Room for improvement? Reporting response rates and recruitment in nursing research in the past decade

AIMS

This paper reports an analysis of recruitment and response rates in published nursing research in three peer reviewed nursing journals in 2002. We wished to establish if the deficits in reporting nursing research identified a decade earlier had been addressed.

BACKGROUND

This analysis was informed by our personal experiences of research which produced widely differing response rates. An examination of the literature revealed a lack of consensus on desirable response rates in nursing research. Previous analyses have shown deficits in describing participants, sampling methods and reporting recruitment.

METHODS

Papers reporting empirical research in three nursing journals in 2002 were reviewed in terms of a number of variables including research methodology, respondent type, recruitment method, response rate, location, and data collection method. Nominal coding was used as necessary. Data were analysed using the Statistical Package for Social Sciences and a variety of descriptive statistics were employed.

RESULTS

Half of the papers did not report a response rate. Of those which did, over three-quarters of both qualitative and quantitative studies had response rates of 60% or more. Research conducted in hospital and educational settings produced higher response rates than those in community settings. Studies with response rates of less than 60% did not always refer to their rates in the study limitations, and low response rates do not appear to be a barrier to publication.

CONCLUSION

Reporting of sampling, recruitment and response rates in nursing research must be improved to support nursings' claim to be an evidence-based profession and to underpin clinical governance requirements. Only through improvements in the quality of nursing research publications can knowledge be extended and a better-informed research community be created.

Information-seeking behavior of nursing students and clinical nurses: implications for health sciences librarians

OBJECTIVES

This research was conducted to provide new insights on clinical nurses' and nursing students' current use of health resources and libraries and deterrents to their retrieval of electronic clinical information, exploring implications from these findings for health sciences librarians.

METHODS

Questionnaires, interviews, and observations were used to collect data from twenty-five nursing students and twenty-five clinical nurses.

RESULTS

Nursing students and clinical nurses were most likely to rely on colleagues and books for medical information, while other resources they frequently cited included personal digital assistants, electronic journals and books, and drug representatives. Significantly more nursing students than clinical nurses used online databases, including CINAHL and PubMed, to locate health information, and nursing students were more likely than clinical nurses to report performing a database search at least one to five times a week.

CONCLUSIONS AND RECOMMENDATIONS

Nursing students made more use of all available resources and were better trained than clinical nurses, but both groups lacked database-searching skills. Participants were eager for more patient care information, more database training, and better computer skills; therefore, health sciences librarians have the opportunity to meet the nurses' information needs and improve nurses' clinical information-seeking behavior.

Research endeavors among pediatric nurse practitioners (REAP) study

INTRODUCTION

The purpose of this study was to identify the facilitators of and barriers to research utilization and to identify research activities and resources needed to promote research among pediatric nurse practitioners.

METHOD

A random sample of 10% of the NAPNAP membership (n = 627) was surveyed with a response rate of 69% (n = 431). The survey included the BARRIERS Scale to identify facilitators of and barriers to research utilization, questions about research activities, and resources needed to promote research.

RESULTS

Barriers to research included time constraints for reading and implementing research, the amount of research information and the way it is compiled, and knowledge deficits about statistical analysis interpretation. Facilitators of research utilization included having time to review and implement findings, authority to change nursing practice based on research findings, and conducting clinically relevant studies. Time constraints (82%), lack of grant writing skills (66%), and funding (57%) were identified as barriers to conducting research.

DISCUSSION

Findings from this study will be used by the National NAPNAP Research Committee to plan and implement programs to increase the utilization of nursing research in clinical practice and provide guidance, education, and support to promote involvement in research activities among the membership.

A survey of mental health nurses' opinion of barriers and supports for research

The need to demonstrate efficacy, efficiency and quality of practice through research is acknowledged in mental health nursing standards of practice. Yet the findings of a preliminary survey of two local District Health Boards (DHBs) shows that high workloads and lack of relief staffing appear as the greatest hurdles to mental health nurses participating in practice-based nursing research. A further constraint on their participation is lack of research expertise and experience. Consultative discussions with senior mental health nurses support these conclusions. In this paper mentoring and flexible research designs are promoted as possible ways of overcoming these barriers.

Military Nursing Research by Students at the Graduate School of Nursing Uniformed Services University of the Health Sciences

Military nursing research has had a long and productive history. Today, much of this research is conducted under two programs, the TriService Nursing Research Program and the Graduate School of Nursing (GSN), both located at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. This article will discuss the 150 military nursing research projects carried out by students at the GSN since its founding in 1992. Although most projects have been small in scope, they have obtained useful results. Some projects have served as the basis for larger-scale research studies, receiving funding from the TriService Nursing Research Program. Reports of all projects are available in an online database and some have been published in professional journals. This review concludes that the research produced by GSN students has been beneficial to students and to the military health system.

