促进护士对学术文献的批判

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A recent interview with medical writer Ivan Oransky, Co-Founder of Retraction Watch (retractionwatch.com), addresses the ongoing problems of quality peer review, flawed research, and subsequent retraction (Flight, 2022). He specifically spoke about nonspecialist readers of scientific literature and their need to be cautious and skeptical about what they read (Flight, 2022). In fact, all readers of JAPNA, regardless of their specialization and scientific background, are consumers of the information they read and should ALWAYS be critical of the research. The information taken from journal manuscripts has the potential to influence patient care. This editorial will focus on the importance of understanding a scholarly journal’s editorial process, including peer review, and critically evaluating the quality of the information presented in the publication. Specifically, this editorial will focus on promoting all nurses’ educated critique of scholarly literature.

Misinformation in scholarly literature pertaining to patient care is not a new concept. Historically, there has been notable erroneous published research that has influenced care practices long after retraction. One of the most influential research studies involved Andrew Wakefield’s assertion that vaccines might be linked to symptoms of autism (Wakefield et al., 1998). He made this assertion with research characterized by a small sample size, uncontrolled design, and speculations that fueled fear in parents and dropped the vaccine rates of children (Eggertson, 2010). It took years for the retraction process to be implemented (Eggertson, 2010) and for correction of the scientific literature to restore the publics’ trust in the safety of vaccines (Rao & Andrade, 2011).

More recently, numerous research papers on the COVID virus have been questioned and retracted. Oransky (Flight, 2022) noted that, as of February 2022, 209 COVID-19 papers had been retracted. He speculated there would likely be more papers retracted in the future as past manuscripts are scrutinized for validity. There is currently less rush to publication for COVID papers and overall more careful review of these published manuscripts. Notably, the rate of retraction of papers relating to COVID is not higher than the retraction rate of all other scientific literature topics (Flight, 2022).

JAPNA has received numerous submissions of papers concerning COVID management, nursing care, and the effects on staff. These papers have received the same diligent editor review and peer review (if they haven’t been rejected by the editor) and decision-making that are applied to all journal submissions. (See “Review Process” at https://us.sagepub.com/en-us/nam/journal-of-the-american-psychiatric-nurses-association/journal201684#submission-guidelines.) Many papers have been rejected. Those accepted have met the quality standards and the goal of adding to nursing knowledge.

Oransky noted the importance of readers evaluating whether a journal does what it says it will do (Flight, 2022). He noted, in Flight’s interview, that “the difference between a journal you can have confidence in and one you shouldn’t have any confidence in, is far less clear than a lot of people, particularly those in large publishing houses, would like you to think” (Flight, 2022, p. 2). This raises the ongoing question around the risk of predatory journals and being wary of the information they present in published research (Flight, 2022).

Critical thinking skills are essential to nursing practice (Papathanasiou et al., 2014). Critical thinking skills, taught in nursing education, allow nurses to specifically and creatively find solutions to problems encountered in clinical practice. Teaching nurses specific research appraisal skills results in an improved view of research that is relevant to patient care (Jelsness-Jørgensen, 2014). Critical thinking is essential in reading, understanding, and applying clinical research to practice.

Nurses need to critically evaluate all the research they read, even those published in “reputable journals.” Certainly, JAPNA adheres to ethical principles such as double-anonymous peer review and assessment of cross-check statistics, and JAPNA’s editors and reviewers evaluate submissions for methodological standards, human subjects approvals, reporting guidelines, and other elements of scientific rigor, but even with this careful attention to detail, it is possible that research is inadvertently published that is flawed or incorrect. The reader is the last step in verifying the ethical and scientific validity of a manuscript. This requires employing a level of questioning while reading an article, regardless of the source where the article is found.

Parse (2017) cited the editorial challenges involved with maintaining the quality of published manuscripts. She advocates for teaching the art of scholarly writing and the development of nursing knowledge in students at all levels of nursing education. Having this knowledge early in a nursing career will assist in judging the validity of research encountered in scholarly journals (Parse, 2017).

How can nurses critically evaluate professional literature? Ask the questions/do the below:

• What is the source of the information, the journal, its quality, and openly identified editorial practice? Is it trustworthy?

• Read and verify the information.

• Ask questions about the paper; contact the author if further clarification is needed.

• Read more literature about the topic.

• Discuss the topics and manuscripts with colleagues.

• Look at the larger context of the research or the clinical opinion; is it the same as your clinical opinion?

• Share your views in a Letter to the Editor or even contact the journal editor to ask further questions.

The authors, reviewers, and editors of JAPNA consistently strive to publish information that is timely, professionally considered, and accurate. The process is imperfect and under constant re-evaluation to ensure the highest quality. Your job as a reader of the scholarly literature, as a consumer of health care information, is to ask critical questions and constantly query whether what you read has validity and applicability to your practice. Ultimately, patients will benefit.

