Prologue: Leading women in respiratory clinical sciences.

Special Series: Leading Women in Respiratory Clinical Sciences Series Editors: Anne-Marie Russell and Kathleen O Lindell See related Letter.

Leveraging biosocial methods to examine and address structural determinants of health and promote health equity.

BACKGROUND: Biosocial approaches in nursing research have largely focused on the ways that social determinants of health influence individual-level outcomes, including symptom management, family and social support, and educational interventions. PURPOSE: Theoretical, methodological, and practical strategies are needed to expand current biosocial methods for nursing science and focus on upstream, structural determinants of health and the policies that underlie health inequities. METHODS: This paper summarizes presentations given at the 2023 Council for the Advancement of Nursing Science Advanced Methods Conference, Biosocial Methods to Advance Health Equity, in a panel titled "Individual, community, systems and policy related to biosocial methods." DISCUSSION: Nurses are uniquely positioned to examine upstream, structural determinants of health by leveraging expertise in biosocial methods, collaborating with interdisciplinary researchers and community members, and advocating for policy change. By conducting theory-grounded biosocial research, nurse researchers can significantly advance scientific knowledge and promote health equity for individuals and communities. CONCLUSION: Nurse scientists are conducting research using biosocial methods and provide recommendations for expansion of this approach in the field.

Using nursing knowledge in the acute phase of stroke: An exploratory qualitative descriptive study / Les connaissances infirmières mobilisées en phase aigüe de l'accident vasculaire cérébral : une étude exploratoire qualitative descriptive

Introduction: Strokes represent a major public health issue in which nurses are involved, both in care and in research. The literature reveals a description of their activities in treating the disease and the altered functions in which it results, as well as in managing the experience of the sufferer. The aim of this work was to describe the knowledge upon which nurses draw when caring for patients in the acute phase of stroke. Methods: This exploratory qualitative descriptive multicentric survey was carried out via non-directive interviews with nurses working in neurovascular units. Thematic qualitative analysis was used to describe their activities and to highlight the knowledge and skills used. Results: The results show that the nurses express themselves with ease when discussing their medical knowledge, and with more difficulty concerning knowledge from the human, social, and nursing sciences. However, they often combine this knowledge in a nursing perspective. Discussion: This work opens up prospects with regard to supporting the nursing knowledge already leveraged and developing the nursing knowledge (concepts and theory of care) relevant to the particular context of strokes. The results also encourage a reflective analysis of nurses' experience.

L'accident vasculaire cérébral (AVC) est un problème de santé publique majeur dans lequel les infirmières s'investissent, dans le domaine des soins et de la recherche. La littérature met en évidence une description de leurs activités de soins sur la maladie et les fonctions altérées, ainsi que sur l'expérience de la personne victime d'un AVC. L'objectif de ce travail est de décrire les connaissances mobilisées par les infirmières quand elles prennent soin de la personne en phase aigüe de l'AVC. Cette enquête exploratoire qualitative descriptive multicentrique a été conduite auprès d'infirmières exerçant en unité neurovasculaire au moyen d'entretiens non directifs. L'analyse qualitative thématique a permis de décrire leurs activités, puis de mettre en évidence les connaissances et savoirs mobilisés. Les résultats montrent que les infirmières s'expriment aisément sur les savoirs issus de la médecine, et plus difficilement sur les savoirs issus des sciences humaines et sociales, et des sciences infirmières. Pourtant, elles combinent souvent ces savoirs dans une perspective de soins infirmiers. Ce travail ouvre des pistes pour soutenir les connaissances infirmières déjà mobilisées et pour développer les savoirs infirmiers (concepts et théories de soins) pertinents dans le contexte de l'AVC. Les résultats encouragent aussi une analyse réflexive sur leur expérience.

Intensive care nurses' lived experience of altruism and sacrifices during the Covid-19 pandemic: A phenomenological study.