Trends in breastfeeding research by Brazilian nurses

Exclusive breastfeeding is acknowledged as important for survival, optimal growth, and development of infants. The current review presents a synthesis of research output by Brazilian nurses on breastfeeding over the last 20 years, analyzes the theoretical and methodological issues emerging from studies on breastfeeding in Brazil, and provides directions for future research and practice by nurses in the area breastfeeding. Studies included in this review were identified through LILACS searches of Portuguese-language sources. Articles were organized and analyzed chronologically by comparing the evolution of the Brazilian Breastfeeding Program. The incomplete research output of the Brazilian nursing profession in regard to breastfeeding research needs to be addressed. In addition, specific cultural, sociological, and anthropological characteristics of Brazilian regional settings remain to be explored. Emphasis on potential confounders and critical interrelations is warranted.

A review of spiritual and religious measures in nursing research journals: 1995-1999

BACKGROUND

A series of systematic reviews has revealed relatively high levels of interest in religion and spirituality in different nursing specialties, but not in general nursing research journals.

PURPOSE

To identify the extent to which spirituality and religiousness were measured in all quantitative and qualitative research articles published in Research in Nursing and Health, Nursing Research, Advances in Nursing Science (ANS), and Image: The Journal of Nursing Scholarship from 1995 to 1999.

METHODS

A full-text search was conducted of ANS and Image using the Ovid search system. Nursing Research and Research in Nursing and Health were hand searched for spiritual/religious measures. Characteristics of selected studies, the measures taken, and their uses were coded for data analysis.

RESULTS

A total of 564 research studies were identified, of which 67 (11.9%) included at least one measure of spirituality or religiousness. A significant difference was found between the percentage of qualitative and quantitative studies that contained measures of these concepts. Of the 119 qualitative studies, 23 (19.3%) contained a measure of religion or spirituality, compared to 44 of the 445 (9.9%) quantitative studies. Nominal indicators of religious affiliation were the most commonly used measures in the quantitative studies and measures of religion and spirituality were rarely used in the analyses. Although only a few quantitative or qualitative studies intended to focus on religion or spirituality, these themes often emerged spontaneously in the qualitative research.

CONCLUSIONS

Research in Nursing and Health, Advances in Nursing Science, Nursing Research, and Image: The Journal of Nursing Scholarship all published research measuring spirituality and religiousness during the time-period studies. The rate at which spirituality and religion appeared in these nursing research articles is substantially higher than that found in most fields outside of nursing. Even more frequent inclusion of spiritual and religious variables and richer measures of spirituality and religiousness would help to increase the available scientific information on the role of spirituality and religion in nursing care.

Why carve up your continuous data?

Continuous data are commonplace in social, biophysical, and health research. For various reasons, researchers often carve up data into ordered chunks. Such data carving results in less information being carried by the data, a reduction or spurious increase in statistical power, and resultant Type I or Type II errors. We give examples of data carving in selected nursing literature, and illustrate how unnecessary categorization can produce erroneous statistical results. Finally, we propose credible alternatives to data carving.

Handling missing data in self-report measures

Self-report measures are extensively used in nursing research. Data derived from such reports can be compromised by the problem of missing data. To help ensure accurate parameter estimates and valid research results, the problem of missing data needs to be appropriately addressed. However, a review of nursing research literature revealed that issues such as the extent and pattern of missingness, and the approach used to handle missing data are seldom reported. The purpose of this article is to provide researchers with a conceptual overview of the issues associated with missing data, procedures used in determining the pattern of missingness, and techniques for handling missing data. The article also highlights the advantages and disadvantages of these techniques, and makes distinctions between data that are missing at the item versus variable levels. Missing data handling techniques addressed in this article include deletion approaches, mean substitution, regression-based imputation, hot-deck imputation, multiple imputation, and maximum likelihood imputation.

Statistical presentation and analysis of ordinal data in nursing research

OBJECTIVES

The aim of this study was to review the presentation and analysis of ordinal data in three international nursing journals in 2003.

METHOD

In total, 166 full-length articles from the 2003 editions of Cancer Nursing, Scandinavian Journal of Caring Sciences and Nursing Research were reviewed for their use of ordinal data.

RESULTS

This review showed that ordinal scales were used in about a third of the articles. However, only about half of the articles that used ordinal data had appropriate data presentation and only about half of the analyses of the ordinal data were performed properly.

