University/Hospital Collaborations to Promote Research and Evidence Based Practice in Clinical Environments

Griffiths, Rhonda The Research Institute of Nursing Science Seoul Na 2007 간호학의 지평 Vol.4 No.1

Systems and processes to provide clinical education to students of nursing have been established between universities and health facilities in all countries where nurse education is tertiary based. However, systems and processes to link nurse researchers based in universities to their clinical colleagues are less well developed. When collaborations are established they are frequently based on personal networks, and while the rhetoric of the organizations encourages these collaborations, they are largely unrecognised by senior administrators in health facilities. The research is frequently "invisible" and the clinician researchers usually do not have access to appropriate infrastructure and other resources that are required to support large projects that have the potential to change practice across organisations. This situation influences the focus and scope of nursing research and limits opportunities for clinicians to be engaged in the generation of professional knowledge. The University of Western Sydney (UWS) has taken a strategic approach to the development of collaborations for research and has linked with health services in Western Sydney to establish and maintain research centres and adjunct appointments. The partner organisations jointly fund the infrastructure of the centres which include a Professor, research assistant position(s) and administrative staff. Five Professors of Nursing have been appointed to positions in one of three nursing research centres. This paper describes the approach established by the School of Nursing at UWS to build collaborations with clinical areas to promote research. This approach could be adopted or adapted by other facilities.

Reassessing Statin Therapy in Elderly Dyslipidemia: A Literature Review

Lee, Kyung-Hwa The Research Institute of Nursing Science Seoul Na 2011 간호학의 지평 Vol.8 No.2

Purpose: An integrative literature review was done to identify the best interventions for older adults with dyslipidemia in an effort to promote nursing involvement in the prevention of statin-induced symptoms (SIS). Such awareness could increase the capacity of interventions by geriatric nurses using evidence-based practices in the reassessment of statin therapy. Methods: CINAHL, Pubmed, and ProQuest were searched using these terms: dyslipidemia in, elderly, statins, adverse effects, and quality of life. Eleven articles fitting the inclusion criteria were identified and analyzed. Results: The findings indicate no evidence for the benefit of statin therapy for morbidity/mortality in a high-risk primary prevention set-up, specifically in the elderly population. Although SIS prevails among older adults, there are limited data that confidently support this observation along with nursing interventions specifically for the geriatric nursing community. Conclusion: Future research is necessary to shift nursing intervention with statin users (specifically in older adults) from an illness-based intervention to a preventive care plan to provide optimal care based on evidence. It is essential to involve self-reporting, cooperation, and communication with health care professionals, specifically with geriatric nurses. Additional studies are needed to further direct practice interventions in elderly statin users.

Fostering Interdisciplinary Research

Heitkemper, Margaret M. The Research Institute of Nursing Science Seoul Na 2007 간호학의 지평 Vol.4 No.1

Today interdisciplinary collaboration is an important component of clinical research. This paper focuses on how the University of Washington School of Nursing (UW-SON) Center for Women's Health and Gender Research (CWHGR) facilitated and sustained interdisciplinary research. The CWHGR funded by National Institutes of Nursing Research has been an important resource for the UW-SON since its inception in 1989. The CWHGR encourages interdisciplinary collaborative research by providing small grant funds, mentoring faculty and pre- and postdoctoral fellows, providing consultation to researchers in other disciplines, and creating a model of biobehavioral and sociocultural research collaboration that facilitates interdisciplinary research. A brief overview of the UW-SON CWHGR is provided as well as identification of barriers to interdisciplinary research.

Nursing Philosophy: Rethinking Nurses' Moral Dilemma and Self-cultivation from the Perspectives of Foucauldian Notions

Koh, Eun Kang The Research Institute of Nursing Science Seoul Na 2015 간호학의 지평 Vol.12 No.2

Purpose: This article discusses nurses' moral dilemma and self-cultivation from the Foucauldian viewpoint. Methods: The philosophical inquiry approach is utilized to analyze the nurses' moral distress. Analyses are based on Foucauldian perspectives. Results: Foucault's codes of conduct comprising the mode of subjection and telos are discussed to explain nurses' moral dilemma. The dual process of caring is also discussed. Conclusion: From dilemmatic experience, nurses practice self-formation or self-cultivation to become more virtuous, well-balanced, or integrated people. Such characteristics form the essence of nursing practice.