AIM: The aim of this study was to understand the lived experience of altruism and sacrifices among Swedish nurses working in intensive care units (ICU) during the COVID-19 pandemic. DESIGN: This was a descriptive phenomenological study. METHODS: The study was conducted between June 2020 and March 2021 and included 20 nurses who were directly involved in the ICU care of COVID-19 patients in Sweden during the pandemic. The text transcripts were analysed using Malterud's Systematic Text Condensation. FINDINGS: The analysis revealed four themes. The work situation changed from 1 day to another-the nurses were brutally confronted with a new and highly demanding situation. Adapting to the chaotic situation-despite fear, anguish and exhaustion, the nurses adapted to the new premises. They shouldered the moral responsibility and responded to the needs of the patients and the health care system since they had the competence. Being confronted with ethical and moral challenges-the nurses were overwhelmed by feelings of helplessness and inadequacy because despite how hard they worked, they were still unable to provide care with dignity and of acceptable quality. The importance of supporting each other-collegiality was fundamental to the nurses' ability to cope with the situation. CONCLUSIONS: Taken together, being exposed to a constantly changing situation, facing the anguish and misery of patients, families, and colleagues, and being confronted with a conflict between the moral obligation to provide care of high quality and the possibility to fulfil this commitment resulted in suffering among the nurses. Collegial back-up and a supportive culture within the caring team were important for the nurses' endurance. IMPACT: The study contributes an understanding of nurses' lived experience of working during the COVID-19 pandemic and highlights the importance of protecting and preparing nurses and nursing organisation for potential future crises.

Assistive robotic systems in nursing care: a scoping review.

BACKGROUND: The use of assistive robotic systems in care is intended to relieve nursing staff. Differentiated and literature-based findings on current application possibilities, technological developments and empirical findings are necessary to enable a goal-oriented and participatory development of assistive robotic systems of care. The aim of this review was to identify assistive robotic systems and their areas of application in nursing settings. Furthermore, an overview of existing social and nursing science findings from the research field of assistive robotic systems will be described. METHODS: A systematic literature search was performed based on the JBI scoping review methodology. During the period from May to August 2020, the databases MEDLINE via PubMed, CINAHL, Cochrane Library, Web of Science, and IEEE Xplore Digital Library were searched. In order to reflect current developments and evidence in the present literature work, a supplementary search with these same requirements was conducted in January 2022. RESULTS: The 47 included publications are divided into 15 studies, 23 technical articles and nine opinion-based articles (text-opinion). A total of 39 different assistive robotic systems were identified. There were 55% in the testing phase and 29% of the systems in the development phase. Assistive robotic systems can be divided into six fields of application: Information and patient data processing, assistance with activities of daily living, fetch and bring activities, telepresence and communication, monitoring, safety and navigation, and complex assistance systems. The description of the study findings is divided into "integration of technology and impact on practice" and "attitude and acceptance of elderly people towards assistive robotic systems". CONCLUSION: The results of the research show that the use of assistive robotic systems in care mainly take place in the context of development and testing phases. In addition to usability and acceptance issues, implementation factors must be integrated into theory-driven research projects.

Leadership moments: Understanding nurse clinician-scientists' leadership as embedded sociohistorical practices.

Nurse clinician-scientists are increasingly expected to show leadership aimed at transforming healthcare. However, research on nurse clinician-scientists' leadership (integrating researcher and practitioner roles) is scarce and hardly embedded in sociohistorical contexts. This study introduces leadership moments, that is, concrete events in practices that are perceived as acts of empowerment, in order to understand leadership in the daily work of newly appointed nurse clinician-scientists. Following the learning history method we gathered data using multiple (qualitative) methods to get close to their daily practices. A document analysis provided us with insight into the history of nursing science to illustrate how leadership moments in the everyday work of nurse clinician-scientists in the "here and now" can be related to the particular histories from which they emerged. A qualitative analysis led to three acts of empowerment: (1) becoming visible, (2) building networks, and (3) getting wired in. These acts are illustrated with three series of events in which nurse clinician-scientists' leadership becomes visible. This study contributes to a more socially embedded understanding of nursing leadership, enables us to get a grip on crucial leadership moments, and provides academic and practical starting points for strengthening nurse clinician-scientists' leadership practices. Transformations in healthcare call for transformed notions of leadership.

Advancing health equity through nursing research.

