Barreras para la utilización de la investigación. Estudio descriptivo en profesionales de enfermería de la práctica clínica y en investigadores activos

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.

Attitudes, capacities and perceived barriers in research of nurses of the Canary Health Service

OBJECTIVE

To evaluate the attitudes, capacities and perceived barriers associated with research among nurses and midwives of the Canary Health Service (SCS).

METHODS

Descriptive observational cross-sectional study with an analytical component carried out in the different SCS departments by means of an online survey in which sociodemographic and specific variables, the Spanish version of the Attitudes towards Research and Development within Nursing Questionnaire (ATRDNQ-e) instrument and the BARRIERS scale were collected. Authorisation was obtained from the two provincial ethics committees. A descriptive and inferential analysis (Mann-Whitney U test and Kruskal-Wallis test, post hoc contrast by Dwass-Steel-Critchlow-Fligne test) was performed with JAMOVI® v.2.3.24 software.

RESULTS

A total of 512 nurses and midwives with a mean age of 41.82 years participated in the study. Regarding the scores with the ATRDNQ-e instrument, the dimension with the lowest score was «Language of research» (mean = 3.55/SD = 0.84) and the highest «Assessment of nursing research and development of the nursing discipline» (mean = 4.54/SD = 0.52). The total mean score with the BARRIERS scale was 54.33 (SD = 16.52), with «Organizational characteristics» being the highest scoring subscale (mean = 17.25/SD = 5.90). The two highest perceived barriers were «Not enough time at work to implement new ideas» (mean = 2.55/SD = 1.11) and «Nursing does not have time to read research» (mean = 2.46/ SD = 1.11).

CONCLUSIONS

SCS nurses have a positive attitude towards research, although there are some barriers where improvement actions for nursing research should be implemented.

Evaluación de la dimensión científico-clínica del cuidado en el personal de enfermería

La evaluación de la dimensión científico-clínica del cuidado de enfermería basado en el modelo HANC en la Unidad de Cuidado Intensivo (VDCC-UCI) permitió medir la calidad del cuidado en los procesos de atención de enfermería en la Unidad de Cuidado Intensivo. Objetivo: Describir la dimensión científico-clínica del cuidado de enfermería en la Unidad de Cuidado Intensivo, comparando entre enfermeras de instituciones públicas y privadas. Método: Estudio descriptivo de tipo transversal realizado entre de julio y diciembre de 2019. Participaron 186 enfermeros que trabajan en la Unidad de Cuidado Intensivo de instituciones públicas y privadas del país. Los datos fueron recolectados con el instrumento de la dimensión científico-clínica. Resultados: Los participantes, en su mayoría mujeres (74 %) y hombres (48 %), contaban con una especialización (75 %) y con experiencia profesional más de diez años; el tipo de contratación más común fue el de término indefinido. Se encontraron diferencias estadísticamente significativas en 18 de los 46 ítems entre las respuestas de enfermeras de instituciones públicas en comparación con las de instituciones privadas. Conclusiones: La evaluación de la dimensión científico-clínica mostró que algunas etapas del proceso de atención de enfermería se llevan a cabo de manera más rigurosa y completa por parte de las enfermeras de instituciones privadas, mientras las etapas del proceso administrativo e investigativo implementadas por enfermeras de entidades públicas y privadas son similares.  

Barriers and Facilitators Perceived by Spanish Experts Concerning Nursing Research: A Delphi Study

The identification of research priorities in line with current health needs and nursing competencies is a priority. Nevertheless, barriers and facilitators perceived by nurses to performing nursing research have scarcely been investigated. The main aim of this study was to explore the situation in nursing research in Spain, as perceived by Spanish experts. A Delphi study technique in two phases was applied using an online survey tool. A panel of 20 nursing experts in nursing, teaching and management positions participated. The strengths highlighted were the possibility of reaching the PhD level, the possibility of receiving continuous training in research methodology, and access to scientific knowledge through the Internet. The weaknesses identified were the lack of Spanish nursing journals in which to publish the research results, the lack of funding in nursing care research, and the lack of connection between the healthcare institutions and the university. According to the experts, elements that could enhance leadership in research are the creation of nursing research units in hospitals, the economic recognition of nurses with PhDs, and considering research work as part of their daily tasks in clinical settings. The idea of being subordinated to physicians still remains in nurses’ ways of thinking.

