THIS MONTH IN JAN

Authors


This month in JAN in October identified that from January 2001 the journal will have a new look. Published fortnightly with 15 papers in each issue, this new version will replace the current monthly journal with up to 30 papers in the contents. Looking forward once more to the New Year, from January 2001 all manuscripts will have a structured abstract normally incorporating the headings shown below:

• Aim(s) of the study/paper

• Background/Rationale

• Design/Methods

• Results/Findings

• Conclusions

If, occasionally, authors find these to be inappropriate they will be advised to substitute those headings which best summarize the content of their papers. Unstructured abstracts will not be used in future. Authors of papers already submitted for review, or accepted for publication in January 2001 or later, are being requested to send revised, structured abstracts immediately. These developments are all a part of the modernization process that the editors are pursuing with Blackwell Science, and readers of this column will be updated on further changes in future issues.

Turning now to this month, the November 2000 issue follows a long tradition in nursing scholarship with several papers concerned centrally with the concepts that nurses use daily in their clinical practice. The issue begins with five papers in the Philosophical and ethical issues category, three of which are concerned with the ethical aspects of the concept of care. Care and caring practices continue to remain high on the nursing agenda, and these three papers encourage nurses once again to reflect upon their origins and ethical meanings, and the implications for modern health care.

Fatigue is another concept widely used in nursing practice, but less subjected to critical scrutiny than care and caring. Two papers in this issue are concerned with this concept. The first, in the Nursing theory and concept development or analysis category, subjects the term ‘chronic fatigue’ to a concept analysis using Walker and Avant’s (1995) framework. This is an essential preliminary exercise before carrying out research into chronic obstructive pulmonary disease as, the author claims, the literature contains no universal definition and fails to distinguish between fatigue and chronic fatigue. The author of the first paper concludes that the concept remains complex, but that a start has been made on clarification. The second paper on fatigue appears in the Issues and innovations in nursing practice category. This is because the authors’ exploration of the concept was carried out within the context of an empirical study of the personal experiences and biochemical analysis of patients with renal failure on maintenance dialysis. This paper takes our understanding of fatigue a step further, for no correlation was found in the study between the biochemical and situational variables measured. There was however, a significant association between sleep problems, poor physical health and depression. Further complex relationships are also noted. Together, these two papers on fatigue illustrate that it is impossible to develop research into caring practices without first exploring in great detail the contexts and the concepts under investigation.

Two further papers in the Nursing theory and concept development or analysis category explore, respectively, the beliefs and meanings in the experience of cancer, and the concept of hope in the Dominican Republic. These concepts have been addressed previously in the Journal of Advanced Nursing, but both papers take our understanding further. The Canadian authors of ‘Understanding beliefs and meanings in the experience of cancer’ argue that there is often overlap in the use of the terms, and that they are sometimes used synonymously. Yet, their analysis leads them to argue that the ‘Clarity in the conceptual definitions of beliefs and meanings can help researchers select measures that accurately reflect the phenomenon of interest’ (my emphasis). Thus, once again, the importance of the prior analysis of terms before embarking on research is emphasized.

In exploring the concept of hope in the Dominican Republic, the North American author asks ‘What are the universals and diversities in the meaning of hope for this cultural group and United States (of America, US) mainstream culture?’ In embarking on this study she points out that little research has explored whether hope has different attributes in various cultural groups. The author arrives at a very complex definition of hope and its attributes derived from the data gathered in a rural Dominican village. She compares this locally derived definition with those developed from research amongst USA populations, to propose universals and diversities of hope. In an international journal, such as JAN, this is important work and perhaps the next step is to conduct a global analysis of nursing work on hope. For example, JAN Volume 28 contained papers on aspects of hope from Sweden, United Kingdom and the USA ( Benzein et al. 1 998, Cutcliffe 1998, Herth 1998). The time is surely ripe to use systematic review techniques in order to test the universals already identified, against the populations in these very different studies? In this way, conceptual generalization in nursing research can move further ahead in this important area.

The November 2000 issue of JAN is not, of course, confined to the discussion of conceptual issues, important though these may be. There are many other papers on significant subjects for nurses in practice, research, management and education. Three papers on aspects of nursing home care are drawn from authors in Northern Ireland, Sweden and Switzerland, demonstrating once again the importance of this ubiquitous trend in the care of older people. Aspects of the support needed for breast feeding may be found in three papers originating from Australia, Slovenia and Sweden. These, together with a paper on ‘Personal control of pain relief in labour’ jointly from authors in Northern Ireland and Scotland, illustrate midwives’ and nurses’ continuing concern with issues in maternal and child health across an international spectrum of countries.

Aspects of cancer care and its research feature in three papers; two more focus on the care of patients with coronary heart disease, and one paper each on the quality of life in a Swedish sample of HIV-infected persons, and dementia mapping in service quality audit. Together, these papers illustrate the breadth of clinical practice content in this month’s issue.

Papers concerning the role, function, education and management of the nurse include health education and promotion. Amongst these is a systematic review of the health promotion role of the school nurse by authors in Wales. A timely paper from Northern Ireland describes the development and definition of the operating theatre nurse, a topical subject given current international interest in the ways that this role may develop in the future. Further papers on clinical supervision, ‘observation levels’ nursing policy, and three on Methodological issues in nursing research complete the 30 papers for November 2000. In this issue JAN demonstrates, once again, that its content is analytic, eclectic, international, and above all, highly relevant to practice.

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