Ann McMahon

On developing an agenda to influence policy in health-care research for effective nursing: A description of a national R&D priority-setting exercise

This paper describes a national initiative to establish a co-ordinated and systematic method for identifying priorities for research and development, jointly set up by the Royal College of Nursing and the Centre for Policy in Nursing Research. It uses an explicit policy-making model described by Lomas1 to outline the stages of the project. This model is also used to consider how nursing is influencing the current national clinical effectiveness and research and development agendas. Consideration is given as to whether the priority- setting exercise could make a difference to this wider policy agenda.

A national initiative to set priorities for R&D in nursing, midwifery and health visiting: Investigating the method

The aim of this paper is to provide a report of the progress made in the first phase of the national initiative established to identify priorities for R&D for the nursing professions, which was reported earlier in this journal (Kitson et al., 1997). Here we describe how the methods were used, discuss the primary and secondary results achieved in the first phase of the initiative and present an outline of how it is proposed to take these results forward in a second and more strategic phase. The aim of the first phase was to explore the feasibility of establishing a national systematic process for identifying priorities for R&D in the nursing professions*. It is now proposed to establish a strategic alliance for research in nursing, midwifery and health visiting and these proposals are summarised at the end of the paper.

Impact case studies submitted to REF 2014: The hidden impact of nursing research

The UK’s Research Excellence Framework (REF) 2014 rated the research from 154 universities, and the impact of research was evaluated in 6975 impact case studies. Nursing was returned within unit of assessment (UoA) 3, which also included Dentistry, Pharmacy and Allied Health Professions, although nursing research was also submitted within other UoAs. The study aim was to collate and categorise available REF impact case studies involving nursing researchers or on topics of relevance to nursing. Using nurs* as a search term, 469 case study entries were retrieved from the REF database and placed into three categories determined by the level of involvement of nurses. Some 80 impact case studies were submitted by nurses across 11 units of assessment, the majority being in UoA 3 (n = 55). A further 50 revealed some relevant impact, although nurses did not have an obvious research role. A total of 248 case studies described actual or potential impact on health or social care but were not associated specifically with nursing. Nursing research has demonstrable impact; however, there is a significant body of research with relevance for nursing that has not been associated with the profession in the REF. More attention should be paid to the ‘hidden impact’ of nursing research to ensure the full impact of nursing is recognised.

Compassion in practice: connected, contested, conflicted, conflated and complex

The focus of this edition of Journal of Research in Nursing (JRN) is on compassion in practice. Hardly a day goes by where there is not a reference somewhere in the media, in all of its forms, that indicates a growing sense that there is a deficit of compassion, whether that be at the societal, organisational, professional or individual level. The reasons for this are complex, multivariate and interconnected. Whilst our focus is on health and social care and the nursing contribution in particular, the evidence of this so called ‘compassion deficit’ is much wider than that, reaching deep into society. This edition of JRN brings readers plenty of food for thought about compassion, in its broadest sense, at organisational, professional and individual levels but these deliberations need to be considered within the context of the societal obligations and relationships that we all practise within. For instance, at the societal level, consider, just one example where people’s propensity for compassion is sometimes questionable – the attitudes towards and treatment of refugees seeking asylum. In this situation there are far-reaching consequences of political action and inaction, including the seismic ramifications of both of these on public health and wellbeing (Walsh, 2015) – in this situation the way nurses use compassion makes a considerable difference. Considering the plight of refugees and reflecting on the attitudes and behaviours of people towards the most vulnerable in society provides a powerful insight

Guest Editorial: Nursing and the UK research councils: time for change?

