Nurses' perceptions of the barriers to and the facilitators of research utilization in Turkey

Construct validity and reliability of the BARRIERS scale in the Spanish context

OBJECTIVE

To establish the construct validity of the Spanish version of the BARRIERS scale.

METHOD

Methodological study of validation of a measurement instrument based on data from previously published studies. The study population consisted of nurses from the Basque Health Service and the Canary Health Service. The following variables were extracted and unified: Years of professional experience, possession of a specialist nursing degree, possession of a doctorate, type of activity performed by the professional and field of work. For construct validation, a confirmatory factor analysis (CFA) was performed based on the initial model proposed for the scale and RASCH analysis. A polychoric correlation matrix, factor extraction by unweighted least squares and PROMIN oblique rotation were used. For the RASCH analysis, the Joint Maximun Likelihood estimation (JMLE) method was used; the fit of the items and persons were estimated by means of outfit - Unweighted Mean Square fit statistic (UMS) and infit -Weighted Mean Square Fit Statistic (WMS), as well as the reliability and separation of items and persons.

RESULTS

A total of 1200 nurses and midwives made up the final validation sample (n = 1200), with a mean professional experience of 21.22 ± 9.26 years. The CFA presented a good fit to the data (KMO = 0.935 [95% CI: 0.921-0.945]), changing the factorial assignment in 6 items, while 5 items received factorial scores in more than one factor. The fit values for the 4-factor solution were RMSEA = 0.026 [95% CI: 0.026-0.027] and GFI = 0.991 [95% CI: 0.986-0.991]. In the RASCH analysis most items presented infit-WMS and outfit-UMS values with a good fit.

CONCLUSIONS

The Spanish version of the BARRIERS scale has adequate construct validity although there are changes in the assignment of items to the dimensions compared to the original model. The RASCH analysis indicates adequate fit for both persons and items.

Nurses' Experiences as Care Providers for Syrian Refugees With Noncommunicable Diseases: A Qualitative Study

INTRODUCTION

Noncommunicable diseases (NCDs) are the leading cause of disability and death in the world. In Syria, the incidence of NCDs in refugees is 45%. Cardiovascular diseases, cancers, chronic respiratory diseases, diabetes, and other NCDs are the most common causes of morbidity in Syria. Nurses have challenges caring for Syrian refugees with NCDs. The purpose of the study was to explore nurses' experiences of caring for Syrian refugees with NCDs in Turkey.

METHODOLOGY

A phenomenology design was used. Inclusion criteria were nurses working experience of more than 1 year, caring for Syrian refugees with NCDs, and willingness and ability to participate in an individual interview. The participants were 20 nurses who worked with Syrian refugees at a public hospital in Kilis Province the border with Syria. Data were collected using semistructured interviews and analyzed by the thematic analysis method of Braun and Clarke.

RESULTS

Three major themes and six subthemes were identified. Major themes included the communication experience, cultural differences, and Syrian refugees' lack of knowledge about NCDs.

DISCUSSION

The results provide insight related to nursing care in Turkey for Syrian refugees with NCDs. The study revealed that nurses encountered challenges when caring for Syrian refugees with NCDs. Culturally competent assessment and interventions for refugees with NCDs should be encouraged considering these three themes.

Barriers to Research Utilization in Nursing: A Systematic Review (2002–2021)

Introduction

There is an existing gap between what people learned from theory and what they clinically practiced, as revealed in research studies in nursing. This gap is primarily due to identified barriers in utilizing the research findings in actual nursing practice.

Objective

To present a scientific mapping of the Scopus-indexed literature published from 2002 to 2021, which studied barriers to research utilization in nursing using the BARRIER scale.

Methods

This systematic review utilized bibliometric analysis. One hundred seventy-nine extracted literature from Scopus was manually reviewed, and the study included 53 documents for further analysis.

Results

Remarkably, almost three-fourths of the documents identified setting-related factors as the most common barrier to research utilization in nursing (n = 39, 73.58%). This is followed by presentation-related factors (n = 16.98%) and nurse-related factors (n = 5, 9.43%), respectively. Findings revealed that insufficient time at work in implementing new ideas was perceived as the top barrier in research utilization in nursing.

Conclusion

It is crucial to determine the hindrances to the utilization of research findings. The results of this study establish the connection between research and evidence-based practice which stimulates in meeting the gap in the current nursing practice. Future studies must include research utilization studies that apply tools other than the BARRIER scale.

Adaptation and validation of the Barriers to Research Utilization (BARRIERS scale) questionnaire among Polish nurses and midwives: Cross-sectional study

AIM

The study was designed to assess a Polish version of the Barriers to Research Utilization (BRU) scale for reliability and validity, in a group of nurses and midwives.