CONCLUSIONS

Ordinal data are rather common in nursing research, but a large share of the studies do not present/analyse the result properly. Incorrect presentation and analysis of the data may lead to bias and reduced ability to detect statistical differences or effects, resulting in misleading information. This highlights the importance of knowledge about data level, and underlying assumptions for the statistical tests must be considered to ensure correct presentation and analyses of data.

O gênero (in)visível da terceira idade no saber da enfermagem

Trata-se de um estudo bibliográfico, no qual realizou-se um levantamento da produção científica de enfermagem referente à Mulher na Terceira Idade no Catálogo de Dissertações e Teses do CD-room do Centro de Estudos e Pesquisas em Enfermagem(CEPEn) da Associação Brasileira de Enfermagem - ABEn no período de 1979 a 1999. Objetivou conhecer os afastamentos e/ou aproximações no saber de enfermagem com o objeto de estudo da tese de doutorado: os saberes e práticas de saúde das mulheres idosas, na perspectiva de gênero. Concluiu-se que a mulher na terceira idade foi investigada em poucos estudos, além do mais, os objetos destas investigações se afastaram fortemente das questões de gênero, demonstrando-se o aspecto assexuado da velhice, e negação dos papéis sociais da mulher.

Mapping the Field

BACKGROUND

Research utilization is the use of research to guide clinical practice. However, little is known about the characteristics of the research utilization literature in nursing, including the development and organization of this field of study. This article addresses the knowledge gap in this field of study by bibliometrically analyzing the research utilization literature in nursing.

OBJECTIVE

To map research utilization as a field of study in nursing using bibliometric methods, and to identify the structure of this scientific community, including the current network of researchers.

METHOD

A search of electronic and hard copy databases resulted in bibliographic data for 630 articles on research utilization in nursing published between 1972 and 2001. Bibliometric techniques used included a statistical analysis of publication counts, co-word analysis, and co-citation analysis.

RESULTS

The analyses showed a trend of increased productivity since the early 1990s. Most publications were authored by a single author, with no tendency toward increased collaboration over time. Most references cited in the articles were nursing references, indicating that there is very little flow into nursing from other fields. Only 4% of the references cited were actual research articles about research utilization, consistent with applied fields in which clinicians most commonly cite other clinicians. The 630 articles were published in a total of 194 different journals, with the Journal of Advanced Nursing identified as a key journal in the field.

CONCLUSIONS

According to the analysis, tremendous growth has occurred in the field of research utilization. However, the limited amount of collaborative research and the repeated citation of a few references indicate that the field is under-developed. The research utilization field would benefit from more substantive conceptual and empirical work, and more collaboration among emerging scholars.

[Nursing research in Brazil: the problem of knowledge creation]

This research analyses aspects from articles published over the last five years, in three nation-wide periodicals divulging the most part of Nursing knowledge produced; it identifies priviledged and silenced points, raising problems around the main issues in knowledge creation. We worked on 811 abstracts and their footnotes. Data were approached and organized in tables. Most researches are in the assistance area: themes around hospital subjects, such as child health, and some others not concerning the hospital field, such as women's health, HIV/AIDS, and Psychiatry and Mental Health Nursing; production is usually made by doctors and Postgraduate students, as public universities are the main locus for scientific production to receive financial support from Federal governmental organs.

A quantitative analysis of qualitative studies in clinical journals for the 2000 publishing year

Background

Quantitative studies are becoming more recognized as important to understanding health care with all of its richness and complexities. The purpose of this descriptive survey was to provide a quantitative evaluation of the qualitative studies published in 170 core clinical journals for 2000.

Methods

All identified studies that used qualitative methods were reviewed to ascertain which clinical journals publish qualitative studies and to extract research methods, content (persons and health care issues studied), and whether mixed methods (quantitative and qualitative methods) were used.

Results

60 330 articles were reviewed. 355 reports of original qualitative studies and 12 systematic review articles were identified in 48 journals. Most of the journals were in the discipline of nursing. Only 4 of the most highly cited health care journals, based on ISI Science Citation Index (SCI) Impact Factors, published qualitative studies. 37 of the 355 original reports used both qualitative and quantitative (mixed) methods. Patients and non-health care settings were the most common groups of people studied. Diseases and conditions were cancer, mental health, pregnancy and childbirth, and cerebrovascular disease with many other diseases and conditions represented. Phenomenology and grounded theory were commonly used; substantial ethnography was also present. No substantial differences were noted for content or methods when articles published in all disciplines were compared with articles published in nursing titles or when studies with mixed methods were compared with studies that included only qualitative methods.

Conclusions

The clinical literature includes many qualitative studies although they are often published in nursing journals or journals with low SCI Impact Factor journals. Many qualitative studies incorporate both qualitative and quantitative methods.

