Evaluación de los Ensayos Clínicos Aleatorios desarrollados por enfermeras según los criterios de la Declaración CONSORT / Evaluation of randomized clinical essays developed by nurses according to the consort declaration criteria

Objetivo: Evaluar si los Ensayos Clínicos Aleatorizados (ECAS) realizados por enfermeras en los últimos siete años, cumplen con la rigurosidad metodológica establecida por los criterios de la Declaración CONSORT. Métodos: Revisión integrativa de la literatura de revistas de enfermería, se analizaron 66 ECAS realizados por enfermeras y publicados en 11 revistas indizadas en bases de datos reconocidas, en cuyo título, palabras clave o diseño se reconocieran como un ensayo clínico aleatorio. Se realizó un instrumento de 48 ítems para evaluar las características de los 66 ECAS publicados. Dicho instrumento está dividido en dos segmentos: el primero evalúa información general de los artículos y el segundo incluye las características de la Declaración CONSORT. Resultados: El 57.6% de los ECAS utilizaron grupo control equivalente, 87.9% utilizó muestreo aleatorio, 28.8% enmascaramiento, 54.5% presentaron diagrama de flujo, 83% realizaron aleatorización, 57.6% describen las intervenciones empleadas a los grupos de estudio. Conclusiones: De forma general, los ECAS publicados por enfermería en los últimos siete años no cumplen con los criterios de la Declaración CONSORT. Estos hallazgos representan un área de oportunidad para que editores de revistas de enfermería soliciten a los autores mayor apego a la rigurosidad metodológica en sus artículos de acuerdo a los criterios de la Declaración CONSORT (AU)

Objective: Evaluate if the Randomized Clinical Trials (RCTs) carried out by nurses in the last seven years fulfill the methodological rigor established by the CONSORT declaration criteria. Methods: Nursing journals literature integral review; sixty-six RCTs carried out by nurses and published in 11 indexed journals within recognized data bases were analyzed and where their title, key words or design allowed them to be recognized as a randomized clinical essay. A 48 item instrument was realized to evaluate the characteristics of the 66 published RCTs. Such instrument is divides in two segments: the first one evaluates general information in the articles, and the second one includes the CONSORT Declaration characteristics. Results: The 57.6% of RCTs used an equivalent control group, 87.9% used randomized sampling, 28.8% blind, 54.5% presented flow chart, groups. Conclusions: In general, the RCTs published by nursing in the last seven years do not fulfill the CONSORT Declaration criteria. These findings present an opportunity area so nursing journals publishers request from the authors the most attachment to the methodological rigor in their articles, according to the CONSORT Declaration criteria (AU)

[Classification of the CNPq areas of knowledge and the nursing field: possibilities and limits]. / Classificação das áreas de conhecimento do CNPq e o campo da Enfermagem: possibilidades e limites.

Knowledge areas have been discussed by Science and Technology managers and administrators and by the scientific community searching for tools to support data systematization, mainly for management and administrative activities. The main table in use by CNPq is admittedly outdated and requires revision or reclassification. The aim of this article is to contribute to the current debate based on previous results from participation in a table review study performed in the 1990 s and on research results in the area of knowledge organization and representation in the context of Information Science. It presents a proposal to reformulate the Nursing Knowledge Area and some reflections about the possibilities of this ongoing process.

Classificação das áreas de conhecimento do CNPq e o campo da Enfermagem: possibilidades e limites / Classification of the CNPq areas of knowledge and the Nursing field: possibilities and limits / Clasificación de las áreas de conocimiento del CNPq y el campo de Enfermería: posibilidades y límites

A classificação das áreas de conhecimento tem sido objeto de discussão por gestores e administradores de C&T e pela comunidade científica na busca de instrumentos de apoio à sistematização de dados, principalmente para atividades de gestão e administração. A principal tabela de áreas em uso pelo CNPq está reconhecidamente desatualizada, necessitando de revisão ou reclassificação. O objetivo deste artigo é contribuir para o atual debate, com base em resultados prévios de participação em trabalho de revisão da tabela realizado na década de 1990 e de resultados de pesquisas na área da organização e representação do conhecimento no contexto da Ciência da Informação. Apresenta uma proposta de reformulação da Área de Conhecimento da Enfermagem e algumas reflexões sobre as possibilidades deste processo em curso.

