"Going global" is a reaching out beyond self and beyond what is familiar; going global is commonly seen as an opportunity to both disseminate an idea and improve it-a kind of "East meets West." Pediatric oncology nursing research, although young as a source of empirically based knowledge, is going global, and this is the basis of this issue dedicated to international pediatric oncology nursing research. This nursing specialty research has advanced its science to a form that can now be characterized. First, the scope of interest for pediatric oncology nurse researchers is very wide, ranging from the composition and behavior of the child's normal and malignant cells to the intricacies of the treatment experience for the ill child's entire family in real time and across care contexts (clinic, hospital, home, and community). Second, quite striking is the diversity of research methods within and across studies and the strong focus on validation methods applied to study procedures and findings. Third is what seems to be a shared determination by different study teams to extract clinical meaning from the research findings. For these study teams, generating new knowledge is not sufficient, instead, the new knowledge must be credibly linked to the implications for actual patient and family care. Clearly, these researchers intend for their research to be so trustworthy that we will alter our clinical care practices and, as a result, directly improve the outcomes for our pediatric patients and their families.
Fourth, pediatric oncology nursing research reflects a concern about fellow clinicians from all disciplines who are involved in the treatment and care of ill children and their family members. This concern is about what clinicians know intellectually and experience emotionally that combine to form clinical wisdom, and the kind of support clinicians need to remain compassionate and competent pediatric oncology clinicians. Fifth is the setting in which care is delivered. These nurse researchers perceive the care environment to be a force to reckon with in improving care experiences and outcomes. The care environment can be an ally or an agent needing to be altered.
Sixth, and perhaps the most distinguishing characteristic, is that the nurse researchers directly seek new knowledge from the ill, seriously ill, cured, and dying child, adolescent, and young adult, as well as from their parents, siblings, and other family members. Each of these voices is considered to be a valid source of knowledge and, thereby, of clinical guidance. But what can the child, adolescent, and young adult with cancer and their family members in one part of the world teach their counterparts and clinicians in other parts of the world? Everything-everything that is essential to provide appropriate and even exquisite individual patient and family level care. The research included in this theme issue repeatedly supports this answer with evidence derived from the pediatric research participants' perceptions of the cancer experience that only they can report. This special theme issue reflects each of these key characteristics of pediatric oncology nursing research and the outcomes of this young source of empirically based knowledge. From cells to communities, from a single child to a whole family system, from the moment of diagnosis to long-term survivorship, and from living with cancer to dying from it, pediatric oncology nursing research has indeed gone global.
Our very best to you,
-Mitsue Maru, RN, DSN
International Nursing Development
Tokyo Medical and Dental University
Tokyo, Japan
-Faith Gibson, PhD, MSc, RSCN, FRCN
Centre for Nursing and Allied Health Research
Great Ormond Street Hospital for Children
NHS Foundation Trust and Department
of Children's Nursing
London South Bank University
London, UK
-Pamela S. Hinds, PhD, RN, FAAN
Department of Nursing
Research and Quality Outcomes
Children's National Medical Center
and School of Medicine & Health Sciences
Department of Pediatrics
The George Washington University
Washington, DC