTQI+ communities started over a decade ago. 2S/LGBTQI+ stands for Two-spirit, lesbian, gay, bisexual, trans, queer, intersect and the “+” is inclusive of diverse sexual orientations (e.g., pansexual), gender identities, and gender expressions (e.g., nonbinary) that are not explicitly named in the initialism. Several years ago, a nurse, who was in an administrative role and claimed to be focused on advocacy for marginalized people in Canada, told me, “You should reconsider your topic, because it won’t be safe to return to Iran for a visit by being engaged in this work!” I should add that this nurse had a visible “positive space” sign on their desk. This comment highlighted personal values that may impact how nurses engage in allyship and advocacy.

Both stigma and discrimination, including a lack of knowledge of and a sense of discomfort in providing care to 2S/LGBTQI+ migrants, manifested themselves in my encounters with nurses, nursing students, faculty, and administrators. I heard comments such as, “They are in Canada now. It is safe here!” Despite the work of nurses as well as allied social and healthcare scholars, practitioners, and activists, some nurses continue to have a limited understanding of the experiences of 2S/LGBTQI+ migrants in the Canadian context, and 2S/LGBTQI+ migrants continue to have troubling experiences with nurses.

Within my research study, I analyze 2S/LGBTQI+ migrants’ encounters with nurses by applying a Gadamerian hermeneutic approach with intersectionality as an analytical lens. I conducted 18 semi-structured, in-depth, individual interviews. Two groups of informants participated in this study: (a) sixteen 2S/LGBTQI+ migrants who received care from nurses and other healthcare professionals in Canada; and, (b) five nurses or nursing students who experienced, observed, heard, or witnessed the provision of nursing care to 2S/LGBTQI+ migrants. Approaching analysis from an intersectional lens, I observed how 2S/LGBTQI+ migrants’ experiences were shaped by considerations of physical, mental, and spiritual well-being, which intertwined with race, ethnicity, migration status, sexual orientation, gender identity, and gender expression. Furthermore, I found that migration status added another layer of complexity to the marginalization of 2S/LGBTQI+ people, which required intentional allyship from nurses.

In this article, the concept of “ally theater” is used as a metaphor to depict meaningless acts of allies’ support for 2S/LGBTQI+ migrants. I underscore how the nursing profession has claimed to be affirming of diverse communities; nevertheless, nurses can do better, which is beyond one dimensional, performative act in education, practice, and policy. Drawing on normative ideologies underpinning performative allyship, a theoretical discussion with selected findings is presented on how 2S/LGBTQI+ migrants experienced cynical comments and unsacred seriousness in play with nurses in practice. In addition, nurses’ genuine acts of allyship with 2S/LGBTQI+ at various practice settings are presented.

Distant Reiki Intervention During the COVID-19 Pandemic

The current ANS featured article is titled “Experiences With a Distant Reiki Intervention During the
COVID-19 Pandemic Using the Science of Unitary Human Beings Framework” authored by Jennifer DiBenedetto, PhD, RN-BC. You can download this article at no cost while it is featured on the ANS website! Here is a message from the author about her research:

One of my research interests centers on mind-body therapies and its integration into conventional medicine to offer non-pharmacologic interventions to manage psychological and emotional distress in the community. A mind-body therapy I am especially interested in researching is Reiki therapy. Reiki therapy is a holistic healing modality that facilitates an exchange of life force energy to promote wellness in its recipient. As a Reiki Master and Registered Nurse, I enjoy integrating Reiki therapy into both my nursing practice and to clients in my local community.

When this study was designed and conducted, I was employed as a critical care nurse during the COVID-19 pandemic. I witnessed the way nurses cared for patients with COVID-19 and the effect it had on the emotional and mental health of patients, nurses, and the community. With stress and anxiety being especially high, along with my personal passion of engaging in self-care and practicing Reiki, it sparked my desire to research distant Reiki and its impact on perceived stress and anxiety using Rogers’ Science of Unitary Human Beings Framework. Distant Reiki was selected for this article due to its ability to offer healing in a socially distant way within the human-environmental field pattern.

