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Oct 2

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Cross-cultural Research: Lessons Learned


For the next couple of weeks we are featuring the article titled “Practical Issues of Conducting a Q Methodology Study: Lessons Learned From a Cross-cultural Study” by Teresa Elizabeth Stone, PhD; Jane Maguire, PhD; Sook Jung Kang, PhD, FNP-C; and Chiyoung Cha, PhD, RN. The

researchers are from Australia and South Korea. Their research focuses on differing health beliefs among nurses. We invite you to obtain your copy of this article while it is featured, and return here to share your comments!  Here is a message from the authors:

In this paper, we address the methodological issues of conducting a Q method study in cross cultural research settings. Four researchers from Australia and South Korea conducted a pilot study using Q methodology design in Japan and South Korea to learn about nurses’ health beliefs. During the research process, we encountered methodological issues and cross-cultural issues which we would like to share with other researchers who may be planning to conduct a Q methodology study. Despite its infrequent use in nursing, Q methodology can yield rich information about differing perspectives. This information might be difficult to uncover using conventional research approaches. The findings of the pilot study are presented in Nurse Education Today.

 The learning from our initial research in Japan and Korea as described in ‘Practical issues of conducting a Q methodology study’ was used in a recently completed five country study The aim of this study was to provide understanding of health belief content, origin, socio-cultural and other influencing factors held by clinical nurses and nursing academics in Japan, Australia, China, South Korea, and Thailand, and its impact on their nursing practice and education. We are looking forward to publishing these fascinating results in the near future.

Chiyoung Cha
Sook Jung Kang
Teri Stone
Jane McGuire

Sep 19

Community-engaged Research: Working Effectively Across Diverse Communities


Our current featured article is titled “Advancing Nursing Science Through Community Advisory Boards: Working Effectively Across Diverse Communities” by Rosa M. Gonzalez-Guarda, PhD, MPH, CPH, RN, FAAN; Emily J. Jones, PhD, RNC-OB; Elizabeth Cohn, PhD, boardRN; Gordon L. Gillespie, PhD, DNP, RN, CEN, CNE, CPEN, PHCNS-BC, FAEN, FAAN; and Felesia Bowen, PhD, DNP, APN.  While this article is featured, you can download it at no cost here.  We welcome your comments and ideas!

Abstract:

The movement toward community-engaged research is well aligned with nursing’s strong tradition of engaging individuals, families, and communities in designing and evaluating nursing care. As such, nurse scientists should consider engaging the recipients of care in the research process. Community advisory boards are a common way in which communities are engaged in research. The purpose of this article is to provide a framework for effectively working with community advisory boards in diverse communities that is informed by evidence and experiences of the Robert Wood Johnson Foundation Nurse Faculty Scholars. Recommendations can serve as a blueprint for nurse scientists as they engage communities in research promoting health equity.

Sep 14

ANS Collections Updated!


One of the most important challenges for scholars in all disciplines is finding the important classic literature related to your line of scholarship!  This is where the ANS Collections can help!  The Collections provide links to important classic articles that have student-thinking-clipart-mystery_clip_artappeared since the early days of ANS (October 1978) through 2009.  While all scholarship requires familiarity with the most recent literature in your field, it is equally important to know the history of your line of inquiry, and the important background leading up to where you are today.  But discovering this history is a major challenge, since keyword search capabilities for deep searches have changed dramatically in recent years and they do not reach back to the important historical documents.  So in addition to library key word searches, scholars also need to be intimately familiar with the content in journals that publish in your area of expertise.

I encourage you to browse these ANS Collections, organized by topics that appear regularly throughout ANS.  You just might find something you never knew existed, or long ago forgot!  This actually happened to me as I selected the articles for each Collection – articles that I had long ago forgotten suddenly came into a new light!

The Collections will be updated again, once sufficient time has passed to recognize material that stands the test of time! Meanwhile, take a virtual stroll through the Collections and discover what is there to inform you work anew!

