Our current featured article is authored by Selma Turan Kavradim, PhD; Şefika Tuğba Yangöz, PhD; and Zeynep Ozer, PhD, titled Research Trends and Hot Topics on Virtual Reality in Nursing: A Bibliometric Analysis Using CiteSpace. Drs Turan Kavradim and Ozer are from the Department of Internal Medicine Nursing, Faculty of Nursing, and Akdeniz University, Antalya, Turkey. Dr Yangöz is from the Department of Internal Medicine Nursing, Faculty of Health Sciences, Pamukkale University, Denizli, Turkey. This article is available to download at no cost while it is featured! Dr. Turan Kavradim provided this background information about their article:
We conducted this bibliometric analysis to provide a comprehensive overview of the development of virtual reality in nursing and to identify research trends and current issues in this field. Virtual reality applications in nursing have been making great progress in recent years, and the number of studies continues to increase over the years. Bibliometric studies can make it easier to master the field by summarizing large amounts of data. By identifying gaps in the field, it can provide important data to researchers, educators, and health professionals in planning new studies, and most importantly, it can guide the realization of collaborations. We have seen that recently published bibliometric studies on virtual reality do not adequately reflect the current situation due to various limitations, so we decided to conduct this research. We obtained important data during this research process, which started with the idea of introducing the roles of virtual reality in the nursing discipline, revealing the most studied areas and collaborations, and identifying research trends, current issues, and gaps in this field. We are excited to share this article and hope that our research results can benefit researchers, educators, and healthcare professionals.
The following editorial is apearing in more than 200 medical journals worldwide between October 25th, and the end of 2023. We are joining this international action to draw attention to the climate and nature crisis.
Over 200 health journals call on the United Nations, political leaders, and health professionals to recognise that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe. This overall environmental crisis is now so severe as to be a global health emergency.
The world is currently responding to the climate crisis and the nature crisis as if they were separate challenges. This is a dangerous mistake. The 28th Conference of the Parties (COP) on climate change is about to be held in Dubai while the 16th COP on biodiversity is due to be held in Turkey in 2024. The research communities that provide the evidence for the two COPs are unfortunately largely separate, but they were brought together for a workshop in 2020 when they concluded that: “Only by considering climate and biodiversity as parts of the same complex problem…can solutions be developed that avoid maladaptation and maximize the beneficial outcomes.”[1]
As the health world has recognised with the development of the concept of planetary health, the natural world is made up of one overall interdependent system. Damage to one subsystem can create feedback that damages another—for example, drought, wildfires, floods and the other effects of rising global temperatures destroy plant life, and lead to soil erosion and so inhibit carbon storage, which means more global warming. [2] Climate change is set to overtake deforestation and other land-use change as the primary driver of nature loss. [3]
Nature has a remarkable power to restore. For example, deforested land can revert to forest through natural regeneration, and marine phytoplankton, which act as natural carbon stores, turn over one billion tonnes of photosynthesising biomass every eight days. [4] Indigenous land and sea management has a particularly important role to play in regeneration and continuing care. [5]
Restoring one subsystem can help another—for example, replenishing soil could help remove greenhouse gases from the atmosphere on a vast scale. [6] But actions that may benefit one subsystem can harm another—for example, planting forests with one type of tree can remove carbon dioxide from the air but can damage the biodiversity that is fundamental to healthy ecosystems. [7]
The impacts on health
Human health is damaged directly by both the climate crisis, as the journals have described in previous editorials, [8,9] and by the nature crisis. [10] This indivisible planetary crisis will have major effects on health as a result of the disruption of social and economic systems—shortages of land, shelter, food, and water, exacerbating poverty, which in turn will lead to mass migration and conflict. Rising temperatures, extreme weather events, air pollution, and the spread of infectious diseases are some of the major health threats exacerbated by climate change. [11] “Without nature, we have nothing,” was UN Secretary-General António Guterres’s blunt summary at the biodiversity COP in Montreal last year. [12] Even if we could keep global warming below an increase of 1.5◦C over pre-industrial levels, we could still cause catastrophic harm to health by destroying nature.