BACKGROUND

The implementation of Evidence-Based in practice is a key element of care and the use of research requirements the research awareness of nurses.

METHODS

In 2018, cross-sectional validation was carried out among nurses and midwives qualified for the project.

RESULTS

The Cronbach alpha internal consistency index and mean correlations between items for each of the five subscales comprised in the BRU Instrument were satisfactory. The regression weights show that the items fit well with the subscales and there are no deviations from it.

CONCLUSIONS

We should the right tools to assess research awareness and be able to identify barriers. Knowing them will allow us to implement preventative measures and allow us to plan our activities.

Identifying international barriers and facilitators to research utilization

PURPOSE

To define research utilization (RU) and identify barriers and facilitators to RU in nursing practice.

METHODS

An international integrative review of 42 studies was conducted related to barriers and facilitators of RU.

RESULTS

Following a review of the research that met the inclusion criteria, the author identifies common themes related to the implementation of research into clinical practice and the challenges surrounding RU.

CONCLUSION

Despite consistently perceived barriers to research among nurses from different geographic, cultural, and clinical backgrounds, practice changes are typically out of their hands. Further research is necessary to gauge perception among the nursing associations, regulatory bodies, healthcare organizations, policy makers, and managers responsible for implementing these changes.

Knowledge implementation in health care management: a qualitative study

Background

The gap between knowledge and practice is a global issue, which increases wasteful spending in healthcare. There are several models and frameworks to address this gap and try to solve the challenge. Promoting Action on Research Implementation in Health Services (PARIHS) framework highlights the interaction of three main elements: evidence, context and facilitation, to implement research into practice, successfully. This framework can use as a tool to evaluate the situation and guide the changing. This study conducted to explain the status of knowledge implementation in Iran’s healthcare management system.

Methods

This qualitative study was done by using a directive content analysis approach through conducting in-depth, structured interviews with 15 health managers based on the PARIHS framework. Guiding questions were based on the three main elements of the framework: evidence, context and facilitation. The content of the interviews entered into the Qualitative Data Analysis software (MAXQDA version 10) and, then, analyzed.

Results

The most common source of evidence used by managers for decision-making was local information and previous experience. Evaluation more emphasized compared to other sub-elements of context, i.e. culture and leadership. In terms of facilitation, performing tasks by others was the dominant opinion.

Conclusion

Our results showed that managers in the healthcare system of Iran use their own and other manager’s experience and the local information for decision-making and have no ideas about facilitation.

Obstacles in employing evidence-based practice by nurses in their clinical settings: a descriptive study

Objective

The challenge of employing evidence-based practice (EBP) is multifarious and varied. Nursing interventions supported by research evidence have been exposed to progress positive patient outcomes, while its implementation is faced with various obstacles. This study aimed to identify obstacles in employing EBP by nurses in their clinical settings.

Methods

This descriptive design study was conducted at Benha University Hospital with a convenient sample of 154 nurses. Two tools were utilized: (I) sociodemographic data sheet, which included sociodemographic characteristics of the participants, and (II) interview scale, which contained two parts: (1) obstacles scale, which contained obstacles that impede nurses from the utilization of EBP, and (2) questions to rank the three greatest obstacles in employing EBP by nurses.

Results

The greatest EBP obstacle ranked by nurses was the organizational limitations (90.9%), followed by research quality (86.9%) and research accessibility (51.0%), while individual characteristics (35.9%) were ranked as the least obstacle. There was a significant statistical correlation between organizational limitations, research quality as well accessibility-related obstacles and nurses’ age, level of education, as well their years of work experience (P<0.05).

Conclusions

Findings of this study showed series of obstacles in employing EBP by nurses in their clinical settings, stressing the call for expansion of nurses’ capabilities related to EBP utilization in patients’ care.

Research is not a ‘scary’ word: Registered nurses and the barriers to research utilisation

The aim of this study was to find out whether registered nurses read research articles, understand them and translate the research to practice. There is a problem with research knowledge translation in the clinical setting. Despite exposure to research, registered nurses often distance themselves from reading nursing research. A point-prevalence survey was conducted on a sample of registered nurses in a peripheral hospital in Western Australia. The survey was distributed to all wards of the hospital ( n = 7). One-hundred and five ( n = 105) registered nurses were eligible to participate. Ninety-five ( n = 95) completed and the survey. The survey consisted of 11 general questions and an open-ended question. The majority of registered nurses in clinical practice found research articles difficult to understand because of research jargon. Most indicated that they sometimes or never understood what they are reading. Almost all nurses revealed that if research articles were in a ‘simpler’ language they would read them more and apply what they had learned. Promoting a common, user-friendly language in a research abstract or summary which is targeted to the registered nurse audience may assist in finding a common knowledge exchange between researchers and nurses and so help bridge the gap between research and practice.

