Heuristic Research in Nursing Science.

The purpose of this article is to reintroduce and describe the processes and phases of heuristic inquiry and to illustrate how the method can advance nursing science. Heuristic inquiry is a rigorous, systematic, phenomenologically orientated research method developed by Clark Moustakas for investigating, discovering, and understanding the nature and meaning of living experiences. Heuristic inquiry invites the inclusion of the researcher's autobiographical living of experience being investigated honoring the personal experiences of the phenomenon from self and each participant in the research study. The author proposes that heuristic inquiry be used in nursing science by including a theoretical interpretive process connecting the thematic essences of the nursing conceptual framework guiding the study. Nursing theory-guided heuristic research advances the study of caring for persons experiencing human-environmental-health transitions to enhance human betterment and wellbecoming.

The Role of Metaphor in Hermeneutic Research.

The identification and interpretation of metaphor is useful to hermeneutic research. Metaphor is a way of conceiving one concept in terms of another and serves as a function of understanding. The author explores the rise of hermeneutics research and its relevance to nurse artsciencing. Metaphors are a creative strategy hermeneutic researchers can use to analyze and interpret data, and serve as a powerful strategy to represent complex realities, illuminate unnoticed aspects of a phenomenon, and provide depth of meaning to the understanding of human experiences.

The Uncertainty in Family Caregivers of Hospitalized Persons With a Stroke in Saudi Arabia: Unitary Caring Perspective.

Uncertainty is a universal experience of family caregivers caring for persons with a stroke and affects caregivers' readiness to care for their family members with a stroke. Guided by the unitary caring theory and unitary-caring hermeneutic-phenomenological research method, this study was conducted among 15 family caregivers of persons in the hospital who have survived strokes through in-depth semi-structured interviews. Five essences emerged from the analysis: living in a dark reality; yearning for professional support; enduring a life full of tribulations; attempting resolution; and creating new patterns of living. Each of the 5 essences was interpreted from Smith's unitary caring theory perspective.

Originating Research Ideas.

Research aimed at generating new knowledge is the heart of the scholarship of discovery. The author of this paper explores how original research ideas can be generated for formal investigations and artsciencing. Curiosity and creativity are presented as "seeds" for originating ideas, and seven patterns (adjacent possible, liquid networks, the slow hunch, serendipity, error, exaptation, and platforms) are described as synergistic potentiators for geminating original research ideas.

Factores que influyen en la alfabetización en salud de los pacientes con enfermedad arterial coronaria / Factors that influence health literacy in patients with coronary artery disease / Fatores que influenciam o letramento em saúde em pacientes com doença arterial coronariana

Objetivo: investigar los factores que influyen en la alfabetización en salud de los pacientes con enfermedad arterial coronaria. Método: estudio transversal, que incluyó 122 pacientes con enfermedades coronarias (60,7% del sexo masculino; 62,07±8,8 años); se evaluó la alfabetización en salud y el conocimiento específico sobre la enfermedad mediante entrevistas con los participantes, utilizando el Short Test of Functional Health Literacy in Adults e Short version of the coronary artery disease education questionnaire. Los datos fueron descritos por medidas de tendencia central y frecuencias. Los factores que influyen en la alfabetización en salud se determinaron mediante un modelo de regresión lineal. El nivel de significación adoptado fue del 5%. El estudio fue aprobado por el Comité de Ética e Investigación. Resultados: la edad y la hipertensión mostraron una relación inversa y significativa con la alfabetización en salud. Por otro lado, un mayor nivel educativo y tener empleo se asociaron con puntajes más altos en el instrumento de alfabetización en salud. El conocimiento específico sobre la enfermedad no influyó en la alfabetización en salud. Las variables del modelo de regresión explicaron el 55,3% de alfabetización inadecuada. Conclusión: en el presente estudio, se concluyó que el conocimiento sobre la enfermedad no influye en la alfabetización en salud, pero los profesionales deben considerar los factores sociodemográficos y clínicos para planificar las intervenciones.

