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W. L. Holzemer (Ed. ). (2009). Geneva/Hoboken, NJ: International Council of Nurses/Wiley-Blackwell. 258 pp. ISBN 978-1-4051-3411-8. Price US47. 99 (paperback) This book is different from previously published textbooks on theory and methodology in nursing science. William L. Holzemer, the Editor of the book, and the other authors work in many parts of the world and generously donate their time to support the work of the International Council of Nursing. Indeed, this book illustrates essential nursing theory and methodology in the context of global health issues and social and environmental trends. It is a practical guide that is intended to broaden the horizons of postgraduate nursing students and nurse researchers who aspire to participate in an exciting, but competitive, interdisciplinary research arena. First, this book is characterized by the theme of the first chapter, titled “Global perspective on health and nursing”. It reminds us that our day-to-day nursing practises and the mission of nursing science to further improve these practises ultimately must address critical global health issues. This philosophical vision is reflected throughout the text. It convinced me that health, illness, and health care are global issues requiring global solutions. For instance, heat illness (a life-threatening medical emergency with conditions such as cramps, exhaustion, and stroke) has been a significant public health problem this summer in many countries. This is a global illness that is caused by the increased temperatures resulting from global warming. Unfortunately, people without access to air conditioning often lose their life from heat illness. Thus, it also is closely related to the global economic recession. The health challenges that nurses face today will not be solved unless the environmental and social realities are considered. Nursing should be sensitive to such changes in health issues in order to solve health problems from a wide-ranging and holistic research perspective that is based on nursing science and, by so doing, improve the situation. This book reveals that the philosophy of nursing science and theory, the foundation of nursing research (including objectives and methodologies), must include the global perspective on health and nursing. As theory is at the core of science, it provides a framework for exploring phenomena and developing research methods and for disseminating the findings to clinical practise. Holzemer points out the power of theory to compel us to look at the complex health issues of socially vulnerable people from their own cultural viewpoints and to establish a human, interdisciplinary healthcare system in order to solve problems in partnership with the people. Second, I am impressed that the book never loses sight of nurse researchers’ mission: improving patient care, enhancing care delivery, and building the profession of nursing as a practical science. No matter where you are in the world, people have common distresses and health problems, such as pain, infectious diseases, depression, and lifestyle-related diseases. Nurse researchers must provide sound evidence to demonstrate how nursing practise can reduce patients’ distress, improve their quality of life, and thereby contribute to society. The authors emphasize that research questions should be refined and studies with high validity should be promoted for the benefit of patients, with the prospect that optimal patient outcomes can be achieved by nursing care. The survival rate is a primary patient outcome of medical treatment. Nursing interventions often make little impact on the survival rate but can affect patients’ conditions dramatically. Nursing interventions facilitate an improvement of function and patient safety. It is essential to identify the areas in which researchers can demonstrate the influence of nursing practises on patient outcomes. Furthermore, the authors underline the enhancement of systems of nursing practise. High-quality, effective care delivery requires adequate staffing with members of the nursing profession, as well as a care-provision system that ensures cost-effectiveness and the quality and safety of care. Thus, nurse researchers not only must develop high-quality care for individual patients, but they also must establish a care-provision system that ensures the efficiency, quality, and use of the developed care. Nursing innovations occur in the context of rapid globalization, in relation to complex and changing historical, political, and economic factors. The authors suggest that it is always necessary to inquire whether or not the development of nursing science is directed toward the well-being and happiness of people in the real world. In other words, nurse researchers should be aware of global trends, as well as local sociopolitical forces, that the nursing research field can adapt effectively to enact change and take a leadership role in addressing both global and local health imperatives with evidence-based innovations. The third characteristic of the book is a solid introductory overview of quantitative and qualitative research methods. The essence of methodologies, in terms of research designs, sampling methods, instruments, and data interpretation, management, and analysis, are presented in a clear format. Knowledge of these research frameworks will allow nurse researchers to select the best direction for their investigations. When I develop a research plan, this book will be in my hand as a guide. Fourth, this book is superior to other textbooks, in that the ethical principles that are required for various stages of the research process are discussed as integral to scientific inquiry. Nurse researchers always must pay attention to the vulnerabilities of research participants and they have the responsibility to design research that minimizes the risk of such vulnerabilities. In addition, it is important that everyone involved in the research shares the responsibility for accuracy and integrity. For that purpose, nurse researchers need discipline to critique the inquiry that informs the research process. Learning about ethics, in terms of defending the participants’ rights and best practise in various research situations and institutions, as this book emphasizes, provides a good ethical foundation for beginning researchers, as well as a well-taken reminder for experienced researchers. This book ends with two chapters that promote the field of nursing research. One focuses on the financial aspect. The reality is that nurse researchers must compete with researchers in other disciplines to accumulate new findings in the development of nursing science. Large national or public grants usually cover a wide range of research fields. The key components of a research proposal include the specific aims, background, and significance, preliminary studies, design and analysis, and budget. Every research group makes a research proposal by following the same format with key components. Nurse researchers need to present a consistent storyline about the need for the research, its social significance, objectives, hypothesis, methodology, and analysis in a limited space. Furthermore, the authors emphasize the importance of seeking opportunities to collaborate with professionals in other healthcare fields while retaining control of the research as the principal investigators. As nursing combines the perspectives of social and natural science, it is highly possible that a clue can be found from nursing practise research in combination with the perspectives and knowledge of other disciplines and it can solve the conflicts that exist in healthcare systems. Nurse researchers should be prepared to obtain the grants and take a primary investigator's role, with a good understanding of what that role entails. For the principal investigator, the book clearly describes the needs of leadership with scientific and ethical rigor and a capacity for assembling and managing a team in order to produce the synergistic effects of integrated knowledge, methodologies, and skills among scientists in different fields. There is a clear need to develop a research center for the support of those who aspire to complete the research mission for sustainable clinical nursing research. As far as I know, there is no such research textbook on this point. The authors conclude with the importance of bringing evidence into practise in feasible ways. It is emphasized that patients should be a key source of evidence in order to improve clinical decision-making and to generate evidence from practise. Presumably, patients’ honest opinions should be accumulated during the process of research-based practise in order to examine whether or not the evidence from research indeed leads to optimal patient care or demonstrates improved patient outcomes as a result of specific nursing practises or innovations. This book is definitely to be recommended, not only for all nursing professionals, but for many other health professionals, as well.
Hiroko Komatsu (Tue,) studied this question.