Awareness and attitudes of Turkish nursing students towards research and development in nursing

BACKGROUND

The research course in nursing is included in almost all nursing curricula in national and international scales.

PURPOSE

To compare awareness and attitudes of Turkish nursing students towards research and development in nursing.

METHODS

This study had descriptive and cross-sectional research design. The research sampling is consisted of 390 senior students studying during the 2013-2014 academic year in six schools of health in six different geographical regions in Turkey. The Personal Identification Form and Nursing Students' Attitudes to and Awareness of Research and Development within Nursing Scale were utilized in data collection.

RESULTS

It was determined that there is difference between awareness and attitude scores of nursing students from six different schools towards research and development in nursing according to their schools and background.

CONCLUSION

It can be suggested that initiatives to increase awareness of students at nursing schools towards research course must be planned.

Developing a tool that explores factors influencing the adoption of evidence-based principles in nursing practice in Jordan

AIM

To measure the psychometric properties, reliability and validity of a tool that explores factors influencing the adoption of principles of evidence-based in nursing practice in Jordan.

BACKGROUND

The use of principles of evidenced-based practice in nursing practice has been widely endorsed in many countries around the world; these principles have not yet been implemented in Jordan. Factors influencing the adoption of evidence-based practice in Jordanian nursing context were not identified to date.

METHODS

A descriptive, cross-sectional research design approached experienced nurses from different specialties across Jordan (3 military, 3 governmental and 5 private hospitals).

RESULTS

The psychometric properties indicated a valid and reliable tool. It consisted of three factors: personal characteristics; source of professional knowledge; and organizational environment.

CONCLUSIONS

Findings provided evidence on the impact of the identified factors on nurses' adoption of evidence-based practice. Although tests in this report showed the validity of this new tool, it still requires further testing to ensure its stability over time.

Research Utilization among Nurses at a Teaching Hospital in Kenya

INTRODUCTION

In the era of evidence based practice (EBP), health care delivery should be grounded on new or validated knowledge and evidence from research. The aim of the study was to assess research utilization by nurses and the influencing factors at Kenyatta National Hospital (KNH), the largest teaching hospital in Kenya.

METHODS

The study employed a descriptive design that utilized both quantitative and qualitative methods of data collection. It incorporated the Barriers to Research Utilization Scale. It was conducted in six specialized care areas at KNH. Data was collected using questionnaires, Focus Group Discussion and in-depth interviews. Data was analyzed using SPSS version 13 and qualitative data analyzed using themes.

RESULTS

The study found that 20.6% of the nurses were participating in research related to their work and 53.6% of these were implementing research findings to practice. Over 2/3 (70.5%) of the respondents were basing their evidence for practice on the knowledge gained during their nursing school. The three greatest barriers to research utilization were that research reports are not readily available (68.7%), unclear implications for practice (66.5%) and inadequate facilities for implementation (66.4%).

CONCLUSION

It is recommended that sensitization trainings on nursing research/ utilization of findings in nursing practice be established to create awareness, motivate and enhance nurses' abilities and also facilities should be provided to enable implementation.

A Descriptive Study on Registered Nurses' Continuing Educational Needs in Research from Three Different Health Care Institutes in Singapore

Introduction:

Nurses are encouraged to engage in research activities in order to stay abreast with the current nursing practice. However, limited knowledge about the research process may influence their level of involvement and utilisation of research in their daily nursing practices. This study examines Singapore nurses' perceived knowledge and educational needs in research as well as to explore their preferred mode and duration of education delivery.

Methods:

This is a multi-site, cross-sectional study that recruited 2248 registered nurses working in Singapore. A self-administered tool was used to examine nurses' perceived knowledge and educational needs in research. Descriptive statistics were used to present the nurses' demographic data; the Kruskal-Wallis and chi-square tests were used to examine the relationship between the nurses' education level and their perceived knowledge and educational needs in research.

Results:

Nurses in this study perceived low levels of knowledge in research. Majority of those who were involved in research activities had a bachelor's degree. There were statistically significant differences between education level and perceived knowledge (p=0.001). However, there was no significant difference between education level and perceived educational needs. Younger nurses (19–35 years old) preferred shorter duration when attending workshops compared to older nurses (36 years old and above). Skill-based workshop and tutorial or seminar that last no longer than a week was the most preferred educational mode and duration.

