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You'll be working on it for years:
make sure you enjoy it!  
Getting a PhD was a challenge overall, but the hardest thing – aside from sitting in the waiting room before and after my thesis defense – was finding something to write about. I'd think, "I'd like to write about X." So I'd check library catalogues, journal indexes, and grad school faculty websites only to find, to my chagrin, that it had been done before. I did my PhD in drama, so I had greater difficulty finding a topic than would someone in science. In the sciences, you can reinvent the wheel. After all, now, we are back to plants and roots, which had been out of vogue for the past millennium. And in healthcare, there's no end to the improvements we'd like to see, things we still need to discover, and conditions we want to cure. Nursing research, in particular, is unique because it explores illness from a patient-centric perspective and tends to take a more integrated, whole-person approach. The research can provide insight into the efficacy of various nursing interventions such as genetic counseling and testing or the care and rehabilitation of patients with chronic illness. So you know you want to do your PhD in nursing, now what? Before you can even begin finding out if your idea has been done before (and, by the way, it's OK if it has – you may have a different take on it), you have to have an idea! As an initial step, narrow down your general area. University-based research in nursing is placed into three categories: Advanced Practice, Health Policy, and Health Service Delivery and/or Work-Life Issues. We know that you'll soon have plenty of research to do, so we've done some for you. Here are some current topics, in each of the three categories from nursing faculties and articles in recently published journals. Reading them should help spark some ideas or at least give you an idea of the spectrum of research you can do. Advanced PracticeAdvanced practice, the largest category, involves research into specific practice areas such as cardiology, genetics, oncology, women's health, patient education, quality assurance, and clinical outcomes. Cardiology
research:
• Marie Cowan of the
School of Nursing at
UCLA is studying behavioral interventions
for patients with cardiac disease, measuring
responses, health-rate variability, quality of
life, and depression.
• Cowan's colleague
Anna Gawlinski is looking at hemodynamic monitoring
and oxygenation in the critically ill, advanced
heart failure patient.
• "Treatment Seeking
for Acute Myocardial Infarction Symptoms: Differences
in Delay Across Sex and Race." (Zerwic, Ryan,
DeVon, and Drell in Nursing Research,
May/June 2003) Geriatrics
research:
• At the
University of Arkansas for Medical Sciences,
Pao-Feng Tsai is studying how chronic pain caused
by osteoarthritis may exacerbate cognitive impairment
in dementia patients.
• Tsai's colleague
Elaine Souder is studying the impact on daily
functioning of changing visuo-spatial skills
in Alzheimer's patients and how environments
can be modified to accommodate the patient.
• "Elderly Patients
With a Hip Fracture: Risk for Delirium." (Schuurmans,
Duursma, Shortridge-Baggett, Clevers, et al.,
in Applied Nursing Research, May 2003) Maternal
child research:
• At the
University of British Columbia (UBC) in
Vancouver, Wendy Hall has written numerous papers
on topics such as family balance and effects
on pre-school children; the impact of living
with a parent who has a mental illness; evaluation
of a smoking relapse prevention program for postpartum
women; and experience of women returning to work
after the birth of their first child. Mental
health research:
• "Understanding Adolescent
Depression in Ethnocultural Context." (Choi in
Advances in Nursing Science, December
2002) Oncology
research:
• "Education and Support
Needs of Younger and Older Cancer Survivors."
(Narsavage and Romeo in Applied Nursing Research,
May 2003)
• "When Death is Imminent:
Where Terminally Ill Patients with Cancer Prefer
to Die and Why." (Tang in Cancer Nursing,
June 2003) Medical/surgical
nursing research:
• "What's New on Defining
Diarrhea in Tube-Feeding Studies?" (Lebak in
Clinical Nursing Research, May 2003) QA
and outcomes research:
• "The Effects of Nurse
Staffing on Adverse Events, Morbidity, Mortality,
and Medical Costs." (Cho, Ketefian, Barkauskas,
and Dean in Nursing Research, March/April
2003)
• "An Alternative Paradigm
for Clinical Nursing Research: An Exemplar."
(Sidani, Epstein, and Moritz in Research
in Nursing & Health, June 2003) or
"An Alternative View on An Alternative Paradigm."
(Ward, Donovan, and Serlin in Research in
Nursing & Health, June 2003), which
look at research design and intervention effectiveness.
• "A Study of Critical
Thinking and Research Utilization Among Nurses."
