Skip to content

Cancer Survivorship


The current featured article in ANS is titled “Transition to Cancer Survivorship: A Concept Analysis” by Sylvia K. Wood, DNP, ANP-BC, AOCNP. This article is available for download at no cost while it is featured. The author explains that ” . . .  it is when treatment ends when life as a new cancer survivor can fall apart. It is during this time of transition, a time of “in-between” having completed therapy, entering a new life in survivorship that both patients and providers are not well prepared” (p. 145).  Dr. Wood provided this background about her work:

Throughout my nursing career, I have always been in awe of my patients.  More than any one thing, patients have been my best teachers, witnessing their intimate struggles, their triumphs,

Sylvia K. Wood

supporting them through living with and surviving cancer.

Research has come so far in changing our prognostic expectations as precision medicine and symptom science are guiding therapeutic approaches with improved response rates. However, knowing how to care for survivors after cancer treatment ends, a distinct phase in the continuum of care throughout the rest of one’s life is developing survivorship science.

There is a wealth of knowledge about the early effects of cancer treatment, yet much more needed for late effects. There is knowledge of survivorship needs for some cancer types but much less for others.

Due to the heterogeneity of cancer disease states, and the diverse populations it affects opens unchartered territory for further research in the personal, sociopolitical and cultural aspects of cancer survivorship to promote health and well-being.

Transition to survivorship is lexicon commonly describing a timeframe, although the richness of past research that can illuminate a holistic understanding of this concept is lost without definition. Weaving together diverse strands of prior research and knowledge uncovers the depth of meaning, context, and gives voice to the multidimensional and temporal nature of this concept.

I hope that interested researchers can use this concept analysis to build theory and new knowledge adding to the growth of survivorship science that will improve the care we give enriching the lives of cancer survivors.

“The real voyage of discovery consists not in seeking new landscapes, but in having new eyes.”    ~ Marcel Proust

Futago-no-baka. (2013) Traveler [Photograph]. Copyright [2018] by Zerochan Anime Images. Retrieved from https://www.zerochan.net/1431033

 

Planned featured topic: Nursing Theory for 2020


The significance of nursing perspectives has gained renewed interest as social pressures to reform healthcare have created challenges for care that is more effective, more effective and more economically sound. In both theory and in practice, nursing offers possibilities that address each of these goals.  We are inviting articles that address the state of the art of nursing theory as we approach the third decade of the 21st century, revealing important contributions that nursing brings to create needed change.  We welcome articles addressing the full range of theoretic development: articles that report empiric research structured from existing nursing theories, philosophic analyses related to theory and knowledge of the discipline, critiques of existing theoretical approaches, and descriptions of new and evolving nursing theories. Manuscripts are due by: July 15, 2019, but are welcomed any time!

Philosophy, Nursing Knowledge, and Nursing Practice


In the current featured ANS article, the authors explain how two philosophic lines of thought — realism and relativism — are useful in helping nurses improve the health of patients and society at large. The article is titled “Realism and Relativism in the Development of Nursing as a Discipline” by Shela Akbar Ali Hirani, MScN, RN, BScN, IBCLC; Solina Richter, PhD, RN, DCur and Bukola Oladunni Salami, PhD, RN, MN. The article is available to download at no cost while it is featured; we welcome your comments and feedback. Ms. Hirani sent this description of the experience that drew her to explore these philosophic ideas and relationship to nursing practice and nursing knowledge development:

On entering into my doctoral studies, during my nursing philosophy class, I came across the terms realism and relativism. Upon learning about theses philosophical schools of thoughts and listening to my colleagues who often used to find these philosophical schools of thought a bit

Shela Hirani

confusing and challenging, I had a feeling that we as nurses often apply these schools of thoughts in a variety of our practice settings without being aware of them. To give tribute to the work of nurses that is often based on the philosophical schools of thought of realism and relativism, under the mentorship of my professors, I decided to write this article entitled “Realism and relativism in the development of nursing as a discipline”. This paper presents the role of realism and relativism in the development of the discipline of nursing, as well as underscores the contribution of these two schools of thought to the work of nurse clinicians, nurse researchers, nurse educators and nurse theorists. As the target audience of the journal “Advances in Nursing Science” include nurses from different specialty areas who have varying levels of understanding about philosophy, while touching upon the basics, this paper intends to discuss the role of realism and relativism in nursing education, nursing research, evidence-based nursing practice, and nursing theory. Specific examples of nursing activities have been discussed in the paper to facilitate the readers to understand how realism and relativism shape the amazing work of nurses and contribute to the development of nursing as a discipline.