This article stretches the lens of what is traditionally published in studies employing Rogers’ framework, particularly in its mixed method design and the interpretation of the qualitative and quantitative results. There is also novelty in the reconceptualization of the terms “stress” and “anxiety” by noting these patterns as perceptions of stress and anxiety. Further emphasis is given on the intentional presence of the nurse who is delivering the distant Reiki and how the openness allowed for the nurse and participant to engage in a mutual and dynamic process of generating new patterns. This pattern change is achieved through the promotion of participant awareness, self-reflection, self-discovery, and human choice. Verbal accounts from the participants, along with the instrument scores, support a transformative experience in fostering mental wellness, wellbecoming, and self-care. Future research into how nurses can use healing modalities into their practice, such as Reiki, to foster the nurse-patient relationship is needed.

COP27 Climate Change Conference: Urgent action needed for Africa and the world

This Commentary is being published simultaneously in multiple journals.
See the full list of journals here.  

Wealthy nations must step up support for Africa and vulnerable countries in addressing past, present and future impacts of climate change

The 2022 report of the Intergovernmental Panel on Climate Change (IPCC) paints a dark picture of the future of life on earth, characterised by ecosystem collapse, species extinction, and climate hazards such as heatwaves and floods (1). These are all linked to physical and mental health problems, with direct and indirect consequences of increased morbidity and mortality. To avoid these catastrophic health effects across all regions of the globe, there is broad agreement—as 231 health journals argued together in 2021—that the rise in global temperature must be limited to less than 1.5^oC compared with pre-industrial levels.

While the Paris Agreement of 2015 outlines a global action framework that incorporates providing climate finance to developing countries, this support has yet to materialise (2). COP27 is the fifth Conference of the Parties (COP) to be organised in Africa since its inception in 1995. Ahead of this meeting, we—as health journal editors from across the continent—call for urgent action to ensure it is the COP that finally delivers climate justice for Africa and vulnerable countries. This is essential not just for the health of those countries, but for the health of the whole world.

Africa has suffered disproportionately although it has done little to cause the crisis

The climate crisis has had an impact on the environmental and social determinants of health across Africa, leading to devastating health effects (3). Impacts on health can result directly from environmental shocks and indirectly through socially mediated effects (4). Climate change-related risks in Africa include flooding, drought, heatwaves, reduced food production, and reduced labour productivity (5). 

Droughts in sub-Saharan Africa have tripled between 1970-79 and 2010-2019 (6). In 2018, devastating cyclones impacted three million people in Malawi, Mozambique and Zimbabwe (6). In west and central Africa, severe flooding resulted in mortality and forced migration from loss of shelter, cultivated land, and livestock (7). Changes in vector ecology brought about by floods and damage to environmental hygiene have led to increases in diseases across sub-Saharan Africa, with rises in malaria, dengue fever, Lassa fever, Rift Valley fever, Lyme disease, Ebola virus, West Nile virus and other infections (8, 9). Rising sea levels reduce water quality, leading to water-borne diseases, including diarrhoeal diseases, a leading cause of mortality in Africa (8). Extreme weather damages water and food supply, increasing food insecurity and malnutrition, which causes 1.7 million deaths annually in Africa (10). According to the Food and Agriculture Organization of the United Nations, malnutrition has increased by almost 50% since 2012, owing to the central role agriculture plays in African economies (11). Environmental shocks and their knock-on effects also cause severe harm to mental health (12). In all, it is estimated that the climate crisis has destroyed a fifth of the gross domestic product (GDP) of the countries most vulnerable to climate shocks (13). 

The damage to Africa should be of supreme concern to all nations. This is partly for moral reasons. It is highly unjust that the most impacted nations have contributed the least to global cumulative emissions, which are driving the climate crisis and its increasingly severe effects. North America and Europe have contributed 62% of carbon dioxide emissions since the Industrial Revolution, whereas Africa has contributed only 3% (14). 

