Callista Roy¹

¹ PhD, RN, FAAN, Professor and Nurse Theorist, Connell School of Nursing, Boston College.

10.5294/aqui.2016.16.2.1

Anniversaries are a time to look backward and a time to look forward. As the School of Nursing and Rehabilitation at Universidad de La Sabana celebrates 25 years, you already have a heritage that provides a proud basis for the future. The future before you is very promising. The basis of scholarship in this journal and at your school creates and reflects your heritage and your future. In the last decade of the last century, you took the best of global nursing and created forward thinking educational programs in nursing. You understood that both theory and research were important in articulating the academic discipline and the clinical practice of nursing. I met members of your faculty for the first time at an international conference in El Salvador in February 2002 (Aquichan, 2002). They were well prepared to spend the interview time clarifying fine points about the Roy Adaptation Model. Since then, I have had the privilege of visiting La Sabana twice and each time was impressed by the scholarship of the programs, the increasing education of the faculty and the impact you have on nursing in Latin America. Between my visits in 2006 and 2011, I am aware that your school and town recovered from a severe flood. This reflects the resiliency you bring from your past into the future.

What does the future hold? The one thing we know for certain is that the future will be different from what we know today. Still, with a strong heritage in nursing knowledge development, significant research, relevant teaching and updated practice, you also will change and meet the changing demands. If we extend the trends of today, we can begin to predict what we will face in the future. In reading about the future in health care, I noted three of the most often mentioned issues that are trending in health care across countries. First, preventive care will soar and will include the use of online and other technology that align health providers and people who need care. At the same time, consumerism will be a major trend, as more people have access to information through technology. People will be self-educated in health. The third major trend that likely will continue to gain strength is collaboration, as nurses align with a variety of providers across the continuum of health.

What does this future ask of us and our knowledge in nursing? I will address the role of nurses in responding to these three trends. Nurses who understand how people adapt to a changing environment will continue to promote healing at the same time that they expand their practice to provide preventive services. Preventive services are assessments or interventions to prevent illnesses before they cause symptoms or problems. They include screening tests, counseling services and preventive medicines. In the United States, the Preventive Services Task Force is one group that develops recommendations on preventive services based on a review of good scientific evidence. For each recommendation, the group provides materials that include guides, fact sheets, slideshows and videos available for viewing and download. As of March 2016, the website had 75 entries in categories such as Behavioral Counseling Interventions to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults. With all nurses have to do, can we also increase preventive services? Yes, we can; teaching for health can become part of all we do. Nurses can help to create both the recommendations and the teaching materials relevant for our populations. Nurses know best about all the influencing factors that affect people as they try to take preventive approaches. Eventually, the efforts of nurses will lead to fewer people with chronic conditions requiring repeated and expensive care.

As the second trend moves forward, millions of consumers will have more access to information about health from magazines, television and the internet. We know that some of the information is reliable and up to date, and some is not. What can nurses do about this trend? In examining the shortcomings of health information on the internet, two authors (Benigeri & Pluye, 2003) identified four specific concerns. (i) the uneven quality of the health information available; (ii) difficulties in finding, understanding and appropriately using this information; (iii) lack of access for the unconnected population; and (iv) the potential for risk and harm from over-consumption. Nurses understand that, to adapt, people often need help in processing health information. Nurses can be key providers who help to overcome the dangers of internet information. Nurses will be involved in the design, dissemination and evaluation of Web-based health information that is well-matched to how people process health information, both cognitively and emotionally.

The last trend for the future I want to address is collaboration. We are hearing more about health providers working together to meet needs across the continuum of health and illness. Nurses have worked hard to define nursing and to develop our own voice in health care. Are we being asked to give this up and meld together with physicians, social workers, physical therapists, pharmacists and others? In a collaborative model of delivering health care, the voice of nursing is ever more important. Some of the trends noted and many others stem from technological advances. Nurses have the dignity of the person as the core of our knowledge. As nurses work with other health care providers in an increasingly technologic world, our voices are needed more than ever to keep the focus of all health providers on the needs of persons, as individuals, families and communities. Our assessments, from a holistic perspective, will be brought to each collaborative venture, in practice, in education and in research. All issues raised in health care need the voice of nursing. Just as thousands of people have benefited from the first 25 years of the focus the School of Nursing and Rehabilitation at Universidad de La Sabana, so will you respond to and lead trends in health care in the decades to come for the benefit of hundreds of thousands more citizens in your country and others.

1. Aquichan. Entrevista con Callista Roy. Aquichan. 2002;2(2):36-39.         [ Links ]

2. Benigeri M, Pluye P. Shortcomings of health information on the Internet. Health Promotion International; 18(4):381-386.         [ Links ]