BACKGROUND: Health inequities are major predictors of poor health and remain a complex and persistent challenge globally and in the United States. Research has documented the underlying causes and mechanisms that give rise to health disparities. However, it lacks adequate attention to the strategies needed to build upon promulgated research to address equity-based challenges to improve health. PURPOSE: This paper describes how building and supporting diverse research teams can play a central role in increasing the research capacity and participation of diverse populations to improve the health of individuals, families, and communities. METHODS: Exemplars from work and discussion of strategies to grow nursing's health equity workforce are presented. DISCUSSION: Actions to build and leverage partnerships to expand capacity, maximize the impact of health equity outcomes, and cultivate a supportive environment to grow the health equity scientific workforce are discussed. CONCLUSION: Nurse scientists can address health equity through the research process.

The impact of the Robert Wood Johnson Foundation Future of Nursing Scholars Program on scholars, schools and nursing science.

BACKGROUND: The Future of Nursing Scholars program prepared a cadre of PhD prepared nurses for long-term careers advancing science and discovery, strengthening nursing education, and leading transformational change in health care. PURPOSE: The purpose of this manuscript was to describe the program's impact on Scholars' outcomes, nursing schools, and perceived impact on nursing science. METHODS: An independent program evaluation was conducted, including interviewing representatives from schools and reviewing Scholars' Curriculum Vitae. FINDINGS: Two hundred one scholars were supported across 45 institutions. To date, 181 scholars graduated within 3.1 years, on average. Most graduates reported holding appointments in academic institutions. School representatives believed the program supported rapid entry into the field, longer research trajectories, and will improve the nursing faculty pipeline. DISCUSSION: The program achieved its goal of developing cohorts of PhD prepared nurses poised for long-term careers. It provided "proof of concept" on high-quality accelerated PhD education for students well matched with mentors, and elevated the national conversation on PhD education.

Moving the needle further and faster: Policy and leadership opportunities to support early career nurse faculty and build resilience in establishing and growing their programs of research.

Nurse scientists play a critical role in advancing the nursing field and improving health, but early career faculty can enter the academic ranks with little training in how to effectively establish, manage, and grow a program of research (POR) or weather the storms that accompany a research-intensive academic path. This can lead many nurse scientists to leave academic positions or even abandon their POR altogether. This is problematic at a societal level because nurse scientists bring a unique and valuable holistic perspective to scientific inquiry and an orientation towards community-based work, team science, intersectionality, and participatory approaches essential to address urgent health challenges. To enhance the impact of nurse scientists as a collective on academic research and human health, more attention should be given to the concept of resilience in the context of a research-focused career and the necessary structural changes that effectively support early career faculty in establishing thriving PORs. This article offers considerations relevant to administrative leaders, policymakers, and established faculty, at both the institutional and disciplinary level, to support early career faculty in establishing PORs that take root and flourish.

On Bender's orientation to models: Towards a philosophical debate on covering laws, theory, emergence and mechanisms in nursing science.

Nursing scholars continuously refine nursing knowledge and the philosophical foundations of nursing practice. They advance nursing knowledge by creating new knowledge and weighing the relevance of developments in cognate sciences. Nurse philosophers go further by providing epistemological and ontological arguments for explanations of nursing phenomena. In this article, I engage with Bender's arguments about why mechanisms should have more primacy as carriers of nursing knowledge. Despite the careful scholarship involved, Bender's arguments need to be more convincing. Accordingly, this article encourages debate about Bender's arguments for reorientating nursing science to mechanisms. I begin by suggesting that the claim that the theory-practice divide can be overcome by reorientating to mechanisms is acceptable only if we accept Bender's depiction of the challenge. Then I question the ontology Bender relies on to justify reorientating nursing science. After that, I argue that mechanisms in models that parallel analytical sociology undermine the kind of nursing science Bender advocates. I illustrate my arguments with a social mechanism thought experiment. Then I explain why Bender's arguments cannot escape the received view of science or inform emancipatory nursing action without theory. Finally, I mention some caveats and implications for nursing science.

Nursing science as the study of how to reconcile behavioral messiness with clinical norms and ideals.