The value and importance of UK nursing research was given a resounding endorsement in a recent assessment of research quality, the Research Excellence Framework 2014 (REF2014). The overview report by the main panel A (MPA) of the REF2014 considered that diversity and quality of research submitted to the sub-panel unit of assessment (UOA) 3 (Allied Health Professions, Dentistry, Nursing and Pharmacy) to be strong. They concluded:

Identifying priorities for strengthening and developing the nursing contribution in a field of practice: A case study in stroke care

Building on earlier work, this paper describes a coordinated and systematic method for identifying priorities for nursing development within a field of practice. The nursing contribution in stroke care serves as a case study, the primary aim of which was to establish priorities for research and development in stroke care from a nursing perspective. The initiative was a partnership between the Royal College of Nursing and the Stroke Association, supported by the Royal College of Physicians.

The Emperor’s Clothes

The overarching theme running through this edition of JRN is evaluation. The business of assessing the value of something is an integral part of the research process. Within the positivist paradigm for example, the randomised controlled trial, the comparison of two possible interventions and the assessment of their difference from a numerical or statistical perspective is a classic example of research as a means to assess the value of something. More recently the notion of evaluation being a distinct social-science method has grown in prominence with, for example, the development of theory driven approaches such as, realistic evaluation (Pawson and Tilley, 1997) and programme theory (Funnell and Rogers, 2011). In this edition we have brought together five papers which show the myriad techniques researchers use to make assessments of interventions or practice as it occurs. However, we begin this edition with an editorial that introduces our latest online collection of papers on grounded theory, which are available open-access through our webpage (http://journals. sagepub.com/home/jrn) for a limited period only. The first paper in this edition is by Howarth et al. They employed a mixed methods approach to assess the value of a therapeutic horticulture intervention, in the North West of England. The aim of the intervention was to reduce social isolation and improve engagement within the context of a mental health recovery programme. The second paper from Sydney, Australia, by Jones et al sets out a rationale for employing a recognised training and education evaluation model for the purposes of assessing the effectiveness of training provided for nurses in a new hospital-at-home paediatric nursing service. The authors argue that such an evaluation should not only assess reaction to and learning from the training but also its impact on the behaviour of the learners and in turn how that effects the service provided. In the third paper Gümüs and Terzi present an evaluation of the health beliefs and their association with testicular self-examination from a sample of men in the Amasya region in Turkey. And, in the fourth paper in this edition, we see an example of an evaluation of the literature. Dalla Nora and colleagues describe a scoping review undertaken to better understand nurses’ practice within the context of primary health care in Portugal. The principles of evaluation have arguably been incorporated not only into management theory but also into management practice.

Perception and Partnership

I write this editorial at the end of a Spring break in Canada. It’s only the second time I’ve visited Canada. My first visit was just after I graduated and registered as a nurse. My best friend was a Chemistry graduate and had moved to Vancouver where she had registered for a PhD at the University of British Columbia. The possibility to visit my friend was just too good an opportunity to miss! Despite falling in love with Vancouver the first time around, it has taken me 35 years to return and my second visit has caused me to reflect on my career, what might have been and indeed what has changed in that time. In the early 1980s, I was very tempted to spend more time in Vancouver, register for a Master’s degree and continue my nursing studies overseas. I confess I had all the paperwork with me when I returned to the UK to consolidate my nursing education. In those days however, it was relatively unheard of to progress academic studies in nursing straight after graduating and indeed credibility as a nurse was solely contingent upon clinical experience. Nurses simply weren’t afforded the opportunity to combine clinical and academic roles even though they were common in disciplines such as medicine and dentistry. As one of the relatively ‘early’ nursing graduates in the UK, I have long recognised the potential of combining clinical practice with research and I have shared a commitment with others to make this a tangible career choice in nursing. After consolidating my undergraduate nursing education in a general surgical ward I opted to specialise in cancer nursing. Working in a tertiary centre, research led by my medical colleagues was commonplace, and I was inspired to register for a Master’s degree and develop my own clinical research. Seven years after graduating with a Bachelor’s degree in nursing, I graduated with a Master’s degree, not in Canada, but in the UK. I applied to undertake my Masters at the University of Manchester where the most straightforward way to fund a Master’s degree at that time was to commit to a career in nursing education. However, there was no option to combine this with a clinical role or focus on an area of specialist practice such as cancer nursing. This didn’t sit comfortably with me and so I followed my heart rather than the funding and was fortunate to secure some support from other sources.

