Archive for the ‘Nursing research’ Category

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Five Steps to Make Writing a Research Paper Less Daunting

May 28, 2015

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

By DeclanTM, via Flickr.

By DeclanTM/Flickr

It takes a certain kind of super strength to be a grad student in springtime. Some days, I’d rather sit on a bench and watch the daffodils sway in the breeze than search for citable references to back up assigned claims. But after three years of graduate study, I’ve found a method that eventually grounds me. A looming deadline helps me hunker down with all necessary objects—iPad, keyboard, headphones, dirty stares for chatty undergrads. Most of my time is spent searching, until I’m finally ready to write. Edits are fairly quick, and my adherence to APA (American Psychological Association) style comes naturally now.

My system for writing a research paper is not new or undocumented. Research papers span all disciplines, but with little structural variation—a research paper is simply that: a paper that discusses research. Once I am able to will myself to focus, my research papers can be written in five basic steps.

Write a Thesis
Writing a research paper (for a school assignment or a work evidence-based practice project) can be intimidating, but fear can be eased by starting with just one sentence. A thesis statement should say exactly what I, the writer, plan to say to you, the reader, and how I will say it. It can vary and change throughout your writing process, but it should always guide you. In research papers, the thesis statement should usually fall somewhere in your first paragraph.

To write a thesis, you must first understand your assignment. What exactly will you write about? How? What matters about your topic? If it’s for a class, what are requirements of your assignment? With an understanding of all of the paper’s elements, you can begin your first and most important sentence. A proper thesis statement of this blog post might be:

“Writing a research paper is hard for me because of the distractions of springtime sunshine. However, this is an important task in grad school, and if I stick to a process, it can be completed. This blog post will tell you about the process that works for me, and the resources you can use to implement it for yourself.”

This simple statement acts as a road map for my writing process, and also gives my readers a heads-up on what to expect:

What I’ll write about (writing a research paper in springtime).
Why I’ll write about it (I must complete research papers to graduate).
How I’ll explain myself (sharing the writing process and resources for implementation).

Research
Once you’ve written a thesis statement and broken it down into each question (what, why, how) that it will answer, you essentially have the research paper. (Some writers literally cut the thesis statement up with scissors into a bunch of key words and phrases. I like to duplicate it in outline form.)

By looking at the separate elements of your thesis, you’ll see exactly what to research, and exactly what to write. To support my springtime thesis, for example, I’d search for articles using the key words writing, processes, springtime, distraction, writing resources, and research papers.

The actual search for thesis-backing sources should be done through an academic database, like Academic Source Complete, PubMed, or CINAHL. These databases can be found on your school or hospital’s library site, typically under “Databases.” If you’re researching for a work project, hospital libraries can sometimes be difficult to find, but they are treasure troves of information, once located, with Web sites often housed on hospital intranets.

To search for the elements of my thesis, I’d connect things in a database search box with Boolean operators, or words like AND/OR/BUT that create a research phrase. In short, I could enter: writing AND “research paper” AND nurs* AND springtime AND process. Many databases allow you to search an entire phrase, or select connecting words from drop-down menus, in addition to a whole complement of other symbols that librarians are experts on (I’ve gotten to be good friends with the Ask-A-Librarian chat function that my school provides).

Unsurprisingly, when I plugged this search into Academic Search Complete on my school’s library Web site, it brought me zero results. It’s probably safe to say that no one has written a study on springtime, nursing, and research papers. However, when I deleted springtime, my search produced 24 results. A lot of times, research for a paper is a matter of trial and error and refining your search.

Unless you’re writing about a niche topic, you’ll often end up with too many results. To narrow it down, I typically start by stripping out articles that fall outside of the publication dates specified by my professor—most nursing programs ask for studies published in the last five years. Further narrowing comes by selecting the type of article (periodical, academic journal, etc.), since most professors prefer academic, peer-reviewed journals (in some circumstances, citations of blogs of academic journals, like this one, are becoming more widely accepted). Rule of thumb: leave out sites like Wikipedia and WebMD; here are some recommendations on evaluating sources.

