Nursing as a scientific undertaking and the intersection with science in undergraduate studies: implications for nursing management

logan p.a. & angel l. (2011) Journal of Nursing Management  19, 407–417
Nursing as a scientific undertaking and the intersection with science in undergraduate studies: implications for nursing management Aim To explore the science–nursing tension and impact for nursing students studying bioscience. Background Several studies have examined why nursing students struggle to be successful in bioscience subjects. Undeveloped science background and theory–practice gaps are noted as contributing factors. Methods A qualitative study explored the science–nursing tension with 100 Australian Registered Nurses using focus groups and a survey. Results The survey response rate was 85 from 550. Of survey respondents, 88% viewed nursing as an applied science. An emphasis on procedural skills and task busyness undermines theoretical understanding of care and can be a negative influence upon the student bioscience experience. Practicum mentors confident in scientific knowledge enhance the student experience of bioscience by providing opportunities for integration with practice. Conclusions Competing philosophies that reinforce the science–nursing tension have an impact upon student endeavours yet the nexus created by practice can be used to activate student curiosity and scientific understanding. Implications for nursing management Nurse managers need to structure the student practicum to encompass scientific theory applied to practice with equal emphasis on task efficiency. This improves student attitudes to learning bioscience and potentially minimizes the impact of the science–nursing tension on student learning.     

Nursing students' knowledge and beliefs about care of older adults in a shifting context of nursing education

baumbusch j., dahlke s. & phinney a. (2012)?Nursing students' knowledge and beliefs about care of older adults in a shifting context of nursing education. Journal of Advanced Nursing68(11), 2550-2558. ABSTRACT: Aim. To a report a study of improvements in students' knowledge and beliefs about nursing care of older adults following completion of an introductory course with integrated adult/older adult content. Background. Nursing schools are under pressure to provide accelerated programmes to meet growing workforce demands and provide students with the knowledge they require to care for an ageing population. Thus, stand-alone courses in gerontological nursing are being eliminated and integrated with general adult content. The effect of this approach remains poorly understood. Design. A one-group pretest-post-test design was used. Methods. Data were collected between September-December 2010. Students completed the Palmore Facts on Aging Quiz, the Perceptions of Caring for Older People Scale, and open-ended questions about their experiences before and after completing a course with integrated adult/older content. Results. Students' knowledge and beliefs about nursing care of older adults demonstrated an important improvement following completion of the course. Qualitative findings reflected three themes: relating to older people; neglect by the system; having time to learn. Conclusions. Findings from this study suggest that even when integrated with general adult content, students' knowledge and beliefs about older adult care can be positively influenced. Furthermore research is needed to examine long-term integration of students' learning about older adult care. Nursing faculty with expertise in nursing care of older adults must develop resources and supports for their colleagues to build capacity among nurse educators and integrate older adult content throughout nursing programmes to enhance nursing practice with an ageing population.     

A paradigm for the production of practice-based knowledge

Aim  The aim of this paper was to explore trends, arguments and issues surrounding knowledge production and nursing practice, and to propose a paradigm of practice-based knowledge along with strategies to promote theory-based knowledge development in practice.
Background  Practice-based knowledge has been marginalized in the current practice and research paradigms. Several reasons for this are presented, some of which may be addressed to facilitate a more inclusive approach to knowledge that can potentially advance patient care and the discipline.
Evaluation  Classic and contemporary scholarly sources in nursing, philosophy, education, social sciences and other areas were critically reviewed and applied to support the argument and propose a paradigm of practice-based knowledge production.
Key issues  A key point identified in the paper is that theory, meaning conceptualizations at all levels of abstraction, is an important tool of knowledge development in nursing practice as it is in traditional research.
Conclusions  Various strategies exist that can be employed to promote development and use of practice-based knowledge in the clinical setting. The strategies are innovative yet practical, and require the support and encouragement of nursing management for their successful implementation.
Implications for Nursing Management  Nursing managers can influence if not facilitate all of the strategies to promote practice-based knowledge development identified in the paper. These efforts could give voice to the caregiver's knowledge and, in turn, enhance patient care and the satisfaction and retention of nurses.     