There is no settled definition of nursing science that describes how this field of scientific research is unique. This paper attempts to correct this problem. It uses a combination of historical analysis and abductive argument to support the thesis that nursing science is a sui generis social science that studies how to reconcile clinical ideals or norms that are applicable to practice in nursing with the messiness of human behavior.

For a better understanding of the profile of nurses working in France who hold or are working toward a Ph.D: A quantitative descriptive study / Mieux connaître le profil des infirmières titulaires d'un doctorat en sciences ou doctorantes exerçant en France : une étude descriptive quantitative

INTRODUCTION: In 2009, the French Association de recherche en soins infirmiers (Nursing Research Association) counted fifty-four nurses holding a doctorate or working toward one. Recent developments in this area include the creation of section 92, for nursing sciences, in the National Council of Universities, making it possible for nurses in France to become professors with teaching and research responsibilities. OBJECTIVES: To update and complete the 2009 data by identifying the grades, fields of activity, and disciplines of nurses holding a doctorate or studying for one. METHOD: A quantitative descriptive study was carried out using an online questionnaire between December 1, 2021 and March 22, 2022. RESULTS: the study involved 147 nurses working in France: seventy-five with a doctorate and 72 doctoral students. The majority of the respondents were women, held a supervisory position, and were working in the field of education. Among the doctorates obtained, education sciences accounted for the largest share. However, this disciple was less well represented among the doctoral candidates. DISCUSSION: This study shows a change in the characteristics of nurses who are also doctoral candidates and in the disciplines in which they have obtained or are currently obtaining a doctorate, and an increase in the value of the degree, particularly in research, but little access to academic posts.

Introduction: En 2009, l'Association de recherche en soins infirmiers avait recensé 54 infirmières titulaires d'un doctorat et doctorantes. Parmi les intérêts récents de s'engager dans des cursus académiques figure la création, en 2019, de la section 92 « sciences infirmières ¼ au Conseil national des universités, rendant possible en France l'accès au corps d'enseignants-chercheurs à des infirmières. Objectifs: Actualiser et compléter les données de 2009 en identifiant les grades, les domaines d'activité, les disciplines des infirmières titulaires d'un doctorat ou doctorantes. Méthode: Une étude quantitative descriptive a été réalisée par un questionnaire en ligne, entre le 01/12/2021 et le 22/03/2022. Résultats: 147 participants, exerçant en France, ont été inclus, dont 75 infirmières titulaires d'un doctorat et 72 doctorantes. La majorité des répondants étaient des femmes, avaient un grade d'encadrement et exerçaient une activité professionnelle dans le domaine de la formation. Le plus grand nombre de doctorats a été obtenu en sciences de l'éducation ; cette discipline est moins représentée chez les doctorantes. Discussion: Cette étude montre une évolution des caractéristiques des infirmières doctorantes et des disciplines des doctorats obtenus ou en cours, une valorisation du diplôme notamment en recherche mais un faible accès aux fonctions académiques.

For a better understanding of the profile of nurses working in France who hold or are working toward a Ph.D: A quantitative descriptive study / Mieux connaître le profil des infirmières titulaires d'un doctorat en sciences ou doctorantes exerçant en France : une étude descriptive quantitative

Introduction: In 2009, the French Association de recherche en soins infirmiers (Nursing Research Association) counted fifty-four nurses holding a doctorate or working toward one. Recent developments in this area include the creation of section 92, for nursing sciences, in the National Council of Universities, making it possible for nurses in France to become professors with teaching and research responsibilities. Objectives: To update and complete the 2009 data by identifying the grades, fields of activity, and disciplines of nurses holding a doctorate or studying for one. Method: A quantitative descriptive study was carried out using an online questionnaire between December 1, 2021 and March 22, 2022. Results: the study involved 147 nurses working in France: seventy-five with a doctorate and 72 doctoral students. The majority of the respondents were women, held a supervisory position, and were working in the field of education. Among the doctorates obtained, education sciences accounted for the largest share. However, this disciple was less well represented among the doctoral candidates. Discussion: This study shows a change in the characteristics of nurses who are also doctoral candidates and in the disciplines in which they have obtained or are currently obtaining a doctorate, and an increase in the value of the degree, particularly in research, but little access to academic posts.