Your search can be repeated on Google Scholar, where you can simply input your Boolean phrase like a normal Google search. Google Scholar prominently shows how many times each article has been cited and where—a feature that easily can lead to more sources.

Organize Your Research
Once I have some studies that seem reputable, I organize them. The actual organization of studies often leads to deeper understanding of my topic. And if I follow recommended processes on literature reviews, I tend to find as well that the organization stage produces a greater sense of whether my evidence has validity. Read the rest of this entry ?

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AJN Collections of Note: From Women’s Health Issues to Assessment Tools for Older Adults

May 18, 2015

By Jacob Molyneux, senior editor

'Nuff Said by ElektraCute / Elektra Noelani Fisher, via Flickr.

Elektra Noelani Fisher/ Flickr

It’s easy to miss, but there’s a tab at the top of the AJN home page that will take you to our collections page. There you can delve more deeply into a wide range of topics—and find many options for obtaining continuing education credits in the process.

For example, you’ll find a collection of recent continuing education (CE) feature articles devoted to women’s health issues, such as menopausal hormone therapy, cardiovascular disease prevention for women, and issues faced by young women who are BRCA positive.

The patient population in the U.S. continues to age. To gain confidence in meeting the needs of these patients, nurses can consult our practical collection of articles and videos devoted to the use of evidence-based geriatric assessment tools and best practices.

For the more creative side of nursing, we have a collection of 20 visual works and poems from our Art of Nursing column.

For those concerned with potential legal issues, it’s a good idea to have a look at the three CE articles from our Legal Clinic column on protecting your nursing license.

For would-be authors and those interested in applying knowledge to practice more effectively, there are step-by-step series on conducting a systematic review and on how nurses can implement evidence-based practice at their institutions. Read the rest of this entry ?

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Cochrane Reviews: An Oft-Overlooked Evidence Source for Nurses at the Bedside

May 1, 2015

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

“Research holding the torch of knowledge” (1896) by Olin Levi Warner. Library of Congress, Thomas Jefferson Building, Washington, D.C./Photo by Carol Highsmith, via Wikipedia

Long ago, in an ICU far away, I picked up the habit of saying, during rounds, “Well, you know, research suggests the practice…” I have trouble remembering who taught me this tactic, but it has always been a highly effective way of advocating for my patients.

The eyes of doctors, never ones to be silenced by a nurse who reads research, usually light up at the challenge.

I’ll admit that, for a while, many of my conversational citations came from ‘clinical pearls’ or tidbits I read from certifying organizations via social media. While my knowledge was based on credible sources, my analysis was topical, at best.

Then I started graduate school. Although my program isn’t a clinical one, the need to seek out evidence for class assignments intensified my practice of trying to apply research evidence at the bedside.

It’s tricky to find and discuss credible research as a bedside nurse. Services like Lexicomp and UpToDate, which most hospitals hold subscriptions to, compile current research for clinician use and provide comprehensive information that’s far more credible than Wikipedia. But they’re exhaustive and often require a pretty hefty chunk of time to really analyze and understand. Printing out a 37-page document to hand to an attending on rounds isn’t a practice I’d recommend.

So how do we get reliable, evidence-based information efficiently when it’s needed? It wasn’t until deep into grad school that I started to realize that Cochrane Reviews were sometimes the best bedside research translator out there. The Cochrane Collaboration is an international, nonprofit organization that performs systematic reviews on peer-reviewed journal articles. The reviews are considered, by my professors at least, often the best form of evidence. Short summaries and abstracts are free to all users and are easy to find via PubMed and print. (Full access is subscription based, at least in the U.S.)