Commercial Sexual Exploitation of Children


The current ANS featured article addresses a hidden, but urgent, threat to the health of children.  The article is titled “School Nurses’ Awareness and Attitudes Toward Commercial Sexual Exploitation of Children” authored by Hannah E. Fraley, PhD, RN; Teri Aronowitz, PhD, APRN, FNP-BC, FAAN; and Emily J. Jones, PhD, RNC-OB.  We are offering continuing education credit with this article because this type of challenge is significant for all nurses. This study reveals the key roles that nurses play in protecting the health and well-being of people who are vulnerable and disadvantaged.  The article is available to download at no cost while it is featured, and we invite you to read it, and share your comments here!  Dr. Fraley has shared this information about her work for ANS blog readers!

I am a nurse educator and scholar and am passionate about vulnerable populations, health disparities, health access, and human rights. With an extensive background in working with vulnerable women and children, I have developed a focused research program targeting youth

Hannah Fraley

violence prevention and risk reduction. As I became aware of the nation-wide problem of child sex trafficking I knew that nurses are in such a pivotal position to be able to identify trafficking victims and intervene. Further, in my extensive study of child trafficking in the U.S. I was led to the unique and frontline role specifically of school nurses; school nurses have routine interaction with youth and are often the only health care provider youth interact with. I knew that school nurses can intervene and prevent child sexual exploitation, but also knew from studying the health care provider role that providers may lack awareness of child sex trafficking and also may have negative perceptions about youth who are most vulnerable impeding identification and intervention. Understanding that perceptions that we internally hold are shaped by our own life experiences and also shaped by societal and institutional influences became the backbone of my work with school nurses given youth who are most at risk of sexual exploitation are often those whom society, institutions, ourselves label as ‘difficult to work with’ or ‘trouble’. These children cross their school nurses’ path day in and day out and their exploitation may not be seen or recognized due to low awareness of sex trafficking coupled with shaped perceptions. This has become the driving force of my work aiming to build sustainable programs for school nurses and multidisciplinary school teams targeting prevention of commercial sexual exploitation of children.

Nursing Practice and the Criminal Justice System


The current issue of ANS features two articles focused on Crime, Justice and Health.  The first of these two articles is titled “In a Spirit of Restoration: A Phenomenology of NursingPractice and the Criminal Justice System” by Geraldine Gorman, PhD; Rebecca M. Singer, ND; Erin Christmas, MS; Catherine Herbstritt, MS; Layne Miller, MS; Mary Murphy, MS; Cailan Shannon, MS; and Katrina Wyss, MS.  We invite ANS readers to download this article while it is featured (no cost), and share your reflections in the comments section below.  Dr. Gorman shared this summary of her work, and how she became dedicated to addressing this timely and important social justice issue, followed by a message from co-author and faculty colleague Rebecca Singer:

From Geraldine Gorman:

Tragedy and crisis divert our attention from other tragedy and crisis. I became interested in prison reform back in the 90’s when I attended a forum focused on the impact of Buddhism on healthcare.  A Religious Studies professor from DePaul University in Chicago talked about  the

Geraldine Gorman

sangha he initiated for the men imprisoned in the maximum security facility in Michigan City, IN. I was intrigued and Ron invited me to attend one of their Zen Buddhist sittings. For the next 15 years I went into the prison as a volunteer with the Buddhist group, sitting and chanting in Korean– not a word of which I understood– and getting to know the men, some of whom had spent time on death row. During those years  3 executions took place, one which took the life of one of the members of the sangha. A peaceful protest accompanied each state-sanctioned murder with black robed Buddhists  sitting silently in the parking lot, from dusk till dawn. The reverberations from each death ran deeply.

But then 9/11 shook the world and my nursing conscience turned from the injustices of the prison industrial complex to the horrors of war. I continued going into the prison but war dominated my thoughts and words and  outrage.  This is what happens when the dike starts springing too many leaks. We have only so many hands, so much time.  It goes without saying that our current political dike has become a sieve.

Ten years ago as part of our public health nursing class, I began bringing students to the Indiana prison. They were able to walk through the cell blocks, observe what passes for healthcare, listen to men describe their journey to and through incarceration. Chicago’s own Cook County Jail had remained an impenetrable fortress until very recently when our reform-minded Sheriff reached out to the College of Nursing and we began providing health education to the men and women detained in the cavernous jail. Our article describes the initiation of this project, along with the gratifications and challenges faculty and students encountered.