An improved methodology for advancing nursing research: factorial surveys

Clinical judgments and decisions are an integral component of nurse work and nurses are increasingly being challenged to account for their judgments and decisions. Nursing research is needed to help explain judgment and decision making in nursing, but most research in this area is almost exclusively characterized by descriptive studies. This article describes the use of the factorial survey method, which combines the explanatory power of a factorial experiment with the benefits of a sample survey. This hybrid technique is an excellent method for studying judgments and decisions across settings, roles, disciplines, and countries. This article outlines the steps of the method and demonstrates its applicability with an exemplar from a study across nurses from 3 countries.

International Content of High‐Ranking Nursing Journals in the Year 2000

PURPOSE

To evaluate the extent of an international perspective in publication in nursing journals.

DESIGN

Characteristics of 2,581 articles, authors of articles, and journals (editorial purpose and editorial team) of 42 high-ranking nursing journals for the year 2000 were analyzed.

METHODS

The characteristics were assessed using seven operational definitions of "international."

FINDINGS

Major findings were: (a) 747 (28.9%) articles were identified as international, of which (b) 705 (94.3%) were placed in the scholarly or empirical categories; (c) more articles were categorized as empirical in the international articles; more articles were categorized as scholarly among the noninternational articles; (d) 763 (79.3%) articles met an international definition based on author characteristics; and (e) 20 (47.6%) journals had international editorial teams.

CONCLUSIONS

Nearly 30% of articles had international content. Articles with international content were more frequently databased than were noninternational articles. The study provides a baseline indication of the extent of international perspectives in published articles in nursing journals. The extent to which these international articles make substantial contributions to knowledge has yet to be discovered.

A Delphi Study on Research Priorities for Emergency Nurses in Western Australia

INTRODUCTION

The Delphi Study on Research Priorities for Emergency Nurses in Western Australia Project was designed to allow emergency nurses to design research questions and then rank them in order of priority.

METHODS

A qualitative methodology allowed the researchers to determine expert opinions from the membership of the Emergency Nurses Association of Western Australia to reach a general consensus related to research questions.

RESULTS

The results placed nurse-initiated analgesia as the top research priority, with ED staffing issues in second place and ED violence issues in third place. In all, 25 research questions were developed and ranked according to priority.

DISCUSSION

Development of these ranked research questions enables researchers not only to pick a research question "off the shelf" but also to be assured that the research question is clinically relevant and is a priority for practicing emergency nurses. These attributes will encourage potential researchers to conduct studies, but they also underscore the importance of the topics for the benefit of those who fund studies.

ENA's Delphi Study on National Research Priorities for Emergency Nurses in the United States

INTRODUCTION

This study identified and prioritized research questions with greatest value to emergency nurses and of highest importance for health care consumers.

METHODS

Three hundred twenty emergency nursing leaders were invited to participate in 3 rounds of mailed surveys aimed at developing consensus. During round I, 147 nurses submitted 456 research problems. These problems were synthesized into 154 researchable questions, encompassing 17 themes. The round II questionnaire listed these questions in random order. Respondents used a 7-point Likert scale to rate each question's value for practicing nurses and importance for health care consumers. One hundred one nurses rated 106 questions >5.0. The round III questionnaire was individualized to provide each respondent's round II score and each item's median group score. Reflecting on these data, subjects again rated the 106 questions.

RESULTS

Seventy-nine nurses rated 16 questions 6.0 or greater for value for practicing nurses; 3 questions were rated 6.0 or greater for importance to consumers. Optimum staff to patient ratios, effects of mandatory overtime, holding admitted patients, and ED overcrowding, as well as effective strategies for educating and ensuring competence of nurses, were highest priority research problems for practicing nurses. Pain relief, impact of and methods of decreasing holding/lengthy ED stay, and effective strategies for patient teaching were judged most important for consumers.

DISCUSSION

Nurses' concerns with staff shortages and overcrowding of emergency departments and their effects on patients are paramount. Pain management and patient education were chief clinical issues requiring research. The mission of ENA is "to provide visionary leadership for emergency nursing and emergency care." This mission encompasses a number of values, including the following: "The discipline of emergency nursing includes a defined and evolving body of knowledge based on research."(1) In 1998, the ENA appointed vision councils to develop futuristic ideas to advance ENA's mission. The Research Vision Council proposed that ENA develop a center for emergency nursing research to provide leadership and focus for scientific approaches to the many issues that concern emergency nurses and their patients. The Board of Directors supported this idea by formulating a work group to develop the National Institute for Emergency Nursing Research. In 1999, the work group proposed that a study be conducted to determine national priorities for emergency nursing research. This article reports on the methods and results of a Delphi study conducted for that purpose.