Access to clean water is fundamental to human health, and yet pollution has damaged water quality, causing a rise in water-borne diseases. [13] Contamination of water on land can also have far-reaching effects on distant ecosystems when that water runs off into the ocean. [14] Good nutrition is underpinned by diversity in the variety of foods, but there has been a striking loss of genetic diversity in the food system. Globally, about a fifth of people rely on wild species for food and their livelihoods. [15] Declines in wildlife are a major challenge for these populations, particularly in low- and middle-income countries. Fish provide more than half of dietary protein in many African, South Asian and small island nations, but ocean acidification has reduced the quality and quantity of seafood.[16]
Changes in land use have forced tens of thousands of species into closer contact, increasing the exchange of pathogens and the emergence of new diseases and pandemics. [17] People losing contact with the natural environment and the declining loss in biodiversity have both been linked to increases in noncommunicable, autoimmune, and inflammatory diseases and metabolic, allergic and neuropsychiatric disorders. [10,18] For Indigenous people, caring for and connecting with nature is especially important for their health. [19] Nature has also been an important source of medicines, and thus reduced diversity also constrains the discovery of new medicines.
Communities are healthier if they have access to high-quality green spaces that help filter air pollution, reduce air and ground temperatures, and provide opportunities for physical activity. [20] Connection with nature reduces stress, loneliness and depression while promoting social interaction. [21] These benefits are threatened by the continuing rise in urbanisation. [22]
Finally, the health impacts of climate change and biodiversity loss will be experienced unequally between and within countries, with the most vulnerable communities often bearing the highest burden. [10] Linked to this, inequality is also arguably fuelling these environmental crises. Environmental challenges and social/health inequities are challenges that share drivers and there are potential co-benefits of addressing them. [10]
A global health emergency
In December 2022 the biodiversity COP agreed on the effective conservation and management of at least 30% percent of the world’s land, coastal areas, and oceans by 2030.[23] Industrialised countries agreed to mobilise $30 billion per year to support developing nations to do so.[23] These agreements echo promises made at climate COPs.
Yet many commitments made at COPs have not been met. This has allowed ecosystems to be pushed further to the brink, greatly increasing the risk of arriving at ‘tipping points’, abrupt breakdowns in the functioning of nature.[2,24] If these events were to occur, the impacts on health would be globally catastrophic.
This risk, combined with the severe impacts on health already occurring, means that the World Health Organization should declare the indivisible climate and nature crisis as a global health emergency. The three pre-conditions for WHO to declare a situation to be a Public Health Emergency of International Concern [25] are that it: 1) is serious, sudden, unusual or unexpected; 2) carries implications for public health beyond the affected State’s national border; and 3) may require immediate international action. Climate change would appear to fulfil all of those conditions. While the accelerating climate change and loss of biodiversity are not sudden or unexpected, they are certainly serious and unusual. Hence we call for WHO to make this declaration before or at the Seventy-seventh World Health Assembly in May 2024.
Tackling this emergency requires the COP processes to be harmonised. As a first step, the respective conventions must push for better integration of national climate plans with biodiversity equivalents. [3] As the 2020 workshop that brought climate and nature scientists together concluded, “Critical leverage points include exploring alternative visions of good quality of life, rethinking consumption and waste, shifting values related to the human-nature relationship, reducing inequalities, and promoting education and learning.” [1] All of these would benefit health.
Health professionals must be powerful advocates for both restoring biodiversity and tackling climate change for the good of health. Political leaders must recognise both the severe threats to health from the planetary crisis as well as the benefits that can flow to health from tackling the crisis. [26] But first, we must recognise this crisis for what it is: a global health emergency.
Kamran Abbasi, Editor-in-Chief, BMJ; Parveen Ali, Editor-in-Chief, International Nursing Review; Virginia Barbour, Editor-in-Chief, Medical Journal of Australia; Thomas Benfield, Editor-in-Chief, Danish Medical Journal; Kirsten Bibbins-Domingo, Editor-in-Chief, JAMA; Stephen Hancocks, Editor-in-Chief, British Dental Journal; Richard Horton, Editor-in-Chief, The Lancet; Laurie Laybourn-Langton, University of Exeter; Robert Mash, Editor-in-Chief, African Journal of Primary Health Care & Family Medicine; Peush Sahni, Editor-in-Chief, National Medical Journal of India; Wadeia Mohammad Sharief, Editor-in-Chief, Dubai Medical Journal; Paul Yonga, Editor-in-Chief, East African Medical Journal; Chris Zielinski, University of Winchester.