We appreciate the opportunity to share this with the ANS audience. While we must pay close attention to the ever present rumors of war and more war, we cannot allow our attention to be diverted from the injustices in our own communities.  And we need to expose our students to what is done in our names without paralyzing them. Such is the challenge for nursing practice, education and scholarship: to witness and confront insurmountable suffering and to move forward.

From Rebecca Singer:

My primary area of practice is within humanitarian response work which takes me to conflict or post-conflict zones where I try to provide services with few resources to displaced peoples who have lost nearly everything but their lives. In my work with students, they express interest in this work and often ask what they should do to prepare for a job in humanitarian response. After

Rebecca Singer

several weeks in the jail, I realized that Cook County Jail was the closest I had ever come to a refugee camp in Tanzania or a displaced persons’ settlement in South Sudan while never traveling beyond my own city’s limits. The students and I needed to travel no further than 26th and California, just over 2.5 miles from our own College of Nursing, to be surrounded by displaced peoples who have lost nearly everything but their lives and to provide health education with few resources but our wits, several pieces of paper and a poster board.

As the weeks passed and we struggled to understand the rules, to navigate the bleak halls, and to be heard over the din, I came to see how much like a foreign country the jail was. Each time we enter the jail, we repeatedly are asked to show our ID and permission letter, which serve as our passport to this foreign land. We pass through metal detectors and check-points which remind me of the international borders and military check-points I cross to get to my other work. They check our bags and confiscate anything that might pass as contraband; this week a permanent marker and next week a roll of tape. We must pack our bags with care.

The people who get caught up in our criminal justice system live in the same city that we do, yet their lived reality is essentially foreign to me and to most of the students.  They often speak a different language, using slang that I have never heard.  Coming from parts of the city with higher rates of unemployment and lower rates levels of education, they function in an economy far removed from the Loop that I can see from our campus. The exchange of illegal items, including illicit drugs and the firearms that drive up the rates of violence in their communities, render the currency they use different from ours. And while our city is diverse, the range of brown and black people I meet in the jail do not look like the faculty I call my colleagues at our university.

Yet, it is only like a foreign country, because, in fact, this jail is in our city. It houses fellow citizens of our Midwestern city–polite, friendly sports’ fans who love to complain about the weather. They are fellow citizens whose current conditions serve as a stark and vivid reminder that the social determinants of health are at play right here. Now when students ask me about my humanitarian response work and express interest in doing it, I can encourage them to come with us to do that very work without traveling more than 2.5 miles—no passport necessary—just pack with care.

Ethnic Diversity and Advanced Health-related Decisions


Our latest featured article it titles “Health-Related Decisions for Serious Illness Among Ethnically Diverse Older Adults” by Zahra Rahemi, PhD, RN; Christine Lisa Williams, DNSc, RN, PMHCNS; Ruth Marchand Tappen, EdD, RN, FAAN and Gabriella Anna Engstrom, PhD. The article is available for free download while it is featured, and we welcome your comments here! In this article, the authors discuss the evidence from their study that supports the great variability in individual situations at the end of life, and the importance of nursing care that remains responsive to each particular situation.  Dr. Rahemi provided this background for ANS reviewers:

Universally, the population of older adults is dramatically growing. In the United States, culturally and ethnically diverse older adults are one of the fastest growing population. Cultural factors, including ethnicity, acculturation, and spirituality, have significant influence on diverse older adults and how and what they plan for their healthcare. Therefore, there is a need for multiple care options to avoid predetermined clinical practice guidelines for ethnically diverse older adults.

Cultural beliefs and value systems frequently prevent people from healthcare service use and healthcare decision making, which contribute to healthcare disparities for ethnically diverse older adults. In my current studies, I am interested in investigating factors that are pivotal for communication of decisions in advance. Innovative strategies to help individuals determine their goals of care are needed to clarify health-related decisions that ethnically diverse individuals may find challenging to articulate. Because ethnically diverse communities have strong family ties in general, the authors encourage informal and general discussions about goals of care among these communities. These conversations may ultimately inform significant others who are called upon to make decisions when older adults cannot. The new strategies recommended in this study may open new venues for professional development in nursing and ultimately promote culturally competent care.

In the field of ethnically diverse older adults and their healthcare decisions and preferences, the I started with a broad literature review and an integrative review that was published in ANS. Later, I continued my research in different ethnically diverse communities using different lenses, such as end-of-life preferences, health-related decisions for serious illness, and attitudes and behaviors regarding planning ahead for end-of-life care. I hope to introduce more innovative strategies to encourage ethnically diverse older adults to communicate their desired care choice when they are capable to communicate.