An Infrastructure for Organizational Support of Research

Nurses are well suited to develop, implement, and disseminate research initiatives. However, most nurses need assistance to translate the idea behind the initiative into reality. This process requires resources and support. The authors outline one organization's infrastructure by which support is provided. Collaboration between a hospital-based research team and bedside nurses has produced a successful, funded program of research that has led to dissemination of findings.

Nurses' Research Activities and Barriers of Research Utilization

PURPOSE

This study was to describe nurses' research activities, perceptions and performances of evidence-based practice and barriers to the use of research evidence in nursing practice in Korea.

METHOD

A cross-sectional survey design was used. A questionnaire, except for Barriers Scale, was developed for the study. Data was collected from a convenient sample of 437 registered nurses working at research and education oriented university hospitals.

RESULT

Nurses' research-related activities were relatively low compared to previous studies. Also perceptions and performances of evidence based nursing practice were low. Preferred informational resources for clinical decision making were identified as ward manuals/clinical guidelines, manager/senior nurses, and literature/research. The major barriers to research utilization were a lack of implication for practice along with inadequate facilitation to implement research evidence and difficulty understanding research written in English. Priorities of barriers factor were Administrator, Communication, Adopter, and Research.

CONCLUSION

The findings provide directions for future training, education, and managerial policy to achieve successful evidence based nursing practice.

Latent Mean Structure Analysis: A Technique to Compare Group Differences in a Second-Order Quality of Life Model

The challenge in using conceptual models to measure multidimensional outcome concepts has been the inability to statistically compare group differences. An illustration of latent mean structure analysis using a second-order factor model representing quality of life is presented. Tests for the structure of the second-order factor model representing quality of life, and for its invariance across the 2 groups were based on the analysis of latent mean structures. Group means on the first-order factors could be compared and there were significant differences. Nursing researchers are often interested in studying theoretical constructs that cannot be measured directly. This analysis demonstrated a process by which means of a quality of life conceptual model could be compared between groups.

Pesquisas sobre qualidade de vida: revisão da produção científica das universidades públicas do Estado de São Paulo

Este estudo tem por objetivo analisar a produção científica sobre a temática qualidade de vida, produzida pelas universidades públicas do Estado de São Paulo. A metodologia escolhida foi estudo exploratório descritivo, com dados coletados através de bibliotecas virtuais das universidades escolhidas. A análise preliminar resultou em 84 pesquisas: 71,4% eram dissertações de mestrado, 23,8% teses de doutorado e 4,7% teses de livre-docência, produzidas entre 1993 e 2001. Desse total foram excluídos 31 estudos. Os 53 (100%) estudos restantes foram desenvolvidos com adultos de ambos os sexos (71,7%), portadores de algum tipo de patologia (69,8%) e que usaram instrumentos já existentes para a avaliação de qualidade de vida (77,3%). O instrumento mais utilizado foi o Medical Outcomes Studies 36-item Short-Form (MOS SF-36), encontrado em 18 (34%) dos estudos revisados.

Barriers to paediatric nurses' research utilization

BACKGROUND

A number of studies have investigated barriers to research utilization among nurses in various countries, and standardized scales have been validated to study this. Reported barriers have been categorized as individual, organizational and environmental, with organizational characteristics generally accounting for more variance. However, information about research utilization among paediatric nurses is lacking.

AIM

The objective of the research reported here was to investigate barriers to research utilization and relationships between those barriers and participation in research, self-reported research utilization and education among paediatric nurses.

DESIGN

A survey of all nurses in a paediatric teaching hospital; 176 nurses (33.3%) responded. Two standardized measures were used, the Barriers Scale and the Edmonton Research Orientation Scale.

RESULTS

Lack of time to read research was the most frequently cited barrier to using research and administrators not allowing implementation was the least frequently cited. Characteristics of the communication and of the setting were more likely to be cited as barriers to research use than were characteristics of the nurse. Nurses who reported higher levels of actual research use were slightly less likely to see characteristics within themselves as barriers. Those who had taken a course about reading or using research were more likely to see the organization as a barrier. Barriers to research use were not associated with self-reported understanding of research.

CONCLUSIONS

These results are congruent with previous findings that implementing research in practice is a complex process. They indicate that individual nurses' knowledge about research may not be as important as the process by which organizations implement research. However, the Barriers Scale measures general perceptions about barriers to research utilization and not nurses' specific experiences with barriers to implementing particular research.