The fight against the climate crisis needs all hands on deck

Yet it is not just for moral reasons that all nations should be concerned for Africa. The acute and chronic impacts of the climate crisis create problems like poverty, infectious disease, forced migration, and conflict that spread through globalised systems (6, 15). These knock-on impacts affect all nations. COVID-19 served as a wake-up call to these global dynamics and it is no coincidence that health professionals have been active in identifying and responding to the consequences of growing systemic risks to health. But the lessons of the COVID-19 pandemic should not be limited to pandemic risk (16, 17). Instead, it is imperative that the suffering of frontline nations, including those in Africa, be the core consideration at COP27: in an interconnected world, leaving countries to the mercy of environmental shocks creates instability that has severe consequences for all nations. 

The primary focus of climate summits remains to rapidly reduce emissions so that global temperature rises are kept to below 1.5 °C. This will limit the harm. But, for Africa and other vulnerable regions, this harm is already severe. Achieving the promised target of providing $100bn of climate finance a year is now globally critical if we are to forestall the systemic risks of leaving societies in crisis. This can be done by ensuring these resources focus on increasing resilience to the existing and inevitable future impacts of the climate crisis, as well as on supporting vulnerable nations to reduce their greenhouse gas emissions: a parity of esteem between adaptation and mitigation. These resources should come through grants not loans, and be urgently scaled up before the current review period of 2025. They must put health system resilience at the forefront, as the compounding crises caused by the climate crisis often manifest in acute health problems. Financing adaptation will be more cost-effective than relying on disaster relief.

Some progress has been made on adaptation in Africa and around the world, including early warning systems and infrastructure to defend against extremes. But frontline nations are not compensated for impacts from a crisis they did not cause. This is not only unfair, but also drives the spiral of global destabilisation, as nations pour money into responding to disasters, but can no longer afford to pay for greater resilience or to reduce the root problem through emissions reductions. A financing facility for loss and damage must now be introduced, providing additional resources beyond those given for mitigation and adaptation. This must go beyond the failures of COP26 where the suggestion of such a facility was downgraded to “a dialogue” (18). 

The climate crisis is a product of global inaction, and comes at great cost not only to disproportionately impacted African countries, but to the whole world. Africa is united with other frontline regions in urging wealthy nations to finally step up, if for no other reason than that the crises in Africa will sooner rather than later spread and engulf all corners of the globe, by which time it may be too late to effectively respond. If so far they have failed to be persuaded by moral arguments, then hopefully their self-interest will now prevail.

Lukoye Atwoli, Editor-in-Chief, East African Medical Journal; Gregory E. Erhabor, Editor-in-Chief, West African Journal of Medicine; Aiah A. Gbakima, Editor-in-Chief, Sierra Leone Journal of Biomedical Research; Abraham Haileamlak, Editor-in-Chief, Ethiopian Journal of Health Sciences; Jean-Marie Kayembe Ntumba, Chief Editor, Annales Africaines de Medecine ; James Kigera, Editor-in-Chief, Annals of African Surgery; Laurie Laybourn-Langton, University of Exeter; Bob Mash, Editor-in-Chief, African Journal of Primary Health Care & Family Medicine; Joy Muhia, London School of Medicine and Tropical Hygiene; Fhumulani Mavis Mulaudzi, Editor-in-Chief, Curationis; David Ofori-Adjei, Editor-in-Chief, Ghana Medical Journal; Friday Okonofua, Editor-in-Chief, African Journal of Reproductive Health; Arash Rashidian, Executive Editor, and Maha El-Adawy, Director of Health Promotion, Eastern Mediterranean Health Journal; Siaka Sidibé, Director of Publication, Mali Médical; Abdelmadjid Snouber, Managing Editor, Journal de la Faculté de Médecine d’Oran; James Tumwine, Editor-in-Chief, African Health Sciences; Mohammad Sahar Yassien, Editor-in-Chief, Evidence-Based Nursing Research; Paul Yonga, Managing Editor, East African Medical Journal; Lilia Zakhama, Editor-in-Chief, La Tunisie Médicale; Chris Zielinski, University of Winchester.

