Browsing through the archived issues of RNJ has been a trip down memory lane, as I've viewed articles from past and present members of ARN as well as what were identified as "hot topics" of that particular year. In identifying an article from the 1990s, I found many topics of interest - integrating rehabilitation content into nursing curriculum, geriatric rehabilitation, addressing sexuality in the elderly, nursing assessment for positive adjustment of individuals with multiple sclerosis - all continuing issues in 2020. The article that caught my attention for this issue of RNJ was "The Impact of Chronic Illness on Patients." For those who don't know me, I have edited a textbook on the psychosocial effects of chronic illness on individuals and their families since 1998.
Two things caught my eye about the article. First, obviously, the content/study that was presented, and second, the format, style, and how the research study was written as compared with RNJ publications in 2020.
The author, Yeh-Juen Hwu, identified the physical, psychological, and social effects of chronic illness by interviewing 177 hospitalized patients with chronic illness. There was no mention of what chronic conditions the patients had or if they had multiple chronic illnesses. Results in physical health were as what might be expected, changes in energy, activity, digestion, sexual activity, urination/defecation and so forth (see Table 3 in the article). One-way ANOVAs were used to determine the association of 14 variables with physical, psychological, social abilities as well as ADLs. The results of the study are hard to interpret because many details have been left out of the article. Now 25 years later, there is an increasing amount of and depth of research on the psychosocial effects of chronic illness. In 2020 there are entire books dedicated to the psychological and social effects of chronic illness. And although we have come a long way since 1995, in describing the effects of chronic illness, we are still in need of effective interventions to address those effects.
Second, it was evident that the standards for publication of a study, the details, specificity, advanced statistics, ethical considerations and write-up of a study were quite different in 1995. In 2020, person first language has been a standard for many years. The term "the chronically ill patient" was used throughout this article as opposed to "the patient with chronic illness." The study did not mention Institutional Review Board (IRB) approval or written informed consent of the patients in the study. The study "used a variety of methods" to measure the impact of the chronic illness on patients, and identified 14 variables (not stated in the text what they were) to determine their effect on functioning. The article had several tables identifying a change or no change in how the patients viewed the effects of chronic illness on their lives; however, the ANOVA tables were missing plus any discussion in the text of these results other than one line about each ANOVA. Ten of these variables demonstrated statistical significance; however, there was no discussion of the specific relationships. The reference list was brief and incomplete as well, even for 1995. Lastly, APA format encourages articles being written in the 3rd person, versus the 1st person as this article was written.
Which brings us to the present day and the progress researchers have made in studying the effects of chronic illness, and what journals require in writing manuscripts - the style, format, details, reliability and validity of instruments, informed content, how patients were recruited, a comprehensive literature review, limitations of the study being discussed - and the list goes on. I think of the vast number of references/resources that are available at the click of a mouse. The complexity of manuscripts that RNJ receives as well as the quality of manuscripts is much different than in 1995. What opinions will future researchers and editors in 2045 have about RNJ articles in 2020?
Pamala D. Larsen, PhD, MS, RN
Editor-in-Chief Rehabilitation Nursing Loveland, CO, USA