How Nursing Research Improves Patient Care and Recovery

Urinary incontinence — involuntary urine loss— is a common and often embarrassing problem that can impair a person’s quality of life. The lower urinary tract is controlled by complex neural mechanisms not only in the periphery, but also in the central nervous system. Thus, patients with a wide variety of neurological diseases often also have lower urinary tract symptoms (LUTS), including those with Parkinson’s disease (PD).

Joanne Robinson, PhD, has witnessed first-hand the distress that lower urinary tract symptoms (LUTS) can have on nursing home residents, men following prostate cancer surgery, individuals with PD, and families and caregivers of anyone with bladder control issues. Her research on lower urinary tract symptoms in older adults has been supported by the National Institute of Nursing Research and recognized with six awards.

Dr. Robinson also serves as associate dean for research and innovation at Jefferson’s College of Nursing, a role that has allowed her to explore her passion for academic nursing leadership and mentoring the next generation of nurses. Find out more about Dr. Robinson’s contributions to these fields.

Q: Tell us a bit about your field or area of research.

A: I have two general areas of focus as a nursing scholar and scientist. The first is lower urinary tract symptoms, including urinary urgency, frequency and incontinence. I studied urinary incontinence in men after surgery for prostate cancer for about 10 years and conducted research on the efficacy of a post-operative pelvic floor muscle training program (kegel exercises) to help with recovery of bladder control. I found that most men regained continence within a year following surgery, but those who received pelvic floor muscle training recovered more quickly.

Around the same time, I worked with a team of colleagues to document the prevalence and impact of lower urinary tract symptoms (LUTS) in men with Parkinson’s disease at the Philadelphia VA Medical Center. At the time, LUTS were not recognized as a big issue in Parkinson’s disease patients. Our findings documented the early incidence and extensive prevalence of LUTS, including incontinence, in this population of patients. Our work also captured the life-altering impact of LUTS on both patients and their partners and caregivers.

The next step in my work with Parkinson’s disease patients would be to test a non-invasive conservative treatment, transcutaneous tibial nerve stimulation, to add to the growing body of evidence of its efficacy. I am currently in search of research partners at Jefferson who share this interest and would like to collaborate to secure funding for a study. In addition, in my work with the International Continence Society, I am currently co-chair of a project to standardize the terminology and definitions for nursing interventions that address incontinence.

Q: What’s one question you’re exploring currently?

A: Is “trauma-informed care” a useful framework for understanding issues of health and well-being among academic nursing leaders? What are some survival skills and strategies from the perspective of trauma-informed self-care that might maximize resilience and well-being in nursing deans?

Q: What first sparked your interest in your area of research/your research question?

A: Personal experience and passion are always behind my scholarly pursuits.

My interest in LUTS started with my experience as a clinical nurse specialist in nursing homes, where I saw the enormous prevalence of urinary incontinence, the very feeble efforts to address it, and its enormous burden on nursing home residents, families, staff and administrators. The more I tried to fix it in the clinical setting, the more I understood its complexity. It was a phenomenon that begged to be studied and very few people were taking it on. My doctoral dissertation focused on urinary incontinence in nursing homes. My post-doctoral mentor, Dr. Ruth McCorkle, persuaded me to look at incontinence and LUTS in men, which was a very closeted clinical phenomenon at the time and similarly understudied.  My clinical and research encounters with men who experienced bladder control issues after surgery for prostate cancer, or in the context of Parkinson’s disease, fueled my passion then and now.

My interest in academic nursing leadership began with the “lived experience” of assuming academic leadership roles, first as a chair and then as a dean. When I stepped up from my deanship, I wanted to contribute to the health, well-being and sanity of people who came after me by creating a practical start-up handbook of “need to know” information for nursing deans.  My academic nursing leadership journey was largely a “seat of the pants” experience despite my connection to a network of very busy mentors who did their best to offer guidance in a pinch amidst the enormity of their day-to-day responsibilities and issues. As I matured as an academic nursing leader, I was limited to the same approach to mentorship despite efforts to be pro-active. To me, production of “Nursing Deans on Leading” was my best effort at succession planning at-large.

Q: What do you enjoy most about your job?

A: My job as associate dean for research and innovation at the College of Nursing is essentially about helping people to succeed. When I became a dean, the first lesson I learned was to embrace the notion that “this job is not about me.” The same applies to my role as associate dean. I especially enjoy helping junior faculty to launch a program of scholarship/research and see them mature and begin to “pay it forward” as mentors to other newcomers and students.

Q: You also mentioned being interested in nursing leadership. What have you worked on in that field?

A: In 2007, my focus as a scholar and scientist shifted from clinical phenomena to higher education in nursing as I assumed roles in academic nursing administration and leadership.

As a chief academic nursing officer for 10 years at Rutgers University in Camden, NJ, I led the growth and development of a small, primitive department of nursing into a large, thriving school of nursing with world class facilities, nationally prominent faculty and excellent students.

With nursing dean colleagues from across the U.S., I produced a book, “Nursing Deans on Leading: Lessons for Novice and Aspiring Deans and Directors” (2020), a first-ever “field guide” to the landscape of higher education leadership for novice and aspiring deans and directors of academic nursing programs. Prior to our book, there was no practical field guide or handbook on the roles and responsibilities of nursing deans. A start-up manual, or “trail of breadcrumbs” was needed.

I am currently extending this work to focus on the health and well-being of nursing academic leaders, particularly deans, who are in extremely short supply due to high turnover and pipeline problems. In addition, I am currently working with Drs. Pat Kelly from Jefferson College of Nursing (JCN) and Sudha Raddi, Dean of the Institute of Nursing Science at India’s KLE Academy of Higher Education and Research, on a grant-funded faculty fellowship program designed to advance collaboration between JCN and KLE nursing faculty on research and scholarly projects that address unmet health and healthcare needs in India.

Q: What’s something you’re passionate about outside of your research?

A: Being a good mom to my 15-year-old son.

Q: Who’s a role model or someone who shaped your research journey? Is there a piece of advice that stuck with you or that you try to pass on to young researchers?

A: Two people come to mind. One is Mathy Mezey, EdD, RN, FAAN, a gerontological nurse extraordinaire and my original academic advisor in the nursing PhD program at the University of Pennsylvania. When I failed to meet the deadline for submission of my doctoral candidacy paper and was terrified that I would be tossed out of the program, Mathy put her hand on my shoulder and said, “Just keep going.” I remember this advice whenever I feel stuck or get bogged down.

The other is Susan Gennaro, PhD, RN, FAAN, a dean colleague, mentor, and distinguished nursing scholar and leader. During a discussion of the challenges of making time for writing, Susan told me to remember that writing and record-keeping are hallmarks of civilization. Neglecting to leave a paper trail deprives future generations of valuable lessons learned and accumulated wisdom. I remember this advice whenever I feel guilty about making time to reflect and write.

Q: What led you to Jefferson?

A: Jefferson’s values were a strong attraction: Put people first; Do the right thing; Be bold and think differently. Seeing leaders who walked the talk, such as Marie Marino, Steve Klasko and Mark Tykocinski was the deal-maker for me.