Page 96 - Encyclopedia of Nursing Research

CLInICAL nURSInG RESEARCH n 63

skill-acquisition component of clinical judg- degrees, doctoral education with a major
ment but also for guiding research on clinical in nursing finally became a reality, and the
reasoning patterns, associated actions, and focus of nursing research shifted more firmly C
practice outcomes. away from nurses and nursing education to
the practice of clinical nursing. The broad
Patricia C. Dykes definition of clinical nursing research, then,
Moreen Donahue was originally formulated to differentiate
between the research conducted by nurses
before the 1960s, which focused on nurses,
and the major shift in focus on practice.
CliniCal nursing researCh Strongly influenced by the establish-
ment of the Center for nursing Research (at
present the national Institute of nursing
Clinical nursing research is both broadly Research) in the national Institutes of Health,
and narrowly defined. Broadly, it denotes clinical nursing research has recently taken
any research of relevance to nursing prac- on a narrower definition, modeled after the
tice that is focused on care recipients, their definition of clinical trials (large-scale exper-
problems and needs. This broad definition iments designed to test the efficacy of treat-
stems from the 1960s, when a major change ment on human subjects) used at national
occurred in nursing science. Before the 1960s, Institutes of Health. This narrow definition
the research of nurses had focused on nurses limits clinical nursing research to only those
and the profession of nursing including studies that focus on testing the effects of
major questions of interest related to nurs- nursing interventions on clinical or “nurse
ing education and the way in which nurses sensitive” outcomes.
practiced within care delivery structures In addition to an evolution in definition,
(i.e., hospitals). The reasons for these foci are clinical nursing research also has changed in
many, but for the most part they stem from form and complexity over time. Early clini-
the dearth of nurses with advanced degrees cal nursing research was characterized by
at that time and the fact that nurses with a focus on circumscribed areas of inquiry
advanced degrees were educated in other using experimental and quasi-experimental
disciplines (e.g., education). methodologies. Investigators were few and
In the late 1950s and 1960s, a major shift tended to work in isolation. often an inves-
occurred, driven by three factors. First, lead- tigator conducted single studies on different
ers in nursing successfully lobbied for the problems rather than series of studies focused
institution of the nurse scientist program on different aspects of the same problem.
through the federal government, which pro- As a result, study results tended to be con-
vided financial support for nurses to be edu- text bound and limited in generalizability
cated in the sciences (e.g., physiology, biology, to other settings, samples, or problems. The
anthropology, psychology). Second, nurse relationship between theory development
theorists such as Faye Abdellah, virginia and research was discussed abstractly but
Henderson, Imogene King, Ida orlando, not explicitly operationalized, and a philoso-
Hildegard Peplau, and Martha Rogers began phy of knowledge building rather than prob-
to formulate conceptual models to direct lem solving had not yet developed.
nursing practice, and attention was focused The next stage in the evolution occurred
on designing research that more or less was with the realization that little was known
guided by those models (or at least the sub- about many of the phenomena of concern to
stantive areas circumscribed by the models). nurses. This heralded a period during which
Third, as more nurses attained advanced emphasis shifted away from experimental