Development Of Nursing Knowledge Research Articles

The Knowledge Crisis of Nursing

In Norway and Denmark, the public healthcare is comprehensive, and nurses constitute a large and important part of these healthcare systems. To handle the increasing complex tasks as a nurse requires a broad range of knowledge. In resemblance to the medical profession, who aim to fight disease and maintain health, nursing is at the same time a practical and a theoretical discipline. The aim for nursing is to offer care for people who cannot care for themselves. An interpretation of human science using health- or natural science methods dominates the academic development of knowledge in nursing. In this article, we engage in a theoretical examination of knowledge within the context of nursing academia in Denmark and Norway, drawing comparisons between two prominent positions. The theoretical framework is built up from the tradition of praxeology and critical theory and used as the pervasive analytical lens. As a model to the interpretation of the two positions, we use argument analysis. The results indicate that the dominating clinical nursing science in Denmark and Norway has been a success when it comes to capacity building at hospitals within an academic research tradition similar to the tradition of the medical profession. However, this research primarily contributes with techniques and models, as it focuses on application oriented research and is eager to produce suggestions in and for practice. This is important research, but insufficient when it comes to producing theories on and about nursing practice as a scientific discipline. We argue that this lopsided academic development supports a crisis in knowledge, because it fails to provide nursing with a proper theoretical scientific base. This is needed if nursing should develop as a subject in the scientific university logic and is essential to enable professional reflexivity in order to meet the demands of contemporary nursing care.

Building a Pluriverse of Nursologies: A paradigm for decolonial theory and knowledge development in nursing.

The imperative to decolonise health disciplines underscores the need for a critical examination of the coloniality of nursing knowledge development. Decolonising nursing requires epistemic resistance aimed at exposing and dismantling epistemological hierarchies that marginalise indigenous knowledges. This paper introduces the 'Pluriverse of Nursologies' as paradigm to guide decolonial theorising in nursing. Through a four-part exploration, I first elucidate the coloniality embedded in mainstream nursing knowledge. Next, I offer a decolonial critique of Fawcett's nursing metaparadigm as an exemplar of pyramidal epistemology. I then discuss pluriversality as an approach to decolonising nursing knowledge. Finally, I introduce the Pluriverse of Nursologies (PoN) as a meta-theoretical paradigm for theory and knowledge development that decentres and dismantles the pyramidal epistemology of colonial/modern nursing, and relinks diverse nursologies from marginalised communities to the centre of intellectual nursing discourse, thereby revitalising the theoretical landscape of the discipline.

Nursing educational framework: A new nurse-driven, conceptually guided approach.

The aim of this article is to present the Nursing Educational Framework (NEF) as an opportunity to integrate core elements of a humanistic person/family-centered view and as guidance in structuring a relationship-based curriculum. Empirical and theoretical literature studies were reviewed to define the framework rationale and its components. A deductive/inductive collaborative expert-informed approach was undertaken to develop this evidence-based codesigned framework. Its mission, along with unique components, implementation strategies, and outcomes, were successively integrated into the framework to guide nursing knowledge, learning, and curriculum development. A hermeneutic collaborative process of circular reflection was used in the development process. The NEF contains central guiding principles and concepts that are intended to provide structural consistency across its included programs from a humanistic person/family-centered approach. This comprehensive theory-guided framework allows educators to suggest specific directions for nursing practice within the nursing discipline and articulate nursing's unique and specialized approach to promoting excellent patient care outcomes. It can assist students to develop critical lens from a person/family-centered relationship-based practice approach.

A visionary platform for decolonization: The Red Deal.