Sep 4

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Embedding a Palliative Approach in Nursing Care Delivery


We are delighted to feature the open access article titled “Embedding a Palliative Approach in Nursing Care Delivery: An Integrated Knowledge Synthesis” authored by Richard Sawatzky, PhD; Pat Porterfield, MSN; Della Roberts, MSN; Joyce Lee, PhD; Leah Liang, MSN; Sheryl Reimer-Kirkham, PhD; Barb Pesut, PhD; Tilly Schalkwyk, MSN; Kelli Stajduhar, PhD; Carolyn Tayler, MSA; Jennifer Baumbusch, PhD; and Sally Thorne, PhD. This article not only addresses the significant challenges of palliative care, but also serves as an example of the translation of knowledge into practice. We welcome you to download and read the article at any time – it is permanently available at no cost to readers.  Then return here and share your comments and ideas!  This is a message from Dr. Sawatzky about the work of this team of authors:

“A palliative approach is not a service” (quote from Carolyn Tayler)

Richard Sawatzky

Although we realize that end of life care may require care from professionals who have been formally trained in palliative care, mostpeople who have life limiting illnesses receive care in settings where access to palliative care professionals is limited. To address this, our team has been studying how the notion of “a palliative approach” can help to embed general principles and practices of palliative care broadly into the healthcare system. The Initiative for a Palliative Approach in Nursing: Evidence and Leadership (www.iPANEL.ca, led by Kelli Stajduhar and Carolyn Tayler) engages nurse researchers, practitioners, and administrators in British Columbia, Canada, who share a common goal to integrate a palliative approach throughout the healthcare system. Building on our prior publication on “Conceptual Foundations of a Palliative Approach” (Sawatzky, Porterfield et al. 2016), the current article is one of the iPANEL studies that specifically seeks to synthesize across insights derived from different sources of knowledge relevant to a palliative approach as the basis for supporting nursing care teams to embed a palliative approach into their practice. In doing so, we have broadened the scope of what is

Pat Porterfield

typically considered “knowledge synthesis”, by translating general knowledge from previous studies into particular contexts of nursing practice. This knowledge synthesis process reflects the fundamental form of nursing knowledge application we articulated in a prior publication in ANS on “Particularizing the General” (Thorne and Sawatzky, 2014). We hope that, in addition to contributing to an understanding of a palliative approach, the article will spark further discourse about effective methodologies for particularizing general knowledge within local contexts of everyday nursing practice.

Aug 21

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A Humanizing Model for Nursing Social Justice Action


The latest featured article from the current issue of ANS is titled “Exercising Nursing Essential and Effective Freedom in Behalf of Social Justice: A Humanizing Model” by Donna J. Perry, PhD, RN; Danny G. Willis, DNS, RN, PMHCNS-BC; Kenneth S. Peterson, PhD, FNP-BC; and Pamela J. Grace, PhD, RN, FAAN. Using powerful personal narratives, the authors provide examples of ways they have broken through barriers, to exercise effective freedom and take specific social justice action within nursing.  Dr. Perry provided this description of their work:

It is increasingly clear that health is dependent upon multiple underlying social factors including environmental conditions, economic status, access to education, employment and a peaceful and participatory society.  These conditions are distributed unequally within our global community.  In this paper we discuss the nursing mandate to act for social justice and the constraints that prevent nursing from realizing this goal.   We argue that nursing has been impeded in addressing underlying socio-political issues that impact health because nursing has historically been positioned within an institutionalized medical paradigm.  We propose a model of nursing essential and effective freedom based on the philosophy of Bernard Lonergan as a framework for addressing barriers to nursing action for social justice.  And we share our personal challenges and strategies for addressing social justice as nurses working in various settings.

 

Aug 8

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Theory of Social Justice in Nursing


Our current featued article is titled “Emancipatory Nursing Praxis: A Theory of Social Justice in Nursing” by Robin R. Walter, PhD, RN, CNE.  In the short video below, Dr. Walter shares what she sees as the important take-aways from her study.  I hope you will not only view the video, but also download this article from the ANS website, then return here to share your comments and ideas related to her work!

