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The nursing workforce has worked hard to professionalise and demonstrate the importance contribution of the nursing profession for quality global health care. The International Council of nurses defines a nurse as one who has completed a basic nursing education and is authorised to practice in their country (ICN, 1987). The ICN definition of nurses also specifically requires that nurses be prepared and authorised to “be involved in research” (ICN, 1987). As leaders in health care provision, nurses advocate tirelessly for their patients and play an important role in promoting and sustaining evidence-based healthcare (Bianchi et al., 2018). It is important that this nursing leadership is acknowledged in consumer care, and in research, innovation and improvement in healthcare delivery.

During the conduct of a systematic review examining nurse roles in physical healthcare of people with mental health, we along with colleagues encountered a clear example of the ad hoc approach to leadership attribution in nursing research (CRD42022321337). While there is clarity around the definition of who is a nurse, there is considerable ambiguity regarding studies that are “nurse-led.” Moreover, clear criteria that define nurse leadership in research pertaining to physical healthcare of people experiencing mental health concerns seem absent from the literature. This ambiguity appears as a continuum and includes studies where “nurse-led” described the role of a nurse as one who collected data, studies where nurses conducted the project yet remain absent from the authorship team, studies where the data was collected by an exercise physiologist or other non-nurse practitioner yet discussion of the nursing role appeared throughout the paper, and studies where nurses were clearly included on the authorship team but reference to nurses or the nursing profession were absent when discussing the study implications. While we acknowledge the diverse roles nurses play in research studies, absence of defined contribution makes the task of identifying the nursing contribution incredibly complex and fails to acknowledge nurses as research leaders.

To gain a greater understanding of the scope and value of nurse-led research we suggest a standardised definition of nurse-led research is adopted, allowing authors to assess and classify research activities appropriately. We recommend such definition is included in all publications of nurse-led work.

We propose that any definition would first require a project to clearly associate with nursing practice:

The project is clearly within the scope of nursing practice;

There is a clear articulation of the connection between the project and implications; for future nursing/nurses/nursing care.

And involve a nurse/nurses in at least three of the following four areas:

Project conception or design;

Leading the project; for example, working as the project manager/supervisor of staff conducting integral components of the project;

Undertaking integral components of the project such as data collection, facilitating organisational access or patient recruitment;

Project promotion and reporting or its dissemination in peer reviewed literature.

Defining the term “nurse-led” in the research context may serve multiple benefits. Firstly, a definition of what research is nurse-led would reduce ambiguity around the role and importance of nurses in research. There is a continued lack of awareness within the general community of the involvement that nurses have in research and the impact of projects that nurses lead on quality of patient care (Nieswiadomy & Bailey, 2018). A clear definition of nurse-led research would allow for more streamlined and targeted professional promotion.

Secondly, as the role of nurses in leading research becomes more clearly identified, it will allow better promotion of nursing research and simplified implementation of relevant research to practice. If academics, and practicing or student health professionals can utilise a single search term such as “nurse-led” to identify practical, relevant research that can be applied to nursing practice, this may encourage research engagement. Nurses working clinically would benefit from clearly defined terminology that allowed them to easily search and identify information that is directly related to their role and scope. Encouraging the use of “nurse-led” as an unambiguous key word would also improve the pragmatics of literature searching and assist in highlighting the importance of nursing in research and research as a career pathway for nurses.

There are a variety of organisations that aim to encourage nurses to engage in research, such as the National Institute of Nursing Research in the United States and the International Association of Clinical Research Nurses globally. Nursing courses often incorporate training relating to research conduct. In Australia, the Australian Nursing and Midwifery Federation has mandated that “research must be a recognised and visible career pathway within all Nursing and Midwifery classification structures” (ANMF, 2019). The visibility of Nursing Research could be improved, and the direct relevance of research to practice could be more easily articulated with the use of a nurse-led as a well-defined concept.

In the systematic review noted previously a definition of nurse-led consistent with the above-described criteria was applied. Subsequently 256 studies or 46.6% of the 549 studies included at full text review were excluded. This is not to imply nurses were not included in some aspect of the excluded projects, but does highlight the difficulty that an absence of a pre-defined definition of nurse -led creates, since some potentially included papers may have been inadvertently excluded.