One of the greatest mysteries in pediatric healthcare today is the ability to understand and predict the children born preterm who will and who will not, do well. Every neonatal intensive care unit (NICU) clinician can share a story about the infant born at 24 weeks who is celebrating their college admission or returning to work in the NICU as a nurse. And every clinician will lament the seemingly healthy preterm infant who experienced multiple setbacks, grows up with developmental disability, or significant ongoing respiratory compromise. We have learned that while gestational age and birth weight offers clues to outcome risk, alone these objective parameters fall short.
Clinicians and researchers have attempted to understand the complex interaction of biology, environment, social context, and development. Experts in theories of resilience1, adaptation2, development3 and even epigenetics4, provide important components, but individually each area of focus is insufficient to use for consistent prediction of outcomes.
Differential susceptibility posits that some individuals, with specific characteristics, are more, or less susceptible than others, to both adverse and beneficial environmental influences5.6. This susceptibility fosters receptivity to environmental context, resulting in better or worse outcomes. Research is ongoing to determine which specific characteristics lead to an increased susceptibility.
Differential susceptibility has the potential to provide a framework for understanding the variation in life course and developmental outcomes experienced by people born preterm. The current manuscript describes differential susceptibility and explores the related preterm birth outcome literature. This includes exploration of prematurity as the specific characteristic which may lead to increased receptivity to environmental context. It is our hope that our in depth exploration of differential susceptibility will make the theory more accessible to nurse researchers and those interested in maximizing the potential of the 15 million infants born preterm worldwide each year7.
References
Masten AS, Barnes AJ. Resilience in children: Developmental perspectives. Children 2018;5:1-16. doi:10.3390/children5070098
Bronfenbrenner U, Evans GW. Developmental science in the 21st century: Emerging theoretical models, research designs and empirical findings. Soc Dev. 2000; 9:115-125.
Sameroff, A. A unified theory of development: A dialectic integration of nature and nurture. Child Develop. 2010;81:6-22.
Rubin LP. Maternal and pediatric health and disease: Integrating biopsychosocial models and epigenetics. Pediatric Research. 2016;79 (1):127-135.
Belsky J, Bakermans-Kranenburg MJ, van IJzendoorn MH. For better and for worse: Differential susceptibility to environmental influences. Curr Dir Psychol Sci. 2007;1;16(6):300-304.
Belsky J, Pluess M. Beyond diathesis stress: Differential susceptibility to environmental influences. Psychol Bull. 2009;135(6);885-908. doi:10.1037/a0017376
Chawanpaiboon, S., Vogel, J.P., Moller, A-B, Lumbigamom, P., et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Lancet. 2018;7:E37-E46. doi:10.1016/S2214-109X(18)30451-0.
My interest in the inner workings of the nurse-patient relationship has been fueled by my experiences using Margaret Newman’s research as praxis approach1. When I asked patients to tell me about the most important people and events in their life or in their present circumstances, I was often met first with a pause as folks gathered their thoughts. Then the stories would start. Stories about their challenges living with a chronic condition – of pain, daily disruptions to usual life from symptoms, treatments, or health care appointments. Sometimes the stories they told began many years ago, but they were told as if it were yesterday. Stories of their divorce, a significant accident or diagnosis, or a traumatic childhood event or relationship. They also shared meaningful experiences like becoming a parent, working in a job they love, dancing, or cooking for friends. Coming to know the person in this way, expanded my awareness of their responses to their life challenges and joys that my usual family nurse practitioner health assessment did not. My practice experience became richer.
Simultaneously, Newman’s research praxis approach gave patients opportunities to come to know their patterns of responses to their current circumstances. Coming to know the whole person in this way led to my discovery that the nurse-patient relationship facilitates healing and personal transformation2. Patients moved through a process of increasing awareness, deepening awareness, appreciating meaning, and personal transformation3. Notably, when patients appreciated the meaning of their circumstances within the whole of their lives, they began to transform and heal in a new way. They made new choices, changed behaviors, and improved healing. The nurse-patient relationship was central to this process. These shared experiences created an environment of caring and trust that promoted access to personalized knowledge on recovery and healing.
For example, a grandmother with a chronic leg wound was caring for her grandson with special needs. For most of her life, she focused on caring for others. Her life spiraled out of control with the onset of her skin wounds. She felt powerless and threatened. She told me, “I was good at advocating for other people and not myself.” Once she became aware that smoking contributed to her leg condition, she quit a 40-year smoking habit cold turkey and remained committed to smoking cessation. She formed a bond with her wound care specialist nurse and learned how to take care of her legs. She expressed living with leg wounds as being in “jail.”.
