70
Western Journal of Nursing Research
is an exciting process that often involves merging several designs. Dickoff and James (1968) suggested a number of years ago that manipulation, merger, and the creation of new designs would be a natural outcome of conducting nursing research in clinical settings. This column on research methodology and the "doing of research" will focus on recurring problems that accompany applied science investigations. If the reader has experienced specific research problems and would like to have those concerns discussed, please write to the editor.
REFERENCES Dickoff, James and Patricia James 1968 Theory in a Practice Discipline. Part II. Practice Oriented Research. Nursing Research. 17:545-554. Hinshaw, Ada Sue, Janice Allen, Rose Gerber, and Jan Atwood In press Operative Trajectory Study: An Example of Collaborative Clinical Research. In, Nursing Research: Its Strategies and Findings. Vol. 2. E. Bauwens, ed. Sigma Theta Tau. Johnson, Jean, K.T. Kirchoff, and M.P. Endress 1975 Altering Children's Distress Behavior During Orthopedic Cast Removal. Nursing Research. 24:404-410.
Ethical Issues In Nursing Research Anne J. Davis
As a general rule, this column will serve several interrelated purposes. This first communication with you outlines its overall nature. A number of groups such as the Department of Health, Education and Welfare; the National Institute of Health; the Federal Drug Administration; and the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research have issued and continue to issue important recommendations and policy statements focused on the ethics of research. From time to time, this column will report such deliberations and any conclusions reached by these and Downloaded from wjn.sagepub.com at University College London on June 5, 2016
1979, Vol. 1, No.1
71
other similar groups. Any modifications in policy or any new policy will be mentioned and will occasionally be commented upon. Another purpose of this column will be to note and comment on particular ethical dilemmas evolving from research with human subjects. These ethical dilemmas range from questions having to do with the risk/benefit ratio, the problems in informed consent, difficulties arising in asking a certain class of individuals, e.g., patients with high medical costs, to participate in research with the possibility that in the short- and/or long-run their participation may prove detrimental to them because the research may negatively effect their care by influencing a change in policy. This column has yet a third purpose in that questions regarding ethics and research will be welcomed, and some attempt at a dialogue will be attempted. The dialogue format has a long and noble history in ethics; however, I do not promise either the wit or the insights that we enjoy in Plato. Such a promise would only be broken, and lead to more ethical problems. As we proceed, if you have any question about ethics of research, please send them to me at Room N505N, University of California, San Francisco, CA 94143. Perhaps before getting into specifics, it would be helpful to have some common ground for our further considerations of ethical dilemmas in research. To that end the next several columns will deal with the basic elements in informed consent, the role and activities of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, the policies from DHEW regarding Institutional Review Boards (I RB's), and some mention of the Codes of Ethics in research. Research with human subjects poses problems in balancing competing social interests. Three major social interests immediately become apparent: the protection of the individual human subject, the needs of society for the benefits of research, and the need to encourage, foster, and promote research. Discussions of ethical aspects of research deal with these competing social interests. Ethics helps us raise the multiple and complex dimensions of these dilemmas and structure our discourse. But the larger question remains as to why all this concern is necessary at all, and why such activity has become so central recently. One reason for all the activity in bioethics has to do with the fact that our knowledge and technology have grown very rapidly. With this growth have come new techniques and procedures that give us more control over life and death. Some of these procedures are invasive, either in the physical sense or in the sense that privacy and personhood may be encroached upon. Another reason for our more recent public concern with ethics and research is grounded in the Neuremberg tradition. The atrocities perpetrated by Nazi physicians in the name of research led to an Downloaded from wjn.sagepub.com at University College London on June 5, 2016
72
Western Journal of Nursing Research
international outcry of protest in the name of humanity after the second world war. This research activity to support a "pure race" ideology went far beyond the usual ethical dilimmas in research that we engage in; but these historical events from our own time can remind us that, along with the profound and immense good in this world, we can also experience great evil. That remains the case in research with human subjects.
Research Utilization Janelle Krueger
What Is It? REAL OR SUPERFICIAL DISSEMINATION This column will focus on the improvement of clinical and/or teaching practice through the use of research findings. The first two columns will provide background information about terminology and the dynamic, cyclical nature of the research utilization process. Your comments, arguments, questions, and manuscripts are welcomed. Future topics will include usable nursing research findings or generalizations and nurses' successful or less than successful experiences with introducing research-based change into care or teaching systems. Research as a knowledge base for nursing practice and teaching is a popular theme in the literature. However, in reading what various authors have written, one is struck by the diversity of terms and meanings that are found for what would seem to be a simple, straghtforward process. Some of the words used to denote the use of research are application, dissemination, diffusion, technology transfer, translation, and utilization. All convey the notion that information is transferred from the developer to the potential user. The differences lie in the interpretation or implication of what happens during, after, or in addition to transfer. Application, as Diers (1972) noted, suggests something that is superimposed and that may not become an integral part of the person or structure to which the thing has been applied. Like a bandage, it may be easily removed and discarded. Although Webster defines application as the act of putting to use, such as the application of new techniques, Downloaded from wjn.sagepub.com at University College London on June 5, 2016
Western Journal of Nursing Research
is an exciting process that often involves merging several designs. Dickoff and James (1968) suggested a number of years ago that manipulation, merger, and the creation of new designs would be a natural outcome of conducting nursing research in clinical settings. This column on research methodology and the "doing of research" will focus on recurring problems that accompany applied science investigations. If the reader has experienced specific research problems and would like to have those concerns discussed, please write to the editor.
