Research resources✜ A group of nurse researchers in sou<strong>the</strong>rn Africa have begun afive-year, multi-national study on HIV/AIDS <strong>and</strong> stigma.Stigma related <strong>to</strong> HIV/AIDS continues <strong>to</strong> have a significantimpact on people living with <strong>and</strong> affected by <strong>the</strong> disease, aswell as on <strong>the</strong>ir <strong>health</strong>-care providers 4 .✜ Nurse scientists report success of a culturally-specific HIVrisk reduction programme aimed at reducing risky sexualbehaviour among Hispanic youths 5 .✜ Nurse researchers in <strong>the</strong> United Kingdom have uncoveredhidden early symp<strong>to</strong>ms of lung cancer. The research iscontributing <strong>to</strong> early detection <strong>and</strong> management of <strong>the</strong>disease.✜ Nurse anaes<strong>the</strong>tists have recently discovered a faster way <strong>to</strong>treat Malignant Hyper<strong>the</strong>rmia, a deadly metabolic muscledisorder 7 .✜ A team of nurse scientists from Canada are leading agovernment funded study on near misses <strong>and</strong> nursing’scontribution <strong>to</strong> patient safety.✜ Nurse researchers in Botswana are examining <strong>the</strong> extent ofnurse migration <strong>and</strong> its impact on <strong>health</strong> services <strong>and</strong> <strong>the</strong>nursing profession. The outcomes will be used <strong>to</strong> developrecommendations <strong>and</strong> strategies <strong>to</strong> inform policy-making 8 .✜ Nurse researcher Dr Kate Lorig <strong>and</strong> her team have beeninstrumental in developing <strong>and</strong> testing a model of chronicdisease self-management which has been adopted by anumber of countries throughout <strong>the</strong> world 9 .✜ Nurse-led research out of <strong>the</strong> United Kingdom has found thatinterventions undertaken by a diabetes nurse specialistresult in fewer prescribing errors <strong>and</strong> reduced length of stayfor hospital patients with diabetes 10 .✜ Interdisciplinary teams involving nurse scholars <strong>and</strong>researchers from o<strong>the</strong>r disciplines are investigating <strong>the</strong> linkbetween nurses’ contributions <strong>and</strong> <strong>the</strong> safety <strong>and</strong> quality ofpatient care as part of <strong>the</strong> Interdisciplinary Nursing QualityResearch Initiative 11 .✜ Dr Linda Aiken <strong>and</strong> colleagues published a l<strong>and</strong>mark studylinking higher nurse staffing levels <strong>to</strong> lower patient mortality<strong>and</strong> increased patient satisfaction. The results are beingused internationally <strong>to</strong> advocate for safe nurse staffinglevels <strong>and</strong> patient safety 12 .✜ A nurse researcher has developed an instrument (<strong>the</strong> BradenScale) <strong>to</strong> aid <strong>health</strong> care workers in assessing patient riskfor pressure sores. The <strong>to</strong>ol is widely used in <strong>health</strong> facilitiesthroughout <strong>the</strong> world 13 .Box 1: Examples of contributions by nurse researchers <strong>to</strong> nursing,<strong>health</strong> <strong>and</strong> <strong>health</strong> systems researchpast <strong>and</strong> being concerned with <strong>the</strong> present [...] Researchshould comply with accepted ethical st<strong>and</strong>ards”.ICN has identified nursing research priorities in two broadareas: (1) <strong>health</strong> <strong>and</strong> illness <strong>and</strong>, (2) delivery of careservices 17 . The Council views gender equality <strong>and</strong> poverty asimportant cross-cutting issues.Health <strong>and</strong> illnessNursing research in <strong>health</strong> <strong>and</strong> illness focuses on a numberof areas including <strong>health</strong> promotion, prevention of illness,control of symp<strong>to</strong>ms, living with chronic conditions <strong>and</strong>enhancing quality of life; caring for patients experiencingchanges in <strong>the</strong>ir <strong>health</strong> <strong>and</strong> illness; assessing <strong>and</strong> moni<strong>to</strong>ringpatient problems; providing <strong>and</strong> testing nursing careinterventions <strong>and</strong> measuring <strong>the</strong> outcomes of care. Therecommended nursing research priorities relating <strong>to</strong> <strong>health</strong><strong>and</strong> illness include issues such as HIV/AIDS <strong>and</strong> o<strong>the</strong>rsexually transmitted infections, chronic illness, infectioncontrol, women's <strong>health</strong> <strong>and</strong> mental <strong>health</strong> 18 .Delivery of care servicesNursing research priorities in this area focus on quality <strong>and</strong>cost effectiveness of care, community-based care, nursingworkforce <strong>and</strong> <strong>health</strong> care reform. Areas for nursing researchinclude <strong>the</strong> impact of nursing interventions on patien<strong>to</strong>utcomes, evidence-based nursing practice, primary <strong>health</strong>care, home-based care, quality of nurses’ work life, retention,satisfaction with work, impact of reform on <strong>health</strong> policy,programme