Correspondence: chris.zielinski@ukhealthalliance.org

References

1. IPCC. Climate Change 2022: Impacts, Adaptation and Vulnerability. Working Group II Contribution to the IPCC Sixth Assessment Report; 2022.
2. UN. The Paris Agreement: United Nations; 2022 [Available from: https://www.un.org/en/climatechange/paris-agreement (accessed 12/9/2022)].
3. Climate change and Health in Sub-saharan Africa: The Case of Uganda. Climate Investment Funds; 2020.
4. WHO. Strengthening Health Resilience to Climate Change 2016.
5. Trisos CH, I.O. Adelekan, E. Totin, A. Ayanlade, J. Efitre, A. Gemeda, et al. Africa. In: Climate Change 2022: Impacts, Adaptation, and Vulnerability. 2022 [Available from: https://www.ipcc.ch/report/ar6/wg2/  (accessed 26/9/2022)].
6. Climate Change Adaptation and Economic Transformation in Sub-Saharan Africa. World Bank; 2021.
7. Opoku SK, Leal Filho W, Hubert F, Adejumo O. Climate Change and Health Preparedness in Africa: Analysing Trends in Six African Countries. Int J Environ Res Public Health. 2021;18(9):4672.
8. Evans M, Munslow B. Climate change, health, and conflict in Africa’s arc of instability. Perspectives in Public Health. 2021;141(6):338-41.
9. S. P. Stawicki, T. J. Papadimos, S. C. Galwankar, A. C. Miller, Firstenberg MS. Reflections on Climate Change and Public Health in Africa in an Era of Global Pandemic.  Contemporary Developments and Perspectives in International Health Security. 2: Intechopen; 2021.
10. Climate change and Health in Africa: Issues and Options: African Climate Policy Centre 2013 [Available from: https://archive.uneca.org/sites/default/files/PublicationFiles/policy_brief_12_climate_change_and_health_in_africa_issues_and_options.pdf (accessed 12/9/2022)].
11. Climate change is an increasing threat to Africa2020. Available from: https://unfccc.int/news/climate-change-is-an-increasing-threat-to-africa (accessed 12/9/2022).
12. Atwoli L, Muhia J, Merali Z. Mental health and climate change in Africa. BJPsych International. 2022:1-4 https://www.cambridge.org/core/journals/bjpsych-international/article/mental-health-and-climate-change-in-africa/65A414598BA1D620F4208A9177EED94B (accessed 26/9/22022).
13. Climate Vulnerable Economies Loss report. Switzerland: Vulnerable twenty group; 2020.
14. Ritchie H. Who has contributed most to global CO2 emissions? Our World in Data. https://ourworldindata.org/contributed-most-global-co2 (accessed 12/9/2022).
15. Bilotta N, Botti F. Paving the Way for Greener Central Banks. Current Trends and Future Developments around the Globe. Rome: Edizioni Nuova Cultura for Istituto Affari Internazionali (IAI); 2022.
16. WHO. COP26 special report on climate change and health: the health argument for climate action. . Geneva: World Health Organization; 2021.
17. Al-Mandhari A; Al-Yousfi A; Malkawi M; El-Adawy M. “Our planet, our health”: saving lives, promoting health and attaining well-being by protecting the planet – the Eastern Mediterranean perspectives. East Mediterr Health J. 2022;28(4):247−248. https://doi.org/10.26719/2022.28.4.247 (accessed 26/9/2022)
18. Simon Evans, Josh Gabbatiss, Robert McSweeney, Aruna Chandrasekhar, Ayesha Tandon, Giuliana Viglione, et al. COP26: Key outcomes agreed at the UN climate talks in Glasgow. Carbon Brief [Internet]. 2021. Available from: https://www.carbonbrief.org/cop26-key-outcomes-agreed-at-the-un-climate-talks-in-glasgow/ (accessed 12/9/2022).