Difficulties Faced by Working Mothers and Potential Solutions to these Problems: A Survey of Nursing Personnel in a Korean Teaching Hospital

Kim, Young Mee,Kim, Min Young The Research Institute of Nursing Science Seoul Na 2013 간호학의 지평 Vol.10 No.2

Purpose: The purpose of this study was to identify difficulties that working mothers face and solutions to the identified problems. Methods: The study design was a cross-sectional, descriptive survey. A survey with 8 items rated on a 5-point scale (1~5) and 5 open-ended questions was administered to 48 married nurses and nurse aides working in 5 nursing units of a teaching hospital in South Korea in April 2013. Results: The score of satisfaction with childrearing patterns (mean=$3.31{\pm}0.79$) was higher than that of satisfaction with spousal support (mean=$3.08{\pm}0.85$). The score of working mother's turnover intention (mean=$2.40{\pm}1.03$) was lowest among the 8 items, but partners did not want their wives to quit work (mean=$3.60{\pm}1.22$). Satisfaction with company employment benefits for childrearing (mean=$2.90{\pm}0.72$) had the lowest score among the 4 satisfaction types analyzed. The turnover intention and satisfactions with childrearing (r=-.51, p<.001), spousal support (r=-.43, p=.002), supervisor's support (r=-.36, p=.013), and company benefits (r=-.37, p=.009) showed significant negative correlations. Conclusion: According to these results, familial support for childrearing is highly correlated with employed mothers' turnover intention. So improvement of familial support for childrearing will reduce married nurses' turnover intention. In addition, well-organized nursery facilities are recommended for enabling working mothers to continue their careers. Furthermore, more family-friendly welfare policies such as a flextime systems or compulsory paternity leave should be reinforced in the workplace.

The Accuracy of Glasgow Coma Scale Knowledge and Performance among Vietnamese Nurses

Hien, Nguyen Thi,Chae, Sun-Mi The Research Institute of Nursing Science Seoul Na 2011 간호학의 지평 Vol.8 No.1

Purpose: The purpose of this study was to investigate the accuracy of Glasgow Coma Scale (GCS) knowledge and performance among Vietnamese nurses. Methods: A cross-sectional descriptive study was conducted using a questionnaire pertaining to the nurses' knowledge of GCS and a structured evaluation tool to measure the accuracy of their GCS scores. A total of 94 Vietnamese nurses participated in this study, all from a general hospital in Ho Chi Minh City, Vietnam. Data were analyzed by conducting a t-test, a $x^2$ test, and ANOVA. Results: This study found that the vast majority of the nurses (>90%) responded correctly to questions regarding their GCS basic knowledge; however, 52.1% of the nurses answered incorrectly questions related to clinical scenarios requiring the application of the basic knowledge. Regarding the GCS performance, the nurses demonstrated acceptable accuracy rates for each component of GCS, but those who scored well in all three components accounted for only 42.6% of the subject group. These findings indicate that the Vietnamese nurses are not able to integrate their GCS knowledge into actual practice as measured by the accuracy of GCS scoring. Conclusion: This study suggests that new educational strategies should be developed for the Vietnamese nurses to improve their performance on accurate GCS scoring based on theoretical knowledge.

Multidisciplinary Approach to Breast Cancer Care

Juon, Hee-Soon The Research Institute of Nursing Science Seoul Na 2007 간호학의 지평 Vol.4 No.1

Aim: The purpose of this paper is to present the importance of multidisciplinary strategies in cancer prevention and control, especially comprehensive breast cancer care. Background: Worldwide, breast cancer is the most common cancer diagnosed among women and is the leading cause of cancer deaths. Although the incidence of breast cancer in Asian countries is still lower than in Western countries, the rate of increase for the last two decades is striking. Methods: Data on cancer mortality, incidence, and risk factors were summarized by using the most recent data available from population-based cancer registries affiliated with the International Union Against Cancer, the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program and the CDC's National Program of Cancer Registries (NPCR). Results: Global differences in breast cancer incidence and fluctuations in rates within a country still exist. The incidence of breast cancer in Asian countries was lower than in Western countries. Breast cancer incidence in the United States decreased each year during 1999-2003. On the other hand, morbidity and mortality related to breast cancer in Asia has increased significantly. Conclusion: Multidisciplinary strategies to reduce breast cancer mortality and promote breast cancer awareness are addressed. Lessons learned from multidisciplinary approaches to cancer treatment and control will be valuable in implementing future breast cancer research in the fields of basic, clinical, and population research in Asia.