planning <strong>and</strong> evaluation, impact upon equity <strong>and</strong>access <strong>to</strong> nursing care <strong>and</strong> its effects on nursing, <strong>and</strong> <strong>the</strong>financing of <strong>health</strong> care 19 .The global emphasis on <strong>the</strong> United Nations MillenniumDevelopment Goals, international calls for <strong>health</strong> systemsstreng<strong>the</strong>ning, <strong>the</strong> renewed focus on primary <strong>health</strong> <strong>and</strong>community-based care <strong>and</strong> mounting concerns about obesity<strong>and</strong> chronic, noncommunicable diseases all presentimportant opportunities for <strong>the</strong> nursing research communityin both industrialized <strong>and</strong> developing countries. Alsosignificant <strong>to</strong> nursing are <strong>health</strong> policy <strong>and</strong> systems research<strong>and</strong> <strong>the</strong> testing of new models of care delivery, especially asgovernments <strong>and</strong> employers struggle with rising dem<strong>and</strong> forservices, issues of cost containment <strong>and</strong> <strong>the</strong> realities ofrapidly shrinking pools of skilled <strong>health</strong> care workers 20 .Particular attention <strong>to</strong> innovative research in evolving areas ofneed such as chronic disease management, care ofvulnerable groups, primary prevention, aged care <strong>and</strong> disasterpreparedness is needed. These are all areas where <strong>the</strong> needfor scientific knowledge is great <strong>and</strong> where nursing excels.Streng<strong>the</strong>ning nursing’s contribution <strong>to</strong><strong>health</strong> researchNursing research has evolved significantly over <strong>the</strong> pastdecade <strong>and</strong> is now well established in most industrializedcountries. However, its development lags behind in manydeveloping countries. Nursing research in developingcountries is largely underfunded <strong>and</strong> capacity for research isoften weakened by a limited cadre of trained <strong>and</strong> skilledresearchers, poor infrastructure <strong>and</strong> support, little or noaccess <strong>to</strong> basic technologies, inadequate opportunities forcontinuing education <strong>and</strong> training <strong>and</strong> few men<strong>to</strong>rshipopportunities for new nurse researchers. Fur<strong>the</strong>r, owing <strong>to</strong>limited financial resources, researchers have fewopportunities <strong>to</strong> present <strong>and</strong> discuss <strong>the</strong>ir findings at national,regional <strong>and</strong> international levels.Dissemination <strong>and</strong> utilization of research findings are alsoequally important challenges which resonate globally. Toofrequently new knowledge <strong>and</strong> evidence lie unused. The needfor effective strategies for research dissemination <strong>and</strong>Global Forum Update on Research for Health Volume 4 ✜ 119
Research resourcesutilization are paramount <strong>to</strong> good decision-making at both <strong>the</strong>policy <strong>and</strong> practice level. Databases, marketing <strong>and</strong> networksare three such strategies. Increased access <strong>to</strong> <strong>the</strong> Internet,particularly in developing countries, will allow better sharingof information – both published <strong>and</strong> that underway.Marketing results in simple, easy <strong>to</strong> read <strong>and</strong> easy <strong>to</strong> applypackaging is also ano<strong>the</strong>r means of advancing dissemination<strong>and</strong> uptake of findings 21 . For example, <strong>the</strong> ICN is launching aseries of Fact Sheets that focus on Innovation, Evidence <strong>and</strong>Effectiveness which aim <strong>to</strong> inform <strong>the</strong> profession, public,politicians, policy-makers <strong>and</strong> o<strong>the</strong>rs about nursing roles <strong>and</strong>outcomes. Networks linking nurse researchers <strong>and</strong> thoseinterested in nursing research (e.g. <strong>the</strong> ICN ResearchNetwork <strong>and</strong> <strong>the</strong> Working Group of European NurseResearchers) are also helping <strong>to</strong> bring synergy <strong>and</strong>stewardship <strong>to</strong> <strong>the</strong> profession’s efforts.There is a need for more national level structures thatsupport/promote nursing research as an element of essentialnational research. Ensuring that reliable, sustainable fundingis available <strong>and</strong> aligning research programmes with national<strong>health</strong> priorities are paramount. Stronger linkages amonggovernment, policy-makers, researchers, practitioners,employers, educational institutions <strong>and</strong> funding agencies arecritical, as is <strong>the</strong> inclusion of nursing in broader policy leveldiscussions <strong>and</strong> decisions about <strong>health</strong>-related researchprogrammes.The International Council of Nurses has long recognizedresearch-based practice as a hallmark of professional nursing<strong>and</strong> maintains an ongoing commitment <strong>to</strong> supportingadvancements in this area 22 . The Council works with <strong>the</strong>World Health Organization, nongovernmental organizations<strong>and</strong> o<strong>the</strong>rs <strong>to</strong> ensure that <strong>the</strong> international nursing researchagenda is visible <strong>and</strong> included in priority statements.ICN works <strong>to</strong> enhance nursing research <strong>and</strong> researchbasedpractice by:✜ Facilitating <strong>and</strong> promoting <strong>the</strong> conduct, dissemination<strong>and</strong> utilization of research related <strong>to</strong> nursing, <strong>health</strong> <strong>and</strong><strong>health</strong> care systems.