“知-信-行”理论在提高护士长科研创新能力中的应用

目的探讨"知-信-行"理论在护士长科研创新活动中应用的效果。方法采取普及科研创新相关的理论知识,培养科研创新信念,督导科研创新行为等管理方法提高护士长的科研创新能力。结果护士长参与科研创新活动的积极性和人均发表论文数量均增加(P<0.01),临床护理科研带教效果也明显提高。结论护理科研知识的普及增强了护士长参与护理科研活动的信心与能力,以及临床护理科研带教效果。     

Transforming Practice Knowledge into Nursing Knowledge—A Revisionist Analysis of Peplau

Nursing practice typically has been viewed as applying knowledge. However, currently, there is increasing awareness that nursing practice is also a process of knowledge development. Still, research and practice are not always connected. Analysis of Peplau's works illuminates a scholarship of nursing practice that is relevant today. This paper focuses on a specific strategy and philosophic perspective, as derived from Peplau, for integrating nursing practice more fully into today's knowledge development. Emphasis is on the need for nursing practice-based theory, as well as nursing theory-based practice.     

Parse's theory as a model for practice: the cutting edge.

If nursing practice is the performing art of the science of nursing, then practice is guided by nursing theory and cannot be considered separately from it. Nursing theory based practice is the cutting edge of the discipline. Practice methods reflect the beliefs and values of the theories from which they evolve. Nurses' values and beliefs about human beings and health are incarnated in the way they practice. This article presents Parse's theory of human becoming as a model for practice; explicates the beliefs, values, and ethic of the practice method; analyzes the logical coherence of theory and method; illustrates the pragmatics of the method, and gives evidence of its soundness. The theory-research-practice triad developed by Parse articulates a paradigmatic view of the discipline as a whole with a view of the human being as a living unity freely choosing personal meanings in life situations. Parse's practice methodology provides nurses with a way of practicing with a focus on the quality of life as it is humanly lived. It is presented here as the practice component of an emergent theory-research-practice tradition on the cutting edge of nursing science.     

Post-positivistic critical multiplism: a beginning dialogue

Following the recognition that logical positivism was no longer tenable in modern science, post-positivism and its research methodology, critical multiplism, emerged and offered a new way of thinking about science. Though not a panacea, critical multiplism, in which methodological pluralism is advocated, offers a way around the debate of which conception of science is appropriate for nursing and, as such, poses advantages for nursing scientific knowledge development.     

Challenging the atheoretical production of nursing knowledge: a response to Reed and Rolfe's column

This column is a response to Reed and Rolfe's column in the January 2006 issue of Nursing Science Quarterly. The authors present their views about Reed and Rolfe's ideas by focusing their discussion and questions on three main topics: the impact of nurses' conceptual thinking, values, and culture on their perspectives and experiences; the reality that nursing theory-guided practice is already a meaningful reality in nursing; and the belief that in order not to limit knowledge development, science must be viewed as more than a study of proximal causes.     

Reconciling nursing's art and science dualism: Toward a processual logic of nursing

There is an enduring debate in nursing regarding the art–science dualism, involving an articulation of two distinct ‘kinds’ of disciplinary knowledge: objective/scientific and subjective/artistic. Nursing identifies both as necessary, yet unbridgeable, which creates problems in constructing a coherent disciplinary knowledge base. We describe how this problem arises based on an ontological assumption of two different kinds of ‘stuff’ in the world: that with essential determinate properties and that without essential properties. We experiment with a solution by ontologically understanding the world as made from a single kind: That the most irreducible element of the world is process, in that reality is a continuous construction whereby subject and object are products, not independent constituents, of reality. Process philosophy overcomes nursing's ontological bifurcation and enables nursing's art–science dualism to be re‐conceptualized as a cohesive logic of skilled reality production. An unavoidable implication of a process turn in nursing philosophy is that the disciplinary goal no longer becomes a privileged ‘body of knowledge’ that authorizes, which has always been a defining challenge in nursing. Rather, and more productively perhaps, the aim is for greater sophistication and plurality in its ongoing commitment to attuning to reality in ways that shape disciplinary attainment.     