Biobehavioral Health Research: A nursing study of women with and without fibromyalgia

Landis, Carol A.,Lentz, Martha J. The Research Institute of Nursing Science Seoul Na 2005 간호학의 지평 Vol.2 No.1

Biobehavioral nursing research is focused on generating knowledge that examines relations among biological, behavioral, and social dimensions of health to improve outcomes. In this paper we review the findings of a biobehavioral nursing study of individuals with fibromyalgia (FM) that was framed from the perspective of an individual human response model, the FM literature, and our previous studies in midlife women. We were particularly interested in the studying the role of 'arousal' secondary to pain or to dysregulated hypothalamic-pituitary-adrenal (HPA) axis hormones during sleep and the impact on symptom expression. Unexpectedly, we did not find evidence of, arousal' or abnormal amounts of HPA axis hormones but we did find reduced amounts of growth hormone (GH) and prolactin (PRL) and of sleep spindle activity, a biomarker of sleep maintenance. We discuss these new findings and how our thinking was re-shaped to better understand the role that disturbed sleep plays in symptom expression in FM. It is argued that disturbed sleep maintenance mechanisms coupled with dysregulated somatotrophic-growth hormone axis and sleep-related PRL render individuals vulnerable to the development of or exacerbations of FM symptoms.

Prospects for Future Multi-disciplinary Collaboration

Lai, Claudia K.Y. The Research Institute of Nursing Science Seoul Na 2007 간호학의 지평 Vol.4 No.1

Background: Intersectoral and multidisciplinary collaboration is becoming more prominent in all facets of government, health, social services, and scientific endeavors. An interplay of a multitude of driving forces moves multiple disciplines forward to achieve quality outcomes in health and social sciences services and research. Aim: This paper aims at discussing the prospects for future multidisciplinary collaboration. If inter organizational integration and multidisciplinary collaboration are the ways of the future in academia and the scientific world, it then becomes crucial to examine what lies ahead for the nursing profession, Discussion: This paper argues that in order for multidisciplinary endeavors to succeed, the leaders in multidisciplinary teams shoulder the largest share of the responsibilities involved. In developing a lasting team constituting professionals from different disciplines, the leader needs to include the right individuals in the team, identify a common goal, build trusting relationships through open communication and interprofessional education, and empower members through creating room for autonomy and at the same time allowing space for personal development. The leader will need to utilize information technologies to manage communication issues in a large multi-site multidisciplinary project. Lastly, he or she must be able to demonstrate team productivity through process and outcome evaluation. It needs to be emphasized that it falls to each individual nurse to speak up and act upon what nursing believes and represents in our quest for success in multidisciplinary endeavors. Conclusion: The significance of the role of the leader is paramount for a team to succeed. Yet there is no prospect if only a handful of exceptional nurse leaders are moving ahead in multidisciplinary endeavors. Without the actualization of professional roles by each individual nurse, the profession will have no prospect in collaborations across disciplines.

A Comparison of NANDA and CCC used in Hospital-based Home Health Care

Park, Hyeoun-Ae,Lee, Jin-Kyung,Lee, Hyun-Jung The Research Institute of Nursing Science Seoul Na 2008 간호학의 지평 Vol.5 No.1

Background: Recent changes in the medical environment have increased the need for the home health care nursing in Korea. Even though the number of home health care patients is increasing, the major nursing problems have not been identified due to lack of a standardized nursing diagnosis. Aim: An investigative study was conducted to determine the frequency and appropriateness of nursing problems in hospital-based home health care patients in Korea using two internationally standardized nursing diagnosis classification systems. Methods: Nursing records of 249 hospital-based home health care patients were reviewed and nursing problems were identified using the North American Nursing Diagnosis Association Nursing Diagnosis Taxonomy I (NANDA) and the Clinical Care Classification of Nursing Diagnoses (CCC). Findings: Out of 463 nursing problems. 403 nursing problems were described using the NANDA whereas 427 nursing problems were described using the CCC. Nursing diagnoses not captured by the NANDA classification include nausea/vomiting, anorexia, risk for nutrition deficit, decreased blood pressure, dying process, blood sugar impairment. infection unspecified, and disuse syndrome. Nursing diagnoses not captured by the CCC include nausea/vomiting and anorexia. Conclusions: In describing nursing problems of home health care patients, it was found that the CCC was able to represent more diagnoses than the NANDA.