Conclusion:

Nurses with high level of education perceived a higher level of research knowledge and thus reported lower educational needs in research. The results showed the need for continual training programs, even for nurses with bachelor's and master's degrees, in order to better prepare them for evidence-based practice. Understanding the demographic of the nurses and their learning styles is important when devising strategies to teach research.

Barriers to and Facilitators of Research Utilization among Iranian Nurses: a Literature Review

INTRODUCTION

Research utilization (RU), is an important strategy to promote the quality of patient care. The aim of this study was to present a comprehensive literature review describing barriers and facilitators of RU among Iranian nurses.

METHODS

Literature review was undertaken using the international databases including Pub Med/Medline, Scopus, Science Direct, and Google Scholar. Also, Persian electronic databases such as Magiran, SID and Iran Medex were searched up to May 2014. The search was limited to articles in the English and Persian languages that evaluate the barriers or facilitators of RU among Iranian nurses.

RESULTS

A total of 11 articles were in the final dataset. The most important barriers to RU among Iranian nurses were related to the organization factors such as inadequate facilities; insufficient time on the job, lack of authority, physician cooperation, and administrative support. The most frequent facilitators of RU were education in enhancing nurses knowledge and skills in research evaluation, support from knowledgeable nursing colleagues and nursing faculty in the clinical setting, access to an expert committee for clinical appraisal, improving skills in English language and searching for articles, sufficient economic resources to carry out research, and having access to more facilities such as internet.

CONCLUSION

Iranian nurses encounter with the same difficulties as to other countries regarding RU; while setting related barriers were the predominant obstacles to RU among them. Therefore, health managers are expected to plan appropriate strategies to smooth the progress of RU by nurses in their practice.

Undergraduate Nursing Students’ Research Activities and Utilization: A Turkish Sample

Objetivo: analizar el estado de la investigación en salud en Colombia, Ecuador y en Latinoamérica; sus implicaciones, la importancia de esta para tratar de impactar en políticas y estrategias de salud que mejoren el nivel de vida de las poblaciones y los asentamientos urbanos. Método: se realizó una revisión de la literatura en las bases de datos latinoamericanas Scielo, Redalyc, Bireme y Pubmed en los últimos 8 años. Resultados: se evidencia la trascendencia de las universidades como instituciones, que tienen la obligación de influir en lo social, lo humano y lo cultural, y transformen en entornos ligados a programas sociales y de gobierno en pro de una comunidad. Igualmente, se hace un análisis de las políticas de investigación, de organismos rectores y sus implicaciones en las instituciones formadoras de recurso humano a nivel superior. Conclusiones: es necesario fortalecer la reflexión crítica en los espacios académicos comprometidos con la transformación de las condiciones colectivas de la comunidad en los procesos de salud, enfermedad, promoción, prevención y atención, que tocan los hilos de la conciencia, afirmando que el individuo y la colectividad son responsables de “cuidar su salud”, mediante el abordaje transdisciplinario, teniendo en cuenta la normatividad ética que rige las investigaciones; fortaleciéndola mediante la consolidación de redes, divulgando los hallazgos.

Evidence-based practice: a survey among pediatric nurses and pediatricians

This survey compared the attitude, awareness, and knowledge of pediatric nurses and pediatricians regarding evidence-based practice (EBP). Potential barriers were also investigated. Both nurses and pediatricians welcomed EBP (mean scores are 73.3 and 75.4 out of 100). Overall, 52% of the nurses and 36% of the pediatricians did not know relevant sources of information, and 62% of the nurses versus 19% of the pediatricians did not know common EBP terms. Time constraints and lack of knowledge were considered as major barriers. Recommendations include multilevel training and continuous exchange of information.

Leading Change and Advancing Health by Enhancing Nurses' and Midwives' Knowledge, Ability and Confidence to Conduct Research through a Clinical Scholar Program in Western Australia

This paper reports on an evaluation of a Clinical Scholar Program initiated at a hospital in Western Australia. The aim of the program was to build the capacity of nurses and midwives to conduct research and evidence-based practice within the hospital. The program was based on a previous program and consisted of six teaching days and four hours per month release for proposal preparation. At the end of the program participants were asked to complete a short anonymous questionnaire. The answers were analysed using standard processes of qualitative analysis. Themes emerging from the data included program strengths, individual gains, ability to conduct research, and areas for improvement. The findings highlighted that, while the participants considered that they were more knowledgeable and confident to conduct research, they still required support. The Clinical Scholar Program has provided a way to increase the capacity of clinicians to participate in research activities.