Jul 31

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The “As-if” World of Nursing Practice: Nurses, Marketing and Decision-Making


We are currently featuring the article titled “The “As-If” World of Nursing Practice: Nurses, Marketing, and Decision-Making” by Quinn Grundy, PhD, RN and Ruth E. Malone, PhD, RN, FAAN. Based on an ethnographic study, the authors conclude that “nursing must deconstruct the “as-if” nondecisional myth by confronting conflicts of interest and owning fully its rightful clinical and advocacy roles.” This article is available to download at no cost while it is featured; I join the authors in inviting you to return here to share your responses and comments!  Dr. Grundy shared this background about her work:

The Physician Payments Sunshine Act, passed as part of the Affordable Care Act, came into effect just at the time I was selecting an area of focus for my PhD dissertation. This legislation required pharmaceutical and medical device companies to publicly report all payments made to physicians and teaching hospitals and issued in a new era of transparency in United States healthcare. What surprised me, however, was that nurses were omitted from the mandate. This caused me to question whether nurses did not have these types of relationships with industry? Or, whether policymakers did not believe they warranted the same level of scrutiny?

Under the supervision of Dr. Ruth Malone, my co-author on this week’s featured article, I conducted an ethnographic investigation into the ways that registered nurses interact with industry in their day-to-day clinical practice at 4 hospitals in the western United States. What we found couldn’t have been more different than what the policy climate suggested.

Often on a daily basis, nurses interacted with industry representatives from multiple medically-related industries including

Quinn Grundy

pharmaceutical, medical device, information technology and infant formula companies. These interactions including attending drug company-sponsored dinners, receiving payments for speaking or consulting, and receiving gifts at conferences or other sponsored events. Among physicians, these types of relationships have been associated with negative changes in prescribing habits including increased prescribing of brand-name, heavily marketed medicines with lower safety profiles.

However, to our surprise, nurses were mystified at the attention of sales representatives and wondered at their inclusion in marketing activities like drug dinners. They explained that as health professionals who cannot prescribe medicines, there was no decision-making for marketing to attempt to sway. Yet, these same nurses described their roles on hospital purchasing committees, narrated multiple instances where they had recommended treatments to providers, and described powerful influence over patient care within the hospital.

This article explores the conditions under which nurses’ considerable influence and power to affect change within clinical practice becomes invisible, even at times to nurses themselves. We call this the “as-if” world of nursing practice — a well-constructed, institutionally-preserved myth that nurses do not make decisions in the absence of doctor’s orders.

We hope this article will stimulate a conversation in the profession about the nature of conflict of interest in nursing practice and the need to recognize, and safeguard, nurses’ considerable decision-making power from marketing influence.

 

Jul 14

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Weight beliefs among African American Women


Our featured article for the next couple of weeks is titled “Development and Validation of the Beliefs About Personal Weight Survey Among African American Women” by Stephanie Pickett, PhD, RN; Rosalind M. Peters, PhD, RN, FAAN and Thomas Templin, PhD. This article reports the development of an empirical measure that integrates culturally related beliefs. The article is available for download at no cost while it is featured.  Here is a message that Dr. Pickett shared about her work:

My program of research focuses on reduction of hypertension-related risk factors among African Americans, with a specific interest in psychosocial factors that influence weight management among African American women such as weight beliefs, perceived stress,

emotions and eating behavior patterns. My initial research examined beliefs about hypertension and self-care behaviors among African

Stephanie Pickett

Americans and found that a significant relationship existed between hypertension beliefs and behaviors that affect blood pressure control. I then became interested in examining weight beliefs and weight management behaviors given that obesity is a risk factor for hypertension. I focused on African American women due to the high proportion of overweight and obese women in this group.

As I examined the weight belief literature, I discovered that most of the research about weight beliefs among African American women were qualitative studies that methodologically could not examine relationships between beliefs and behaviors. I also discovered that there were numerous instruments that measured weight beliefs that mainly focused on beliefs about obesity. These instruments gathered important information, but none measured beliefs about personal weight across the weight spectrum and none were developed and normed with African American women. My dissertation work filled this gap in the literature with the development and initial testing of the Beliefs about Personal Weight Survey (BPWS) with young African American women. This survey shows promising results with adequate reliability and validity.

My next step is to revise the BPWS to make it a useful tool for clinicians and researchers   to examine weight beliefs as a component of weight management interventions among African American women.