‘Sedation vacations': yes, no, maybe? A topic I’ve always loved to use my research line on is the practice of ‘sedation vacations.’ When patients are deathly ill and ventilated, their lives depend on the use of sedatives. However, studies have linked lengthy use of sedative agents to serious complications—drug bioaccumulation, postextubation delirium, decreased quality of life, and adverse events, to name a few. Hence, the daily sedation vacation was born.

Most ICUs these days require a daily sedation vacation for intubated, sedated patients. There’s little doubt that patients are often oversedated, and the practice of pausing the sedation to see if they wake up and then readjusting their sedation according to policy can cut excess use. Some units allow nurses to perform the practice without input from an attending physician. Others rely on a case-by-case method. I’ve worked in both, and in both have said the words, “You know, research calls for daily sedation vacations, and this patient meets the criteria. Should I move forward?”

In most such instances, a sedation vacation was authorized for the patient, and sometimes a discussion of current practices was stimulated by my reference to research. I’d always thought that sedation vacations were a validated, proven, evidence-based practice, and had always advocated for them when my patients met clinical criteria. Read the rest of this entry ?

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Breathing Training May Ease Depression in Dialysis Patients: Study Findings

April 7, 2015

By Sylvia Foley, AJN senior editor

It’s estimated that depression afflicts between 25% and 50% of people who have chronic kidney disease. And depression has been associated with numerous adverse outcomes in this population, including poor sleep, reduced quality of life, and higher rates of hospitalization and death. Researchers Siou-Hung Tsai and colleagues wanted to know whether teaching patients a basic relaxation technique—deep, slow breathing—could alleviate depressive symptoms.

To learn more, they developed a four-week intervention and conducted a trial. The intervention included instruction by a dialysis nurse trained in deep breathing techniques, additional audio device–guided instruction, and guided exercises. The authors report on their findings in this month’s CE–Original Research feature, “The Efficacy of a Nurse-Led Breathing Training Program in Reducing Depressive Symptoms in Patients on Hemodialysis.” Here’s a brief summary.

Objectives: The purpose of this randomized controlled trial was to examine the efficacy of a nurse-led, in-center breathing training program in reducing depressive symptoms and improving sleep quality and health-related quality of life in patients on maintenance hemodialysis.
Methods: Fifty-seven patients on hemodialysis were randomly assigned either to an eight-session breathing training group or to a control group. The Beck Depression Inventory II (BDI-II), the Pittsburgh Sleep Quality Index (PSQI), and the Medical Outcome Studies 36-Item Short Form Health Survey (SF-36) were used to assess self-reported depressive symptoms, sleep quality, and health-related quality of life, respectively.
Results: The intervention group exhibited significantly greater decreases in BDI-II scores than did the control group. No significant differences in PSQI change scores were observed between the groups. SF-36 change scores for both the domain of role limitation due to emotional problems and the mental component summary were significantly higher in the intervention group than in the control group.
Conclusion: This intervention significantly alleviated depressive symptoms, reduced perceived role limitation due to emotional problems, and improved the overall mental health component of quality of life in patients on maintenance hemodialysis.

Pointing to the intervention’s simple design and ease of implementation, the authors note that it offers nurses “a novel way to relieve depression in and offer psychological support to a vulnerable population.” For more details, read the article, which is free online.

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Have You Fallen Prey to a Predatory Publisher?

April 6, 2015

Predatory publishers promise prompt, easy publication. The hidden charges come later, as well as the realization that the journal has no real standing or quality control. Not only is this bad for potential authors, it’s bad for knowledge, flooding the market with inferior information made to superficially resemble the information you need.

Imagine this scenario: You receive an email from a seemingly respectable journal inviting you to submit a paper for publication. You’ve wanted to publish on this topic for some time, and this journal promises you a quick review and publication within a few months. As a new author, you are thrilled . . . that is, until you get charged an outrageous processing fee upon turning the article in. You’ve just fallen victim to a predatory publisher.