Nursing research and nurse involvement in healthcare research are increasing (Bianchi et al., 2018). Now is the time to define and agree upon a definition that can be used to identify nurse-led projects in a way that is clearly distinguishable. Having a clear definition of nurse-led projects has the potential to provide significant benefit to the nursing profession.

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護(hù)理工作人員努力實(shí)現(xiàn)專業(yè)化，并證明護(hù)理專業(yè)對(duì)全球醫(yī)療質(zhì)量的重要貢獻(xiàn)。國(guó)際護(hù)士理事會(huì)將護(hù)士定義為已完成基本護(hù)理教育并被授權(quán)在本國(guó)執(zhí)業(yè)的護(hù)士（ICN，1987）。ICN對(duì)護(hù)士的定義還特別要求護(hù)士做好準(zhǔn)備并獲得授權(quán)“參與研究”（ICN，1987）。作為醫(yī)療保健領(lǐng)域的領(lǐng)導(dǎo)者，護(hù)士孜孜不倦地為患者辯護(hù)，并在促進(jìn)和維持循證醫(yī)療保健方面發(fā)揮重要作用（Bianchi等人，2018年）。重要的是，這種護(hù)理領(lǐng)導(dǎo)力在消費(fèi)者護(hù)理、研究、創(chuàng)新和醫(yī)療保健提供方面得到認(rèn)可。

在對(duì)心理健康患者的物理保健中的護(hù)士角色進(jìn)行系統(tǒng)審查的過(guò)程中，我們和同事們遇到了一個(gè)明確的例子，即護(hù)理研究中領(lǐng)導(dǎo)歸因的特殊方法（CRD42022321337）。雖然關(guān)于誰(shuí)是護(hù)士的定義是明確的，但關(guān)于“護(hù)士主導(dǎo)”的研究存在相當(dāng)大的模糊性。此外，文獻(xiàn)中似乎沒(méi)有明確的標(biāo)準(zhǔn)來(lái)定義護(hù)士在與心理健康問(wèn)題患者的身體健康相關(guān)的研究中的領(lǐng)導(dǎo)作用。這種模糊性表現(xiàn)為連續(xù)性，包括“護(hù)士領(lǐng)導(dǎo)”將護(hù)士的角色描述為收集數(shù)據(jù)的人的研究、護(hù)士進(jìn)行項(xiàng)目但仍不在作者團(tuán)隊(duì)中的研究、由運(yùn)動(dòng)生理學(xué)家或其他非護(hù)士從業(yè)者收集數(shù)據(jù)但對(duì)護(hù)理角色的討論貫穿論文的研究、，在研究中，護(hù)士被明確納入作者團(tuán)隊(duì)，但在討論研究含義時(shí)，沒(méi)有提及護(hù)士或護(hù)理專業(yè)。雖然我們承認(rèn)護(hù)士在研究中所扮演的不同角色，但由于缺乏明確的貢獻(xiàn)，確定護(hù)理貢獻(xiàn)的任務(wù)變得極其復(fù)雜，無(wú)法承認(rèn)護(hù)士是研究領(lǐng)導(dǎo)者。

為了更好地理解護(hù)士主導(dǎo)的研究的范圍和價(jià)值，我們建議采用護(hù)士主導(dǎo)研究的標(biāo)準(zhǔn)化定義，允許作者對(duì)研究活動(dòng)進(jìn)行適當(dāng)?shù)脑u(píng)估和分類。我們建議將此定義納入所有護(hù)士主導(dǎo)工作的出版物中。

