Mary K. Kirkpatrick

A Review of Narrative Pedagogy Strategies to Transform Traditional Nursing Education

Traditional nursing pedagogies using teacher-centered learning approaches have produced efficient, knowledgeable nursing graduates for many years. However, 21st century learners will require and demand new educational approaches. The information age of computers has challenged all facets of education to keep pace. Nursing education must evolve with ever-changing forms of communication and technology and recognize generational differences in learning. The creation of partnerships in learning, rather than the traditional hierarchy of education, is projected to meet the needs of todays learners more effectively. The National League for Nursing, in its position statements, has challenged nurse educators to develop new research-based pedagogies responsive to the changing health care environment and reflective of new partnerships between and among students, teachers, and clinicians. This article will explore examples of one approach, narrative pedagogy, and its usefulness in nursing education as a way to expand the pedagogical literacy of nurse educators.

Pain experience of the elderly.

Too often, the elderly suffer silently and needlessly with chronic pain. To investigate the pain experience of the elderly living in the community, a descriptive research design was used. The aims of the study were to determine the prevalence of pain in an older population living in the community, to obtain a description of the older adults pain experience, and to determine strategies used to manage their pain. The results of the study indicated that >90% of the elderly living in the community experienced pain within the past month, with 41% reporting discomforting, distressing, horrible, or excruciating pain. Musculoskeletal pain was found to be the most predominant pain, and inactivity was the most effective strategy used to lessen pain. Pain in the elderly continues to be a challenge which needs to be addressed more effectively by health care providers. Based on the high prevalence of pain experienced by the elderly and the expected demographic shifts in the next two decades, it is imperative to continue research in this area to assure the highest quality of life, as well as maximum functional ability, for the elderly. Health care providers need to understand the multidimensional pain experience that occurs in the daily life of the community-dwelling older adult and the most effective management strategies that can be used to provide pain relief.

THE USE of Innovative Pedagogies in Nursing Education: An International Perspective

ABSTRACT The purpose of this global study was to explore the types of innovative pedagogies used in nursing education worldwide; transformative learning theory served as the theoretical basis for the study. A descriptive, mixed‐method design with a researcher‐developed instrument was used to conduct the electronic survey. Respondents were 946 nurse educator members of Sigma Theta Tau International; more than 93 percent were Caucasian women. Respondents indicated that the conventional teacher‐centered approach remains the most prevalent pedagogical style (56 percent); fewer than 20 percent of respondents used feminist or postmodern approaches. Ninety percent of respondents reported using instruments to evaluate the effectiveness of their teaching. The majority viewed their faculty role as facilitator (88 percent) or information provider (65 percent). Greater efforts are needed to create an evidence base for nursing education through research that focuses on the effectiveness of innovative pedagogical strategies. This study, by describing the current patterns of teaching/learning strategies and approaches used by nurse educators, provides a beginning research base for improving nursing education.

The ovarian cancer journey of families the first postdiagnostic year.

Ovarian cancer care has shifted from hospitals to families and has resulted in an unanticipated cancer journey as survivability for women so diagnosed has increased. This research investigated the impact of this responsibility on selected aspects of family functioning. Eighteen families participated in 5 family research visitations over the first postdiagnostic year. Quantitative data were obtained on socioemotional responses, behaviors, and coping strategies. Accounts of family experiences were recorded in field notes and narrative descriptions. Descriptive and narrative analyses were used. Subject families were strong and experienced a mosaic of variations in socioemotional and behavioral responses. Coping responses relied primarily on reframing and spiritual support. Families had hope and optimism and received socioemotional support from kin and friends. Response patterns consisted of providing support and care to sick members; making transformative changes in family structures, roles, and functions; reorganizing daily living experiences to integrate new situations; and minimizing gaps between professional and familial perspectives and realities. On this journey, families could have used timely knowledge and professional expertise to plan care, balance illness and family needs, restructure roles and responsibilities, maintain family unity, and give meaning and wholeness to experiences. Family-based oncology nursing is essential for family well-being and growth.

Health seeking related to ovarian cancer.