Unfortunately, this scenario is becoming all too common. These journals are often difficult to spot, with their professional-looking Web sites and names that sound legitimate, if a little vague. In fact, just recently at AJN, we stumbled across a Web site featuring a journal that looked a lot like ours and had a very similar name. (Jeffrey Beall, a librarian at the University of Colorado, has been tracking predatory publishers since 2009 and maintains a list of them on his Web site, Scholarly Open Access.)

shawnkennedyIn our April issue, editor-in-chief Shawn Kennedy tackles this topic in her editorial, “Predatory Publishing Is No Joke.” As Kennedy explains, predatory publishers “take advantage of the relatively new open access model in publishing,” in which authors “pay the publisher a fee in order to make their article freely available or ‘open’ to all.” Read the rest of this entry ?

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AJN in April: Deep Breathing for Dialysis Patients, Isolation Care, Sleep Loss in Nurses, More

March 27, 2015

AJN0415.Cover.OnlineOn our cover this month is Pablo Picasso’s Le Rêve (The Dream). We chose this portrait of a woman in a restful pose to highlight the importance of proper sleep to a person’s overall health and well-being. Unfortunately, not many Americans are able to get the proper amount of rest. The Institute of Medicine (IOM) estimates that 50 to 70 million U.S. adults have chronic sleep and wakefulness disorders—and nurses are not immune.

Between long shifts and the stressful nature of their jobs, nurses are especially vulnerable to not getting an adequate amount of quality sleep. Fatigue from lack of sleep may diminish the quality of nursing care. Sleep loss has been linked to impaired learning, memory, and judgment and is also associated with a slew of chronic diseases. This month’s CE feature, “The Potential Effects of Sleep Loss on a Nurse’s Health,” describes the acute and chronic effects of sleep loss on nurses, strategies nurses can use to improve the quality of their sleep, and institutional policies that can promote good rest and recuperation.

This feature offers 2 CE credits to those who take the test that follows the article. You can further explore this topic by listening to a podcast interview with the author (this and other free podcasts are accessible via the Behind the Article podcasts page on our Web site, in our iPad app, or on iTunes).

Deep breathing for dialysis patients. Chronic kidney disease (CKD) generally has a poor prognosis and often causes poor sleep quality, reduced quality of life, and is associated with high rates of hospitalization. It’s no surprise that an estimated 25%–50% of patients with CKD suffer from depression. This month’s original research CE, “The Efficacy of a Nurse-Led Breathing Training Program in Reducing Depressive Symptoms in Patients on Hemodialysis: A Randomized Controlled Trial,” examines the efficacy of a nurse-led breathing training program in reducing depression and improving quality of sleep in patients on maintenance hemodialysis. This feature article offers 2.5 CE credits to those who take the test that follows the article. Read the rest of this entry ?

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AJN in March: Post-ICU Syndrome, Workplace Conflict Resolution, Prostate Cancer Options, More

February 27, 2015

AJN0315.Cover.OnlineAJN’s March issue is now available on our Web site. Here’s a selection of what not to miss.

New program for postintensive care syndrome (PICS). With increased ICU survival rates, we are seeing more complex cognitive, physical, and psychological sequelae. The authors of “Critical Care Recovery Center: An Innovative Collaborative Care Model for ICU Survivors” share how they created and implemented an evidence-based collaborative care program for ICU survivors to reduce morbidities that can affect their quality of life. This CE feature offers 2.5 CE credits to those who take the test that follows the article.

Helping men with localized prostate cancer make informed decisions. The information men receive at diagnosis of prostate cancer can be overwhelming. “Early Localized Prostate Cancer” reviews the multiple treatment options available for men with newly diagnosed, low-risk, localized prostate cancer and explains how nurses can help these men make informed decisions. This CE feature offers 2.5 CE credits to those who take the test that follows the article.

Further explore this topic by listening to a podcast interview with the author (this and other free podcasts are accessible via the Behind the Article podcasts page on our Web site, in our iPad app, or on iTunes). Read the rest of this entry ?

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