Research Database -
International Updates

Nursing Research

Issue 32

HARTRICK, University of Victoria, British Columbia, Canada writes that recent research has raised questions regarding the validity and relevance of practitioners’ perspectives regarding diabetes and diabetes care.
Methods: The author conducted a qualitative research study to reveal an insider’s perspective of how Type I diabetes is meaningfully experienced.
Results: The results indicate that although diabetics share a common disease, the meaning of this disease in people’s lives is unique and varied. In order to provide holistic care, nurses must help people to discover and articulate the meaning of diabetes in their lives and to acknowledge and attend to the significant elements within their experiences.
Hartrick GA. The meaning of diabetes. Significance for holistic nursing practice. J Holist Nurs. 16(1): 76-87. Mar 1998.

MATZ and BROWN, Cape Fear Community College, Wilmington, North Carolina USA review the current literature (30 references) regarding humour and pain management.
Results: Following a brief review of the therapeutic benefits of humour for the body, there is a review of the literature regarding articles about humour and pain, (acute and chronic) management. The review of scholarly unresearched articles includes articles providing guidelines regarding the use of humour, suggested guidelines for humour assessment, discussion of the nurse’s role in the use of humour and implementation strategies using humour carts and rooms.
Matz A and Brown ST. Humor and pain management. A review of current literature. J Holist Nurs 16(1): 68-75. Mar 1998.

WARDELL and ENGEBRETSON, School of Nursing, University of Texas Houston Health Science Center, USA write that technological advances and economic, social and cultural conditions have created a climate of change in health care and that new roles and approaches are being developed in relation to the holistic health profession.
Results: Within the holistic nursing community three concepts of holistic practice have emerged. The authors describe for purposes of promoting future discussions the differentiations among 1) certified holistic nurses 2) practitioners of a healing modality and 3) healers.
Conclusions: Because new roles must match a social need and become institutionalised in order to secure a professional role, the authors speculate regarding possible directions for the certification in holistic nursing.
Wardell DW and Engebretson J. Differentiating holistic practice and speculations for future directions. J Holist Nurs 16(1): 57-67. Mar 1998.

Issue 24

ROYLE and colleagues, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario Canada write that in the rapidly changing health care environment nurses need to keep up-to-date with new developments, assess whether these are applicable to practice and to make appropriate changes. The authors state that there is evidence that nursing research is underutilised and there exists a considerable gap between nursing research and practice (Boxtrum & Suter, 1993; Brett, 1987; Sokop & Coyle, 1990). METHODS: The authors conducted a study using guided imagery to decrease patient anxiety within a bone marrow transplant unit in order to: 1) enhance research utilisation in a specific setting; evaluate the outcomes upon a specific clinical nursing problem chosen by nurses and researchers. RESULTS and CONCLUSIONS: The paper describes the research utilisation process and outcomes, evaluates the participatory approach from the perspective of the participating nurses and discusses aids and barriers regard research utilisation.
Royle JA et al. The research utilization process: the use of guided imagery to reduce anxiety. Can Oncol Nurs J 6(1): 20-5. Feb 1996.

KACPEREK, Independent British Healthcare Fulwood Hall Hospital, Preston, Lancashire UK describes how her nursing practice was enhanced following the loss of her voice. Surprisingly, being unable to speak seemed to improve the nurse/patient relationship. RESULTS: Patients responded positively to a quiet approach and silent communication. The skilled use of non-verbal communication via silence, facial expression, touch and closer physical proximity appeared to encourage active listening and helped to develop empathy, intuition and presence between nurse and patient. “Being with” patients and non-verbal communication was an effective form of communication. CONCLUSIONS: Effective communication depends upon the nurse’s ability to listen and use non-verbal communication skills. Also, reflection upon practical experience may be an important technique of uncovering and exploring tacit knowledge in nursing.
Kacperek L. Non-verbal communication: the importance of listening. Br J Nurs 6(5): 275-9. Mar 13-26.

