Part 1: Application of Carper's Fundamental Ways of Knowing
Among the tangible incidences that come to mind when reflecting on Barbara Carper's theory on “ways of knowing” is an incidence relating to a child who had been suffering from anxiety. The child had been brought in for a routine vaccination and her anxiety had not been diagnosed or even identified as an issue. The patient was a male child, 7 years old and a grade 2 pupil. The first impression that the child could be having anxiety issues was how the parents seemed to walk on eggshells around the child, always eager to please and placate. Further, both parents had to be present and within close proximity of the child at all times, more so in the presence of strangers. The child would also scream and cry whenever a stranger, including the gentlest professionals, touched him.
Empirical Knowing
Under Carper’s ways of knowing, the empirical approach entails factual knowledge about an issue that is already a settled science (Terry, Carr & Curzio, 2017). In the instant scenario, I used empirical knowledge to rule out other explanations regarding the behavior of the child and also focus more on anxiety as the course of his behavior. For example, the lack of hyperactivity enabled me to rule out Attention Deficit Hyperactivity Disorder (ADHD) while the close attachment to parents enabled me to rule out domestic abuse as the cause of the child’s behavior.
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Personal Knowing
The personal knowing perspective involves elements such as self-understanding and empathy (Terry, Carr & Curzio, 2017). With my patient being a minor, the care-based concept of the patient also extended to the parents. In the instant case, I noticed their extreme efforts to have their child presented as normal as possible. They also seemed eager to get the vaccination done with and leave. I was able to empathize with the parents form the personal knowledge that every parent aspires for a perfect child and will be in denial if the child exhibits less than perfect behavior. I quickly discerned that the parents may be in denial and will require some coaxing for the child to get the necessary assistance.
Ethical Knowing
In nursing practice, ethical knowing is dominated by nursing Code of Ethics for Nurses as well as personal ethics and morals. In the instant case, ethical knowing was critical in determining what to be done next. On the one hand, I would respect the parents’ wishes to have the child considered just fine and on the other, there was the obligation to ensure the child gets the necessary assistance. In the instant case, I took the high road, sat the parents down and enabled them to understand that their son was having anxiety problems and they needed to get to the bottom of it before it becomes debilitating.
Aesthetic knowing
Aesthetic knowing in nursing can be defined as the ‘aha’ moment when the nursing officer makes a new and important discovery (Terry, Carr & Curzio, 2017). In the instant case, the ‘aha’ moment came when I realized that I was not the first clinician to tell the couple that their son was having a problem. The couple was torn between being seemed to do the right thing and clinging to the notion that their child was just fine. I, therefore, realized that if the child leaves, chances of getting professional assistance were limited. I was determined to take advantage of the parent's desire to be seen to be doing the right thing to ensure that they met with the clinic’s child psychiatrist before they left for the day. I, therefore, got them into the first session and due to the impact of that session, they followed through and the child got the necessary assistance to overcome the anxiety problem.
Part II: Nursing Research in Diabetes Mellitus Management
Diabetes mellitus (DM) commonly referred to simply as diabetes is a set of chronic ailments that involve the elevation of blood sugar. According to CDC (2017), DM affects almost 30% of the entire US population or approximately 100 million people. Most forms of DM do not have express cures and require comprehensive management regimens, sometimes lasting for a lifetime.
Specifics of Nursing Research
Symptom Management
Symptom management is critical in DM research since the specific symptoms of DM and related complications visit inordinate suffering on patients. According to CDC (2017), among the common outcomes of DM include: “ premature death, vision loss, heart disease, stroke, kidney failure, and amputation of toes, feet, or legs ”. It is critical to undertake research so as to understand how to alleviate symptom without adverse consequences on patient health and well-being.
Health Promotion
The second important research component is health promotion and prevention due to the rapid increase in DM prevalence. According to CDC (2017), over 1.5 million new adult cases were diagnosed in 2015 alone. Increase in prevalence stretches resources for all patients hence the need for research to mitigate the lifestyle based DM causations. Important areas of research under this category include areas such as nutrition and exercises to mitigate obesity, a major bearing factor for DM.
