ERLINDA CASTRO-PALAGANAS, PhD, RN
January-June 2017 Issue
Nortifying refers to strengthening the foundation of something. In relation to the nursing profession, it can mean strategies to to impart vigor, to increase effectiveness, to strengthen and protect against opponents’ attack; or to strengthen mentally or morally (http://www.definitions.net). One of the strategies that can fortify our nursing profession is the conduct of research and utilizing these findings derived.
There is no escaping the reality that nurses need to fortify the nursing profession through the conduct of research. We belong to a practice profession thus, research is essential in developing and refining knowledge that can be used to improve practice. We need to use research findings to determine the best way to deliver services and to ensure that the greatest number of people receive services. A step forward after the conduct of research is research utilization, which is the use of knowledge typically based on a single study. This leads us further to a higher step of fortifying nursing practice by moving on to an evidence-based practice (EBP). EBP takes into consideration a synthesis of evidence from multiple studies/evidences and combines them with clinical expertise and patient preferences and values. The call towards building a EBP quality improvement and health care transformation calls for practice adoption; education and curricular realignment; model and theory development; scientific engagement in the new fields of research; and development of a national research network to study improvement (Munhall, 2012). Our journey with EBP has long started but we have yet to make an impact, as I am of the belief that much has yet to be done.
This issue features articles that showcase initiatives and efforts to fortify our nursing profession. Borromeo’s article on the Life and Times of Anastacia Giron-Tupas, whose story tells the evolution of Philippine nursing and is inextricably linked to the history of the Philippine Nurses Association. I join forces with Borromeo’s belief that nurses “can learn from the exemplary leadership practices and behaviors that helped her succeed to bring Philippine nursing out of the dark.” Fortifying nurses and our profession entails understanding our roots, and this historiography provides “the unique perspective and context that spurred Anastacia Giron- Tupas to become an agent of change”.
Four nurses’ voices from the field echoed in this issue. I so particularly appreciate Celiz and Estacio’s reflections on nursing research, paradigms and perspectives in the conduct of nursing research. Celiz never thought of herself other than being a positivist, but she realized that she needs to be “more assertive in my creativeness. I should learn not to fear “out-of-the-box” thinking. For starters, I have to improve on my teaching strategies with the realization that some of my students may be constructivists as well.” On the other hand, Estacio’s The Colors of Paradigms and Perspectives: Recognizing Complexities, Contentions, and Transitions narrates his coming to grips to the various ways of knowing. “The trajectory of finding truth (or several truths) persists and may continue to persist through time. The very nature of knowledge generation and research must not focus on discovering the truth, but with how the findings become the key to current problems and their acceptability in addressing issues.” These voices from young nurses add to fortifying nursing through the development of nursing knowledge using various lenses. The third voice, Leyva’s Nursing Perspective on Climate Change and Planetary Health explores the links between human activity, climate change and planetary health. He identifies nurses’ role in climate-smart health systems and in building community resilience. He calls for planetary health as an opportunity for collaboration. Santos’ voice on the Philippine Nurses’ Association (PNA) and its mandate as the Accredited Professional Organization is a reminder of what our organization has represented all these years, what it represents to day and the future as its centennial year approaches.
The original research articles in this issue are nurse researchers’ contribution to fortify our nursing profession.
Cura’s Development of Framework for Clinical Nursing Research Fellowship in the Philippines is a research study using a sequential non-dominant mixed method design; he posits that fellowship programs serve as alternative means to bridge the gap between undergraduate education and nursing practice. He found that the CNR Fellowship Program framework contained “contextually-relevant core competencies in clinical nursing research that are needed to augment basic nursing research education and to benefit clinical nursing practice.” De leon and De leon’s Assessment of Health Care Needs of Older Persons with Type 2 Diabetes Mellitus assessed the health care needs of older persons’ physical, cognitive, functional and self-care abilities and determine relationship of these to their profile as bases for a Diabetes Self-management Education training module for diabetes educator.
Garma and Kuan’s Goal Attainment Theory-Based Empowerment for Chronically Ill Older Persons in the Community tested the effects of the goal attainment theory-based empowerment (GATE) on self-efficacy and health empowerment among chronically ill older persons in the community and showed positive effects. Ablog et al.’s Effect of Psychoeducation on Self-esteem and Self efficacy among College Students suggest that efforts are needed to further explore the usefulness and utilization of psychoeducation at the community and professional levels. His research revealed “that both psycho-education models (informational and comprehensive) showed evidence of effectiveness in increasing the self-esteem and self-efficacy levels of college students.” Santos’ Staff Nurses’ Competency and Patients’ Satisfaction in an Accredited Maternity Hospital: Basis for Enhancement Program reveals that though nurses are competent and satisfied, he suggests enhancement programs to fortify nursing practice. Manarang & Cueva’s Relationship Between Level of Readiness for Self-directed Learning and Learning Styles of CEU Nursing Students fortifies nursing practice by acknowledging the need to assess the level of readiness of student nurses for self-directed learning and their learning styles. Roces’ concept analysis on Dyspnea Among Patients with Advanced Lung Cancer shows that “despite the frequency and complexity of this symptom, little research has been conducted to specifically identify effective treatment in patients with advanced lung cancer.” Roces’ recommends further investigations in this area to assert the total dyspnea experience could be influential in regards to the quality of life in patients with advanced lung cancer.
Lauro et al.’s article on the experiences of oncology nurses as they wave through misery, hope and beauty on caring for cancer patients, provides another lens of understanding nursing phenomenon. The only qualitative research study in this issue, this article showed that “health-related quality of life interventions were essential in nursing care among cancer patients. In addition, it may be of value for nursing leaders to provide specified training programs for oncology nurses working on issues relevant to the HRQoL intervention skills.”
As earlier stipulated, we need to utilize these findings as a springboard to a higher form of fortifying the nursing profession. For this to happen, a culture of inquiry and innovation must be evident across all areas where we practice. We need to adopt research utilization as a practice standard for nurses or as integral part of professional accountability, and that it will result in improved social sciences interventions and outcomes. This culture of inquiry and innovation manifest itself with questioning historical practices, exploring evidence-based literature and implementing practice changes to ensure that care is safe, effective and provides the best care to partners/customers (Fineout-Overholt & Melnyk, 2005; Ackley, et al., 2008).
The challenge is for us to adopt approaches in conducting research that is critical, reflective and rigorous (Holloway Galvin 2017). The PJN will continue to be a channel for research dissemination so that we and our colleagues may utilize and translate findings of research and EBP projects within our organization at all levels. Let us continue to develop sustainable mechanisms to support and enable research-based practice.
Ackley, B,, Ladwick, G., Swan, B., & Tucker, S. (2008). Evidencebased nursing care guidelines, medical- surgical interventions. Mosby Elsevier St Louis Missouri.
Fineout-Overholt, E. & Melnyk, B. (2005). Building a culture of best practice. Nurse Leader. 3:6, pp. 26-30.
Holloway, I. & Galvin, K. (2017). Qualitative research in nursing and healthcare (4th ed.). United Kingdom: John Wiley & Sons.
Munhall, P. L. (2012). Nursing Research: A qualitative perspective (5th ed.). USA: Jones & Bartlett Learning.
Streubert, H. J. & Carpenter, D. R. (2011). Qualitative research in nursing: Advancing the Humanistic Imperative (5th ed.). USA: Lippincott Williams & Wilkins.