Jul 5

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Help for Veterans with PTSD


Our current featured article addresses one of the most pressing health problems for those who have served in military combat – post-traumatic stress disorder.  The article, titled “Efficacy of the Mantram Repetition Program for Insomnia in Veterans With Posttraumatic Stress Disorder: A Naturalistic Study” is authored by Danielle Beck, MPH, CCRC; Lindsay Cosco Holt, PhD, RN; Joseph Burkard, DNSc, CRNA; Taylor Andrews, BA; Lin Liu, PhD; Pia Heppner, PhD and Jill E. Bormann, PhD, RN, FAAN.  The article is available at no cost while it is featured!  The program described in this paper was recently designated as an “Edgerunner” by the American Academy of Nursing.

Dr. Borman shared this message about the article for ANS readers:

As nurses, we embrace a holistic perspective to patient care. In this study, we tested a mind-body-spiritual intervention, repeating a mantram (sacred word), to help manage symptoms of post-traumatic stress disorder (PTSD) in Veterans. A “mantram” has been described as a “spiritual formula for transformation;” a self-selected, spiritually based word or phrase (sometimes called a Holy Name) that reflects all the major spiritual traditions of the world. For a more detailed description, see: The Power of the Mantram or learn about its origins from the Blue Mountain Center of Meditation.  Veterans found that this intervention promoted the relaxation response and reduced symptoms of PTSD and insomnia.

Authors of this paper collectively brought expertise from nursing, psychology, public health, and psychiatry. We wanted to capture the “real-world” experience of Veterans seeking care for their symptoms. Here is a brief video with examples and stories from veterans about their experiences:

 

Danielle Beck

Pia Heppner

Joe Burkard

Jill Bormann

Jun 26

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Enhancing Person-Centered Care


Kristin Thórarinsdóttir

For the next couple of weeks, the ANS featured article will be “Development of Hermes, a New Person-Centered Assessment Tool in Nursing Rehabilitation, Through Action Research” by Kristin Thórarinsdóttir, RN, BScN, MScN; Kristing Björnsdóttir,EdP, RN; Kristján Kristjánsson, PhD. In the article they describe the clinical application of a tool based on existentialist and hermeneutical phenomenology, a philosophy that they believe is meant to be a philosophy for real life.  I join the authors in inviting you to read their article (available at no cost while it is featured), and share your comments here!  Here is Kristin Thórarinsdóttir’s description of this work:

On behalf of my co-authors, Dr. Kristín Björnsdóttir and Dr. Kristján Kristjánsson, and myself, I would like to say that it is an honour to have our article featured in the “Editor’s Picks”. This article is a part of my PhD project at the Faculty of Nursing, University of Iceland.  My co-authors, who both are my supervisors, have guided me through the challenging but fruitful journey involved in my doctoral studies. To them I am deeply

grateful, as well as to the nurses who participated with genuine effort in developing Hermes. I am also thankful for the organizational leaders who supported the study.

The motivation for the development of the person-centered assessment tool Hermes, outlined in the article, arose in a

Kristing Björnsdóttir

project in which I was engaged, aimed at implementing standardized nursing systems at two rehabilitation wards. As the project progressed, it became apparent that the perspectives of the patients did not reveal themselves satisfactory in the existing nursing assessment at the wards. These practices raised concern for the nurses at the ward, as needing improvement, because they contradicted the person-centered approach that was independently emerging as a central aim at the wards. This recognition provided the platform for the action research through which Hermes was developed in collaboration with the nurses at the respective wards. The tool was meant to facilitate a person-centered approach to the participation of patients in nursing assessment and care planning. In this research project, I had the role of a consultant who provided for solutions in the form of the theoretical and phenomenological background of Hermes, its structure and potential use. In addition to reviewing the structure and use of Hermes, the nurses had the important role of testing out and evaluating Hermes in practice. Evaluations plans were designed through reflection in focus groups for revising and retesting the tool in practice. In spite of many challenges faced during the project, Hermes was adopted in practice at the respective wards where its use has been sustained.  The study showed that, as aimed for, person-centered assessment practices were enhanced through the use of Hermes. Moreover, several aspects of its phenomenological grounding were supported.

Since this study was conducted, an ethnographical study has been embarked upon in which the ways Hermes is used in

Kristján Kristjánsson

nursing assessment of patients with chronic pain are explored. Further studies are needed to explore the use of Hermes in practice for establishing an evidence base for its use.

The fact that Hermes has been implemented at two other rehabilitation settings, in addition to the wards where it was developed, is a positive indication of its practical applicability, but again its effectiveness stands in need of further research.

 

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