What a year

When penning the editorial of the final edition of the year, it always seems right to reflect back on the year, and this year is no exception. ‘What a year it has been!’. . . do we think that every year? Possibly, but 2017 does seem to have had more than its fair share of environmental and humanitarian strife. This has been coupled with ever increasing political chaos, perhaps as a result of people’s inability to make any sense of the conditions in which they find themselves, fuelled by the belief that what is offered as radical change is their only hope. Trying to make sense of the conditions in which we find ourselves, as a means of improving them, is arguably contingent upon rational thought. I hang onto the fundamental belief that we can make better decisions that lead to better outcomes when we marshal evidence to inform our decision making. However, there seems to have been something of a backlash against the premise that better outcomes are achieved when decisions are informed by strong evidence, particularly within the realms of political decision making at an individual level and policy decision making at a Governmental level. I am well aware that decision making on any level is a political process and there are multiple factors to consider as well as evidence, including context, competing demands and the availability of resources, but decision making devoid of the consideration of robust evidence, and driven purely by ideology, cannot be healthy, surely? It is that belief, that better outcomes are realised when we marshal robust evidence to inform our decision making, that underpins the raison d’être of JRN and keeps us going as we strive to make the connections between research evidence, nursing practice and health and social policy more explicit. We started the year with a bumper edition focusing on compassion in nursing. Since then the ongoing global refugee crisis, evidence of what appears, on the surface, to be increasing levels of intolerance of difference, and the ravages of the environment, have continued to point towards the need for greater individual and collective compassion if we are to realise a just, equitable and humanitarian society. Nurses and nursing play a central role in changing society and supporting those whose health and wellbeing are compromised regardless of, for example, place, time, culture and gender; however, reaching agreement on how to provide appropriate culturally sensitive and compassionate care still remains hard to attain. Achievement is contingent upon a deeper understanding of the root causes of the absence

The voice of nursing

More than 15 years ago I attended an International Council of Nurses conference. North American feminists and journalists Bernice Buresh and Susanne Gordon had a powerful message for their nursing audience: they argued why nurses should and how they could get their research and voice heard in the public domain and through the media. Their message struck a chord: their analysis showed that the problem lay not just in a lack of interest in nurses from the media, but in that there was also a clear reticence in the nursing profession to engage with the media and speak to the public at large. This had been my experience too. I have been the professional lead at the Royal College of Nursing of the United Kingdom (RCN) working with the RCN Research Society for more than 20 years. We have held a nursing research conference every year throughout my tenure. I, like Buresh and Gordon (2000), firmly believe that ‘patients, families and the health care system, can only reap the benefits of research done by nurses if that research is disseminated and publicised beyond the nursing community’ (Buresh and Gordon, 2000: 261). The sharing of research at an RCN conference was surely an ideal platform for researchers to disseminate their research more widely. However, 20 years ago I found that the majority of nurse researchers were extremely reluctant to engage in any media work related to their research. That picture has changed dramatically over the years, and since the advent of social media the level of activity to secure public engagement has increased exponentially. The beauty of social media is that it gives the researcher an unmediated and immediate voice. The fear of being misquoted or having your research misrepresented by a third party is taken away, and perhaps as a consequence many more researchers are engaging more with the public at large. Of course, such technological developments are only an enabler of engagement; there have also been policy drivers that may well have influenced this behavioural change. For instance, it is now the norm in healthcare research in the UK that there is explicit public and patient involvement in the research process, and public and patient involvement is now almost universally a funding requirement. This, coupled with the requirement that researchers must demonstrate the impact of their research (Kelly et al., 2016), has led to innovative approaches to dissemination and engagement with those whom researchers seek to influence. For example, Brightlight (http://www.brightlightstudy.com) is a series of research studies that aim to answer the question: Do specialist services for teenage and young adults with cancer add value? The findings from the ‘young people’s experiences of care’ study were