Page 112 - Encyclopedia of Nursing Research

CoMPARATIvE EFFECTIvEnESS RESEARCH n 79

value they placed upon serving those with expand, it will be difficult for nurses to plan
severe mental illness, they were also directed and test community interventions to decrease
to develop and apply evidence-based inter- stigma and/or disparity and to understand C
ventions with this population. how such interventions work. Research pri-
one needs only to scan recent reviews of orities related to stigma and disparity are
nursing research to gain an appreciation of nonetheless fertile grounds for future nurs-
the effort that has and is being put forth by ing research in community mental health.
psychiatric nurses in the United Kingdom to
meet this mandate. The nursing literature is Wendy Lewandowski
replete with studies investigating the clinical
impact of specific interventions with severely
mentally ill patients. Examples include nurs-
ing interventions for early detection of med- CoMparative eFFeCtiveness
ication side effects (Jordan, Tunnicliffe, &
Sykes, 2002), for identifying psychiatric ill- researCh
ness in the elderly (Waterreus, Blanchard, &
Mann, 1994), for providing sex education to
mentally ill patients (Woolf & Jackson, 1996), Comparative effectiveness research in nurs-
for using an “insight program” with patients ing is the generation and synthesis of evi-
diagnosed with schizophrenia (Pelton, 2001), dence generated through prospective and
and for implementing a self-management retrospective nursing studies with either pri-
model of relapse prevention for psychosis mary or secondary data sources by
(Stevens & Sin, 2005). Findings from a sys-
tematic review of 52 randomized controlled • comparing the benefits and harms of
trials of mental health interventions deliv- alternative nursing methods to prevent,
ered by the U.K. mental health nurses (Curran diagnose, treat, and monitor a clinical con-
& Brooker, 2007), such as family work with dition or to improve the delivery of care;
families of patients with schizophrenia (Leff, • comparing the same nursing method(s)
Sharley, Chisholm, Bell, & Gamble, 2001) and between different patient groups;
transitional discharge planning (Reynolds • comparing the same nursing method(s)
et al., 2004), show that psychiatric mental between different clinical environments; or
health nurses are involved in the delivery of • comparing one or more nursing methods
a wide range of evidenced-based interven- across combinations of treatments, patient
tions in the community. groups, and/or environments.
Today in the United States, the call by
the U.S. Surgeon General (U.S. Department At the clinical level, comparative effec-
of Health and Human Services, 1999) and tiveness research investigates nursing
the Presidents’s new Freedom Commission methods (preferably already shown to be effi-
on Mental Health (2007) to reduce stigma cacious in randomized controlled trials) in
and disparity related to accessing commu- real-world settings; that is, under ordinary
nity mental health care services has spurred and variable conditions, when prescribed
nurses’ interest in stigma research (Halter, by licensed nurses with varying degrees of
2004a, 2004b; Raingruber, 2002); however, expertise and practicing across the spectrum
movement toward understanding and reduc- of health care settings, to treat a heteroge-
ing stigma and disparity is still at its infancy, neity of patients. Comparative effectiveness
and nursing research in these areas has been research in nursing aims to discover the
qualitative and nonexperimental (Pinto-Foltz best nursing methods for personalizing care
& Logsdon, 2009). Until these research areas to individual patients by broadening the