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Investigación y Educación en Enfermería

Print version ISSN 0120-5307On-line version ISSN 2216-0280

Invest. educ. enferm vol.36 no.1 Medellín Jan./Apr. 2018

https://doi.org/10.17533/udea.iee.v36n1e01 

Editorial

Promotion and Enhancement of Knowledge in Nursing

Jhon Henry Osorio-Castaño1 

1 Nurse, Masters, Ph.D. Candidate. Associated Professor, Universidad Pontificia Bolivariana, Medellín (Colombia). email: jhon.osorio@upb.edu.co


Knowledge is the product of the action of learning and has as requisite that it can be expressed and communicated to others.(1) According to Fawcett,(2) one of the central issues for the survival of nursing as a discipline is understanding the nature and structure of nursing knowledge. This can be interpreted as the clarity about that which should be investigated, what should be done in the practice, and what should be taught during the formation of professionals. Although research, practice, and formation have been based on the body of knowledge from other disciplines,(3) it is not possible to achieve autonomy and independence in practice, as a given right,(4) if progress is not made in the construction, consolidation, and appropriation of nursing’s own knowledge. Hence, to promote the development of nursing knowledge requires three central elements: formation, practice, and research; and each of them transversed by other support elements, like the development and analysis of concepts, the use of medium-range theories, the use of a standardized language, and evidence-based nursing.

The first necessary element is the undergraduate and graduate formation. It gains importance because the learning and teaching processes permit understanding and favoring the appropriation of nursing as a scientific discipline and as an autonomous profession. To achieve this, it is indispensable to support this formation on transversal elements, especially on the use of medium-range theories and of a standardized language. Medium-range theories deal with specific phenomena of the discipline, like - for example - transitions, the maternal role, unpleasant symptoms, self-transcendence, suffering, ailing, comfort, and uncertainty, among many others, that emerge from the practice and return to it in a more elaborate manner. Moreno(5) and Seguel et al.,(6) ratify that the construction of theories, especially the medium-range theories, has been essential for the practice due to the limited number of concepts and because of their great use in understanding specific phenomena of the nursing practice.

Standardized languages are used to document the professional practice, given that they permit comparing and evaluating the effectiveness of the care offered in multiple scenarios of professional performance and provide a tool to communicate what is being done clearly and similarly.(7) For Seguel et al.,(6) and Silva et al.,(8) the nursing process and the use of standardized languages, in spite of having a strong positive influx, favor a work method that contributes to appraising, planning, and evaluating under standards that can guide the practice; besides generating questions on the effectiveness of the nursing interventions that must be strongly adhered to by professionals since the formative processes.

Using a standardized language through a work method somehow defines the knowledge of the discipline and, if used properly, can permit nursing professionals to describe, communicate, investigate, and teach consistently the phenomena concerning the nursing practice and discipline.(9) But achieving undergraduate and graduate formation also requires the formation of the teaching staff. As mentioned by Ramírez et al.,(10) formation in Nursing requires highly trained faculty to promote autonomous learning of their students, the same that will give origin to graduates committed to their self-education, so that as a professional group they assume a leading role in the development of humanity and learn from the classroom to create and participate in a more humane, equitable, and responsible world. This generates another challenge and the curricular structure of the undergraduate and graduate formation programs must respond to many components, like progress in the discipline, the new action domains, national and global population needs, and strengthening of their own knowledge to participate actively in the multidisciplinarity approach.

Strongly linked to the formation, the practice is the soul of a professional discipline. This element is crucial when favoring the development of nursing knowledge, given that it is where the problems or phenomena appertaining to inquiry derived from the discipline are generated; it is also in the practice where it can be seen what nursing is and what its practice supports. As stated by Duran de Villalobos,(11) the practice is accompanied by a system of abstract knowledge, dynamic development, which for its production and modification requires its being supported on daily practice that, in the end, evidences the relevant phenomena and problems of the disciplinary knowledge.

To understand the practice as promotion of nursing knowledge, it is necessary to recur to a mainstreaming element and that is evidence-based nursing, understood as the conscious, judicious, and explicit use of the best scientific evidence available related with nursing knowledge that permits making decisions about care, bearing in mind the patients’ preferences and values.(12) It is fundamental in the practice and in the formation to contrast, verify, test, refute, question, and rethink.(6)

Practice and formation of a discipline based on tradition, on intuition, and on the hegemonic power of other disciplines are probably condemned to disappearing. Hence, the emergence of a new connection between formation and formative professional practice in evidence-based nursing; understanding here that the evidence may come about from the generation of concepts, theories or their corroboration, the validation of a standardized language, and - of course - from the use of research results to generate new knowledge and inquiries that contribute to consolidating the practice. Practice that can achieve a balance and a link between the orientation to the task and the procedure and the care of experiences that are not tangible or measurable to facilitate the generation of new concerns, innovative proposals and the permanence of both orientations within a discipline dedicated to bedside baths and to the balance of liquids, as well as to interventions to favor an adaptive system and accompany the transition toward motherhood.(13)

Everything described until now would not be possible without the aid of research. For several authors,(6,10,14,15) research is the motor that drives disciplinary and professional development. It favors the generation, renovation, and consolidation of the discipline’s knowledge. It is fundamental for the formation and practice, as well as for the other transverse elements that have already been described. According to Fawcett,(16) Nursing research can be carried out under two perspectives: to generate theory or to test theory, but the author warns that both can be based on a conceptual and theoretical structure of the discipline and it would not be possible if there were no paradigmatic nucleus, as denominated by Fawcett,(17) or some domains of knowledge, as called by Meleis.(18)

It is important to highlight the pertinence of research by identifying the phenomena of the nursing domain. These phenomena can be defined through a single word or in theoretical terms, through a concept. Concepts include an experience that can be identified through observation, cognition, or language.(19) Moreno(5) indicates that the analysis of concepts is the first step for the theoretical development of nursing. Now, research cannot have repercussions upon it, on the formation and practice of Nursing if it is not disseminated. In this sense, the dissemination becomes a more real element of the promotion of the development of nursing knowledge, given that whatever is not published perishes, inexistent. Only that which can be read, shared, socialized will be used in the consolidation of the formation, practice, research, and professional autonomy. The publication of research results, especially in peer-reviewed journals,(20) determines the production of knowledge in a profession,(21) enables the dissemination of new knowledge, and contributes decidedly to scientific progress.(22) Although, as mentioned by Fawcett,(23) local, regional, national, and international conferences are another platform that favors the dissemination of research results in nursing, but do not have the potential of reaching thousands as do serial publications. Another fundamental aspect in research is funding. This is a first-order challenge in nursing, given that - according to Avena(24) - some negligence is noted from funding agencies to offer and disburse resources for nursing research when considering it of low impact.

Finally, everything exposed in terms of factors that contribute to promoting nursing knowledge is condensed in the great autonomy that, in spite of being real according to Legislation 266 of 1993,(25) seems more of an illusion because of all the breaches and disconnections occurring among formation, practice, and research; furthermore, because of all the setbacks found in the medium-range theories - both in the formation, as in the practice and as foundations of research, as well as with the use of a standardized language and evidence-based nursing, ignoring that everything as a whole makes up a structure of knowledge that permits promoting its development and which shields from the consumption of knowledge from other disciplines and from the generation of questionings on the phenomena not appertaining to Nursing.

References

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