In this study, we discuss the colonial project as an eliminatory structure of indigenous ways of knowing and doing that is built into Canadian social and health institutions. We elaborate on the role nursing plays in maintaining systemic racism, marginalization and discrimination of Indigenous Peoples. Based on historical practices and present-day circumstances, we argue that changing language in research and school curriculums turns decolonization into what Tuck and Yang call a 'metaphor'. Rather, we propose decolonization as a political project where nurses acknowledge their involvement in colonial harms and disrupt the assumptions that continue to shape how nurses interact with Indigenous people, including knowledge systems that perpetuate colonial interests and privilege. Decolonization requires nurses to understand the colonial practices that led to dispossession of land, erasure of knowledge, culture and identity, while upholding indigenous ways of knowing and doing in health, healing and living. As a political manifesto that liberates indigenous life from oppressive structures of colonialism and capitalism, The Red Deal is presented as a visionary platform for decolonization. The aim of this study is to articulate three dimensions of caretaking within The Red Deal as a framework to decolonize nursing knowledge development and practice. Based on the philosophical dimension embedded in The Red Deal that revoke norms and knowledge assumptions of capitalism that destroy indigenous ways of knowing and doing, we underscore an approach toward decolonizing nursing. Our approach rejects the apolitical nature of nursing as well as the unilateral western scientific knowledge approach to knowledge development and recognition. A critical emancipatory approach that addresses the socio-political and historical context of health care, recognizes dispossession of land and adopts a 'multilogical' vision of knowledge that gives space for representation and voice is needed for true decolonization of nursing.

Dialectical Pluralism for Nursing Knowledge Development.

The purpose of this paper is to explore the potential of dialectical pluralism (DP) for nursing knowledge development. Nursing scholars have discussed ways of developing nursing knowledge, exploring the fit and relevance of various worldviews for knowledge development and examining the dynamic and perpetual processes of knowledge development. Scholars have argued that knowledge development occurs under a certain worldview to which the researcher adheres. Many nurses employ various worldviews, which can give rise to ontological and epistemological conflicts. DP can help nurses appreciate the diversity of worldviews and recognize the importance of implicit worldviews to generate more practical nursing knowledge. DP as a philosophical approach can enable nurses to communicate between diverse worldviews, become tolerant of conflicting differences, and develop an array of nursing knowledge.

A Dialogue with Dr. Marilyn A. Ray: Nurse Scholar and USAF Veteran.

Dr. Marilyn A. Ray, nurse scholar and retired United States Air Force (USAF) veteran and former flight nurse, began her nursing scholarship in Canada. She was influenced by the experiences and interprofessional scholarly ideas that she encountered along her career trajectory. Her early love of the air and space led her to the United States Air Force Nurse Corps, where she served as a flight nurse during the Vietnam war era, followed by leadership positions in nursing education, administration, practice, and research. Dr. Ray's contributions to nursing knowledge includes two nursing theories and a caring inquiry methodology. Dr. Ray is helping to create a new caring science certificate program at Florida Atlantic University, Christine E. Lynn College of Nursing. In this column, Dr. Ray shares the story of her scholarly influences and how they helped her care for her husband and gain insight into her contributions to nursing knowledge development.

Nurse scholars of the Robert Wood Johnson Foundation Harold Amos Medical Faculty Development Program

BackgroundThe challenge to increase the diversity, inclusivity, and equity of nurse scientists is a critical issue to enhance nursing knowledge development, health care, health equity, and health outcomes in the United States. PurposeThe purpose of this paper is to highlight the current nurse scholars in the Robert Wood Johnson Foundation (RWJF) Harold Amos Medical Faculty Development Program (AMFDP). DiscussionProfiles and the programs of research and scholarship of the current AMFDP nurse scholars are described and discussed. Scholars share lessons learned, and how the AMFDP program has influenced their thinking and commitments to future action in service of nursing science, diversity efforts, legacy leadership, issues of health equity. ConclusionRWJF has a history of supporting the development of nursing scholars. AMFDP is an example of legacy leadership program that contributes to a culture of health and the development of next-generation nursing science scholars.

Two-Eyed Seeing as a strategic dichotomy for decolonial nursing knowledge development and practice.

