Uncontested categories: the use of race and ethnicity variables in nursing research

Classifying human beings according to race and ethnicity may seem straightforward to some but it, in fact, belies a difficult process. No standard procedure exists for categorizing according to race and ethnicity, calling into question the variables' use in research. This article explores the use of race and ethnicity variables in the nursing research literature. Content analysis was conducted of a sample of 337 original research studies published in Nursing Research from the years 1952, 1955, and then every 5 years through to 2000. Of the 337 research articles reviewed, 167 mentioned race, ethnicity, or their 81 code words or phrases. Out of the 167 articles, 153 used race or ethnicity to describe the study sample, and 45 of the 167 articles included race or ethnicity as an element of data analysis. Throughout the sample, there was substantial inconsistency related to race and ethnicity categorization, meanings of the terms, and use of these variables. Specificity related to conceptual assumptions, definitions, and context was missing and, as a result, data interpretation and understanding are suspect. The integrity of nursing knowledge requires that nurse researchers recognize and address the difficulties inherent in using race and ethnicity in health research.     

A systematic review of the psychiatric/mental health nursing research literature 1982–1992

The purpose of this study was to assess the quality of quantitative psychiatric/mental health nursing research articles published in English between 1982 and 1992, worldwide. Criteria for selection of articles included nurse authorship or co-authorship, use of a quantitative design and pertinence to an aspect of the nursing process with psychiatric/mental health patients. One hundred and ninety-four articles met these criteria. The quality of each article was assessed by two nurse experts using Duffy's Research Appraisal Checklist (RAC). Forty-six point nine per cent of the articles were rated as superior, 50% as average and 3.1% as below average. Other findings identified journals that published research articles, countries in which research was completed, applicability of funding and qualifications of the authors. The major implications of this study are that nurses can be directed to superior articles; more publication of research by nurse authors is warranted, research is being completed with little financial support, highly rated research publications tend to get funding and editorial policies affect the quality of publication.     

Motivation for health behaviours: a systematic review of the nursing literature

AIMS AND RATIONALE: This research review examines nursing and allied health studies exploring motivation for health behaviours to identify the state of understanding of this construct within nursing. This review contributes to nursing science by synthesizing nursing research regarding motivation for health behaviour. METHODS: Integrative research review methodology. FINDINGS: Problems of existing research include nonprobability sampling of heterogeneous populations, low statistical power, and colinearity. Studies identifying predictors of motivation explained large proportions of variance using regression. Motivation was not a significant predictor of health behaviours for over one-third of the studies. Overall, the studies suggest that either motivation is not being effectively measured because of a lack of conceptual clarity or that motivation is not an essential determinant of health behaviours. The latter cannot be verified until psychometric research advances current measurement of motivation to a higher level. LIMITATIONS; The literature for this review was accessed through the Cumulative Index of Nursing and Allied Health Literature (CINAHL) database. Databases for other disciplines were not included in this search. This work represents a first step towards understanding motivation for health behaviour as it is currently defined in the literature. Future studies are necessary to broaden this understanding beyond nursing. CONCLUSIONS: Motivation is a frequently cited rationale underlying the adoption and maintenance of health behaviours in research and practice. Motivation is complex and multidimensional, and clearer definitions for motivation are needed. Populations that have been underrepresented in motivation research need to be targeted in future research. Researchers and practitioners are challenged to examine carefully the role of motivation for health behaviours and explore other factors that may more strongly influence health behaviours.     

Men and health help-seeking behaviour: literature review

AIM: This paper reviews the key research literature regarding men's health-related help seeking behaviour. BACKGROUND: There is a growing body of research in the United States to suggest that men are less likely than women to seek help from health professionals for problems as diverse as depression, substance abuse, physical disabilities and stressful life events. Previous research has revealed that the principle health related issue facing men in the UK is their reluctance to seek access to health services. METHOD: The investigation of men's health-related help seeking behaviour has great potential for improving both men and women's lives and reducing national health costs through the development of responsive and effective interventions. A search of the literature was conducted using CINAHL, MEDLINE, EMBASE, PsychINFO and the Cochrane Library databases. RESULTS: Studies comparing men and women are inadequate in explaining the processes involved in men's help seeking behaviour. However, the growing body of gender-specific studies highlights a trend of delayed help seeking when they become ill. A prominent theme among white middle class men implicates "traditional masculine behaviour" as an explanation for delays in seeking help among men who experience illness. The reasons and processes behind this issue, however, have received limited attention. CONCLUSIONS: Principally, the role of masculine beliefs and the similarities and differences between men of differing background requires further attention, particularly given the health inequalities that exist between men of differing socio-economic status and ethnicity. Further research using heterogeneous samples is required in order to gain a greater understanding of the triggers and barriers associated with the decision making process of help seeking behaviour in men who experience illness.     