Participants’ comments about being known in this way contributed to deeper understanding of caring in the human health experience. Many shared what was meaningful about their wound care nurse. They said, “they were in good hands,” that their nurse “was very particular, very fussy” and “was a good friend and confidant,” and that getting asked “did you do a lot?” triggered them to think about their activity and connect it to how well their wound was healing.
My discovery that the nurse-patient relationship was central to patients’ wholistic healing and personal transformations, sparked my interest to illuminate some of the mystery of relationship-based care from the perspective of Newman’s theory of health as expanding consciousness. I conducted an integrative review of 20 years of Newman’s science to answer the question on how nurses use relationship dynamics4. The reports focused on adults living with a chronic life disruption such as a chronic disease or living with medically fragile children. Data were organized by the relationship dynamics of caring, consciousness, health, meaning, mutual process, presence, and patterning5. My review revealed that when the nurse-patient relationship includes a focus on the meaningful people and events in the patient’s life, then the nursing care is patient-centered, comprehensive, compassionate and safe. In a second phase of this work, the empirical knowledge on the experiences of patients working with their nurses was translated into questions for use in a measurement scale.
This measurement scale, the RELATE Scale, will contribute to enhancing our understanding of what works when patients and nurses come to know what is personally meaningful in their human health experiences. My praxis research journey — from explicating knowledge of being within the relationship, to analyzing relationship dimensions, to developing and psychometrically testing a measurement scale for patients’ perspectives of their nurse-patient relationship — has taken a full turn around the spiral of nursing’s evolving knowledge development on relationship-centered care. Knowledge development on a person’s patterns of responses when living with a chronic illness began in the environment of direct patient care, and it returns as a scale to measure patients’ perceptions of their nurse-patient relationship as healing transformations.
I’m grateful to Drs. Margaret Newman and Dorothy Jones whose clarity of thought and compassion supported me throughout this scholarly journey. I am deeply indebted to them and all the Newman scholars who preceded me. May the RELATE scale benefit patients and nurses as they work together to foster healing transformations.
Resources
1. Newman MA. Health as expanding consciousness. 2nd ed. New York: National League for Nursing Press; 1999.
2. Rosa K. A process model of personal healing and transformation in persons with chronic skin wounds. Nursing Science Quarterly. 2006;19(4):349-358.
The current featured ANS article is titled “Evaluation of an Ecological Model for Work-Related Musculoskeletal Disorders” authored by Minjung Kyung, RN, MPH; Laura Wagner, PhD, RN, FAAN; Soo-Jeong Lee, PhD, RN, FAAOHN; and OiSaeng Hong, PhD, RN, FAAN. Visit the ANS website to download this article at no cost while it is featured. Minjung Kyung has shared this message about this work:
Minjung Kyung
Musculoskeletal disorder is the largest category of occupational health problem that not only affects nurses but also many other occupations, causing a temporary or permanent disability. Work-related musculoskeletal disorders are the results of the interaction between external physical demands, psychosocial work factors, and the internal biomechanical, physiological, and psychological responses of individuals. Many interventions focusing on correction of individual’s biomechanics and lifting techniques have been implemented, but they were not very effective for reducing musculoskeletal injuries. Considering various risk factors and their interactions, a comprehensive understanding of the physiology of work-related musculoskeletal disorders is required for developing an effective intervention to prevent WRMSDs.
Sauter and Swanson’s ecological model for work-related musculoskeletal disorders consist of three parts: biomechanical, psychosocial, and cognitive structures. This model is also distinguished by its focus on cognitive processes and expanded musculoskeletal outcomes such as symptom reporting, health care utilization, disability, and performance problems. Employing Chinn and Kramer’s framework, we evaluated the ecological model to determine its appropriateness and usefulness in nursing paradigm.
I am very excited to share this paper and hope this would be helpful.