The profession of nursing has recognized the need for contextual and relational frameworks to inform knowledge development. Two-Eyed Seeing is a framework developed by Mi'kmaw Elders to respectfully engage with Indigenous and non-Indigenous knowledges. Some scholars and practitioners, however, are concerned that Two-Eyed Seeing re-instantiates dichotomized notions regarding Western and Indigenous knowledges. As dichotomies and binaries are often viewed as polarizing devices for nursing knowledge development, this paper explores the local worldviews in which Two-Eyed Seeing emerged, proposing that the onto-epistemological and axiological 'roots' of the framework are antithetical to divisiveness, paradoxically asserting space for the dichotomy to stand. Two-Eyed Seeing, if understood as a relational, decolonial praxis, could fundamentally change the way nursing scholarship and practice operate by facilitating space for diverse knowledges, ways of being, doing and relating. In this paper, considerations for nursing scholarship and practice, as well as recommendations to support the uptake of Two-Eyed Seeing are explored. The authors assert that conceptual divisiveness, dichotomization and exclusion can be mitigated if nursing is informed by contextual knowledge, seeks to enact accountable partnerships with Indigenous knowledge holders, and holds the Mi'kmaq worldview upon which the concept developed in positive regard.

A Labor of Love: From Cranberry Biologist to Nurse Scholar and Educator.

There are many nursing scholars who have contributed to nursing knowledge. Dr. Monika Schuler started her career as a cranberry biologist and is now a nurse scholar and educator. Her contributions to nursing knowledge include two new models that contribute to our understanding of nursing professional growth: (1) the reflection, feedback, and restructuring model for role development in nursing and (2) the substance use disorder nursing attitude model. Dr. Schuler is working with colleagues toward developing an understanding of how nursing experiences inform their role development. In this scholarly dialogue, Dr. Schuler shares her path to nursing scholarship and her recent contributions to nursing knowledge development.

The Relational Virtual Nursing Practice Model: A Web-Based Nursing Intervention.

This discussion paper aimed to reflect on the development of relational connections in the context of a web-based, tailored, asynchronous nursing intervention (VIH-TAVIETM) aimed at empowering people living with HIV in taking their antiretroviral treatment. Our reflection culminates in the Relational Virtual Nursing Practice Model. This paper builds on nurse-researchers and people living with HIV's experiences, nursing theories, and cross-disciplinary work on relational engagement. The model shows the disciplinary principles underpinning VIH-TAVIETM, engagement processes used to create humanistic and supportive relational environment and people's relational experiences and it contributes to the development of conceptual nursing knowledge on how generating meaningful relational nursing care in virtual environments.

What nurses of color want from nursing philosophers.

Scholars of color have been instrumental in advancing nursing knowledge development but find limited spaces where one can authentically share their philosophical perspective. Although there is a call for antiracism in nursing and making way for more diverse and inclusive theories and philosophies, our voices remain at the margins of nursing theory and philosophy. In nursing philosophy, there continues to be a lack of racial diversity in those who are given the platform to share their scholarship. Five nurse scholars of color attended the International Nursing Philosophy Conference in August 2022. We established a collective system of support by sharing our experiences as researchers, scholars, and educators with each other. The theory of emancipatory nursing praxis informed this process. In this dialogue, we reflected on what it is like to present at and attend predominantly white nursing conferences. We shared our experiences of how we exist as nurse scholars, our philosophical views, and our thoughts on how we create spaces where scholars of color can feel welcomed and acknowledged for their contributions to advancing nursing knowledge.

The operating room, a place of training with multiple benefits for future professionals

The importance of internships, as part of the alternating training of nursing students, is no longer in question. Thus, to obtain their diploma, out of the 180 European credits expected, 60 come from these placements. Although very specific and not very much involved in the training of students in initial training, an internship in the operating room is very instructive and contributes to the development of multiple nursing knowledge and skills.

Specifics of and training needs in the inter-professional home care ofpeople with dementia.

Introduction: Successful home care for people living with dementia (PLwD) allows them to live in their own home environment for as long as possible. Current findings indicate a need for further development of medical and nursing knowledge and skills in evidence-based collaborative care for these patients. Aim: To identify specifics of inter-professional care for PLwD and training needs of home care nurses and general practitioners involved in care. Method: A multi-perspective qualitative study was conducted, comprising focus groups as well as individual interviews. Focus groups and interviews followed a semi-structured topic guide. Interview data was digitally recorded and transcribed verbatim, followed by a thematic framework analysis. Results: The sample consisted of nine nurses, one medical assistant, three general practitioners and nine family caregivers of PLwD. Five themes related to inter-professional home care were inductively developed: challenges in outpatient dementia care, challenges in collaboration, insufficient healthcare infrastructure, competencies needed in dementia care, and training requirements. Challenges were a lacking flow of information as well as continuity and organization of care. Home care nurses and family caregivers complained about missing communication skills in health professionals involved in the care of PLwD. Conclusions: The interviews revealed heterogeneous training needs of home care nursing staff and general practitioners that can be addressed by an inter-professional training course.