(Profetto-McGrath, Hesketh, Lang, and Estabrooks
in Western Journal of Nursing Research,
April 2003) Patient
education research:
• "Ethnicity and Prenatal
Health Promotion Content." (Vonderheid, Montgomery,
and Norr in Western Journal of Nursing Research,
June 2003) Health PolicyResearch in Health Policy is centered on how governments and communities influence that way healthcare is delivered to different populations, for example, under-served, rural, or international. Or you may be interested in AIDS prevention in vulnerable populations; TB incidence in homeless shelters; domestic violence and stress; or nursing interventions to reduce high-risk pregnancies in young people. These are some current topics of research in the area of health policy at nursing faculties: • At the
University of Toronto School of Nursing, in
Ontario,
Rebecca Hagey has embarked on fascinating research
related to racial disputes in nursing, employment
equity for visible minority nurses, and the politics
of aboriginal health and culture.
• Hagey's colleague Denise
Gastado has looked at the efficacy of health promotion
for immigrant women. A
sampling of recently published articles related
to health policy include::
• "Ethical Issues in
Qualitative Health Research with Homeless Youths."
(Ensign in
Journal of Advanced Nursing, July
2003)
• "An Intensive Cultural
Experience in a Rural Area." (Thomas, Olivares,
Sergio, Kim, and Beilke in
Journal of Professional Nursing,
May-June 2003)
• "Measuring Nursing
Power Within Organizations." (Sieloff in
Journal of Nursing Scholarship,
Second Quarter 2003)
• "Servants of the
State: Nurses Caught Between Professional Ethics
and Deathwork." (Nelson and Holmes in Nursing
Inquiry, March 2003)
• "Ethical Conflict
Associated With Managed Care." (Ulrich, Soeken,
and Miller in Nursing Research, May/June
2003) Health Service Delivery and/or Work-Life IssuesIn this field, the research is less focused on specific clinical processes and interventions. Rather, it focuses on how nursing practice is managed, such as informatics, performance management, and leadership styles in nursing. Below are three examples of research at the University of Arizona College of Nursing as well as one example of a published piece in the area of Health Service Delivery and/or Work-Life Issues. • Judith Effen, associate
professor of the University of Arizona College of
Nursing, evaluates how information systems are used
in healthcare. Among her research interests are e-learning
and the implications for nursing informatics curricula
with increased focus on patient safety.
• Gerri Lamb, one of Effen's
colleagues and associate dean, has evaluated how
data can be used to design systems of care for adults
with chronic illnesses using large databases to assess
the quality healthcare delivery systems.
• Another University of
Arizona College of Nursing colleague Rita Snyder-Halpern
has identified indicators of organizational readiness
for clinical information technology/systems innovation
as well as looking at the specific role of the informatics
nurse and the nurse as knowledge worker in a clinical
setting.
• "Snap-Shots of Live Theatre:
The Use of Photography to Research Governance in
Operating Room Nursing." (Riley and Manias in Nursing
Inquiry, June 2003) Places to Look When Considering Topics of Nursing ResearchThere
are many places to look when considering nursing
research. Here are some places that should get
you started::
• Nursing Journals
– and there are many – for example:
Advances
in Nursing Science; Applied
Nursing Research; Cancer
Nursing; Clinical
Effectiveness in Nursing; Clinical
Nursing Research; Computers,
Informatics, Nursing; Dimensions
of Critical Care Nursing; International
Journal of Nursing Studies; Journal
for Specialists in Pediatric Nursing;
Journal
of Advanced Nursing; Journal
of Professional Nursing; Nurse
Researcher; Nursing
Inquiry; Nursing
Research; Nursing
Science Quarterly; Research
in Nursing & Health.
• Nursing faculty webpages,
particularly of schools you are interested in.
• The National
Institute of Nursing Research. This body
supports "clinical and basic research to establish
a scientific basis for the care of individuals
across the life-span from management of patients
during illness and recovery to the reduction
of risks for disease and disability, the promotion
of healthy lifestyles, promoting quality of life
in those with chronic illness, and care for individuals
at the end of life. This research may also include
families within a community context."
• The
Center for Research Libraries "is a consortium
of North American universities, colleges, and
independent research libraries. The consortium
acquires and preserves newspapers, journals,
documents, archives, and other traditional and
digital resources for research and teaching and
makes them available to member institutions through
interlibrary loan and electronic delivery."
• MEDLINE
is the US
National Library of Medicine's bibliographic
database, which has broad coverage for literature
searches in basic biomedical research and clinical
sciences including nursing. Have fun as you explore research topics. And make sure you pick a topic you think you'll really like, because you'll be up-close-and-personal with it for an extended period of time. One good thing is that, if necessary, you can change your topic midway through the process (like I did). And once you're done, you can bask in the joy of seeing your name in Dissertation Abstracts International, and anywhere else your magnum opus ends up catalogued or printed. If you really enjoy research, keep in mind the words of one of my professors regarding dissertations: "This is not the culmination of your research, it's the beginning."
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