Knowledge areas have been discussed by Science and Technology managers and administrators and by the scientific community searching for tools to support data systematization, mainly for management and administrative activities. The main table in use by CNPq is admittedly outdated and requires revision or reclassification. The aim of this article is to contribute to the current debate based on previous results from participation in a table review study performed in the 1990s and on research results in the area of knowledge organization and representation in the context of Information Science. It presents a proposal to reformulate the Nursing Knowledge Area and some reflections about the possibilities of this ongoing process.

La clasificación de las áreas de conocimiento viene siendo objeto de discusión por parte de los gestores y administradores de C&T y por la comunidad científica en busca de instrumentos de apoyo a la sistematización de datos, principalmente para actividades de gerencia y administración. La principal tabla de áreas utilizada por el CNPq está reconocidamente desactualizada, necesitando de revisión o reclasificación. El objetivo de este artículo es contribuir para el actual debate sobre el asunto, con base en resultados previos de participación en trabajo de revisión de la referida tabla, realizado en la década de 1990, bien como de investigación en el área de la organización y representación del conocimiento en el contexto de la Ciencia de la Información. Se presenta una propuesta de reformulación del Área de Conocimiento de Enfermería y algunas reflexiones sobre las posibilidades de este proceso en curso.

Cómo cuantificar los aspectos cualitativos en escalas de clasificación de resultados NOC para etiquetas psico-socioculturales / Como quantificar os aspectos qualitativos nas escalas de classificação de resultados NOC para etiquetas psicossocioculturais / How to quantify the qualitative aspects of nursing outcomes classification scales with psychosociocultural indicators

El hecho de trabajar necesariamente con escalas Likert en la medición de resultados NOC tiene la ventaja de la unificación, pero acarrea también la dificultad de cómo reducirlo a un número del 1 al 5, especialmente cuando una investigación es cualitativa y que por tanto trabaja con palabras y expresiones, con observaciones y percepciones. ¿Qué quiere exactamente decir un 2 o un 3 en el NOC Creencias sobre la salud? En el artículo se muestran las diferentes propuestas para la operacionalización de conceptos y su transformación en números, pero se advierte que en ellas siempre se termina con un análisis cuantitativo. Se hace una propuesta de utilización de observaciones cualitativas emic/etic para las etiquetas psicosociales y culturales siguiendo los postulados de la etnografía. La investigación en lenguajes enfermeros, básica y aplicada, debe tener cimientos metodológicos correctos y atender los mismos criterios de idoneidad metodológica que cualquier otra investigación.

O fato de trabalhar necessariamente com Escalas tipo Likert para medir resultados NOC tem a vantagem de unificar, mas existe a dificuldade de como convertê-lo a um número de 1 ao 5, especialmente, quando uma pesquisa é qualitativa e por tanto trabalha com palavras e expressões, com observações e percepções. Que quer dizer exatamente 2 ou 3 nos NOC Crenças sobre a saúde? Neste artigo apresentamos diferentes propostas para operacionalização de conceitos e sua transformação em números, advertindo que a mesma sempre termina com uma análise quantitativa. Propomos utilizar as observações qualitativas emic/etic para etiquetas psicossociais e culturais, seguindo postulados da etnografia. Os estudos em linguagem enfermeiro, básica e aplicada, devem ter cimentos metodológicos corretos e atender aos mesmos critérios de idoneidade metodológica que qualquer outro estudo.

Working necessarily with Likert scales to measure Nursing Outcomes Classification (NOC) outcomes has the advantage of unification, but also presents difficulty in reducing the rating from 1 to 5, especially when the research is qualitative and thus includes the use of words and expressions, as well as observations and perceptions. What exactly does a score of 2 or 3 mean with regard to the NOC Health beliefs? In this paper, we make a number of different proposals for operationalizing concepts and transforming them to numbers; however, it should be noted that such proposals always end in a quantitative analysis. Thus, we propose the use of emic/etic qualitative observations for psychosocial and cultural indicators, following ethnographic principles. Basic and applied research on nursing languages must have correct methodological foundations and seek to satisfy the same criteria of methodological suitability as any other research.

Mixed methods research in mental health nursing.