Mapping the organizational culture research in nursing: a literature review

AIM: This paper reports a critical review of nursing organizational culture research studies with the objectives of: (1) reviewing theoretical and methodological characteristics of the studies and (2) drawing inferences specific to the state of knowledge in this field. BACKGROUND: Organizational culture is regarded as significant in influencing research use in clinical practice yet it is not understood how culture shapes practitioners' behaviours. Only one review of this empirical literature in nursing has been completed. METHOD: Using selected computerized databases, published nursing research studies in English that examine organizational culture were accessed. Organizational culture studies were categorized using Hatch's three perspectives on organizational culture: (1) modern, (2) symbolic-interpretive and (3) postmodern. The review was conducted in 2005. RESULTS: Twenty-nine studies were in the final data set. Results pointed to variations in cultural definitions and incorporation of organizational sciences theory. In classifying the studies, modern perspectives dominated (n = 22), symbolic-interpretive approaches were an emerging group (n = 6) and one study was unclassifiable. Our results expand current cultural instrument reviews by pinpointing tools that have been previously overlooked and by identifying ongoing theoretical and methodological challenges for researchers. CONCLUSION: An exclusive reliance on modernistic approaches in organizational culture research cannot yield a complete understanding of the phenomenon. Rather, the field could benefit from a variety of cultural approaches. In a similar vein, researchers need to be mindful of the terminology and the unit of analysis they use in their research, as these are the two largest research challenges.     

Peer review in nursing and midwifery: a literature review

Aims and objectives. The Clinical Education Project investigated clinical education in nursing and midwifery settings. The aim of this phase was to investigate and evaluate the processes and outcomes of clinical assessment of preregistration nurses and midwives, focusing on the assessment interview, and to evaluate the feasibility of introducing peer review of the clinical assessment interview in acute clinical settings. Background. Peer review is common in many professional areas. The literature describes various applications of peer review and makes recommendations for its use. However, there is a shortage of studies investigating the use of peer review in nursing and midwifery education and practice. Design. The project involved a systematic literature review and a qualitative exploratory study. This article describes the first part of the study: a systematic literature review of peer review. The second part of the study is reported elsewhere. Methods. The systematic literature review investigated international articles written since 1994 that contained information on peer review in pre/post registration nursing and midwifery within higher education or practice. Results. From the available literature, 52 specific initiatives were analysed. The majority of articles originated in America and involved nursing staff working in secondary care settings. Fifty‐one articles had missing information varying from not stating the sample size to not including information about evaluations. Conclusions. The literature review found that whilst peer review is commonplace in nursing and midwifery practice, there is a lack of robust literature about its use. Relevance to clinical practice. Peer review in clinical settings such as nursing and midwifery can facilitate the sharing of good practice and personal and professional growth. It allows participants to learn from each other and gain insight into their development.     

A scoping review of environmental health nursing research

Objective

The purpose of this scoping review was to determine the extent and focus of published environmental health nursing research.

Design and Sample

The search was limited to peer reviewed, English‐language environmental health nursing research with at least one nursing author, published between 1995 and 2015 in a nursing journal, and catalogued in CINAHL.

Results

Publication of the 548 identified articles occurred in 118 different nursing journals. Annual number of publications increased from nine articles in 1995 to 50 in 2013 and 2014. Most (63%) of the studies occurred in the Unnited States; the remaining studies took place in 33 other countries. Three primary focus areas were identified: disasters/disaster preparedness, occupational health, and the home environment. Other focus areas included environmental exposures, environmental risk perception, secondhand smoke, and environmental health education. The primary populations studied were nurses/nursing students (40%) and adults (26%). Most common research designs employed were cross‐sectional (42%) and qualitative methods (20%).

Conclusions

Findings from this scoping review support a global expansion of published environmental health nursing research addressing a variety of environmental health topics. Additional studies are needed that use more complex research methods and address timely topics such as climate change and sustainability.     