Barriers to the implementation of research perceived by nurses from Osakidetza

OBJECTIVE

To understand the barriers to implementing nursing research findings into practice, as perceived by the nurses working in Osakidetza and to analyze if the workplace factor and time worked affect the perception of these barriers.

METHODS

Cross-sectional study. BARRIERS Scale questionnaire was given to a representative sample of 1,572 Basque Health Service nurses, stratified and randomized, according to scope of work and job responsibility (response rate: 43.76%).

RESULTS

According to the research results, the first important barrier was "insufficient time on the job to implement new ideas". Nurses have perceived the organizational factor as the most important barrier in their practice. Nurses in "Special hospital departments" perceived more barriers in the "quality of research" factor than those working in "Primary Care". Years of service showed a slight influence.

CONCLUSIONS

The nurses stated that external factors related to the organization principally interfered in implementing results into clinical practice. They placed lack of critical reading training second. Working environment and seniority mark differences in the perception of barriers. This study may help to develop strategies for planning training programs to facilitate the use of research in clinical practice, in order to provide quality care.

Cultural adaptation and validation of an instrument on barriers for the use of research results

Objective

to culturally adapt The Barriers to Research Utilization Scale and to analyze the metric validity and reliability properties of its Brazilian Portuguese version.

Method

methodological research conducted by means of the cultural adaptation process (translation and back-translation), face and content validity, construct validity (dimensionality and known groups) and reliability analysis (internal consistency and test-retest). The sample consisted of 335 nurses, of whom 43 participated in the retest phase.

Results

the validity of the adapted version of the instrument was confirmed. The scale investigates the barriers for the use of the research results in clinical practice. Confirmatory factorial analysis demonstrated that the Brazilian Portuguese version of the instrument is adequately adjusted to the dimensional structure the scale authors originally proposed. Statistically significant differences were observed among the nurses holding a Master's or Doctoral degree, with characteristics favorable to Evidence-Based Practice, and working at an institution with an organizational cultural that targets this approach. The reliability showed a strong correlation (r ranging between 0.77 and 0.84, p<0.001) and the internal consistency was adequate (Cronbach's alpha ranging between 0.77 and 0.82).

Conclusion

the Brazilian Portuguese version of The Barriers Scale was valid and reliable in the group studied.

[Barriers and motivations of nurses for conducting research in Intensive Care Units and Emergency Medical Service]

BACKGROUND

The implementation of evidence based practice is essential in clinical practice. However, it is still a challenge in critical care patients.

AIM

To identify the barriers for conducting research that nursing professionals perceive in intensive care and medical emergency departments, as well as to investigate the areas of interest and motivations to carry out research projects.

METHOD

Cross-sectional and multicentre study carried out in 4 intensive care units and in one Medical Emergency Department emergency pre-hospital carein Catalonia on 2014. The instrument used was The Barriers to Research Utilization Scale which had been previously validated into Spanish. A descriptive and bivariate analysis was performed. A statistical significance of P<.05 was assumed.

RESULTS

One hundred seventy-two questionnaires were obtained (69.9% response). Of the total, 135 were from critical care, 27 to pre-hospital care, and 10 from both. Just over half (57.3%) had research experience, although 44.4% had related training. The questionnaire dimension considered most relevant was organisational characteristics. The most important barriers were: there is not enough time at work [3.11 (SD 1.21)], physicians do not collaborate in its implementation [2.99 (SD 1.22)], and nurses are isolated with respect to other professionals [2.86 (SD 1.32)]. Significant differences were observed in the barriers according to research experience and work place. The main motivation was to be updated in critical patient care.

CONCLUSIONS

The main barriers perceived are related to the organisation. There are differences in the barriers according to research experience and work place.

The Nursing Diagnosis Development of Unemployment Disorder: Content Validation With Nursing Experts

PURPOSE

This study aimed to validate the definition and define the characteristics and related factors of unemployment disorder, a proposed nursing diagnosis.