Mixed methods research is becoming more widely used in order to answer research questions and to investigate research problems in mental health and psychiatric nursing. However, two separate literature searches, one in Scotland and one in the USA, revealed that few mental health nursing studies identified mixed methods research in their titles. Many studies used the term 'embedded' but few studies identified in the literature were mixed methods embedded studies. The history, philosophical underpinnings, definition, types of mixed methods research and associated pragmatism are discussed, as well as the need for mixed methods research. Examples of mental health nursing mixed methods research are used to illustrate the different types of mixed methods: convergent parallel, embedded, explanatory and exploratory in their sequential and concurrent combinations. Implementing mixed methods research is also discussed briefly and the problem of identifying mixed methods research in mental and psychiatric nursing are discussed with some possible solutions to the problem proposed.

The needs and experiences of family members of adult patients in an intensive care unit: a review of the literature.

AIMS AND OBJECTIVES: Insight into the needs and experiences of family members is an initial but necessary step in providing appropriate care for both family members and the patient. This literature review aims to structure the available scientific knowledge on needs and experiences of family members of intensive care unit patients with particular extension to coma patients. Qualitative as well as quantitative studies are discussed. METHOD: Literature review. RESULTS: Needs are divided into four categories: cognitive, emotional, social and practical needs. The need for accurate and comprehensible information that leaves room for hope is universal. Family members want to speak to a doctor every day about the condition of and the prognosis for the patient, and want a nurse to explain to them about the care, the unit, the equipment and what they can do for the patient during visiting hours. Family members place great importance on being called at home if the condition of the patient changes. Emotional needs as hope, reassurance and being able to remain in the vicinity of the patient are crucial. Family members always give priority to the welfare of their relative. In their confused state, they often do not get around to paying attention to themselves. Caregivers underestimate all of the needs of family members and do not do enough to meet these needs. RELEVANCE TO CLINICAL PRACTICE: Priority needs should be central in the nurses' approach of family members. The initiative for meeting the needs must be with the caregivers. Future, focused and well-designed qualitative research over a longer period of time could clarify the process that family members go through and explain the results of quantitative studies.

Some remarks on the relevance of basic research in nursing inquiry.

The aim of this article was to illuminate the issue of basic research in nursing and to problematize its relevance for our discipline. First, we asked leading nursing scholars in the Nordic countries to share their views on basic research in nursing. Thereafter, the ideas, views and suggestions of the scholars were amalgamated with insights from the literature and from the discussions in our project team. Our two guiding questions were: What role can basic research be assigned? Which, if any, forms of basic research can be identified? We found that basic nursing research may be seen as a necessary basis for applied research, as a contribution to applied research, or that the whole issue is seen as a pseudo-issue. We further found that basic nursing research can be seen as either contextual or general as well as either intradisciplinary or multidisciplinary in form. We conclude by the following three succinct remarks or assertions: that basic nursing research is not to be equated with biomedical conceptions of basic research; that basic nursing research may take place on several theoretical levels; and finally, that an indiscriminate dismissal of basic research in nursing may affect the cognitive autonomy of our discipline.

Mitos, retos y falacias de la investigación enfermera

Cuando se cumplen 25 años de la integración de la Enfermería en la Universidad española, el autor propone un ejercicio reflexivo sobre la labor de la investigación en el conocimiento enfermero y la consolidación de la enfermería como disciplina. Después de desmontar la mitología negativa en torno a la investigación enfermera, desarrolla lo que considera sus tres grandes retos en este comienzo de milenio: hacer visible el potencial investigador de la Enfer-mería, construir la ciencia enfermera a través de la investigación, y utilizarla como estrategia emancipatoria de la Enfermería. Al final propone utilizar el espíritu crítico que desarrolla el ejercicio investigador para pensar críticamente el sistema, de cara a adoptar el compromiso intelectual de dar respuestas científicamente válidas a las contradicciones del sistema médico hegemónico, favoreciendo la democratización de la asistencia (AU)

[Classification of researchers/consultants in the nursing area in the CNPq: contribution to a data bank]. / Classificação dos pesquisadores/consultores da área de enfermagem no CNPq: contribuição para um banco de dados.

This study is an analysis of the themes and the knowledge subareas where nursing researchers from CNPq (Brazilian Council for Technological and Scientific Development) are included, based on the projects assessed over the period from 2002 through 2003. Their goals were to present the distribution of researchers according to their present classification in the Nursing area adopted by CNPq and discuss the representativity of the researchers from this knowledge area. Results evidenced that the predominant subareas regarding research in this category were: fundamentals of the care process, followed by the area of adult nursing care. This study also revealed the existing concentration of researchers and pointed out for the need to establish inclusion strategies and to stimulate the return on financial resources to the research they develop. Authors emphasize the importance of an update in the subareas as well as a strengthening effort in scientific production.