Longitudinal study of Finnish nursing students' preferences for knowledge in nursing practice

The curriculum of Finnish nursing education is based on nursing science. The aim is to educate nursing students to internalize the logic, concepts and major subject areas of nursing science. The purpose of this longitudinal study was to examine Finnish nursing students' knowledge base of nursing after 6, 18 and 30 months of education and at the end of the degree programme. The study group consisted of 158 students selected by means of stratified sampling from the six specialities of Finnish nursing education programs. Data were collected by means of a questionnaire from 26 institutes. A factor analysis of 21 items was done, where three factors emerged. The summarized variables based on the factors were subjected to one-way analysis of variance to elucidate the differences between the six groups of students. The students prioritized biomedical knowledge. Knowledge of diseases and anatomy was preferred to the other knowledge areas. The students also valued psychological knowledge. Nursing knowledge was the least preferred knowledge area at every phase of education. The students of the different specialities preferred knowledge areas congruent with the nursing practice of their speciality.     

The influence of liberal political ideology on nursing science

Previous notions of science as impartial and value-neutral have been refuted by contemporary views of science as influenced by social, political and ideological values. By locating nursing science in the dominant political ideology of liberalism, the author examines how nursing knowledge is influenced by liberal philosophical assumptions. The central tenets of liberal political philosophy - individualism, egalitarianism, freedom, tolerance, neutrality, and a free-market economy - are primarily manifested in relation to: (i) the individualistic focus of our science; (ii) our view of society as essentially egalitarian and equitable; (iii) our preference for politically neutral knowledge development, and (iv) an economy of knowledge development that supports rather than challenges the status quo. I argue that exposing, rather than ignoring, the liberal ideological values inherent in nursing science will render these assumptions open to debate, stimulate ongoing development of critically oriented knowledge, and increase our capacity to influence the social, political and economic determinants of health.     

Interpersonal relations in nursing: a philosophical-ethical analysis of the work of Hildegard E. Peplau

Interpersonal relations in nursing: a philosophical-ethical analysis of the work of Hildegard E. Peplau ¶ Nursing typically has been viewed as a moral practice, for instance by new developments in the ethics of care. Nevertheless, many philosophical-ethical presuppositions of nursing theories remain to be clarified. This paper presents a philosophical-ethical analysis of the work of Hildegard E. Peplau. Analysis of the philosophical-ethical background of Peplau's works illuminates a view on nursing practice that is relevant today. Three main components are analysed more deeply, i.e. the professionalization of nursing, the philosophical underpinnings of Peplau's view on nursing science, and the nurse–patient relationship as the central event in nursing.     

Impact of theory and clinical placement on undergraduate students' mental health nursing knowledge, skills, and attitudes

Mental health issues are common and contemporary nursing students need to be well prepared to meet the mental health care needs of Australians. This study explored the influence of the mental health component of a Bachelor of Nursing course on second-year undergraduate nursing students' self-reported knowledge, skills, and attitudes in relation to mental health nursing. The study used a quasiexperimental research design involving questionnaires and individual interviews to determine nursing students' self-reported knowledge, skills, attitudes. Questionnaires were administered prior to undertaking the mental health theory, repeated prior to undertaking a clinical placement in either a community or inpatient mental health setting, and again after the clinical placement. The findings of the study indicated that a positive clinical placement had the greatest influence on nursing students' self-reported knowledge, skills, and attitudes and interest in nursing people experiencing mental health problems; however, the quantity of theoretical education also emerged as an influencing variable.     

不同教育层次护生对社区护理认知及就业意愿的调查

目的了解不同教育层次护士学生（以下简称护生）对社区护理的认知及就业意愿,为促进高校社区护理教育改革,发展社区护理提供依据。方法采用自行设计的调查问卷对821名不同教育层次护生进行调查。结果不同教育层次护生对社区护理工作的主观认识及社区护理的就业意愿比较,差异具有统计学意义（均P〈0.01）。影响护生选择社区护理作为就业意向的因素有个人因素、专业因素和社会因素。已学习《社区护理学》课程的护生较未学习的护生对社区护理知识的认知得分高。结论在校护生对社区护理知识整体认知不足,就业于社区的意愿不高。学校应加强指导,改善社区护理实践环境,并适当开展职业指导以培养护生正确的择业观。     