'Marking' the white terrain in indigenous health research: literature review

AIM: This paper is a report of a literature review of the concept of whiteness in relation to research partnerships with indigenous Australian healthcare professionals, participants and community members. BACKGROUND: As researchers, we were confronted with the visibility of our whiteness and the oppressive, discriminating history on our indigenous partners wrought by the colour of our skin. This personal discord began an intensely provocative, reflective journey accompanied by a search of the literature on 'whiteness'. METHODS: The EBSCOhost, InfoTrac, Blackwell Synergy, ScienceDirect, SAGE Full-Text Collections and CINAHL databases were searched in 2004. The primary keywords were 'whiteness', 'white studies' and 'white privilege'. Secondary keywords: 'culture', 'race', 'racism', 'indigenous', 'indigenous communities', 'race relations' and 'colonialism'. No date restrictions were imposed, but most of the literature dated from the 1990s. FINDINGS: Exposure to the literature on 'whiteness' and the experience of working with indigenous Australians challenged us to recognize and address the privilege and power historically and contemporaneously conferred on us as white women. Largely invisible to white people is the structural advantage conferred by the 'white' standpoint and the set of 'unmarked' cultural practices that are usually set as the default positioning. CONCLUSION: To achieve useful research outcomes that influence the well-being of indigenous populations necessitates that non-indigenous researchers and healthcare providers stringently examine their own racial and social positioning. Without doing this we, consciously or otherwise, uphold white hegemony and racialist inequality.     

Forensic nursing educational development: an integrated review of the literature

The forensic area of practice has been a popular career choice and area of study for many of the health science disciplines. Forensic nursing is a nursing specialty with subspecialties that focus on nursing practice who care for victims and offenders, living and deceased at the clinical legal interface. This integrated review of the literature overviewed the historical development of each of the forensic nursing subspecialties and identified gaps in specialty nursing educational development. Although multiple studies for the last 30 years identified the need for forensic nursing education, recommendations did not soon translate into educational curriculum development. The literature showed that role development was not concurrent with educational development in all forensic nursing subspecialties.     

Relational ethics and advocacy in nursing: literature review

AIM: The purpose of this paper is to analyse themes from accounts of nurses' experiences with advocacy that may expand our understanding of advocacy in nursing practice. BACKGROUND: Although the ethical obligation to advocate is universal, a lack of clarity persists about the nature of advocacy in nursing practice. METHOD: This discussion of advocacy is based on a synthesis of qualitative studies that focus on nurses' experiences with advocacy in practice. Empirical studies were retrieved through searches on the CINAHL and Academic Search Premier databases for the years 1993-2005. The search terms used were advocacy, advocate role, ethics, nursing practice and qualitative research. FINDINGS: Empirical studies related to the role of advocacy in nursing are limited in number. Nurses' experiences with advocacy reveal important themes in relation to factors that influence the application of advocacy in nursing practice. Evidence suggests that the nature and context of relationships plays a significant role in influencing the enactment of advocacy. CONCLUSION: The application of advocacy in nursing practice is complex. The philosophy of relational ethics emphasizes the contextual features of relationships. An examination of relational ethics as it applies to advocacy in nursing brings us closer to a deeper understanding of the process by which nurses make advocacy choices in practice, and raises implications for the development of advocacy in nurses' practice. Advocacy is universally considered a moral obligation in nursing practice, and thus advancement of our knowledge about its nature in nursing is relevant to nursing across multiple contexts and cultures.     

The purpose and function of humour in health, health care and nursing: a narrative review

Title. The purpose and function of humour in health, health care and nursing: a narrative review Aim. This paper is a report of a review conducted to identify, critically analyse and synthesize the humour literature across a number of fields related to health, health care and nursing. Background. The humour–health hypothesis suggests that there is a positive link between humour and health. Humour has been a focus of much contention and deliberation for centuries, with three theories dominating the field: the superiority or tendentious theory, the incongruity theory and the relief theory. Data sources. A comprehensive literature search was carried out in January 2007 using a number of databases, keywords, manual recursive searching and journal alerts (January 1980–2007) cross‐referenced with the bibliographic databases of the International Society of Humor Studies. An inclusion and exclusion criterion was identified. Review methods. A narrative review of evidence‐ and non‐evidence‐based papers was conducted, using a relevant methodological framework with additional scrutiny of secondary data sources in the latter. Humour theories, incorporating definition, process and impact constituted a significant part of the appraisal process. Results. A total of 1630 papers were identified, with 220 fully sourced and 88 included in the final review. There is a dearth of humour research within nursing yet, ironically, an abundance of non‐evidence‐based opinion citing prerequisites and exclusion zones. Examination of physician–patient interaction and the humour–health hypothesis demonstrates that use of humour by patients is both challenging and revealing, particularly with regard to self‐deprecating humour. Conclusion. Nurses and nursing should adopt a circumspect and evidenced‐based approach to humour use in their work.     

