Mixed-methods: An Excellent Example

Are you interested in mixed methods – the use of qualitative and quantitative approaches in a single research project? Here is an example article of this approach.

In a secondary analysis of four mixed-methods studies, parametric statistics were used to study the relationships among primary variables. Qualitative findings were used to further explore the relationships among key variables. The authors responded to the reviewer’s comment on the analysis by adding a recommended moderation analysis.

If your interests include chronic conditions and self-care, this article is likely to interest you. The peer review of the article may be of interest, too; the reviews of the article are posted on the Nursing Research Open Manuscript Review feature as Manuscript 72.

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Farewell and Welcome the New Editor

My editorship of Nursing Research ends this month. Separating from the editorship causes me to reflect on the excellent articles that our authors have placed in the scholarly record and the pleasure that I take in seeing each issue – in print and on line. But, I admit that I’m eager to use the time I will gain differently, too.  Thanks to all of you who have followed the blog and those who have communicated to us about it.

I would like you to welcome Sue Henly who becomes the Editor of Nursing Research on January 1. Sue has been an Associate Editor for the journal for several years and has contributed some of the best ideas that we have incorporated into the journal. Sue has taken the lead on projects to evaluate peer review and her ideas about a quality assurance approach to the editorial process have helped us give you information about the review process that few academic journals offer. I think we can expect to see other innovations in the journal under Sue’s leadership and urge you to turn to MyLWW for Nursing Research often for journal content and other information about nursing research.

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New Articles on Preterm Infants and Their Mothers

Are you interested in preterm infants and their families? In this issue we have two articles about very different topics related to the care of preterm infants.

An article by Gail McCain and colleagues addressed the all-important topic of the transition from gavage to nipple feeding using semi-demand method. Results showed that infants in the semi-demand group achieved nipple feeding 6 days earlier than the infants on standard care.

Another article by Klanci McCabe and colleagues addressed depression screening of mothers of infants in the NICU. They employed the widely used Postpartum Depression Screening Sale (PDSS) with mothers of infants in the NICU who were 14 or more days postpartum. They reported that the PDSS is a promising screening tool for this group. Positive screening scores were identified in most of the mothers and nearly an additional third scored in the “at risk” range.

These articles address a highly vulnerable group and bring clinically relevant research findings to nurses who work with preterm infants.  Did these articles help you think about your practice differently?

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Postpartum Depression Articles in Nursing Research

Are you concerned about postpartum depression? In Nursing Research we have published 8 articles on this topic since 2000. In four of the articles the Postpartum Depression Screening Scale (PDSS) was used. These articles and a few others in Nursing Research before 2000 show the careful work needed to refine a screening scale. The PDSS had been translated and tested for use in other languages (Spanish and Chinese).

To see articles in Nursing Research on postpartum depression go to the MyLWW homepage and use the search feature. At the enter key word box, type “postpartum depression” and click on search. Some of the articles are by Cheryl Beck and colleagues whose work has stimulated scholarship on postpartum depression globally and improved nursing care of postpartum women.

In the Nov/Dec 2012 issue of Nursing Research we will publish another article on the use of the PDSS with mothers of infants in the NICU, a vulnerable group of women who may be overlooked in health care.

When you trace the development of research on this topic in the pages of Nursing Research over the years, share your thoughts with us.

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Screening for Post Stroke Depression

Did you know that post stroke depression occurs in 1 out of 3 stroke survivors and symptoms often occur during hospitalization?

In this article the clinical utility of two related instruments used to screen for depression (PHQ-9 and PHQ-2) were evaluated and the diagnostic accuracy of the PhQ-9 was shown to be good for major depression and for any depression.

This is an article with clinical relevance that you can use in your clinical practice in the hospital.

You may also be interested in the open peer review process (see Manuscript #71) for this article because the authors were careful and complete in addressing the reviewers’ comments. They describe in their response to reviewers some of the decisions they made in planning their study that were not fully discussed in the article.

The article stands out because of its immediate relevance to clinical care.

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Update on Propaganda

This quadrennial political season is a good time to think about propaganda again. Inspired by a presentation by Eileen Gambrill at the peer review congress in 2010, I wrote an editorial encouraging authors to think about how they frame the background literature for articles in Nursing Research. I cautioned about the use of propaganda, which is defined as encouraging beliefs and actions with the least thought possible.

When I read and listen to the political activity lately I’m reminded of this definition of propaganda and its pernicious influence in campaigns and on the democratic process. But, it is also a damaging influence on the advance of science in nursing and Gambrill helped me define the problem within the scope of Nursing Research. Recently, Gambrill and Reiman published an article on a propaganda index and their ideas about the damage that propaganda has done and continues to do in psychiatry, clinical social work and psychology.

Gambrill and Reiman point to the silence in research reports about controversies represented in the literature and failure to address legitimate alternative views and evidence. Their particular concern is translating common problems-in-living into mental illness.