Pesquisas em enfermagem e o perfil epidemiológico do nordeste

O estudo busca analisar a relação entre o perfil epidemiológico da região Nordeste e a produção científica do Programa de Pós-Graduação em Enfermagem/UFC, identificando as temáticas das teses/dissertações defendida e aprovadas(1995/julho,2001). Para atingir os objetivos, desenvolveu-se um estudo exploratório e descritivo cuja fonte primária foram os dados OPAS/OMS, os indicadores demográficos e sócio-econômicos e os IDB para 2000, que incidiram sobre a classificação das temáticas segundo o Esquema Categorial de Linhas de Pesquisa. Os resultados mostram a concentração da produção científica desse programa nas linhas de pesquisa Determinantes da qualidade de vida e saúde doença (71,3%) referentes a área assistencial e Tecnologia de Enfermagem (57,2) a área profissional, corroborando com as prioridades de indução à pesquisa do CNPq e fortalecendo o atendimento da demanda social. Sugere o incremento das pesquisas para a área de saúde da criança e do idoso e da violência para acompanhar as necessidades geradas pelo perfil epidemiológico gerado pela região Nordeste.

Using multilevel analysis in patient and organizational outcomes research

BACKGROUND

Outcomes research often compares patient and organizational outcomes across institutions, dealing with variables measured at different hierarchical levels. A traditional approach to analyzing multilevel data has been to aggregate individual-level variables at the institutional level.

OBJECTIVES

To introduce the conceptual and statistical background of multilevel analysis and provide an example of multilevel analysis that was used to examine the relationship between nurse staffing and patient outcome.

METHODS

A two-level model was presented employing multilevel logistic regression analysis.

RESULTS

Outputs from multilevel analysis were interpreted. Other statistics were presented for model specification and testing.

CONCLUSION

Researchers should consider multilevel modeling at the study design stage to select theoretically and statistically sound research methods.

Impact of nursing education in Slovenia on nurses' publishing in their professional journal

The paper discusses influences of developments in nursing education in Slovenia on the structure and contents of publications in the Slovene journal of the nursing profession--the Review of Nursing. Undergraduate nursing education in Slovenia changed from Associate Degree to Diploma level, while the B.S.N. type programme was of brief duration. Bibliometric data was gathered on all the scientific and technical papers published in the Review of Nursing between 1977 and 2001. Statistical analyses were carried out to study characteristics and inter-relations of authorship, cited references and contents. A positive impact of improved and extended education of nurses on quantity and quality of their publications has been confirmed. The paper is part of a larger study on nursing education in Slovenia and its relation to the works published in the Review of Nursing.

Midwifery research: the past, present and future

This paper examines midwifery research in light of the Research Assessment Exercise and explores the research undertaken in the UK during the last ten years. It compares midwifery and general practice research, as well as a transatlantic comparison as to the research output in the UK and US. It also presents an assessment of the impact of midwifery research.

[Nursing research on classifications: the Brazilian experience]

This is an evaluation of Brazilian scientific production on nursing classifications, presented during the 6th National Symposium on Nursing Diagnosis and 1st International Symposium on Nursing Classification, held in São Paulo city on August 2002. Four different types of research studies were identified being developed in the country, and the participation of Brazilian nurses at NANDA's last five biennial conferences was measured, as an indicator of this production.

At the millennium: a slice of scholarship

Scholarly output is the standard by which academics are judged; in particular journal articles. This study aimed to examine the scholarly output of nursing academics over a two-year period, and to establish benchmark data for future longitudinal comparisons. Journal articles were used as the unit of analysis. The following characteristics of articles were examined: whether articles were refereed or non-refereed; the type of journal; content characteristics; scholarly focus; predominant methodology of research articles; and predominant focus of specialty areas. The characteristics of principal authors and their effect on articles were also examined. The study demonstrated that while there had been no substantial increase in scholarly output, there was a clear link between higher academic rank and type of scholarly output. An increasing predominance of research articles was demonstrated, with a striking trend towards increased use of qualitative methodology, and in the number of publications by groups of authors.

