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Posts from the ‘Nursing Practice’ Category

Evidence supporting father-friendly care for families

One of our “Editor’s Picks” for the current ANS issue is the article titled “Transition to Fatherhood: Modeling the Experience of Fathers of Breastfed Infants.”  The authors, Francine deMontigny, Carl LaCharite and Annie DeVault, describe a research project in which they examined a model of the relationships among father involvement, perceived parental efficacy, events related to breastfeeding, support, stress, and income with a sample of 164 fathers of breastfed infants.  The lead author, Dr. deMontigny, whose photo is featured here, describes their work that led to this study:

For over 15 years, I have been meeting with fathers, their partner, health professionals, to hear their point of view of what influences this transition. Needless to say, their spouse is an important source of support. But it stands out that nurses too can make a difference in fathers’ experience. Every time a nurse remarks positively about fathers’ abilities with their newborn, she contributes to strengthening the relationship between the father and the child. Our team has developed the Father Friendly within the Family Initiative to support health professionals in their efforts to build stronger ties with fathers and their families. We strongly believe that engaged fathers contribute to the family’s development.

This article is available for free download now!  So visit the ANS web site, and discover this and many other recent articles that can shape the future of nursing practice!

Choosing contentment in the midst of life transitions

Susan Bonis’ featured article, which describes a philosophic (hermeneutic) study,  is an example of scholarship that some assume is far removed from the practical realm of nursing practice.  But to the contrary, this thought-provoking article sheds light on one of the most vexing challenges of human practice – how do people come to a sense of enduring serenity (contentment) in the midst of the disharmony created by serious health challenges?  As Dr. Bonis states in her article: “Evidence-based practices begin with understanding the science that underpins the discipline. Nursing is a human science; therefore, it is essential to understand the basic human phenomena that underpin being human, such as contentment.” (see page 274 of her article, available for free download until 9/30/12).

Dr. Bonis examined the published memoir of Dawn Prince-Hughes, a researcher of primate identity and culture.  The memoir, titled “Songs of a Gorilla Nation: My Journey through Autism,” recounts Prince-Hughes’ experience of coming to understand her own journey living with autism.  Dr. Bonis’ hermenuetic interpretation of the memoir, cast in the perspective of the nursing human becoming philosophic framework, provides the basis for her analysis of the experience of contentment.  As a reader of this article, you may not share for yourself the human becoming philosophy, but you will find connections between this philosophy and the most fundamental of nursing concerns.  For me one of the fundamental nursing concerns that this article addresses is that of promoting high-level wellness.  Dr. Bonis describes the process of  contentment as a paradoxical living calm-turbulence in challenging situations – a process that seems to me as central to the basic nursing concept of high-level wellness.  In her conclusion, Dr. Bonis states that “As humans live rhythms of contentmentdisharmony, contentment is glimpsed in serene and pleasurable moments of feeling listened to, understood, cared for, loved, and respected, as well as in moments when they trust, unburden, and laugh while all-at-once acquiescing to arduous situations.” (See page 282). What an inspiring image for nursing practice, and for the outcomes that I believe we all seek!

Let us know your thoughts and responses to this featured article!  Leave your comments here – and we will respond!

Aging, language and health care

How we talk and think about aging is something that most often is taken for granted.  This is not the case for Connie Madden and Kristin Cloyes who have investigated the language of aging in history, theory and research.  They point out in their featured article titled “The Discourse of Aging,” the experience of aging is common to all humans, but it remains poorly understood.  Their analysis reveals how the language of aging has shaped not only our general ideas about the “common” aging experience, but the research and theories related to aging.  Their analysis shows how language has tended to dichotomize how we think about aging as an either-or — living longer or living better.  Nursing, they believe, can make a significant contribution to understanding aging by bringing a holistic view to this experience, and challenge notions that perpetuate limited and stereotyping assumptions about aging. Here are some reflections from the authors about their work on aging:

Connie Madden: My interest in the language of aging has been fueled through my experiences as a nurse educator talking with students about their experiences and perceptions.  Through PhD course work as a student in the University Of Utah Hartford Center Of Geriatric Nursing Excellence, I have been able to expand my interest through exploring the relationship between language, perception and the practice of providing nursing care for older adults.  In a particular course, The Philosophy of Inquiry ,  Dr. Kristin Cloyes helped put those  pieces together  through examination of anti-aging and healthy aging language as it intersects in the larger aging discourse.
Kristin Cloyes: It’s always inspiring when a scholar is able to take the typical structure of a required course and shape it into something they really want to say, growing a field she or he is passionate about in new directions. In this case, the structure involved a required course paper in which I ask students toexplore a central concept in their area of interest, to identify common epistemological assumptions that shape the field and to explore how these assumptions stand up when viewed from differing frameworks. Connie used the paper to embark on an incisive analysis of assumptions about aging, and how these may shape nursing education. After I suggested that her thesis should be developed for publication, I was lucky enough for Connie to invite me to help expand and refine her ideas about the discourse of gerontology as an emerging area of study.
The credit on the illustration “The Seven Ages of Man” shown above reads:  Bartolomaeus Anglicus, Le Proprietaire des Choses tres Utiles … Paris 1510

Improving transition outcomes

Carol Geary and Karen Schumacher explain some of the most vexing issues in nursing care – effective transitions for patients who move from one care setting to another.  The evidence points to major issues in health care that add up to astounding costs – readmissions for Medicare patients alone add up to billions of dollars.  Geary and Schumacher address this issue theoretically by proposing an integration of transitions theory and complexity science.  Their work provides a new and expanded perspective that can improve outcomes for people who are transitioning from hospital to home.
Carol Geary shares this message about her work:
My research addresses care transitions from hospital to skilled nursing facilities among aging patients with advanced chronic disease. I am specifically interested in the multiple perspectives of patients, informal caregivers, and health care providers as described within this paper and suggested by viewing the phenomenon through a complexity lens.
Professionally, as an administratively focused nurse functioning both within and as a consultant to hospitals, the dynamic of care “across the continuum” intrigued me. When Dr. Sheila Ryan introduced me to complexity science in an informational interview for the PhD program in nursing at UNMC, my initial response was: “THIS changes everything.”  After two years of study, I remain fascinated by the challenge of viewing the world through this new lens.
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