The nature of nursing research: dissertations in the Nordic countries, 2003

Nursing and caring research has followed various paths in different countries and there are diverse views regarding the central phenomena in nursing science. An overview of Nordic nursing and caring science from 1974 to 2000 revealed that conceptualizations and design of enquiry differed. It therefore was of interest to investigate the overall picture regarding more recent and present doctoral dissertations on this subject. The aim of this study was to investigate the locus of interest and the content of current nursing and caring research in Nordic doctoral dissertations within the field presented during 2003. A total of 26 doctoral dissertations were read and studied. The analysis was inspired by Kim's metaparadigmatic typology of four domains for structuring nursing knowledge. The investigation shows that the research in these dissertations, with some exceptions, was oriented towards phenomena belonging to the client domain (18 dissertations). Less knowledge has been gained in the client–nurse (two dissertations); four dissertations were categorized within the practice domain and environment domain includes two dissertations. The research conducted was primarily oriented towards pragmatic aspects and the practical application of knowledge, whereas basic research aiming at defining an autonomous science is exceptional. This means that scientific knowledge regarding and forming the discipline's unique perspective and value system could still be in evolution. A combination of a carefully and well-designed research practice, reflecting the need to further research and investigate new theoretical regions would appear to constitute the direction forward.     

Revisiting the nursing metaparadigm: Acknowledging technology as foundational to progressing nursing knowledge

The nursing metaparadigm, as described by Fawcett in 1984, includes human, health, nursing, and the environment, all of which support theory development by giving direction to our focus as a scientific body. Nursing scientists make their mark in biotechnological applications, mobile health, informatics, and human factors research. We give voice to the patient through design feedback and incorporating technological advancements in our evolving nursing knowledge; however, we have not formally acknowledged technology in our metaparadigm. To continue patient-centered care in this age where machines are enmeshed in daily human life, we propose technology must be a domain of the metaparadigm to continue advancing nursing science and knowledge. In this paper, we propose a separate domain of technology within the metaparadigm to challenge nurses to consider approaches within their research and practice of how technology will impact patient care and their personal development within the profession. A technology-specific domain within the metaparadigm also is a signal to other bodies of science of our willingness and ability to run at pace with novel, exciting new discoveries while adding our perspective. Nurses may become active agents in novel developments rather than passive adopters, continuing our legacy of patient advocacy through new knowledge generation. Emerging and continuing nurse leadership has set the stage for the next era of nurse-led innovation and technology development, which provides an opportunity to embed technology as a core aspect of the nursing metaparadigm.     

护理本科生临床实习带教方法的探讨与分析

护理是一门科学性极强的应用性学科,在临床实习期运用好的带教方法为护理本科生实施带教,以帮助其更快、更好地完成从单纯接受知识到运用知识解决实际问题的转变。文章总结了近年来在护理本科生临床实习过程中所采用的创新带教方法,并对其科学依据和特点进行分析,为本科护理实习临床带教提供理论参考。     

Sexuality: a critical component of quality of life in chronic disease

Nursing is a science and an art. The science aspect of including sexuality in nursing practice requires knowledge about "normal" sexual functioning, an understanding of the pathophysiology and pharmacotherapies that may cause changes in sexuality, and knowledge about assessing and treating sexual difficulties. The art of including sexuality into nursing practice comes from awareness of one's beliefs and values, and comfort in talking about sexuality. The nurse will find that most patients will be pleased that he/she has taken the time to broach this important concern with them. This article provides an overview of the relationship among sexuality, chronic disease, and quality of life. Two frameworks are suggested that are useful in operationalizing sexuality in nursing practice.     

对临床护理中医疗侵权行为的法律思考

护理学是一门理论性严密,技术性很强的独立学科。众所周知,护理模式历经发展,已由以执行医嘱为中心的疾病护理,发展到以患者为中心的整体护理,因而医护实务上,对护理人员提出必须具备更高的理论知识和临床技能的要求。事实上,医学不能囊括护理学,而医师也无法代替护士。也唯有护理工作,才能使医师的治疗意图得以实现,临床工作也才能得到完善。医疗护理服务的增多,使得医疗侵权行为产生的机率也大大增加。本文拟从临床护理的实际工作出发,对于医疗侵权行为的概念、临床护理中医疗侵权行为产生原因和类型进行一些法律层面的探讨。