METHODS

Using Fehring's diagnostic content validity model, Spanish experts were asked to assess the adequacy of the label, defining the characteristics and other related factors.

FINDINGS

The content validity index was 0.8690. A total of 16 defining characteristics reached major criteria (>0.80).

CONCLUSION

The present study supports the proposed development of a nursing diagnosis for the human response to unemployment.

PRACTICE IMPLICATIONS

The results suggest that the inclusion of the "unemployment disorder" diagnostic NANDA-I taxonomy would allow nursing professionals to identify the disorder and its causes and manifestations, and therefore provide the information needed for planning more relevant interventions and results.

OBJETIVO

Validación de la definición, características definitorias y factores relacionados de trastorno por desempleo, una propuesta de diagnóstico enfermero. METODOLOGÍA: Usando el modelo de validación de contenido de Fehring, se consensuó mediante expertos españoles la denominación de la etiqueta, las características definitorias y otros factores relacionados.

RESULTADOS

El índice de validez de contenido global fue 0.8690. Un total de 16 características definitorias alcanzaron carácter crítico (>0.80). CONCLUSIÓN: El presente estudio apoya la propuesta de elaborar un diagnóstico de enfermería para la respuesta humana al desempleo. IMPLICACIONES PRÁCTICAS: Los resultados obtenidos sugieren que la inclusión en la taxonomía NANDA-I del diagnóstico "trastorno por desempleo" permitiría a los profesionales de enfermería identificar el problema, sus causas y manifestaciones, y por lo tanto ofrecerían la información necesaria para planificar las intervenciones y resultados más pertinentes.

Nursing Taxonomies in Spain: Research Themes Presented at the AENTDE Conferences Over a 16-Year Period

OBJECTIVE

To identify the types of studies of nursing taxonomies and priority research themes presented at AENTDE conferences between 1996 and 2012.

METHOD

Four hundred oral communications and posters and 27 lectures presented at the AENTDE meetings were reviewed by means of a descriptive analysis of the types of studies conducted and a content analysis of priority research themes.

RESULTS

The most commonly presented studies were descriptions of the implementation of nursing taxonomies, which accounted for 27.4% of the total over the 16-year period. However, their prevalence fell from 31.8% in 1996 to 9.1% in 2012. Basic research studies accounted for 17.4% of studies overall but were the most frequent in 2012, when their proportion had risen to 37.5%.

CONCLUSION

The prevalence of basic research studies increased notably over the 16-year period. Content validity studies rose in number, while face validity studies fell. Studies of the practical implementation of taxonomies also declined.

OBJETIVO

Identificar los tipos de estudios de taxonomías enfermeras y los temas de investigación prioritarios presentados en las convenciones de AENTDE desde 1996 a 2012. MÉTODO: Se revisaron 400 comunicaciones y 27 ponencias presentadas a 9 simposiums de AENTDE realizando un análisis del tipo de estudio y un análisis de contenido de los temas.

RESULTADOS

Los estudios más frecuentes son las experiencias de implantación de las taxonomías enfermeras con un porcentaje medio de un 27.4% que partiendo de un 31.8% en 1996 disminuyó a un 9,1% en 2012. La investigación básica tienen un porcentaje medio del 17.4% obteniéndose el mayor porcentaje en 2012 con un 37,5%. CONCLUSIÓN: La prevalencia de los estudios de investigación básica se incrementó notablemente durante el período de 16 años. Los estudios de validez de contenido aumentaron en número, mientras que los estudios de validez aparente cayeron. Los estudios sobre la aplicación práctica de las taxonomías también disminuyeron.

Validation of the Portuguese version of the Evidence-Based Practice Questionnaire

OBJECTIVES:

to describe the process of translation and linguistic and cultural validation of the Evidence Based Practice Questionnaire for the Portuguese context: Questionário de Eficácia Clínica e Prática Baseada em Evidências (QECPBE).

METHOD:

a methodological and cross-sectional study was developed. The translation and back translation was performed according to traditional standards. Principal Components Analysis with orthogonal rotation according to the Varimax method was used to verify the QECPBE's psychometric characteristics, followed by confirmatory factor analysis. Internal consistency was determined by Cronbach's alpha. Data were collected between December 2013 and February 2014.