Social Media Use by Nursing Journals

The current ANS featured article is titled “An Exploratory Study of Social Media Use and Management by
Nursing Journals” authored by Jayne Jennings Dunlap, DNP, FNP-C; and Julee Waldrop, DNP, PNP, FAANP, FAAN. We invite you to download the article at no cost while it is featured, and share your comments here. Dr. Dunlap sent this message about this work for ANS readers:

I am the Director of Social Media at the Journal for Nurse Practitioners and my co-author Julee Waldrop is the Editor-in-Chief. Social media posting and presence take time and resources. As we considered expanding our journal’s social media platforms, we wondered what other nursing journals were doing. In searching the literature, we discovered that medical journals have looked at the concept of social media editors for some time but to date there has been no nursing specific literature on this topic. This knowledge motivated Julee and I to explore the use and management of social media at nursing journals.

Nurses as leaders and patient advocates may be interested in how peer-reviewed nursing journals are currently using social media and the role of the social media editor.  We believe this is an evolving and important area for investigation and Julee and I hope to continue tracking more information as we begin to understand social media impacts which may transcend the discipline. Nurses should lead, always. And this is an area ripe for future research. 

Creation of Care through Communication

The current ANS featured article is titled “Creation of Care Through Communication by Nurses, Welfare Workers, and Persons (Children) With Profound Intellectual Multiple Disabilities at a Day Care Center: Emancipation From the Japanese ‘Shame Culture‘” authored by Tomoni Sato, PhD, RN. Visit the ANS website to download the article at no charge! Here is a message from Dr. Sato about her work:

Persons with PIMD have difficulty communicating both verbally and nonverbally, and are susceptible to life-threatening situations. Therefore, these individuals have high medical dependency and require concentrated care. However, the uniquely Japanese tradition of “shame culture” constrains the lives and behaviors of persons with PIMD and their families.

Japan has a long cultural background of “shame culture” and thus Japanese parents have typically been more reluctant to let children with disabilities out in public. Japanese people place great value on obligations and repaying favors, and “shame” is an emotion that is evoked when one is unable to meet an obligation or return a favor. Japan also used to have a “family reign system,” in which a male succeeded the family genealogy, so the birth of a male child has traditionally been desired.

The family reign system was abolished in 1947, but the belief that the birth of a child with a disability disgraces the family has persisted. Against this backdrop of “shame culture” and the resultant tendency toward prejudice and discrimination, an increase was seen in the number of cases in which Japanese families refused to take their children with PIMD home from the hospital or infant care home. As a countermeasure, a policy was implemented to place children with PIMD in a facility for protection and ryoiku (treatment, childcare, and education). As a result, participation in society by persons with PIMD in Japan was delayed and has only been considered since the beginning of the 21st century. In 2010, the Japanese government created a system that aimed to support independence based on the principle of normalization, stipulated participation by persons with PIMD in social activities as equal members of society through self-selection and selfdetermination, and proceeded to introduce necessary laws.

In this study, care that emancipates persons with PIMD and their families from Japanese “shame culture” was identified using ethnographic research methods. Nurses and welfare staff at a day care facility provided coordinated care to address the medical needs of persons with PIMD and to promote their self-expression and autonomy. This result should be of interest to a broad readership, particularly researchers and practitioners in the field of palliative care. This research provides insight into ways to support persons with PIMD and their families to emancipate them from Japanese “shame culture” and enable their autonomy.　

Early Detection of Patient Deterioration

The featured ANS article for the next two weeks is titled “Patient Deterioration on General Care Units: A Concept Analysis” authored by Mary Rose Gaughan, MS, RN, CNE and Carla R. Jungquist, PhD, ANP-BC, FAAN, both at the School of Nursing, University at Buffalo (SUNY Buffalo). While this article is featured, please visit the ANS website where you can download it at no cost, and we welcome you to add your comments here about this work. Here is a message from Mary Rose Gaughan about this work:

I have been a practicing critical care and emergency room nurse in upstate New York for many years. During my time at the bedside, I have directly observed patients exhibit specific cues that alert the nurse that deterioration is occurring. This concept is difficult to teach by textbook and requires direct observation to understand the phenomena. My future research will involve interviewing expert nurses to clarify these cues that hallmark patient deterioration.

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.