Self-management
Self-management is another important area of research due to the chronic nature of DM. It is not possible to keep all DM patients in healthcare institutions all the time hence the need to research on and improve self-management regimens. Areas of research under this category include patient education, the different ways of testing blood sugar as well as administration of insulin under informal settings.
Palliative Care
Palliative care is an integral aspect of DM management with CDC (2017) reporting that a quarter of all Americans over 65 years have one form of DM or another. Palliative care and quality of life during such care are critical to the modern concept of nursing. Research is important towards the establishment of a way to ensure that those dying from DM or those at very advanced ages yet suffering from DM live and die with dignity.
Technology innovations
Finally, caring for DM patients effectively is almost impossible without the use of technology. DM management involves inter alia seeking to regulate blood sugar through the alternate introduction of either sugar or insulin into the body (CDC, 2017). For most DM patients, knowing how much insulin to introduce to the body at what time or when to urgently ingest a sugary snack is a matter of life and death. To assist nurses and patients through this process, advanced technology is necessary. Developing and advancing such technology requires research.
Role of Nursing Research
Conditions like DM, therefore, present an example where nursing research is just as important if not more important than any other form of research in applied medicine. The statement above is based on the fact that when it comes to DM, research on how to take better care of the patient both in outpatient and inpatient basis is more valuable than any other form of research. Management, not curative science, is the actual difference between life and death for DM patients. DM is not a peculiar case as there are variety of diseases and conditions where care precedes clinical attention, hence the need for nursing research.
Part III: Best Methods for Conducting Nursing Research for DM
Literature Review
The review of current literature is an important method of conducting nursing literature in general and specifically for DM. Literature review entails seeking for relevant literature for a specific subject then carefully perusing and analyzing it to establish what is already know about the specific subject (Tappen, 2016). Literature review as a research method is important to learn what is known about the subject of DM locally and around the world and also to determine knowledge gaps for further research. Normally, research on DM is exponentially expensive hence literature review prevents conducting expensive research on the phenomenon about which settled science already exists.
Quantitative Research
Quantitative research entails the use of statistical, mathematical, or computational techniques to investigate scientific phenomena (Kumar, 2019). In nursing research for DM, quantitative research is fundamental as it enables an understanding of key clinical and care intervention. A lot of computation is necessary for DM management including in the subject of insulin administration.
Qualitative Research
Qualitative research, on the other hand, is a model of nursing research that utilizes observational techniques to collect non-numerical data (Kumar, 2019). There are several important phenomena in the management of nursing that cannot be reduced into numeral data, key among them being patient satisfaction and quality of life. Different observational approaches based on expert observation of patient inference are used to undertake nursing research in the advancement of knowledge for the management of DM.
The Mixed Method
In nursing and management of DM, most research processes are not on black and white and will involve a combination of different elements hence the need for the mixed research methods. The mixed research method contemporaneously combines elements of both quantitative and qualitative research (Kumar, 2019). The mixed research method was traditionally associated with sociology and anthropology but modern changes in nursing theory have blurred the line between nursing and these disciplines . For example, good pain management medication may mitigate pain as a symptom of DM but cause a secondary problem like the inability to function sexually. A mixed method approach will create an understanding of how these contrasting effects act bearing factors to the quality of life for a young patient, a middle-aged patient, and an old patient.
References
CDC. (2017). New CDC report: More than 100 million Americans have diabetes or prediabetes. Retrieved from https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html
Kumar, R. (2019). Research methodology: A step-by-step guide for beginners . California: Sage Publications Limited.
Tappen, R. (2016). Advanced nursing research: From theory to practice (2 nd Ed). Massachusetts. Jones & Bartlett Learning
Terry, L., Carr, G., & Curzio, J. (2017). Expert nurses' perceptions of the relevance of Carper's patterns of knowing to junior nurses. Advances in Nursing Science , 40 (1), 85-102.