 

Caring for People with Dementia


Our current featured article is a report of a phenomenological, hermeneutic investigation titled “Former Work Life and People With Dementia” authored by Bente Nordtug, PhD, MA, RN; Karin Torvik, PhD, MA, RN; Hildfrid V. Brataas, PhD, MA, RN; Are Holen, PhD, MD (psychiatrist); and Birthe Loa Knizek, PhD, MA.   The research team was led by Dr. Bente Nordtug, a registered nurse, specializing

Bente Nordtug

in dementia care. She has a PhD in Health Science from Norwegian Science and Technology University (NTNU). Currently she works as an associate professor at the Department of Nursing and Health Sciences at Nord University (NU). Her research has mainly concerned issues such as the mental health of informal caregivers of patients, and how social support affects the caregivers’ caring burden.

This article is available to download at no cost while it is featured!  We invite all comments and ideas related to this work – leave you message below!

Emancipatory Policies for Environmental Health


Our current featured article addresses one of the most pressing issues of our time – environmental health.  The article is titled “Environmental Health: Advancing Emancipatory Policies for the Common Good,” authored by Sarah K. Valentine-Maher, MSN, RN,

Sarah Valentine-Maher

FNP; Patricia G. Butterfield, PhD, RN, FAAN; and Gary Laustsen, PhD, RN, FNP, FAANP, FAAN.  The article is available at no cost while it is featured on the ANS website.  Authors Valentine-Maher and Butterfield  talk about their work in this video we recorded for ANS blog followers; we welcome your comments below!

Message from Sarah Valentine-Maher:

Nurses hold a great potential to improve human wellbeing by addressing the environment that determines health.  Many of us will recognize this ethos within nursing. Yet, our potential to address one of the major determinants of health, the integrity of the natural environment, is not yet actualized.  In the article “Environmental Health: Advancing Emancipatory Policies for the Common Good” we point towards a way forward. Overviews of contextual issues and specific environmental concerns are paired with recommendations for nurses’ actions.

The discussion in the video posted here touches on an overview of the paper as well as the themes of; ‘why nursing and environmental health’ and the emancipatory implications of such work.

Healing Genocide Rape Trauma


Our current featured article is representative of a long ANS tradition – articles that address topics that are rarely brought to public attention.  The article is titled “Genocide Rape Trauma Management: An Integrated Framework for Supporting Survivors” authored by Donatilla Mukamana, PhD, RN; Petra Brysiewicz, PhD, RN; Anthony Collins, PhD; and William Rosa, MS, RN, LMT, AHN-BC, AGPCNP-BC, CCRN-CMC. The article is available for download here at no coast while it is featured. Dr. Mukamana shared this information about the background of this article:

The idea of writing about  genocide rape trauma came after a discussion I had with one of my patients in 2000. She had been gang

Donatilla Mukamana

raped and contaminated with HIV during the genocide against Tutsi in 1994,  At that time we met in 2000 she  was  dying.

She told me: “ Go and tell the world about the unspeakable cruelty of genocide rape which leaves the victim as living dead… then those who are in power should  prevent the occurrence of rape”

Rape used as a weapon of genocide affects all aspects of the survivor’s life. Therefore the healing process requires a holistic approach, one that I attempt to present in the current article.

I join the authors in welcoming your ideas, comments and questions about this work in the “comments” section below.

New – ANS Continuing Education!


With the current issue of ANS, we have launched Continuing Education for at least one article each issue!  When you visit the online Table of Contents of each issue, you will see a red “CE” symbol, indicating that you can visit the ANS page on Nursing Center CEConnection to proceed with the process to obtain continuing education credits. In the current issue, CE credit is available for the article titled End-of-Life Communication: Nurses Cocreating the Closing Composition With Patients and Families by Mary J. Isaacson and Minton, Mary E.

In addition we have provided CE credit for two other recently published articles, which you can see on the CEConnections ANS page:

A Qualitative Study of Difficult Nurse-Patient Encounters in Home Healthcare by Mary Kate Falkenstrom that appeared in ANS 40:2, April-June 2017.

Embedding a palliative approach in nursing care delivery: An integrated knowledge synthesis by Richard Sawatzky, Pat Porterfield, Della Roberts, Joyce Lee; Leah Liang, Sheryl Reimer-Kirkham, Barb Pesut, Tilly Schalkwyk, Kelli Stajduhar, Carolyn Tayler, Jennifer Baumbusch, and Sally Thorne that also appeared in ANS 40:2, April-June 2017.

These articles, and the future articles that will be available for continuing education, have implications for practice, education, policy and research. I trust that this new initiative will provide an important resource for our discipline!