✜ Collaborating with national <strong>and</strong> internationalorganizations <strong>to</strong> enhance nurses’ contributions <strong>to</strong>nursing, <strong>health</strong> <strong>and</strong> <strong>health</strong> systems research.✜ Promoting opportunities for nurses <strong>to</strong> disseminateresearch <strong>and</strong> publish in international journals such as <strong>the</strong>International Nursing Review.✜ Supporting networks that link nurse researchers (e.g. <strong>the</strong>ICN Research Network http://www.icn.ch/resnet.htm).✜ Providing opportunities for nurses from around <strong>the</strong> globe<strong>to</strong> exchange experiences <strong>and</strong> views on current issues <strong>and</strong>trends in nursing research (e.g. ICN Research Networkmeetings at ICN congresses <strong>and</strong> conferences).✜ Encouraging member national nurses associations in<strong>the</strong>ir research-related capacity building.✜ Promoting research in areas which have practicalimplications <strong>and</strong> improved outcomes for patients, <strong>and</strong>which are meaningful <strong>to</strong> nurses’ daily practice.✜ Providing global leadership in establishing ethicalguidelines for nurses in <strong>the</strong> conduct, dissemination <strong>and</strong>utilization of research.✜ Publishing comprehensive guidance (e.g. ICN PracticalGuide for Nursing Research <strong>and</strong> Ethical Guidelines forNursing Research).✜ Maintaining position statements on nursing research <strong>and</strong>fact sheets.✜ Lobbying for <strong>the</strong> inclusion of nurse researchers onappropriate research boards, <strong>and</strong> <strong>health</strong>-relatedinternational research bodies.ICN is also supporting its member associations in <strong>the</strong>irefforts <strong>to</strong> enhance nursing research, particularly through:✜ Improving access <strong>to</strong> education which prepares nurses <strong>to</strong>conduct research, critically evaluate research outcomes,<strong>and</strong> promoting appropriate application of researchfindings <strong>to</strong> nursing practice.✜ Lobbying for nursing research funding from public <strong>and</strong>private sources.Concluding remarksGlobally, nurses are discovering new <strong>and</strong> improved ways ofdelivering care that are grounded in new knowledge <strong>and</strong>evidence derived through research 23 . Today nursing researchis increasingly part of <strong>the</strong> curriculum of basic nursingeducation <strong>and</strong> students <strong>and</strong> staff are expected <strong>to</strong> incorporateresearch findings in <strong>the</strong>ir daily practice. Investing in nursingresearch <strong>and</strong> <strong>health</strong> research more generally makes goodeconomic <strong>and</strong> <strong>social</strong> sense. The knowledge acquired throughresearch is a public <strong>health</strong> good that helps find better ways of<strong>health</strong> promotion, disease prevention, treatment <strong>and</strong>rehabilitation as well as improved systems design, financing<strong>and</strong> functions 24 . This is assuredly <strong>the</strong> case with nursingresearch. ❏Judith A Oul<strong>to</strong>n is Chief Executive Officer (CEO) of <strong>the</strong> GenevabasedInternational Council of Nurses. She also serves as CEO of<strong>the</strong> Florence Nightingale International Foundation <strong>and</strong> <strong>the</strong>International Council of Nurses Foundation. Judith Oul<strong>to</strong>n’sparticular areas of expertise include human resources, strategicplanning <strong>and</strong> futures. Her Bachelor of Nursing <strong>and</strong> Master inEducation were earned at <strong>the</strong> University of New Brunswick. Shealso holds honorary doc<strong>to</strong>ral degrees from McMaster University <strong>and</strong>l’Université de Monc<strong>to</strong>n in Canada. Judith Oul<strong>to</strong>n sits on a numberof <strong>health</strong>-related boards of direc<strong>to</strong>rs <strong>and</strong> advisory groups <strong>and</strong> haspublished extensively.Patricia Caldwell is an independent consultant in <strong>the</strong> field ofnursing <strong>and</strong> <strong>health</strong> services. She has undertaken extensive work for<strong>the</strong> International Council of Nurses, primarily in <strong>the</strong> area of <strong>health</strong>human resources. Patricia holds a Master’s degree in nursing from<strong>the</strong> University of Toron<strong>to</strong>.120 ✜ Global Forum Update on Research for Health Volume 4