我們建議，任何定義都首先要求項(xiàng)目與護(hù)理實(shí)踐明確相關(guān)：

該項(xiàng)目顯然屬于護(hù)理實(shí)踐范圍；

項(xiàng)目與影響之間有明確的聯(lián)系；用于未來(lái)護(hù)理/護(hù)士/護(hù)理。

并讓護(hù)士至少參與以下四個(gè)領(lǐng)域中的三個(gè)：

項(xiàng)目構(gòu)思或設(shè)計(jì)；

領(lǐng)導(dǎo)項(xiàng)目；例如，擔(dān)任執(zhí)行項(xiàng)目組成部分的員工的項(xiàng)目經(jīng)理/主管；

承擔(dān)項(xiàng)目的組成部分，如數(shù)據(jù)收集、促進(jìn)組織訪問(wèn)或患者招募；

項(xiàng)目推廣和報(bào)告或在同行評(píng)審的文獻(xiàn)中傳播。

在研究背景下定義“護(hù)士主導(dǎo)”一詞可能有多種益處。首先，定義什么是護(hù)士主導(dǎo)的研究將減少圍繞護(hù)士在研究中的角色和重要性的模糊性。普通社區(qū)對(duì)護(hù)士參與研究以及護(hù)士領(lǐng)導(dǎo)的項(xiàng)目對(duì)患者護(hù)理質(zhì)量的影響仍然缺乏認(rèn)識(shí)（Nieswiadomy&Bailey，2018）。護(hù)士主導(dǎo)研究的明確定義將有助于更精簡(jiǎn)和更有針對(duì)性的專業(yè)晉升。

其次，隨著護(hù)士在領(lǐng)導(dǎo)研究中的作用越來(lái)越明確，這將有助于更好地促進(jìn)護(hù)理研究，并簡(jiǎn)化相關(guān)研究的實(shí)施。如果學(xué)者、執(zhí)業(yè)或?qū)W生健康專業(yè)人員可以使用“護(hù)士主導(dǎo)”等單一搜索詞來(lái)識(shí)別可應(yīng)用于護(hù)理實(shí)踐的實(shí)用相關(guān)研究，這可能會(huì)鼓勵(lì)研究參與。臨床護(hù)士將受益于明確定義的術(shù)語(yǔ)，使他們能夠輕松搜索和識(shí)別與其角色和范圍直接相關(guān)的信息。鼓勵(lì)使用“護(hù)士主導(dǎo)”作為一個(gè)明確的關(guān)鍵詞，也將提高文獻(xiàn)檢索的實(shí)用性，并有助于強(qiáng)調(diào)護(hù)理在研究中的重要性，并將其作為護(hù)士的職業(yè)道路。

有許多旨在鼓勵(lì)護(hù)士參與研究的組織，如美國(guó)國(guó)家護(hù)理研究所和全球國(guó)際臨床研究護(hù)士協(xié)會(huì)。護(hù)理課程通常包括與研究行為相關(guān)的培訓(xùn)。在澳大利亞，澳大利亞護(hù)理和助產(chǎn)聯(lián)合會(huì)（Australian Nursing and Missifery Federation）規(guī)定，“研究必須是所有護(hù)理和助產(chǎn)士分類結(jié)構(gòu)中公認(rèn)且可見(jiàn)的職業(yè)道路”（ANMF，2019）。護(hù)理研究的可見(jiàn)度可以提高，研究與實(shí)踐的直接相關(guān)性可以更容易地通過(guò)使用護(hù)士作為明確定義的概念來(lái)表達(dá)。

在先前提到的系統(tǒng)審查中，采用了與上述標(biāo)準(zhǔn)一致的護(hù)士領(lǐng)導(dǎo)定義。隨后，256項(xiàng)研究或全文審查中549項(xiàng)研究的46.6%被排除在外。這并不是說(shuō)護(hù)士沒(méi)有被排除在被排除項(xiàng)目的某些方面，而是強(qiáng)調(diào)了缺乏護(hù)士主導(dǎo)的預(yù)定義定義所帶來(lái)的困難，因?yàn)橐恍撛诘谋慌懦撐目赡苁菬o(wú)意中被排除的。

護(hù)理研究和護(hù)士參與醫(yī)療保健研究的人數(shù)正在增加（Bianchi等人，2018年）。現(xiàn)在是定義和商定一個(gè)定義的時(shí)候了，這個(gè)定義可以用來(lái)明確區(qū)分護(hù)士主導(dǎo)的項(xiàng)目。對(duì)護(hù)士主導(dǎo)的項(xiàng)目有一個(gè)明確的定義，有可能為護(hù)理專業(yè)帶來(lái)巨大的好處。

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