In Nursing Research the problem is most apparent in truncated presentations of the background literature that lead only in the direction of the specific problem under study and fail to provide balance or representation of alternative views in the background literature. I think the propaganda problem is also present in the conceptualization of some nursing issues.

Gambrill and Reiman provide an index with which to assess propaganda. I invite you to explore their development of the problem and reflect on the approaches used in your area of research. As you explore the literature in nursing and beyond, do you notice some ideas that are repeated frequently without supporting evidence? Does this repetition encourage you to accept these ideas with little thought? Does repetition influence the way you frame a problem, even though you see the gaps in logic? May I invite you to think about the national political stage and consider the wider consequences of propaganda in our lives?

There is little question that propaganda has always been a part of the political process – almost any political slogan meets the definition of propaganda. As scientists and discerning consumers of science, we hold ourselves to a high standard. With propaganda commonplace in scientific literature we need to stay alert and insist that our conversations range widely and embrace alternative views.

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Systematic Reviews in Nursing Research

Systematic reviews are a key source of evidence on which to base nursing practice. Two articles in the July/August issue are systematic reviews and fall within the subject area of women’s health.

Health promotion interventions for postpartum women from studies carried out in the United States were analyzed by Fowles and colleagues.  The studies featured diverse health promotion behaviors as outcomes and showed varied effectiveness.

Self-management of lymphedema was studied by Ridner and colleagues who used the Oncology Nursing Society’s levels of evidence to score the articles. They observed that few studies used outcomes associated with lymphedema.

In both articles the need for more studies using randomized controlled trials design was noted.

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Q-sort: An Adaptable Qualitative Methodology

Q-sort methodology is a valuable approach to better understand the viewpoint of a sample and to detail how they organize information within a topical area. It is not often used in nursing research and it was a pleasant surprise to read Lobo and colleagues’ submission to Nursing Research on retention strategies for mid-career critical care nurses (see short video clip from the editor here:   http://nursing-research-editor.com/videos/NRes_Video_7_26_12.MOV ).

Lobo contacted the editor with questions which promoted an email exchange that illustrates how a submission may be shaped by communication with the editor and result in more complete information for readers.

The author asked, “The second reviewer asks for some potential applicability to the US, and I’m just not sure where to take it.  The article is written in a Canadian context primarily for Canadian ICU managers.” To which I responded, “Making comparisons between Canadian and other ICUs is a good idea, but it has limitations. Most of our readers are outside of Canada and making your results more relevant to other systems is important because of our international audience. However, unless handled well, it is conjectural. We hold a fairly hard line (for a nursing journal) on not allowing authors to go very far beyond their finding in the article. One way to handle it is to provide some background literature about the distribution of ICUs globally and to address any issues known about retaining nurses in these settings internationally. It seems that the Q-sort methodology requires tailoring to the cultural setting in which it is done, which means that others who want to replicate your work will need to work out some important details. The matter of making the Q-sort work in other settings is one way that you can address the applicability of your work to international settings. I think the background of your manuscript would be fairly easy to modify to include more about the international context of ICUs (in following the APA guidelines, you are required to set up the background with the literature that you will refer to in the discussion). I think you could address some international issues in the discussion.” You may read the article here.

The supplemental digital content for the article includes a table with all of the statements used in the Q-sort that is not ordinarily included in Q-sort articles but provides ideas to others who may want to adapt the method to their own work.

In addition, the presentation was well received by the reviewers and this article is included in our collection of articles under open manuscript review as manuscript # 70.

Do you see an application of Q-sort methods in your work? Let us know how you are able to use it.

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Children’s Health Studies in Nursing Research

The July/August issue of Nursing Research has two articles on children’s health. The articles show the highly varied methodologies that are used in nursing research.

Daytime physical activity levels in school age children with and without asthma were studied by Tsai and colleagues.  Children with asthma reported more activity limitations based on breathing problems, but the two groups did not differ on activity levels. Activity was measured by self-report and actigraphy, an objective measure that involved measurement of motion by the child.

Home-based care for children with special health care needs in England was studied with qualitative methods derived from Appreciative Inquiry by Carter and colleagues. Data were obtained from advisory groups that included children and young people who received services, parents and professionals. Program components that worked well featured effective communication, strong leadership, activities that permitted the child to remain at home and partnerships based on mutual trust. The article is augmented by extensive supplemental digital content.

Are you looking for the ideal approach to measurement for a study in children’s health? What challenges do you face in identifying an appropriate approach?

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Future Table of Contents

The Table of Contents for the July/August issue of Nursing Research is posted here.   There will be 8 articles in this particular issue, so check them out first online before the print version arrives.  Many of the articles will be published ahead of print, and available for download when they appear in the “Published Ahead-of-Print” section of the web site.  Of course you will be able to enjoy all of the articles as soon as the publication date arrives in July 2012!

Don’t miss out on the issue about statistics in nursing research!!

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