Nurses' perceptions of online continuing education

BACKGROUND

There is increasing attention to online learning as a convenient way of getting professional training. The number and popularity of online nursing continuing education programs are increasing rapidly in many countries. Understanding these may contribute to designing these programs to maximize success. Also, knowing the perceptions and preferences in online learning aids development and orientation of online programs. The aims of this study are to show nurses' perceptions of online continuing education and to determine perceptions of various groups; area groups, working companies, frequency of computer usage and age.

METHODS

The survey method was used in this quantitative study to reveal perception levels and relationship with related variables. Data were collected through an online instrument from a convenience sample of 1041 Registered Nurses (RNs) at an online bachelor's degree program. Descriptive and inferential analysis techniques were performed.

RESULTS

Nurses generally have positive perceptions about online learning (X = 3.86; SD = 0.48). A significant difference was seen between nurses who used computers least and those with the highest computer usage [F (3, 1033) = 3.040; P < .05]. Neither nurses' ages nor lengths of working experience are significantly related to perceptions of online programs (r = -.013; P > .05 and r = -.036; P > .05, respectively). Nurses' perceptions are significantly different depending on the settings where they work [F (3,989) = 3.193; P < .05]. The difference between perceptions of nurses living in urban areas (X = 3.82; SD = .51) and those living in rural areas (X = 3.88; SD = .47) was not significant [t (994) = -1.570, P > .05].

CONCLUSIONS

We found that nurses regard online learning opportunities as suitable for their working conditions and needs. Nurses should be provided with continued training through online learning alternatives, regardless of age, working experience or area of residence.

Evidence-Based Practice Among Nurses in Italy

A cross-sectional survey was conducted among a random sample of 449 nurses in Italy, using a self-administered questionnaire to assess knowledge, attitudes, and behaviors regarding evidence-based practice (EBP). A significantly higher level of knowledge was observed among nurses who (a) did not work in medical and surgical wards; (b) believed that the evaluation of the efficacy of the health interventions is needed in their activity; (c) believed that the clinical experience must be combined with the evidence; (d) attended a course about EBP in the last year; and (e) received information from courses and scientific journals. The perceived importance of the application of guidelines and protocols was significantly higher among nurses who (a) worked in medical wards; (b) agreed that the guidelines are useful in identifying and selecting interventions; (c) believed that the evaluation of the efficacy of the health interventions is needed in their activity; (d) believed that the clinical experience must be combined with the evidence; (e) attended a course about EBP in the last year; and (f) received information from courses and scientific journals. Nurses were more likely to have modified their practice in the last year if they attended a course about EBP in the last year and if they often/always read scientific journals and guidelines. While these data were cross-sectional and the response rate was only 49%, the results suggest that continuing education programs are needed for improving nurses’ knowledge and practice of EBP among nurses in Italy.

The BARRIERS scale -- the barriers to research utilization scale: A systematic review

Background

A commonly recommended strategy for increasing research use in clinical practice is to identify barriers to change and then tailor interventions to overcome the identified barriers. In nursing, the BARRIERS scale has been used extensively to identify barriers to research utilization.

Aim and objectives

The aim of this systematic review was to examine the state of knowledge resulting from use of the BARRIERS scale and to make recommendations about future use of the scale. The following objectives were addressed: To examine how the scale has been modified, to examine its psychometric properties, to determine the main barriers (and whether they varied over time and geographic locations), and to identify associations between nurses' reported barriers and reported research use.

Methods

Medline (1991 to September 2009) and CINHAL (1991 to September 2009) were searched for published research, and ProQuest^® digital dissertations were searched for unpublished dissertations using the BARRIERS scale. Inclusion criteria were: studies using the BARRIERS scale in its entirety and where the sample was nurses. Two authors independently assessed the study quality and extracted the data. Descriptive and inferential statistics were used.

Results

Sixty-three studies were included, with most using a cross-sectional design. Not one study used the scale for tailoring interventions to overcome identified barriers. The main barriers reported were related to the setting, and the presentation of research findings. Overall, identified barriers were consistent over time and across geographic locations, despite varying sample size, response rate, study setting, and assessment of study quality. Few studies reported associations between reported research use and perceptions of barriers to research utilization.

Conclusions

The BARRIERS scale is a nonspecific tool for identifying general barriers to research utilization. The scale is reliable as reflected in assessments of internal consistency. The validity of the scale, however, is doubtful. There is no evidence that it is a useful tool for planning implementation interventions. We recommend that no further descriptive studies using the BARRIERS scale be undertaken. Barriers need to be measured specific to the particular context of implementation and the intended evidence to be implemented.