Critical review of general health-seeking models showed a need for expansion to include the early and atypical symptom period associated with ovarian cancer and the role of self and primary care in the diagnostic process. Data from family functioning research showed that in the self-care phase, the initial gastrointestinal symptoms were unrecognized as serious, given common sense labels, and self-managed. When primary care provider care was sought, misdiagnoses occurred three fourth of the time. Diagnostic delays occurred in these 2 phases of care. An expansion of a model of health seeking links personal and family risks and adds early symptom data may be obtained through monthly self-monitoring by women using a symptom checklist. Organization of risks and symptom information assists in interpretation of disparate streams of data and gives a recommended outcome: high personal risk level + high family risk level + high early and persistent symptoms presence = high need for a prompt gynecological evaluation. The restructured health-seeking process requires women be taught how to monitor their ovarian health. Nurses and primary care providers need frequent continuing education updates and the health media need current and accurate information about this malignancy.

An Ovarian Cancer Diagnosis-Seeking Process: Unraveling the Diagnostic Delay Problem

PURPOSE/OBJECTIVES To propose a conceptualization that identifies when diagnostic delays occur and suggests a delay-reduction strategy for the diagnosis of ovarian cancer. DATA SOURCES Findings and extrapolations from published national and international research studies, research reviews, books, Internet sources, and a family-functioning research project. DATA SYNTHESIS Three phases of diagnosis seeking were identified. Self-care was characterized by self-diagnosis, self-interpretation of symptoms, and self-management. Primary provider care was characterized by misdiagnosis and ineffective symptom management. Specialist care was characterized by specialized examinations, tests, and definitive diagnoses. Diagnostic delays were associated with extended periods of self-care and the misinterpretation of symptoms in primary care. CONCLUSIONS Periods of opportunity for early diagnosis occurred in the early symptom stages, when self- and primary care were dominant. IMPLICATIONS FOR NURSING Women must be taught to self-monitor for early ovarian cancer symptoms. Primary care providers should be urged to attend frequent state-of-the-science updates that regard early symptoms as manifestations of ovarian cancer.

Storytelling. An approach to client-centered care.

Storytelling as a communication technique influences listeners in a powerful way. The rebirth of storytelling, an old art form, is evident in nursing education programs. This approach enhances the learners sensitivity to the illness experience. Stories relating to clinical situations use examples that address chronic illnesses, humanity, death, dying, and advance directives. Well-chosen stories have the ability to motivate, inspire, teach, or enhance the human sensitivity skills needed by interdisciplinary healthcare providers.

Using the Internet to integrate cultural diversity and global awareness.

Societal paradigm shifts are fundamentally changing nursing education and practice. A global view is fostered in business, education, and healthcare; a microcosmic view is no longer acceptable. Seeking to increase the global and technological knowledge of their students, the authors describe how they used electronic technology to integrate cultural diversity and global awareness concepts into a nursing curriculum.

Women's health and the acute myocardial infarction

T his year alone, coronary artery disease will claim approximately 500,000 women in the United States, for exceeding the mortality rate far all neoplastic diseases combined. 1 Women today constitute 52% of the U.S. population and account for an increasing percentage of the workforce. There are greater numbers of singleparent families headed by women, and women in general are largely responsible for the upbriqging of our children. It would seem only reasonable that the health care of this group would be of great interest to the health care community. But medical research has virtually neglected women, especially in the research of ca.rdiovascular disease. Past studies on the effects of aspirin on cardiovascular disease, risk-factor analysis and modification, and the benefits of coronary artery ‘bypass surgery in angina victims -all were done using study groups that did not contain women. Much time, money, and labor have gone into the research of cardiovascu-

Leadership development in geriatric care through the Intergeneration Make a Difference Project.

The Intergeneration Make a Difference Project (MADP) is designed to develop leadership skills in geriatric nursing for seniors in a baccalaureate nursing program. This service-learning project with octogenarians and older individuals is based on theoretical constructs of caring. Stories and journaling are of great importance in the project. Expected outcomes are cognitive, affective, personal, and interpersonal. Students are expected to engage in critical/reflective thinking and develop leadership skills, heightened respect for the elderly, and interest in lifelong learning and a service orientation to society. Empowered to influence their clients, students receive the reciprocal benefits of an intergenerational relationship that, it is hoped, will affect how they care for the elderly in the future.