全文翻译（仅供参考）

最近对 Retraction Watch ( retractionwatch.com )的联合创始人、医学作家 Ivan Oransky 的采访解决了质量同行评审、有缺陷的研究和随后的撤回 ( Flight, 2022 ) 等持续存在的问题。他特别谈到了科学文献的非专业读者，以及他们需要对阅读的内容保持谨慎和怀疑（Flight，2022 年）。事实上，JAPNA的所有读者，无论他们的专业和科学背景如何，都是他们阅读的信息的消费者，应该始终对研究持批评态度。从期刊手稿中获取的信息有可能影响患者护理。这篇社论将侧重于理解学术期刊的编辑过程的重要性，包括同行评审，并批判性地评估出版物中提供的信息的质量。具体来说，这篇社论将着重于促进所有护士对学术文献的有教养的批评。

与患者护理有关的学术文献中的错误信息并不是一个新概念。从历史上看，已经发表了值得注意的错误研究，这些研究在撤回后很久就影响了护理实践。最有影响力的一项研究涉及 Andrew Wakefield 的断言，即疫苗可能与自闭症的症状有关（Wakefield 等人，1998 年）。他通过以小样本量、不受控制的设计和引发父母恐惧并降低儿童疫苗接种率的推测为特征的研究做出了这一断言（Eggertson，2010 年）。实施撤回过程（Eggertson，2010 年）和纠正科学文献以恢复公众对疫苗安全性的信任需要数年时间（饶和安德拉德，2011）。

最近，许多关于 COVID 病毒的研究论文受到质疑和撤回。Oransky ( Flight, 2022 ) 指出，截至 2022 年 2 月，已有 209 篇 COVID-19 论文被撤回。他推测未来可能会有更多的论文被撤回，因为过去的手稿会受到审查以确保其有效性。目前对于 COVID 论文的发表并不那么急迫，对这些已发表的手稿的总体审查也更加谨慎。值得注意的是，与 COVID 有关的论文的撤稿率不高于所有其他科学文献主题的撤稿率（Flight，2022）。

JAPNA收到了大量关于 COVID 管理、护理和对员工的影响的论文。这些论文接受了同样勤奋的编辑审查和同行评审（如果它们没有被编辑拒绝）和适用于所有期刊提交的决策。（请参阅https://us.sagepub.com/en-us/nam/journal-of-the-american-psychiatric-nurses-association/journal201684#submission-guidelines上的“审查流程” 。）许多论文已被拒绝。那些被接受的人已经达到了质量标准和增加护理知识的目标。

Oransky 指出了读者评估期刊是否按其承诺行事的重要性（Flight，2022 年）。他在 Flight 的采访中指出，“一本你可以信任的期刊和一本你不应该信任的期刊之间的区别，远不如很多人，尤其是大型出版社的人所希望的那样清楚。思考”（Flight，2022 年，第 2 页）。这引发了围绕掠夺性期刊的风险以及对它们在已发表研究中提供的信息保持警惕的持续问题（Flight，2022）。

批判性思维技能对护理实践至关重要（Papathanasiou 等人，2014 年）。护理教育中教授的批判性思维技能使护士能够专门和创造性地找到临床实践中遇到的问题的解决方案。教授护士特定的研究评估技能可以改善与患者护理相关的研究观点（Jelsness-Jørgensen，2014 年）。批判性思维对于阅读、理解和将临床研究应用于实践至关重要。

护士需要批判性地评估他们阅读的所有研究，即使是那些发表在“知名期刊”上的研究。当然，JAPNA遵守道德原则，例如双重匿名同行评审和交叉核对统计数据评估，JAPNA 的编辑和审稿人评估提交的方法标准、人体受试者批准、报告指南和其他科学严谨要素，但即使有这种对细节的仔细关注，可能会无意中发表有缺陷或不正确的研究。读者是验证手稿伦理和科学有效性的最后一步。这需要在阅读文章时采用一定程度的提问，无论文章的来源如何。

Parse (2017)提到了维护已发表手稿质量所面临的编辑挑战。她提倡在各级护理教育的学生中教授学术写作的艺术和发展护理知识。在护理生涯早期掌握这些知识将有助于判断学术期刊中遇到的研究的有效性（Parse，2017 年）。

护士如何批判性地评价专业文献？提出问题/执行以下操作：

• 信息的来源、期刊、质量和公开确定的编辑实践是什么？它值得信赖吗？

• 阅读并验证信息。

• 询问有关论文的问题；如果需要进一步说明，请联系作者。

• 阅读有关该主题的更多文献。

• 与同事讨论主题和手稿。

• 查看研究或临床意见的更大背景；和你的临床意见一样吗？

• 在致编辑的信中分享您的观点，甚至联系期刊编辑询问更多问题。

JAPNA的作者、审稿人和编辑始终致力于发布及时、经过专业考虑和准确的信息。该过程是不完善的，并不断重新评估以确保最高质量。作为学术文献的读者和医疗保健信息的消费者，您的工作是提出关键问题并不断质疑您所阅读的内容是否对您的实践具有有效性和适用性。最终，患者将受益。

原文链接：

https://journals.healio.com/doi/10.3928/00220124-20081001-02

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