Evidence-based practice.

This article summarises how evidence-based practice is defined, and what might constitute evidence. It describes the steps that should be taken in a systematic review of evidence, and some of the issues involved in implementing the findings of such reviews in practice.

[Multiple issues researched and to research in nursing]. / Os múltiplos problemas pesquisados e a pesquisar na enfermagem.

The present study aims at analyzing topics of master's thesis and doctoral dissertations submitted to nursing graduate programs in Brazil from 1998 to 2000. The sample comprised abstracts of 337 thesis and 153 dissertations that were analyzed based on scheme category proposed by Carvalho (2000) to group nursing graduate scientific production. Results evidenced that research carried out addressed a great range of themes, comprehending all research lines of the three areas of the referred scheme. The Assistance and Organizational fields concentrated most of the production (45.0% and 38.8% respectively) and the Professional field relied on 16.2% of the studies. Based on the results, authors emphasize the need to bind together thematic-affinity projects in order to deepen studies and to move forward in the process of nursing knowledge construction.

Systematic reviews: gatekeepers of nursing knowledge.

The past few decades have seen a considerable increase in the number of available health care products and interventions. This growth has been matched by a similar expansion in the health care literature. As a result of these factors, the demand for evidence to support practice is growing, but finding the best evidence is becoming increasingly difficult. In response, the use of systematic reviews is increasing and they are starting to replace the primary research as the basis for health care decisions. To date, these reviews have focused predominantly on effectiveness and so have been limited to randomized controlled trials. As a result of this, the interpretive, observational and descriptive research methods that are utilized by nursing have commonly been either excluded from the review or are classified as 'low level' evidence. To address this, nursing must participate in the development of systematic review methods that better answer the questions posed by the profession.

Introduction to the nursing research process.

Many nurses have expressed an interest in conducting a nursing research project, but some have not had sufficient or recent exposure to the process of how to develop a research study. The nursing research process can be outlined using the nursing process steps of assessment, planning, intervention and evaluation. In the assessment phase the problem is identified, the literature is reviewed, and the variables are identified. In the planning phase the research question or hypothesis is formulated, and decisions are made on how the variables will be measured and how the sample will be chosen. In the intervention phase the data collection occurs; in the evaluation phase the data is analyzed and interpreted and the findings are communicated. By giving nurses a detailed yet understandable plan on how to conduct nursing research, their curiosity is encouraged and the body of knowledge will grow.

Qualitative and quantitative approaches in mental health nursing: moving the debate forward.

In recent years, two distinct, and apparently opposing, positions have arisen in debates concerned with mental health nursing research, education and practice. Each of the two has its champions and 'gurus', and its detractors. Writers associated with the quantitative camp have argued in favour of: experimental research where the aims are the investigation of the outcomes of nursing care; multidisciplinary rather than unidisciplinary research; a physiological explanation for mental illness; clinical practice which is evidence based, and skills based education. Qualitative camp writers, on the other hand, have argued for: qualitative research to explore the experiences of illness, and of nursing; the preservation of nursing-only research; the relative irrelevance of physical explanations of mental illness, and holistic nursing practice in which clinical techniques are less important than interpersonal relationships. In this paper, we first review and criticize some key ideas associated with these two positions. In our subsequent analysis, we argue that, rather than differing at some fundamental level, the differences found between the two camps may be more a matter of emphasis. The possibilities of reconciliation and synthesis are, finally, presented and discussed.

[Initiation to science in the undergraduate nursing program at the University of São Paolo (1993-1996): critical analysis]. / A iniciação científica na graduação em enfermagem da Universidade de São Paulo (1993 a 1996): análise crítica.

This study search to delineate the profile of the scientific production of the undergraduate nursing programme of the University of São Paulo from 1993 to 1996, identifying its main lines and tendencies. In order to characterize it, the summaries of the proceedings of the Scientific Initiation Symposium of USP were analyzed (SICUSP) and of the Symposum of the University of São Paulo at Ribeirão Preto College of Nursing (SICEERP), through a classification in research types, themes and departments of origin. We observed a prevalence of descriptive research and an expressive number of investigations directed to the study of socio-cultural aspects among other results.