The research potential of practice nurses

Little is known about the research aspirations and experiences of practice nurses. The study discussed in the present paper had three main aims: (1) to assess the level of research interest among practice nurses working in Essex and East London, UK; (2) to identify practice nurses' research priorities; and (3) to explore factors which facilitate and impede the development of practice nursing research. All practice nurses (n = 1,054) in the above areas were sent a questionnaire, and a total of 40% (n = 426) responded after two follow-up letters. Fifty-five respondents who volunteered for further participation were interviewed, either individually or in focus groups. About half (n = 207) of the survey respondents expressed an interest in undertaking research. One-third (n = 145) reported previous participation in research, and 20% (n = 85) had initiated their own research. Logistic regression showed that practice nurses educated to graduate level, and those working in practices with nurse training or participation in external research, were most likely to want to undertake research. Working in a medical training practice was found to be a negative predictor of research interest. Respondents prioritised research into long-term health problems with a high prevalence in the local population; for example, diabetes. Their reasons for wishing to engage in research included improving the service, career development, making work more interesting and reducing isolation. The main barriers identified were lack of time, lack of support from some general practitioners and poor access to higher education resources outside formal courses. The development of practice nurse research would provide a distinctive perspective on health need and service provision. It would contribute to the achievement of the national strategic objective of improving the quality of primary care, enhance the status of the profession, utilise the enthusiasm of individuals, increase job satisfaction and staff retention, and answer real questions.

[Multiple issues researched and to research in nursing]

The present study aims at analyzing topics of master's thesis and doctoral dissertations submitted to nursing graduate programs in Brazil from 1998 to 2000. The sample comprised abstracts of 337 thesis and 153 dissertations that were analyzed based on scheme category proposed by Carvalho (2000) to group nursing graduate scientific production. Results evidenced that research carried out addressed a great range of themes, comprehending all research lines of the three areas of the referred scheme. The Assistance and Organizational fields concentrated most of the production (45.0% and 38.8% respectively) and the Professional field relied on 16.2% of the studies. Based on the results, authors emphasize the need to bind together thematic-affinity projects in order to deepen studies and to move forward in the process of nursing knowledge construction.

Measuring the outputs of Australian nursing research published 1995-2000

AIMS

To analyse the research published in refereed nursing journals by Australian authors from 1995 to 2000.

BACKGROUND

Analysis of the research topics and types of methodologies used by Australian nurse researchers has not been recently undertaken. The study was similar to an analysis of United Kingdom (UK) nursing research between 1988 and 1995 to allow comparison between the two countries.

DESIGN

A quantitative approach analysed the research abstracts for the topic researched, source of data, location of data collection, paradigm and methodology used and funding source.

RESULTS

A total of 509 articles from 11 generalist Australian and UK nursing journals were analysed. The highest numbers of articles were published in Australian Journal of Advanced Nursing and Journal of Advanced Nursing. The most popular topics were education of nurses (18.7%, n=95) and practice issues relating to patient care (15.3%, n=78). However, scant attention was paid to major Australian health issues. Most research was undertaken in the hospital setting (55.8%, n=247). Data were most often drawn from nurses themselves (40.7%, n=206), followed by patients (25.5%, n=129). Both quantitative (41%, n=203) and qualitative approaches (47%, n=230) were employed. A minority of studies acknowledged any funding (14.9%, n=76).

CONCLUSIONS

Research findings need to be applied in practice to improve patient care. Nurse researchers need to publish their findings and align their research interests to meet national health priorities. They need to be involved in setting these health priorities to ensure that nursing has a place in health research.

Doctorial dissertations on nurse practitioners: 1970-2000

PURPOSE

To understand more about the nurse practitioner (NP) profession, a study was undertaken of the dissertation literature.

DATA SOURCES

A search of Dissertation Abstracts Online yielded 134 dissertations that included NPs in the title or abstract and were awarded between 1970 and 2000.

CONCLUSIONS

Most of the degrees are either PhD (61%) or EdD (27%). State-based universities produced the most degrees (70%) and six universities accounted for one-fourth of the degrees. The topics of NP-focused dissertations are wide ranging and include history, medical economics and managed care, NP education and professional role, and clinical and behavioral research.

IMPLICATIONS FOR PRACTICE

This dataset provides an important source of information for research on the NP profession.

Publication Syndicates: In Support of Nursing Scholarship

BACKGROUND

Within the university sector, one's corporate worth is, to a great extent, measured by research output, including refereed publications. Currently, only 7% of nurse academics publish each year. If nurses are to be competitive in the university arena and close the research-practice gap, they must be encouraged to publish.

METHOD

This article examines publication rates within nursing, explores the role publication syndicates can play in supporting manuscript development, and offers a case study on the development of a publication syndicate within a School of Nursing at Griffith University, Australia.

RESULTS

Syndicate members increased their publication rates two-fold, engaged in additional collaborative ventures, and demonstrated a renewed interest in writing for publication.

DISCUSSION

Case study results confirmed that publication syndicates can decrease manuscript development time, increase the quality of work, influence productivity, and support collaborative faculty activities.

Examining test-retest reliability: an intra-class correlation approach

BACKGROUND

There are limitations of inter-class correlation (usually, the Pearson's product-moment correlation) in evaluating reliability of an instrument. An intra-class correlation approach would be appropriate to examine the test-retest reliability of an instrument.