Objective: to investigate the factors that exert an influence on health literacy in patients with coronary artery disease. Methods: a crosssectional study, including 122 patients with coronary diseases (60.7% male; 62.07 ± 8.8 years old). Health literacy and specific knowledge about the disease were evaluated through interviews with the participants by means of the Short Test of Functional Health Literacy in Adults and the Short version of the coronary artery disease education questionnaire. The data were described by means of central tendency measures and frequencies. The factors that exert an influence on health literacy were determined by means of a linear regression model. The significance level adopted was 5%. The study was approved by the Research Ethics Committee. Results: age and arterial hypertension presented an inverse and significant relationship with health literacy. On the other hand, higher schooling levels and having a job were associated with better scores in the health literacy instrument. Specific knowledge about the disease did not exert any influence on health literacy. The variables included in the regression model explained 55.3% of inadequate literacy. Conclusion: this study, knowledge about the disease exerts no influence on health literacy: however, the professionals should consider the sociodemographic and clinical factors to plan the interventions.

Objetivo: investigar os fatores que influenciam o letramento em saúde em pacientes com doença arterial coronariana. Método: estudo transversal, incluindo 122 pacientes com coronariopatias (60,7% do sexo masculino; 62,07±8,8 anos); letramento em saúde e conhecimento específico da doença foram avaliados por meio de entrevista com os participantes, pelo Short Test of Functional Health Literacy in Adults e Short version of the coronary artery disease education questionnaire. Os dados foram descritos por medidas de tendência central e frequências. Fatores que influenciam o letramento em saúde foram determinados por modelo de regressão linear. O nível de significância adotado foi de 5%. O estudo foi aprovado pelo Comitê de Ética e Pesquisa. Resultados: idade e hipertensão apresentaram uma relação inversa e significativa com letramento em saúde. Por outro lado, maior escolaridade e estar empregado associaram-se com maiores pontuações no instrumento de letramento em saúde. O conhecimento específico da doença não influenciou o letramento em saúde. As variáveis do modelo de regressão explicaram 55,3% do letramento inadequado. Conclusão: no presente estudo o conhecimento sobre a doença não influência o letramento em saúde, mas os profissionais devem considerar os fatores sociodemográficos e clínicos para planejar as intervenções.

Factors that influence health literacy in patients with coronary artery disease / Fatores que influenciam o letramento em saúde em pacientes com doença arterial coronariana / Factores que influyen en la alfabetización en salud de los pacientes con enfermedad arterial coronaria

OBJECTIVE: to investigate the factors that exert an influence on health literacy in patients with coronary artery disease. METHODS: a cross sectional study, including 122 patients with coronary diseases (60.7% male; 62.07 ± 8.8 years old). Health literacy and specific knowledge about the disease were evaluated through interviews with the participants by means of the Short Test of Functional Health Literacy in Adults and the Short version of the coronary artery disease education questionnaire. The data were described by means of central tendency measures and frequencies. The factors that exert an influence on health literacy were determined by means of a linear regression model. The significance level adopted was 5%. The study was approved by the Research Ethics Committee. RESULTS: age and arterial hypertension presented an inverse and significant relationship with health literacy. On the other hand, higher schooling levels and having a job were associated with better scores in the health literacy instrument. Specific knowledge about the disease did not exert any influence on health literacy. The variables included in the regression model explained 55.3% of inadequate literacy. CONCLUSION: this study, knowledge about the disease exerts no influence on health literacy: however, the professionals should consider the sociodemographic and clinical factors to plan the interventions.

OBJETIVO: investigar os fatores que influenciam o letramento em saúde em pacientes com doença arterial coronariana. MÉTODO: estudo transversal, incluindo 122 pacientes com coronariopatias (60,7% do sexo masculino; 62,07±8,8 anos); letramento em saúde e conhecimento específico da doença foram avaliados por meio de entrevista com os participantes, pelo Short Test of Functional Health Literacy in Adults e Short version of the coronary artery disease education questionnaire. Os dados foram descritos por medidas de tendência central e frequências. Fatores que influenciam o letramento em saúde foram determinados por modelo de regressão linear. O nível de significância adotado foi de 5%. O estudo foi aprovado pelo Comitê de Ética e Pesquisa. RESULTADOS: idade e hipertensão apresentaram uma relação inversa e significativa com letramento em saúde. Por outro lado, maior escolaridade e estar empregado associaram-se com maiores pontuações no instrumento de letramento em saúde. O conhecimento específico da doença não influenciou o letramento em saúde. As variáveis do modelo de regressão explicaram 55,3% do letramento inadequado. CONCLUSÃO: no presente estudo o conhecimento sobre a doença não influência o letramento em saúde, mas os profissionais devem considerar os fatores sociodemográficos e clínicos para planejar as intervenções.