REFERENCES Dickoff, James and Patricia James 1968 Theory in a Practice Discipline. Part II. Practice Oriented Research. Nursing Research. 17:545-554. Hinshaw, Ada Sue, Janice Allen, Rose Gerber, and Jan Atwood In press Operative Trajectory Study: An Example of Collaborative Clinical Research. In, Nursing Research: Its Strategies and Findings. Vol. 2. E. Bauwens, ed. Sigma Theta Tau. Johnson, Jean, K.T. Kirchoff, and M.P. Endress 1975 Altering Children's Distress Behavior During Orthopedic Cast Removal. Nursing Research. 24:404-410.
Ethical Issues In Nursing Research Anne J. Davis
As a general rule, this column will serve several interrelated purposes. This first communication with you outlines its overall nature. A number of groups such as the Department of Health, Education and Welfare; the National Institute of Health; the Federal Drug Administration; and the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research have issued and continue to issue important recommendations and policy statements focused on the ethics of research. From time to time, this column will report such deliberations and any conclusions reached by these and Downloaded from wjn.sagepub.com at University College London on June 5, 2016
1979, Vol. 1, No.1
71
other similar groups. Any modifications in policy or any new policy will be mentioned and will occasionally be commented upon. Another purpose of this column will be to note and comment on particular ethical dilemmas evolving from research with human subjects. These ethical dilemmas range from questions having to do with the risk/benefit ratio, the problems in informed consent, difficulties arising in asking a certain class of individuals, e.g., patients with high medical costs, to participate in research with the possibility that in the short- and/or long-run their participation may prove detrimental to them because the research may negatively effect their care by influencing a change in policy. This column has yet a third purpose in that questions regarding ethics and research will be welcomed, and some attempt at a dialogue will be attempted. The dialogue format has a long and noble history in ethics; however, I do not promise either the wit or the insights that we enjoy in Plato. Such a promise would only be broken, and lead to more ethical problems. As we proceed, if you have any question about ethics of research, please send them to me at Room N505N, University of California, San Francisco, CA 94143. Perhaps before getting into specifics, it would be helpful to have some common ground for our further considerations of ethical dilemmas in research. To that end the next several columns will deal with the basic elements in informed consent, the role and activities of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, the policies from DHEW regarding Institutional Review Boards (I RB's), and some mention of the Codes of Ethics in research. Research with human subjects poses problems in balancing competing social interests. Three major social interests immediately become apparent: the protection of the individual human subject, the needs of society for the benefits of research, and the need to encourage, foster, and promote research. Discussions of ethical aspects of research deal with these competing social interests. Ethics helps us raise the multiple and complex dimensions of these dilemmas and structure our discourse. But the larger question remains as to why all this concern is necessary at all, and why such activity has become so central recently. One reason for all the activity in bioethics has to do with the fact that our knowledge and technology have grown very rapidly. With this growth have come new techniques and procedures that give us more control over life and death. Some of these procedures are invasive, either in the physical sense or in the sense that privacy and personhood may be encroached upon. Another reason for our more recent public concern with ethics and research is grounded in the Neuremberg tradition. The atrocities perpetrated by Nazi physicians in the name of research led to an Downloaded from wjn.sagepub.com at University College London on June 5, 2016
72
Western Journal of Nursing Research
international outcry of protest in the name of humanity after the second world war. This research activity to support a "pure race" ideology went far beyond the usual ethical dilimmas in research that we engage in; but these historical events from our own time can remind us that, along with the profound and immense good in this world, we can also experience great evil. That remains the case in research with human subjects.
Research Utilization Janelle Krueger
What Is It? REAL OR SUPERFICIAL DISSEMINATION This column will focus on the improvement of clinical and/or teaching practice through the use of research findings. The first two columns will provide background information about terminology and the dynamic, cyclical nature of the research utilization process. Your comments, arguments, questions, and manuscripts are welcomed. Future topics will include usable nursing research findings or generalizations and nurses' successful or less than successful experiences with introducing research-based change into care or teaching systems. Research as a knowledge base for nursing practice and teaching is a popular theme in the literature. However, in reading what various authors have written, one is struck by the diversity of terms and meanings that are found for what would seem to be a simple, straghtforward process. Some of the words used to denote the use of research are application, dissemination, diffusion, technology transfer, translation, and utilization. All convey the notion that information is transferred from the developer to the potential user. The differences lie in the interpretation or implication of what happens during, after, or in addition to transfer. Application, as Diers (1972) noted, suggests something that is superimposed and that may not become an integral part of the person or structure to which the thing has been applied. Like a bandage, it may be easily removed and discarded. Although Webster defines application as the act of putting to use, such as the application of new techniques, Downloaded from wjn.sagepub.com at University College London on June 5, 2016