Introduction: En 2009, l'Association de recherche en soins infirmiers avait recensé 54 infirmières titulaires d'un doctorat et doctorantes. Parmi les intérêts récents de s'engager dans des cursus académiques figure la création, en 2019, de la section 92 « sciences infirmières ¼ au Conseil national des universités, rendant possible en France l'accès au corps d'enseignants-chercheurs à des infirmières. Objectifs: Actualiser et compléter les données de 2009 en identifiant les grades, les domaines d'activité, les disciplines des infirmières titulaires d'un doctorat ou doctorantes. Méthode: Une étude quantitative descriptive a été réalisée par un questionnaire en ligne, entre le 01/12/2021 et le 22/03/2022. Résultats: 147 participants, exerçant en France, ont été inclus, dont 75 infirmières titulaires d'un doctorat et 72 doctorantes. La majorité des répondants étaient des femmes, avaient un grade d'encadrement et exerçaient une activité professionnelle dans le domaine de la formation. Le plus grand nombre de doctorats a été obtenu en sciences de l'éducation ; cette discipline est moins représentée chez les doctorantes. Discussion: Cette étude montre une évolution des caractéristiques des infirmières doctorantes et des disciplines des doctorats obtenus ou en cours, une valorisation du diplôme notamment en recherche mais un faible accès aux fonctions académiques.

Study protocol for the implementation and evaluation of a digital-robotic-based intervention for nurses and patients in a hospital: a quantitative and qualitative triangulation based on the Medical Research Council (MRC) framework for developing and evaluating complex interventions.

BACKGROUND: Nurses spend part of their working time on non-nursing tasks. Unnecessary walking distances and the assumption of service activities and other non-care-related tasks take up a lot of space, which reduces the time for direct patient care and demonstrably increases the dissatisfaction of the persons involved. The REsPonSe project aims to relieve nursing staff by using a smartphone app for communication in combination with an autonomous service robot to reduce walking distances and service activities. The technical systems are tested on a nuclear medicine ward and are intended to reduce the radiation exposure of the staff. The aim of this study is to test and evaluate the use and intervention of the technical systems, the acceptance of the users and the change in the utilisation of the nursing service. In addition to findings on usability and manageability, effects on nursing practice, as well as facilitating and inhibiting contextual factors for implementation, will be identified. METHODS: The Medical Research Council (MRC) Framework for Developing and Evaluating for Complex Interventions was chosen as the theoretical basis. The data collection in the Feasibility and Evaluation phase is a triangulation of quantitative and qualitative methods. Standardised observations are planned to collect data on non-care activities and walking distances, and a survey of utilisation by use of a questionnaire based on the NASA TLX. Qualitative individual interviews with patients and group discussions with nursing staff will be conducted. Statements on the subjective experiences, as well as the evaluation of the use of the digital-robotic system in the clinical setting, will be collected. The descriptive evaluation of the usage and retrieval data will provide information on duration, time, requests, and reduced contact times, as well as error and fault messages. DISCUSSION: The evaluation study will make it possible to represent a variety of perspectives from different interest groups. The results should contribute to the definition of implementation and evaluation criteria and facilitate the integration of digital-robotic assistance systems in nursing acute inpatient settings. TRIAL REGISTRATION: The trial was registered with the German Clinical Trials Register (DRKS) on 16.02.2022: DRKS00028127.

A scoping review of outcomes of operational success for nurse scientists in clinical practice settings.

BACKGROUND: The nurse scientist in the clinical setting is a role that has evolved over recent decades to encompass the concomitant development of personal research programs and the facilitation of staff and advanced practice nurse research in health care settings. However, the definition, operationalization, and measures of success are extremely variable. PURPOSE: To identify the defining features and characteristics of the nurse scientist role in clinical practice settings as represented in the existing literature. METHODS: We conducted a scoping review using PubMed and CINAHL databases. We initially identified a total of 3345 references from 1976 to June 2020, 217 of which were published from 2005-2020. We used the Joanna Briggs Institute (JBI) framework to explore the state of the science of the role of nurse scientists in practice settings. DISCUSSION: Approximately 100 articles met the criteria for full-text analysis, and the final review consisted of 20 descriptive analytic studies addressing the nurse scientist role definition, operationalization, and outcome measures. CONCLUSION: Findings suggest that nurse scientist roles serve to promote health system success through a host of research-focused activities that conceivably contribute to improved patient care outcomes. Work is needed to support the cost of requisite resources and infrastructure and to increase acceptance of the role as part of a tenure-earning track in academic settings that also stand to benefit.