Our current featured article is titled “Guided Participation for Clinical Practice: A Middle-Range Theory of Teaching and Learning” authored by Karen Pridham, PhD, RN, FAAN and Rana Limbo, PhD, RN, CPLC, FAAN. While it is featured you can download the article at no cost! We welcome your comments and discussion of this article in the comments below. Dr. Pridhame shared this background about their work for ANS readers –
Karen Pridham
The article, “Guided Participation for Clinical Practice,” written with Rana Limbo, is the culmination to date of years of experiences working with families. These experiences include observing, reflecting, and wondering with parents of children and with our research team about how parents and later, the nurses we were working with, were thinking through and coming up with new solutions to the health-related issues they were dealing with. Our observations led us to reflect and wonder how my students, and later my colleagues, made their own assessments about parents and their children working on health-related tasks and responsibilities. In the process, were parents themselves learning to more confidently and competently manage these issues–specifically problems or goals–and achieve the outcomes they wanted to accomplish?
Rana Limbo
Together, research assistants, graduate students, colleagues (e.g., co-investigators and research teams), and I, kept on thinking, learning about, and developing Guided Participation over the decades, a process that remains ongoing due to the assumption that Guided Participation is dynamic. Our many miles of automobile travel together, most often in pairs, to observe and discuss feedings with many families and the in-depth reflection and analysis that followed on the ride home were invigorating and productive of new insights and concepts for describing parents’ goals and competencies and Guided Participation processes. These concepts had origins in Rogoff’s work, were studied together in seminar courses, and in our own meaning making and concept naming from discussion of research experiences. Ours was a process of theory development through deep and challenging experiences with families—parents and their infants—in need of description and explanation–cast against study of the literature. The rich description in the literature included Dewey’s Education as Experience; Vygotsky’s concepts of socially-based learning, among them the zone of proximal development; and Rogoff’s ideas of learning as a collaborative process, contextually and culturally attuned to the other.
We went beyond noticing that something was missing or incomplete in traditional teaching/learning patterns based in information sharing, important in its own right but not sufficient for theory development of participatory learning in clinical practice. We had experienced, over decades of our lives and in many settings, learning within a relationship, another Guided Participation assumption, when we were engaged in activity vital to projects that mattered deeply to us. Among the guides who shaped my orientation towards learning through experience was my mother. When I was 12 years old and teaching summer Vacation Bible School in the small community in which my family lived, I was challenged by the behavior of an 8-year-old boy who disengaged from participation with the group, seemingly self-absorbed and fidgety—clearly not having a good time, consequently making a nuisance of himself. When I asked my mother, who was an experienced Sunday School teacher, how to handle the situation that was joyless for both the child and me, she suggested I find out from him what he wanted to work on at Vacation Bible School. He surprised me with a clear and doable activity, and with my asking the question (later to be learned as joining attention), we formed a relationship, and had a time that I remember as good for the rest of the week. It was a pivotal, amazing teaching/learning experience for me. Later, as a graduate student in nursing, I had the good fortune to be one of the four students in the first class the renowned scholar and practitioner of pediatric nursing, Florence Blake, had at the University of Wisconsin-Madison. She taught me the meaning of “being with” when she and I were with a toddler having a tantrum, so angry that it was enough to drive anyone in the vicinity away. But Florence Blake stayed put, sitting close to the child and telling him that she knew he was angry and upset. She would not leave him, she assured him, talking gently through his shrieks and thrashing about, a powerful lesson to me regarding how trust with a young child was maintained and strengthened—and what it took to be with someone and why.
With students and research assistants, we did not dwell on what was lacking in traditional teaching in clinical practice. Our new, evolving frames of mind oriented us to finding a language for recording our work with families and communicating what we were observing in learning through participation. We were also creating a “dictionary” of sorts of issues families were working on or needed to work on, the processes we were using to work on the issues with them, and the competencies they were developing in Guided Participation sessions, often focused on the infant’s feeding, sleeping, growth, and development.
Dr. Rana Limbo, co-author of this article and first author of a companion article¸ collaborated with me in many home visits, reflected with me in depth about what we had experienced with a family, and co-taught classes of public health and neonatal intensive care nurses and led many reflective practice sessions with these nurses and nurses providing Guided Participation to parents of fragile infants. These experiences with Dr. Limbo greatly enlarged my thinking about Guided Participation concepts, including joining attention, sharing understanding, making connections, and transferring responsibilities, as well Guided Participation as a clinical practice. The collaboration with Dr. Limbo in many contexts and venues, including automobile trips generally 90 minutes one way, has kept Guided Participation a dynamic and developing—exciting and intriguing–practice.