Nursing Knowledge Development from the Standpoint of Philosophical and Methodological Perspective

Knowledge development is one of the foundations for nursing to grow as a profession. Knowledge development in nursing has been greatly influenced by the philosophical perspective in different eras. This study aims at exploring the philosophical standpoints and methodological perspective of nursing knowledge development. Performing research guided by philosophy and using suitable methodology underpinning the philosophical approach is the need for strengthening nursing knowledge at present.

Reflective practice in nursing: A concept analysis.

This paper aims to clarify the concept of reflective practice in nursing by using Rodgers' evolutionary method of concept analysis. Literature and references on the concept of reflective practice were obtained from two databases: Scopus and Nursing and Allied health database. Peer-reviewed articles published in English language between 2011-2021 that included the terms 'reflection' and/or 'reflective practice' in the title were selected. Seminal pieces of work were also considered in this analysis. A total of 23 works were included. Most of the selected works addressed the concept of reflective practice in nursing education or nursing practice. The data analysis integrated the stages identified in Rodgers' method of concept analysis to analyze the concept of reflective practice. Analysis of selected works provided an understanding of common surrogates, antecedents, attributes, and consequences of the concept of reflective practice. Reflective practice is a cognitive skill that demands conscious effort to look at a situation with an awareness of own beliefs, values, and practice enabling nurses to learn from experiences, incorporate that learning in improving patient care outcomes. It also leads to knowledge development in nursing. Considering the current circumstances of the COVID-19 pandemic, this paper identifies the need for nurses to go beyond reflection-on-action and also include reflection-in-action and reflection-for-action as part of their practice. This analysis identifies the need for future nursing researchers to develop reflective models or strategies that promote reflection among nurses and nursing students before, during, and after the clinical experiences.

Le sentier en spirale du développement du savoir infirmier : l’apport de la proposition de Reed

This article presents Reed’s perspective on the development of nursing knowledge. Her concept is embedded in the perspective of intermodernism. For Reed, intermodernism is a philosophy for nursing science and practice and thus represents a way of looking at the content, structure, and process of scientific theory. Reed presents her concept in the form of a spiral path composed of the philosophical, practical, and theoretical dimensions of nursing knowledge. After an overview of Reed’s perspective, we offer an illustration of her proposal with Lawler’s theoretical development of somology. Lawler’s development pathway can be used to incorporate the components of Reed’s spiral path in a meaningful way. The discussion shows how Reed’s concept can improve the description and understanding of a nursing knowledge development process. Finally, the article provides a rare summary of Reed’s work in French.

Revolution of Nursing Science in the Next Decade

Knowing a history of nursing science allows nurses to understand the journey of nursing theorists and scientists in developing the nursing science. Since the era of Florence Nightingale in the mid-18th century, the nursing theories and nursing research were published to the public, particularly scientific community. During late 18th and 19th century, there were many interesting questions among these debates that have not been answer yet, such as is it a nursing science or science of nursing? and is it a pure science or applied science? Even though the scientific community acknowledges that nursing is known as a science, many scholars remain to discuss the definition and category of nursing science. 
 
 Along the history of nursing knowledge development, nursing scholars faced many challenges concerning the difficulty to develop the required content for nursing practices, to be an excellent discipline in the developing science base, to prepare nurse researchers, and to disseminate research results to the community and to the public (Hinshaw, 1989). Nowadays nursing science is entering into the postmodern era and it will be continued development in the next decade. Even if nurses do not recognise that nursing knowledge is currently in crisis, looking for the future of nursing science throughout the principle of Kuhn’s paradigm shift might provide valuable direction for nurse. Therefore, this paper aims to explain Kuhn’s revolutionary theory and its principle. Moreover, the influence of Kuhn’s revolution theory on the revolution of nursing science that will be present in this paper.