[Implementing the Objective Structured Clinical Examination (OSCE) in postgraduate education in nursing science-a pilot project to assess ethical competences in nursing practice and research]. / Implementierung des Objective Structured Clinical Examination (OSCE) im Masterstudiengang Pflegewissenschaft ­ Pilotprojekt zur Prüfung der ethischen Kompetenz in Pflegepraxis und -forschung.

Background: Teaching ethical competencies is an essential component of professional and postgraduate curricula. Developing practical-ethical problem-solving competencies as well as appraising program-specific studies and related research ethics are topics typically addressed. However, assessment of these ethical competencies poses a challenge. Written or oral assessment formats addressing relevant learning objectives is mainly limited to knowledge testing alone, often not capturing relevant skills or attitudes pertinent to those competencies. Aim: During the reaccreditation of the masters of science (MSc) program in Nursing Science at Witten/Herdecke University, this challenge was addressed by implementation of an innovative examination format for postgraduate education. Procedure: For the module "Ethics in nursing practice and research" a format based on the Objective Structured Clinical Examination (OSCE) format was developed. This assessment method incorporates evaluation of acquired skills and attitudes of nursing students. Conclusion: The article demonstrates development and adaption of the OSCE format for this purpose.

[Thinking about the caregiver]. / Penser le proche aidant.

The importance of the family members of those being cared for has been more recognized for about twenty years. However, if there is a literature on the subject, the latter does not exist in the scientific sense. Proposition to conceptualize the notion of the family caregiver based on the nursing sciences.

[Diving into the heart of the initial training of future nurses in Switzerland]. / Au cœur de la formation initiale des futurs infirmiers en Suisse.

Within the framework of the foreign internship program of his nursing school, a third year student was able to follow his fifth semester at the Haute École de santé du canton de Vaud, in Switzerland. He shares his experience and sheds light on the pedagogical orientations implemented in the initial training of nurses in this country neighbouring France.

The Experts' Advice: Prevention and Responsibility in German Media and Scientific Discourses on Dementia.

In the absence of effective pharmacological therapy options, the focus of dementia and Alzheimer's research has shifted from treatment and care to risk prediction, early detection, and prevention. Public health communication and media coverage regarding dementia emphasize the individual responsibility for dementia risk management. Focusing on the social and moral implications of the new understanding and public representation of dementia, we present an analysis of medical science, nursing science, and media discourses in Germany between 2014 and 2019. We show which notions of dementia and prevention characterize the medical and nursing science debates regarding dementia and how scientific knowledge is transferred into media discourses on dementia. We further discuss how dementia risk communication interacts with contemporary social and health policies and in what ways current dementia discourses are associated with a (self-)responsibilization of cognitive aging.

The interprofessional VA quality scholars program: Promoting predoctoral nursing scientists and their career trajectories.

BACKGROUND: The VA Quality Scholars (VAQS) program is an interprofessional fellowship that provides a unique opportunity for predoctoral nurse scientists to embed their work in quality improvement learning "laboratories" to inform their scholarship, science, and research. PURPOSE: To describe the VAQS program in relation to promoting nursing science and predoctoral nurse scientist (PhD) career trajectories, and to propose policy implications. METHOD: Data were collected on all predoctoral (PhD, DNP) nurses who entered and completed the VAQS program nationally. FINDINGS: A total of 17 predoctoral nurses (11 PhD and 6 DNP) have completed the VAQS program. Ten predoctoral PhD nurses (91%) completed their degree while in the program. Nine predoctoral PhD nurses (82%) entered a postdoctoral fellowship, and many obtained positions as faculty at research-intensive universities postfellowship. DISCUSSION: The knowledge, skills, and experiences gained by predoctoral nurse scientists from the VAQS's program contribute to their nursing research and professional career growth.