RESULTS:

358 nurses delivering care in a hospital facility in North of Portugal participated in the study. QECPBE contains 20 items and three subscales: Practice (α=0.74); Attitudes (α=0.75); Knowledge/Skills and Competencies (α=0.95), presenting an overall internal consistency of α=0.74. The tested model explained 55.86% of the variance and presented good fit: χ2(167)=520.009; p = 0.0001; χ2df=3.114; CFI=0.908; GFI=0.865; PCFI=0.798; PGFI=0.678; RMSEA=0.077 (CI90%=0.07-0.08).

CONCLUSION:

confirmatory factor analysis revealed the questionnaire is valid and appropriate to be used in the studied context.

Online training course on critical appraisal for nurses: adaptation and assessment

BACKGROUND

Research is an essential activity for improving quality and efficiency in healthcare. The objective of this study was to train nurses from the public Basque Health Service (Osakidetza) in critical appraisal, promoting continuous training and the use of research in clinical practice.

METHODS

This was a prospective pre-post test study. The InfoCritique course on critical appraisal was translated and adapted. A sample of 50 nurses and 3 tutors was recruited. Educational strategies and assessment instruments were established for the course. A course website was created that contained contact details of the teaching team and coordinator, as well as a course handbook and videos introducing the course. Assessment comprised the administration of questionnaires before and after the course, in order to explore the main intervention outcomes: knowledge acquired and self-learning readiness. Satisfaction was also measured at the end of the course.

RESULTS

Of the 50 health professionals recruited, 3 did not complete the course for personal or work-related reasons. The mean score on the pre-course knowledge questionnaire was 70.5 out of 100, with a standard deviation of 11.96. In general, participants' performance on the knowledge questionnaire improved after the course, as reflected in the notable increase of the mean score, to 86.6, with a standard deviation of 10.00. Further, analyses confirmed statistically significant differences between pre- and post-course results (p < 0.001). With regard to self-learning readiness, after the course, participants reported a greater readiness and ability for self-directed learning. Lastly, in terms of level of satisfaction with the course, the mean score was 7 out of 10.

CONCLUSIONS

Participants significantly improved their knowledge score and self-directed learning readiness after the educational intervention, and they were overall satisfied with the course. For the health system and nursing professionals, this type of course has the potential to provide methodological tools for research, promote a research culture, and encourage critical thinking for evidence-based decision making.

Attitude towards Evidence-Based Nursing Questionnaire: development and psychometric testing in Spanish community nurses

BACKGROUND

A readiness assessment for identifying and measuring variables that can facilitate evidence-based nursing (EBN) is important. Attitude towards EBN is one of its components. However, questionnaires that exclusively measure attitude to EBN do not exist in Spanish-speaking contexts.

AIM

This paper is a report of the development and psychometric testing of a Spanish-language assessment tool: the Evidence-Based Nursing Attitude Questionnaire (EBNAQ).

METHODS

The questionnaire was developed in three phases: item generation through a review of scientific literature and focus groups; item selection through an expert review; content and construct validity testing, and internal consistency reliability testing. The instrument was validated in terms of construct validity by a factorial analysis and content validity by grouping the items into the three categories of attitude: cognitive, affective and behavioural. Data were collected from May to November of 2008.

RESULTS

The questionnaire was validated in a sample of 219 Spanish community nurses, who had a mean age of 43.21 (SD 10.3) years, and 64.5% (141) were women. A total of 54.3% (121) had been working in the community for more than 10 years. The questionnaire consisted of 15 items grouped into the three factors that make up the concept of attitude. Cronbach's alpha was 0.853 for the entire questionnaire. The factor solution explained 54.70% of the variance.

CONCLUSIONS

The EBNAQ is brief, making it a user-friendly tool. It is the first Spanish-language questionnaire that exclusively measures attitude towards EBN in nurses who work in the community. The EBNAQ can be used efficiently in research and practice settings to better understand nurses' attitudes towards evidence-based practice.