Our current featured article is titled “Scandinavian Online Cancer Information as Expressions of Governmentality A Comparative Qualitative Study” authored by Elin Margrethe Aasen, PhD, RN; Berit Misund Dahl, PhD, RN;Aase Marie Ottesen, PhD, RN; Jeanne Strunck, PhD;Henrik Erikson, PhD, RN; Elisabeth Dahlborg, PhD, RN;Åse Boman, PhD, RN; Lisbeth Alnes Vestgarden, MScN, RN; and Ellinor Tengelin, PhD. Download the PDF of the article on the ANS website and share your thoughts here. This is the background about this work provided by Dr. Aasen:
Dr. Elin Margrethe Aasen
This article is the result of a collaboration between Denmark, Sweden and Norway. A Nordic network working with discourses.
The Nordic countries represents a model for health care in the welfare system, where equal health is a goal. However, there are considerable variations in the structural levels and in the institutional design and policy. Care organized around the care-seeking person has the potential to improve clinical outcomes and satisfaction with care and a more patient focused care have the potentials to an equal and cost-effective care and treatment, yet there may be hindrance for this to be implemented.
In order to uncover if the political intentions have been implemented, the overall purpose of the study is to generate knowledge and understanding of the relation between the Nordic health care legislations level, institutional/organizational level and the experiences of the care-seeking person.
The part studies are described below:
Part study one (Macro-level):
The aim of this study is to explore and analyze how persons in need of care are discursively constructed and interdiscursively related in Nordic health care legislation in Norway, Sweden and Denmark. To conclude part study one, results obtained in the three countries will be compared. Articles:
Lyckhage, E.D., Pennbrant, S. and Boman, Å (2016) ”The Emperor’s new clothes”: discourse analysis on how the patient is constructed in the new Swedish Patient Act. Nursing Inquiry. Wiley, 1-11. DOI: 10-1111/nin.12162
Lassen I, Ottesen AM, Strunck J. Health care policy at a crossroads? A discursive study of patient agency in national health quality strategies between 1993 and 2015. Nursing inquiry. 2018;25(4):e12252.
Lassen, I., Ottesen, A.M. & Strunck, J. (2015) Identitetskonstruktioner af patienter. Malene Kjær (red.). Sundhed. Aalborg: Academic Quarter. Volume 12, 136-153. http://www.akademiskkvarter.hum.aau.dk/UK/index.php
The aim of this study is to explore and analyze how persons in need of care are discursively constructed in health care documents in Nordic institutional organizations. To conclude part study two, results obtained in the three countries will be compared.
Articles:
Ottesen A. M., & Strunck J. The discursive construction of person-centredness in online information leaflets addressed to patients with cancer. https:// vbn.aau.dk/en/publications/the-discursiveconstruction-of-person-centredness-in-online-infor-2. 2021.
Aasen EM, Crawford P, Dahl BM. Discursive construction of the patient in online clinical cancer pathways information. J Adv Nurs. 2020;76(11): 3113-3122. doi:10.1111/jan.14513
Boman Å, Dahlborg E, Eriksson H, Tengelin E. The reasonable patient—a Swedish discursive construction. Nurs Inq. 2021;28(3):e12401. doi:10. 1111/nin.12401
The aim of this study is to explore and analyze individual narratives about becoming a person in need of care. To conclude part study three, results obtained in the three countries will be compared and a joint article will be prepared for publication in an international journal.
We are now working on micro levels and have put focus on the cancer patient and how they express themselves online via blogs.
The current ANS featured article is titled “The Current Status of Research Mentoring in Nursing Across 4 Countries: A Discussion Paper” authored by Eun-ok Im MPH, RN, FAAN; Hsiu-Hung Wang, PhD, RN, FAAN; Hsiu-Min Tsai, PhD, RN, FAAN; Reiko Sakashita, PhD, RN; Eui Geum Oh, PhD, RN, FAAN; Haewon Kim, PhD, RN; and Ching-Min Chen, DNS, RN, FAAN. While this article is featured is available for free download here. Here is a message about this work that Dr. Eui Geum Oh provided for ANS readers:
Eui Geum Oh
Developing future professional nurses hinges on effective research mentoring, a crucial strategy. Research mentoring differs from clinical mentoring, by focusing on training young nurse researchers to become independent, skilled investigators who secure research funding. Our journey began with a discussion among nursing leaders from different countries during an international conference. We discovered a lack of knowledge about research mentoring in nursing globally. To tackle this issue, we conducted a detailed study on research mentoring in nursing across four countries, and we offer suggestions for improvement.