OBJETIVO: investigar los factores que influyen en la alfabetización en salud de los pacientes con enfermedad arterial coronaria. MÉTODO: estudio transversal, que incluyó 122 pacientes con enfermedades coronarias (60,7% del sexo masculino; 62,07±8,8 años); se evaluó la alfabetización en salud y el conocimiento específico sobre la enfermedad mediante entrevistas con los participantes, utilizando el Short Test of Functional Health Literacy in Adults e Short version of the coronary artery disease education questionnaire. Los datos fueron descritos por medidas de tendencia central y frecuencias. Los factores que influyen en la alfabetización en salud se determinaron mediante un modelo de regresión lineal. El nivel de significación adoptado fue del 5%. El estudio fue aprobado por el Comité de Ética e Investigación. RESULTADOS: la edad y la hipertensión mostraron una relación inversa y significativa con la alfabetización en salud. Por otro lado, un mayor nivel educativo y tener empleo se asociaron con puntajes más altos en el instrumento de alfabetización en salud. El conocimiento específico sobre la enfermedad no influyó en la alfabetización en salud. Las variables del modelo de regresión explicaron el 55,3% de alfabetización inadecuada. CONCLUSIÓN: en el presente estudio, se concluyó que el conocimiento sobre la enfermedad no influye en la alfabetización en salud, pero los profesionales deben considerar los factores sociodemográficos y clínicos para planificar las intervenciones.

Cultivating Awe: A Means to Inspire Sciencing.

Awe is an emotion involving a feeling of being in the presence of something vast that transcends one's current understanding of the world and is associated with creating a sense of wonder and curiosity. The author explores how awe experiences can have a role in igniting and sustaining research endeavors, and how nurse researchers can cultivate everyday awe experiences as sources of inspiration when engaged in the art of nurse sciencing.

Biographical Narrative Research From the Perspective of the Science of Unitary Human Beings: A Methodological Approach.

Narrating or storytelling is a fundamental practice for human survival and a means for finding meaning in experiences and for enhancing self-understanding. The use of story has been present in nursing since its origins. Biographical narrative has rarely been used as a research method in nursing, and there are no examples conceptualizing biographical narrative research methods within a unitary science perspective. The purpose of this paper is to describe one specific narrative methodological approach-the biographical narrative research method-and to link the method to the science of unitary human beings as a means of creating a unitary understanding of the storied nature of human-health experiences.

A Unitary Caring Theory Perspective of Labyrinth Walking Research.

The purpose of this narrative review of labyrinth walking research literature was to identify its experiences and potential health benefits and to conceptualize the labyrinth walking experience within Smith's (2020) unitary caring theory. A total of 29 research studies from a 2022 annotated bibliography of 160 publications on labyrinth related research were selected for analysis. The findings coalesced around four themes. Labyrinth walking is an experience of irenic requiescence; expanding awareness; transforming potentials; and connecting to the beyond. A process of interpretive theorizing was used to interpret each theme from the perspective of the concepts within the theory of unitary caring.

Factors that influence health literacy in patients with coronary artery disease. / Factores que influyen en la alfabetización en salud de los pacientes con enfermedad arterial coronaria.