Desde la enfermería basada en evidencia: patrones de conocimiento: mirando su narrativa: fenómeno del cuidado

Introducción. Desde la enfermería basada en evidencia, como procesos cognitivos que ponen en marcha frente a cada situación hacen evidente al proceso de Enfermería como herramienta fundamental para la dirección del cuidado. En el fenómeno de cuidado, surge la situación de enfermería como herramienta científica que permite poner en evidencia los patrones de conocimiento enfermero propuestos por Barbara Carper, los elementos del metaparadigma, así como las fases del proceso de enfermería. Para la operacionalización del mismo, se utilizó la taxonomía de diagnósticos propuestos por la NANDA, así como los resultados esperados (NOC) y las intervenciones sugeridas (NIC). Metodología. Para precisar la realidad, se abordó desde el equipaje etnográfico focalizado como metodología analítica explorando desde el aspecto antropológico del cuidado, la enfermería basada en evidencia, patrones de conocimiento desde la narrativa del cuidado como base epistémica para los dominios y taxonomías, teniendo en cuenta la adecuación teórico-epistemológica fundamentada en el paradigma cualitativo-interpretativo a través del interaccionismo simbólico. Resultados y discusiones. La enfermería basada en evidencia, surge como el nuevo paradigma emergente, a través de los patrones de conocimiento, hacen parte de la enseñanza y de la práctica de enfermería, de tal forma que aumentan su complejidad y su diversidad epistemológica. Por lo tanto, cada patrón da una orientación de los problemas y las preguntas de la disciplina, reconociendo que los cambios son inherentes al desarrollo del conocimiento en enfermería. Propuestas metodológicas. El fenómeno del cuidado, emerge como necesidad la simbiosis entre el proceso de enfermería y su transcendencia en la investigación científica a través de la enfermería basada en evidencia, vista como un proceso único, individualizado de la práctica de enfermería a través de la narrativa, usando las herramientas de los patrones de conocimiento, teniendo en cuenta que las repuestas de salud-enfermedad de los seres humanos, forman parte del núcleo central del relato y de los significados que las personas les otorgan.

Social Factors as Antecedents of Depression among Community-Dwelling Older Persons

Recognizing depression among older persons is often challenging as they tend to attribute their problems to physical rather than emotional origins. The association between socio-economic factors and depression among 384 older persons was determined through descriptive-correlational design. Path analysis revealed that depression is influenced directly by one’s age (r = .108), education status (r = .514), marital status (r = .011), occupation (r = .003), social status (r = −.116), physical stature (r = .099) and economic status (r = .011). Additionally, the type of community where the older persons dwell and gender have a direct influence on occupation (r = .003) and indirectly affecting depression (r = .103). On the other hand, family component has a direct influence on social status (r = .069) but indirectly influences the occurrence of depression (r = .127). Explicitly, these variables render a predictive path on the occurrence or non-occurrence of depression among the respondents. The study suggests that the diagnosis of depression and its prompt interventions can be traced to the socio-economic dimensions of older persons. Implications to research suggest that determining the antecedents to depression of older persons, this provides a projective analysis which can lead to the development of new knowledge in nursing. This will further influence the holistic management in dealing with an older person’s depression.

Advancing Emergency Nurses’ Leadership and Practice through Informatics

Collection of data in healthcare is vitally important to inform healthcare resource planning and monitor effectiveness of care. The Canadian Emergency Department information System and Canadian Triage Acuity Scale are primary tools for collecting such data. Although emergency nurses use these tools to collect significant patient and healthcare data on daily basis, their understanding of the purposes and implications for collecting these data is sub-optimal. Furthermore, emergency nurses’ awareness about informatics, and the limited representation in information and communication technology strategic initiatives and research within Canadian emergency nursing are some barriers preventing nurses from realizing the full benefits of information and communication technology to improve patient and system outcomes, and nursing knowledge development. The National Emergency Nurses Association is well positioned to provide the leadership required to move nurses from being data collectors, to information users by maximizing their potential to advance Canadian emergency nursing practice through informatics.