This paper introduces the concepts of ‘mentoring in nursing research’ and ‘good mentoring’. Our findings emphasize the need for research mentoring to teach integrity, facilitate practical learning through respectful, trusting, and well-communicated approaches, and require consistent support from governments, professional bodies, and institutions. We hope our insights could benefit nursing research mentors and mentees globally.
This paper evolved out of praxis as a primary care nurse practitioner (NP) and nurse educator and culminated in my research as a doctoral student. Early on in my NP career I was faced with the stark realization that my nursing education and training did not prepare me to identify and address the significant bio-psycho-social issues stemming from adverse childhood experiences (ACEs) that deeply affected adults under my care. Armed with the knowledge that significant research questions emerge from clinical practice, I had many questions that needed answers and I wanted to have an impact on the health and wellbeing of the people under my care that went beyond the exam room.
As a doctoral student, I was interested in understanding how primary care NPs communicate with adults about ACE exposure, including their perceptions, experiences, and use of the electronic health record as a tool for such communication. Communicating with adults about childhood adversity is not an innate clinical skill nor is it a routine assessment element. NPs may be aware of the significance that ACE exposure has on adult health and wellbeing; however, they may not be prepared to identify, solicit, interpret, and subsequently act on that information. Presently, the concept of “trauma informed care” (TIC) has come to represent the conceptualization and delivery of ACE-related communication in a variety of healthcare settings, including primary care. This framework can be applied by clinicians to gain a better understanding of childhood trauma among adults and to establish a context of care; however, its abstract nature has made it challenging to operationalize and implement in primary care.As a result, the development of a more specific, middle range conceptual model to further operationalize and study these concepts was needed to better understand factors that influence this phenomenon. Doing so created an actionable opportunity to more richly describe critical elements that may be missing from this process.
As a result, the PPC-ACE Model is a product of the synthesis and reformulation of core concepts and constructs foundational to Carrington’s(2012) Effective Nurse-to-Nurse Communication Framework (ENNCF) and Bandura’s(2004) Social Cognitive Theory (SCT). Foundational research focused on patient-to-provider communication of ACEs in the context of the primary care setting has clarified 1) how the concepts “communication” and “childhood adversity” are defined in the literature and applied to patient-to-provider communication of childhood adversity; 2) what is currently known about this phenomenon; 3) how the application of the PPC-ACE Model was used to explore the experiences and perceptions of NPs who communicate with adults about ACEs during routine primary care visits; and 4) how the conceptual model was revised based on the outcomes of the aforementioned exploratory study.
Outcomes of preliminary research using this model have informed future research focused on advanced practice nursing education and practice. Outcomes also present opportunities to shape health policy and to continue to test and refine the PPC-ACE Model. My hope is that others interested in studying this phenomenon will find this model useful in exploring and/or engaging in ACE-related communication among adults in the primary care setting, which can lead to improved mental and physical health outcomes among adults with ACE exposure.
I would like to publicly thank Dr. Pamela Reed and Dr. Jane Carrington for their expertise, encouragement, and mentorship as this conceptual model came together both during and after my time as a doctoral student.
Carrington, J. M. (2012). Development of a conceptual framework to guide a program of research exploring nurse-to-nurse communication. Comput Inform Nurs, 30(6), 293-299. https://doi.org/10.1097/NXN.0b013e31824af809
The essential purposes of ANS are to advance the development of nursing knowledge and to promote the integration of nursing philosophies, theories and research with practice. We expect high scholarly merit and encourage innovative, cutting edge ideas that challenge prior assumptions and that present new, intellectually challenging perspectives. We seek works that speak to global sustainability and that take an intersectional approach, recognizing class, color, sexual and gender identity, and other dimensions of human experience related to health.
This journal is a member of, and subscribes to the principles of, the Committee on Publication Ethics (COPE) www.publicationethics.org
The ANS Blog provides a forum for discussion of issues raised in the articles published in Advances in Nursing Science. We welcome all authors and readers to post your comments and ideas on the blog! If you would like to be an author on this blog, let us know!
The journal Editor is Peggy L. Chinn, RN, PhD, FAAN. Dr Chinn founded the journal in 1978.
ANS: Advances in Nursing Science Blog 