OBJECTIVE: to investigate the factors that exert an influence on health literacy in patients with coronary artery disease. METHODS: a crosssectional study, including 122 patients with coronary diseases (60.7% male; 62.07 ± 8.8 years old). Health literacy and specific knowledge about the disease were evaluated through interviews with the participants by means of the Short Test of Functional Health Literacy in Adults and the Short version of the coronary artery disease education questionnaire. The data were described by means of central tendency measures and frequencies. The factors that exert an influence on health literacy were determined by means of a linear regression model. The significance level adopted was 5%. The study was approved by the Research Ethics Committee. RESULTS: age and arterial hypertension presented an inverse and significant relationship with health literacy. On the other hand, higher schooling levels and having a job were associated with better scores in the health literacy instrument. Specific knowledge about the disease did not exert any influence on health literacy. The variables included in the regression model explained 55.3% of inadequate literacy. CONCLUSION: this study, knowledge about the disease exerts no influence on health literacy: however, the professionals should consider the sociodemographic and clinical factors to plan the interventions.

Community-Based Participatory Research Guided by Critical Caring Theory.

While community-based participatory research (CBPR) and other related participatory action research approaches are increasingly being used in nursing research, few of these studies are conceptualized within an extant nursing framework. Instead, CBPR is typically only grounded in socio-ecological and social justice frameworks. However, knowledge is developed in a discipline through research that is conceptualized within the discipline's conceptual systems, frameworks, or theories. This article begins with an explication of the processes and theoretical foundations of CBPR and concludes by offering Falk-Rafael's Critical Caring Theory (CCT) as an ideal theory for reframing CBPR within a nursing science perspective.

A Unitary Caring Theory Perspective of Family Caregiving for Patients Hospitalized With a Stroke in Saudi Arabia.

The aim of this study was to gain a deeper understanding of the experience of Saudi informal family caregivers of hospitalized patients who have experienced a stroke. In-depth, face-to-face, semistructured interviews of five family caregivers using open-ended questions were conducted in a major hospital in Saudi Arabia. The interviews were recorded, transcribed verbatim, and analyzed using the unitary-caring hermeneutic phenomenological research method. Data analysis revealed six major essences that were synthesized into one statement reflecting the essence of caring for a family member with a stroke in Saudi Arabia: Living with the uncertainty of ambiguity amid feeling distressed with worries and fears replete with unfulfilled desires while yearning for compassionate caring and overcoming uncertainties through connections and faith honoring abiding commitments. As a means to transform the findings into theory and language of the nursing discipline, the essences were then interpreted within the theory of unitary caring.

Unitary Caring Science: A Hermeneutic-Phenomenological Research Method.

All phenomenological research, including descriptive phenomenological methods, are theory based. The knowledge in a discipline is built using discipline-specific methods. The purpose of this article is to develop and describe the processes of a mode of inquiry specific to caring in nursing theories housed within the unitary caring paradigm. Morgan's practical framework examining ontological-epistemological-methodological linkages was used to develop the unitary-caring hermeneutic phenomenological research method The method is specific to conducting hermeneutic phenomenological research within Watson's unitary caring science and Smith's theory of unitary caring. The method includes a process of linking and interpreting themes generated from the textual analysis of participant descriptions of the caring phenomena to concepts in the specific unitary caring theory that informs the researcher's a priori theoretical perspective to develop a theoretical understanding of the experience and contribute to the development of unitary caring nursing science.

Blood Pressure Control and Adherence to Drug Treatment in Patients with Hypertension Treated at a Specialized Outpatient Clinic: A Cross-Sectional Study.

OBJECTIVE: To evaluate and identify variables associated with the control of hypertension and adherence to antihypertensive drug treatment in a group of patients with hypertension monitored in a specialized, highly complex outpatient service. METHODS: A prospective, cross-sectional study was carried out in the hypertension unit of a tertiary teaching hospital. Patients diagnosed with hypertensive aged 18 years and over and accompanied for at least six months were included in the study. Patients with secondary hypertension and pregnant women were excluded. The sample consisted of 253 patients. Adherence/concordance to antihypertensive treatment was assessed using the Morisky Green Levine Scale. Blood pressure control was set for values less than 140/90 mmHg. Variables with p≤0.20 in univariate analysis were included in multiple logistic regression. The level of significance adopted was p ≤0.05. RESULTS: Most of patients were white, married and women, with a mean age of 65 (13.3) years old, low income, and education levels. Blood pressure control and adherence were observed in 69.2% and 90.1% of the patients, respectively. Variables that were independently associated with blood pressure control were (OR, odds ratio; CI, 95% confidence interval): married marital status (OR 2.3; CI 1.34-4.28), use of calcium channel blockers (OR 0.4; CI 0.19-0.92) and number of prescribed antihypertensive drugs (OR 0.78; CI 0.66-0.92). Adherence was not associated with any of the variables studied. CONCLUSION: There was a high frequency of patients with satisfactory adherence to antihypertensive drug treatment. Blood pressure control was less frequent and was associated with social and treatment-related factors.