OBJECTIVES

To introduce an intra-class correlation approach to examine the test-retest reliability of an instrument.

METHOD

The method of constructing an intra-class correlation coefficient was presented.

RESULTS

The instrument with visual analog scales to measure the perceived competence to practice breast self-examination and perceived barriers to breast self-examination was tested. The intra-class correlation coefficient was 0.640.

CONCLUSION

The intra-class correlation is an alternative to test the reliability of an instrument and it is more sensitive to the detection of systematic error.

Assessing group change under conditions of anonymity and overlapping samples

BACKGROUND

A commonly used research design in the social sciences involves the matching of observations over 2 time periods (i.e., Time 1 --> Time 2) to assess group change. Because coupled observations are usually correlated, a paired- or dependent-samples t test is generally recommended in such applications to determine if there has been a statistically significant change in mean scores across time. Consequently, it is typically believed that unless information for matching respondents' observations is available, researchers have no choice but to treat the observations as if they were independent.

OBJECTIVES

To demonstrate alternative statistical approaches for employing the paired samples ttest when information for matching respondents' observations is unavailable and to illustrate the applicability of these alternatives to longitudinal designs in which respondents at Time 1 are partially replaced by new respondents at Time 2.

METHOD

Theoretical arguments and examples are employed to achieve the specified objectives.

RESULTS/DISCUSSION

Performing an independent-samples ttest when a paired-samples t test is more appropriate will lead to a loss of statistical power and, thus, increase the likelihood of a Type II statistical error. The statistical approaches that are demonstrated allow researchers to account for pair wise dependency across observations and, therefore, to obtain a fairer test of group change in means.

Research in Nurse Education Today: do we meet our aims and scope?

All issues of Nurse Education Today between January 1996 and July 2001 were examined manually and categorized as 'research' or other forms of scholarship. A total of 356 articles were reviewed and 193 of these were considered to be some form of research. The prevalence of well known methods of data collection was noted and broad trends identified. Questionnaires, reflective diaries, Delphi surveys, focus groups and individual interviews formed the backbone of methods used in educational research. There was a marked absence of experimental work. Proportionally more UK based papers avoided inferential analysis than those from overseas. We show that 'research' in Nurse Education Today has become rather narrow. It rarely incorporates 'user' (client/patient) perspectives, and rarely (especially in the UK) uses more than one site for study. More papers which undertake comparison of nurse education between countries, which employ samples from more than one country, and which address the impact of findings from an international perspective should be sought in order to enhance this aspect of the diversity of the journal.

Handling missing data in nursing research with multiple imputation

BACKGROUND

In the data analysis phase of research, missing values present a challenge to nurse investigators. Common approaches for addressing missing data generally include complete-case analysis, available-case analysis, and single-value imputation methods. These methods have been the subject of increasing criticism with respect to their tendency to underestimate standard errors, overstate statistical significance, and introduce bias.

OBJECTIVES

This article reviews the limitations of standard approaches for handling missing data, and suggests multiple imputation is a useful method for nursing research.

METHOD

Secondary analysis was conducted to examine the effect of a public policy on the health of women using a data set that had a large degree and complex patterns of missing data.

DISCUSSION

In the example, accommodation of the incomplete data was critical to making valid inferences; however, complete-case, available-case, or single imputation could not be defended as an adequate method for dealing with the missing data patterns. Alternative methods for dealing with incomplete data were sought, and a multiple imputation approach was selected given the missing data pattern. Nurse researchers confronting similar complex patterns of missing data may find multiple imputation a useful procedure for conducting data analysis and avoiding the bias associated with other methods of handling missing data.

A feminist critique of research on cancer pain

A number of studies on cancer pain have been conducted but the researchers rarely considered gender and ethnic differences in cancer pain. In this article, nursing research on cancer pain is critiqued from a feminist perspective, and directions for future nursing research are proposed. A total of 82 nursing articles published in the United States were retrieved through MEDLINE and MELVYL data retrieval systems, and analyzed and critiqued in terms of four basic elements of research from a feminist perspective (bias as resources, dependability, credibility and adequacy, and intersubjectivity). In this article, the critique is presented with four themes that may provide reasons why nursing research on cancer pain rarely incorporated gender and ethnic differences: absence of participants' own views and experiences, androcentrism and ethnocentrism, lack of consideration on contextual factors, and distant relationships between researchers and research participants. To overcome the limitations, six critical elements including gender and ethnic sensitivity, avoidance of distorted views, respectfor participants' own views and interests, trust and openness, empowerment, and multiple methods are suggested to be incorporated in future nursing research on cancer pain.