Advancing Oncology Nursing Science

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Foreword

Advancing Oncology Nursing Science is a timely and important text that provides an assessment of the strengths and gaps in the current field of knowledge of cancer nursing. This text provides a foundation for developing future research directions and synthesizing the science for dissemination and use by oncology nurses and other health professionals. Oncology nursing research has a long history, which has advanced exponentially after the establishment of a stable funding base for nursing research and has strengthened the discipline’s opportunities within several institutes at the National Institutes of Health. The professional associations for oncology nursing research have shown a strong focus on the generation and dissemination of nursing research for professional oncology practice. Cancer nursing was one of the first disciplines to develop nursing research priorities and to focus the investigators’ endeavors on developing in-depth science in the critical areas needed for practice and health policy. In a short time, those pioneering steps advanced the field of oncology nursing research to the point that a “state-of-the-science” text is required that translates the evolving knowledge base to professional practice and facilitates shaping health policy.

Advancing Oncology Nursing Science not only provides a strong state-of-the-art assessment for cancer nursing research, but it also addresses several other purposes. A vision of oncology nursing and its scientific agenda is developed as part of suggesting future directions for research. The focus on systematically analyzing the current body of knowledge to provide valuable information to nurse leaders for practice, health policy, and educational initiatives, while also generating a thoughtful foundation for setting the future directions for oncology nursing science, is important to this vision. Generating a scientific base for cancer nursing requires understanding the methodologic and research issues, the processes and politics of translating research results into practice and health policy, and the incorporation of multiple disciplines into the study of oncology nursing problems and questions. Practice problems in cancer nursing are very complex and require numerous perspectives and fields of knowledge to gather information that can be valuable in practice settings. Nurse investigators in oncology nursing have been leaders in incorporating multiple health professionals and disciplinary scientists in their research programs. Knowing how to form, lead, and participate in multidisciplinary teams is critical in terms of enriching the scientific base of knowledge for cancer nursing, as well as for other professionals’ knowledge bases.

Evidence-based practice (EBP) is a major commitment and initiative for all health professions. Advancing Oncology Nursing Science makes a significant contribution to the EBP agenda because it provides synthesized information to all health professionals on bodies of substantiated science that can be translated into clinical practice and health policy. Major areas of knowledge available from cancer nursing research systematically are assessed, including a focus on prevention and detection, symptom management through the continuum, a focus on palliative and end-of-life care, and quality of life through the cancer continuum. Concerns with issues and problems experienced with several site-specific cancers also are addressed, including breast, lung, prostate, and colorectal cancers.

Nursing research and medical research each have different perspectives on the research questions that are consistent with their practice domains and orientation to health care. Nursing research focuses primarily on the person and family experiencing the cancer and asks questions related to how they are preventing, handling, coping with, or responding to the disease, its consequences, and its treatments. Medical research focuses mostly on the disease, its causation, progress, manifestations, and numerous types of treatments. The two types of research are strongly interrelated and strengthen each other. This text illustrates the nursing perspective in terms of oncology nursing research and the science that is generated.

A number of years ago, oncology nursing research focused on prevention and detection of cancer conditions. Multiple studies have provided results on behavioral interventions that can be taken to motivate individuals, families, and communities in adopting healthy lifestyles to prevent cancer. The strong focus on symptom management is evident in the number of nurse investigators studying the side effects and consequences of the disease and its treatments. Numerous reports in nursing research address strategies for handling nausea and vomiting, fatigue, hair loss, mucositis secondary to radiation therapy, and many other symptoms. Quality-of-life and end-of-life issues have been major subjects of study for nurse scientists. A number of quality-of-life measures were developed and tested by nurse scientists, and the end-of-life nursing research programs are influencing end-of-life processes by shaping health policy for terminally ill individuals and their families. These areas all show the professional perspective and commitment of leaders in oncology nursing research.

Addressing the current and emerging issues in oncology science provides an important understanding of the factors influencing the development of the knowledge base and future vision for the field. Multiple factors, such as understanding research results within a cultural context, the use of diverse methodologies for enriching data, the contributions made by nurse investigators, the theoretical and methodologic biobehavioral approaches to oncology nursing research, and the family as part of the oncology experience, as well as other issues, are valuable in understanding the perspectives taken and the richness of oncology nursing science. The preparation of nurse scientists in oncology research and the multiple processes involved in launching and sustaining a research career are basic to the long-term consistent evolution of oncology nursing science and provide important lessons for educational planning and mentoring through predoctoral, postdoctoral, and career-development stages of the research trajectory. Securing funding as part of the preparation is basic to being able to build a long-term research program that will contribute substantiated findings to the body of knowledge. All of these factors are critical to the generation of oncology nursing science.

The initiators of Advancing Oncology Nursing Science are to be commended for their foresight and vision in providing the discipline of nursing and the field of oncology nursing with this major contribution to understanding the state of the science and directions for the future. A special word of appreciation to the chapter authors who have contributed their unique expertise and perspective. Many health professionals will benefit. Practitioners will have an evidence base for health care. Nurse investigators', faculty members', and graduate students' careers will be enhanced by the opportunity to build on the knowledge and information provided in this text as oncology nursing science continues its rapid evolution and translation into professional practice and health policy.