Motivational interviewing: Validation of a proposed NIC nursing intervention in persons with a severe mental illness.

INTRODUCTION: Low adherence to treatment is a common problem in the care of patients with severe mental illnesses. Motivational interviewing is a directive, client-centered counseling therapeutic approach designed to elicit behavior change by helping clients to explore and resolve ambivalence. Nurses use motivational interviewing, although it has not been defined from a nursing perspective nor with nursing language. Thus, nursing research on the use of these techniques is being carried out, supported by their effectiveness in many health problems. The development of motivational interviewing as a standardized nursing intervention for inclusion in the Nursing Interventions Classification (NIC) may promote its use by mental health nurses in their daily work and thus improve the quality of care. OBJECTIVES: To validate a proposed motivational interviewing nursing intervention for inclusion in the NIC. MATERIALS AND METHODS: We followed the validation methodology of the NIC of the Iowa and the Intervention Normalization for Nursing Practice projects. The study comprised theoretical (scientific and expert validation) and empirical (terminological and clinical validation) phases. RESULTS: There is ample evidence supporting the efficiency of the motivational interviewing to improve the therapeutic adherence of people with severe mental illness. The group of experts agreed on the label name "motivational interviewing" for the NIC based on the modified model by Miller & Röllnick (2015), which includes 28 associated activities through the phases of engaging, focusing, evoking, and planning. Development of the NANDA International and the Nursing Outcomes Classification nursing language was completed. Knowledge and drug attitude improved in the motivational intervention group. CONCLUSIONS: We validated the nursing intervention motivational interviewing for inclusion in the NIC that will help improve therapeutic adherence. The intervention may be used for other behavioral changes.

Brazilian Nursing Process Research Network contributions for assistance in the COVID-19 pandemic.

OBJECTIVE: to describe the theoretical construction process of nursing process support documents in COVID-19 care scenarios. METHODS: an experience report of the joint activity of the Brazilian Nursing Process Research Network (Rede de Pesquisa em Processo de Enfermagem) composed of Higher Education and Health Institution researchers in Brazil. RESULTS: five instruments were organized collectively, involving the elements of nursing practice (nursing diagnoses, outcomes and interventions) in assistance for community; for patients (with suspected or mild, moderate, and critical COVID-19 and residents in Nursing Homes); for nursing workers' health support, also subsidizing registration and documentation during the COVID-19 pandemic. FINAL CONSIDERATIONS: valuing the phenomena manifested by families/communities, patients and health professionals is essential for early detection, intervention, and prevention of diseases.

Brazilian Nursing Process Research Network contributions for assistance in the COVID-19 pandemic / Contribuciones de la Red de Investigación en Proceso de Enfermería para la asistencia en la pandemia de COVID-19 / Contribuições da rede de pesquisa em processo de enfermagem para assistência na pandemia de COVID-19

ABSTRACT Objective: to describe the theoretical construction process of nursing process support documents in COVID-19 care scenarios. Methods: an experience report of the joint activity of the Brazilian Nursing Process Research Network (Rede de Pesquisa em Processo de Enfermagem) composed of Higher Education and Health Institution researchers in Brazil. Results: five instruments were organized collectively, involving the elements of nursing practice (nursing diagnoses, outcomes and interventions) in assistance for community; for patients (with suspected or mild, moderate, and critical COVID-19 and residents in Nursing Homes); for nursing workers' health support, also subsidizing registration and documentation during the COVID-19 pandemic. Final considerations: valuing the phenomena manifested by families/communities, patients and health professionals is essential for early detection, intervention, and prevention of diseases.