HALL, University of Texas as Austin, USA outlines a critique of existing knowledge regarding spirituality, gleaned from data and insights during 10 years of research and practice regarding the psychosocial and spiritual aspects of living with HIV, and proposes an alternative model especially relevant to nurses. RESULTS and CONCLUSIONS: The author writes that nurses are in an excellent position to experience the human spirit and can use such insights to be present with others and to become more self-aware and self-loving. Professional objectivity and application of professional knowledge were anathema to self-discovery, as the author was taught by patients and research participants and her philosophy and personal rules for understanding the spirit are presented in this paper. A critique of certain confining aspects of nursing theory, particularly those built upon developmental frameworks, is presented. This shows how our vision is skewed negatively ty such frameworks and how such practices may cause nurse to look down at patients rather than treat them as equals.
Hall BA. Spirituality in terminal illness. An alternative view of theory. J Holist Nur 15(1): 82-96. Mar 1997.

SHAW, Marquette University College of Nursing, Milwaukee, Wisconsin USA writes that the “hot flash (flush)” (HF) or vasomotor instability is experienced by 75% of perimenopausal and menopausal women in the US. RESULTS and CONCLUSIONS; While in some women HF are a minor annoyance, for others HF is intensely unpleasant and disruptive to their lives. HF is thought to be triggered by various external and internal stimuli including anxiety, stress, ambient high temperatures, caffeine and alcohol. Thinner women tend to experience more severe and frequent HFs than women with more fatty tissue, probably due to the ability of fatty tissue to transform androstenedione to oestrone and oestradiol. Smoking history tends to be associated with the experience of HFs at an earlier age. The aetiology of HFs in the decreasing oestrogen state is associated with a downward resetting of the hypothalamic thermoregulating mechanism, via norepinephrine, which is usually modulated by oestrogen. When the body attempts to dissipate unwanted body heat by vasodilation, this causes the sensation of the HF. The most successful treatments have been hormone replacement therapy with oestrogen and progesterone, although alpha 2-adrenergic blockers have also shown some limited effectiveness. There is anecdotal support for many alternative therapies including vitamin E, evening primrose oil, dong quai and black cohash, but these have not been thoroughly studied. Relaxation, exercise, avoidance of triggering factors and control of external environment have all be used with some success by women.
Shaw CR. The perimenopausal hot flash: epidemiology, physiology, and treatment. Nurse Pract 22(3): 55-6; 61-6. Mar 1997.

WALLACE, Department of Veterans Affairs, VA Western New York Health Care System USA writes that a review of the literature regarding relaxation and imagery interventions for cancer pain is required because major review articles have excluded nursing research or were written prior to the publication of controlled studies conducted by nurses regarding cancer pain. The author reviews (45 references) published nursing/medical/psychological literature of adults with cancer pain which had been conducted between 1982-95. RESULTS: This body of literature contained few controlled studies, weak theor-etical frameworks, few complete descriptions of the pain problem and lack of control over interventions. Most studies had small numbers and could not demonstrate significant effects, and the intervention methods and lengths were highly variable. RESULTS: However, despite these design shortcomings, relaxation and imagery appear to reduce the sensory experience of pain, have equivocal effects upon affective measures and appear to have no effect upon functional status. CONCLUSIONS: There is a need for more experimental studies with more complete description of pain, improved statistical reporting, controls over adequacy of and compliance to interventions, use of single interventions and use of more complex measures of affective outcomes.
Wallace KG. Analysis of recent literature concerning relaxation and imagery interventions for cancer pain. Cancer Nurs. 20(2): 79-87. Apr 1997.

COMMENTS: Reading between the lines of the above research studies lies a plea for more research to be carried out by nurses and for greater acknowledgement and recognition of the research which is carried out and published by nurses. Although nurses have been in the vanguard for carrying many complementary healthcare techniques into the hospital care setting – massage, aromatherapy, reflexology, visualisation – they are frequently not given the credit for such valuable work by their medical colleagues, nor by the complementary medical professions. To read further about the extensive impact nurses are making toward the practice of complementary therapies, readers are referred to the major special feature in this issue of Positive Health starting on page 15.