Assessing the relationships between contextual factors and research utilization in nursing: systematic literature review

AIM: This paper reports a systematic literature review examining relationships between contextual factors and research utilization in nursing, examining the strength of these relationships, and mapping the contextual factors to the Promoting Action on Research Implementation in Health Services model of research implementation. BACKGROUND: Healthcare organizations have long struggled with how to improve clinical care outcomes. Understanding which contextual factors enhance nursing research utilization may support organizations in creating environments that facilitate the uptake of evidence in nursing practice to improve these outcomes. METHODS: A search of five electronic bibliographic databases and a manual search of specific journals were conducted for studies that were published in English and examined contextual factors as independent variables and research utilization as the dependent variable from the perspective of nurses working in clinical practice. The studies were assessed for quality of design, sample, measurement and statistical analysis. RESULTS: Ten papers met the search criteria. Six contextual factors were identified as having a statistically significant relationship with research utilization, namely the role of the nurse, multi-faceted access to resources, organizational climate, multi-faceted support, time for research activities and provision of education. The contextual factors could successfully be mapped to the dimensions of context in the Promoting Action on Research Implementation in Health Services framework (context, culture, leadership), with the exception of evaluation. CONCLUSION: The strength of the relationship between the six contextual factors and research utilization by nurses is still largely unknown as (a) few studies were found of sufficient quality because of methodological limitations and (b) the results in reviewed studies were mixed. More robust methods in future work would yield a better understanding of the full impact of contextual factors on nurses' use of research.     

Influencing mental health nursing practice through the teaching of research and theory: a personal critical review

This paper will critically review the factors that influence the teaching of theory and research to mental health nurses. Following a brief historical review it is asserted that current educational approaches fail to address the complexity and context-dependent nature of mental health nursing practice. The author then argues for a radical approach to education which will enable students and practitioners to engage critically in deconstructing and developing theories that illuminate and help us understand the multiple realities of our post-modern professional world. In conclusion, the author provides an example of a casework-based curriculum that emphasizes the ways in which clinical experience with clients in a range of contexts should be the main focus of knowledge and skill development for the emerging profession of mental health nursing.     

The integration of solution-focused brief therapy principles in nursing: a literature review

The ongoing movement from institutional care to community-orientated care has gradually spread around the developed world. This shift in the philosophy of care has resulted in a reduction in the length of inpatient admissions and contributed to a decline in the number of inpatient beds. This literature review seeks to establish the suitability and relevance of solution-focused brief therapy (SFBT) to mental health nursing practice, with particular emphasis being given to acute inpatient settings. Databases searched for published material in English between 1980 and 2006 were: Cumulative Index of Nursing and Allied Health Literature; MEDLINE; Applied Social Sciences Index and Abstracts; Sociological abstracts; and social service abstracts. Search terms included: SFBT and solution-focused approaches. Only nine papers from the original 203 citations met the inclusion criteria and were thus reviewed. These papers indicated that SFBT constitutes an appropriate set of techniques for use in mental health nursing particularly where staff have relatively brief contact with patients. Preliminary data suggest that SFBT is congruent with the philosophical underpinning of contemporary mental health nursing. However, its clinical utility and effectiveness is not well established and methodologically rigorous studies are urgently needed to determine the appropriateness and effectiveness of such approach to nursing practice.     

Use of the male condom by heterosexual adolescents and young people: literature review

AIM: This paper is a report of a literature review to explore issues influencing condom use in heterosexual adolescents and young people. BACKGROUND: Sexually transmitted infections (STIs) are a major international health issue and adolescents and young people are particularly vulnerable. Efforts to address the rapid spread of STIs have largely focused on promoting the use of condoms as a protective 'safer sex' measure. However, use of the male condom is still inconsistent and the incidence of STIs continues to increase. METHOD: A search of the literature using EBSCO Host databases was undertaken in 2006, with a focus on women, young people, condoms and STIs. Papers published in English from 1992 to 2006 were sought. Only research papers are included in this review. RESULTS: Factors impeding decisions to use protection by young people include lack of knowledge about prevalence of STIs, ambiguity around contraception and safer sex practices, and the difficulty faced by young women in particular in negotiating safer sex. The notion of romantic love confounds the assessment of risk and can render young people, particularly young women, ineffective in negotiating safer sex practices. CONCLUSION: Adolescents and young adults are particularly vulnerable in relation to STIs. There is a need to ensure that accurate messages are delivered about safer sex and contraception to this very vulnerable group. Furthermore, it is important to recognize that romantic love comprises strong emotions that have a role in decision-making and options for reducing personal-health risk during sexual activity.