RESUMEN Objetivo: describir el proceso de construcción teórica de los documentos de respaldo del Proceso de Enfermería en los escenarios de asistencia al COVID-19. Métodos: es un relato de experiencia de la actividad conjunta de la Red de Investigación de Procesos de Enfermería, formada por investigadores de las Instituciones de Educación Superior y Salud de Brasil. Resultados: se organizaron cinco instrumentos de manera colectiva, involucrando elementos de la práctica de enfermería (diagnósticos, resultados e intervenciones de enfermería) en el cuidado comunitario; al paciente (sospechoso o con COVID-19 leve y moderado, crítico y residente en Hogares para Ancianos); y apoyo a la salud del trabajador de enfermería, subsidiando además el registro y documentación durante la pandemia de COVID-19. Consideraciones finales: valorar los fenómenos manifestados por las familias/comunidades, pacientes y profesionales de la salud es fundamental para su identificación temprana, intervención y prevención de enfermedades.

RESUMO Objetivo: descrever o processo de construção teórica dos documentos de apoio ao Processo de Enfermagem nos cenários de atendimento à COVID-19. Métodos: trata-se de um relato de experiência da atividade conjunta da Rede de Pesquisa em Processo de Enfermagem, formada por pesquisadores de Instituições de Ensino Superior e de Saúde do Brasil. Resultados: cinco instrumentos foram organizados coletivamente, envolvendo os elementos da prática de enfermagem (diagnósticos, resultados e intervenções de enfermagem) na assistência à comunidade; ao paciente (suspeito ou com COVID-19 leve e moderada, crítico e residente em Instituições de Longa Permanência para Idosos); e ao suporte à saúde do trabalhador de enfermagem, subsidiando igualmente o registro e a documentação durante a pandemia de COVID-19. Considerações finais: valorizar os fenômenos manifestados por famílias/comunidades, pacientes e profissionais de saúde é essencial para sua identificação precoce, intervenção e prevenção de agravos.

Health care innovations across practice and academia: A theoretical framework.

BACKGROUND: An innovation scholarly interest group used the Jobs to Be Done Theory from the business literature to provide insight into the solution-focused progress that nurses are trying to make in challenging situations. PURPOSE: This article presents a theoretical framework for understanding the progress nurses are trying to make through health care innovations across both practice and academic environments. METHOD: This was a qualitative descriptive study using directed content analysis. We used the Jobs to Be Done Theory to guide the development of the semistructured questionnaire and the interpretation of findings. FINDINGS: A theoretical framework of nursing innovations was derived to summarize and visually display the pathways and linkages of challenges, innovations, and impact domains of nursing innovations. Situations and opportunities arise within the context of interconnectedness and can lead to health care innovations in care delivery, patient care interventions, role transitions, research and translational methods, communication and collaboration, technology and data, teaching methods, and processes to improve care. DISCUSSION: This theoretical framework offers insight into the dynamic interactions of academic-practice partnerships for innovation. Workplace situations are interconnected and can result in needed innovations designed to impact care delivery.

Burden and Coping Ability of Individuals Caring for Chronically Ill Older Adults in Nigeria: A Mixed Methods Study.

Family members play key roles in the care of older adults with chronic illness. However, little is known about the negative consequences of caregiving in Sub-Sahara Africa. The current study examined the influence of caregivers' burden and coping ability on the health-related quality of life of caregivers of older adults with chronic illness. An exploratory sequential mixed methods study was conducted among 16 family members. Findings showed that caregivers experienced severe burden, coped moderately with the burden, and had poor quality of life. Furthermore, directed content analysis of the in-depth interviews uncovered six major themes: (a) Being Pulled in Opposite Directions, (b) Experiencing Poor Health, (c) Receiving Support From Family and Friends, (d) Turning to God for Help, (e) Seeking Relief for Aching Bodies, and (f) Seeking Remedies for Sleeplessness. The current findings may have implications for designing programs that aim to improve the well-being of caregivers. [Journal of Gerontological Nursing, 45(1), 39-46.].