Nursing research:opportunities and challenges

Exploratory factor analysis of the research and development culture index among qualified nurses

AIMS AND OBJECTIVES

This paper presents the exploratory factor analysis of a rating instrument for assessing the strength of organizational Research and Development (R&D) culture.

BACKGROUND

Despite nursing's limited research capacity, the discipline is capitalizing upon opportunities to become involved in research and is making strong progress. Within the context of the debate on nursing research capacity, the R&D Culture Index was developed as a means of appraising R&D culture within health care organizations.

DESIGN

Factor analysis was carried out on data collected from 485 nursing staff. The method of extraction was Principal Components Analysis with oblique rotation.

METHODS

The Index was developed from the findings of qualitative research conducted with NHS staff. Eighteen items, encompassing the main themes from the data, were initially included in the Index. This pilot instrument was distributed to nursing staff within three different types of NHS Trust. Factor analysis resulted in rejection of two items and the analysis was repeated using the remaining 16 items.

RESULTS

Three latent factors were extracted accounting for 58.0% of the variance in the data. The factors were: R&D Support, describing the perceived support within the working environment for R&D activity; Personal R&D Skills and Aptitude, describing an individual's perception of their ability towards R&D activity; and Personal R&D Intention, describing an individual's willingness to engage in R&D activity. Each factor had good internal reliability, as did the overall index.

CONCLUSION

The R&D Culture Index provides an efficient means of assessing the strength of an organization's R&D culture in a way that captures the role of the individual practitioner and the organizational environment.

RELEVANCE TO PRACTICE

These findings suggest that the continuing promotion of R&D within health care organizations is dependent upon a multi-faceted approach that addresses the learning needs of the organization as well as those of the individual practitioners.

British nurses in behavioural psychotherapy: a 25-year follow-up

BACKGROUND

The National Service Framework for Mental Health has emphasized the need to prioritize the provision of cognitive behaviour therapy as the central evidence-based non-pharmacological intervention for mental health problems. For 25 years one programme (English National Board Course No. 650--Diploma in Behavioural Cognitive Therapy, formerly called Nursing in Behavioural Psychotherapy) has trained nurses in such methods. This is the only programme in nursing which qualifies graduates to be fully certified as a cognitive behaviour therapist by the British Association of Behavioural Psychotherapy and by the United Kingdom Council for Psychotherapy. The practice of these nurse therapists (most commonly known as nurse behaviour therapists, NBTs) is the most rigorously evaluated in mental health nursing, with several randomized controlled trials to testify to clinical and economic efficacy.

AIM

The aim of this study is to continue the systematic follow-up of all NBT graduates previously undertaken in two earlier surveys published in 1986 and 1994. These previous surveys examined clinical practice, organizational context and career and professional development issues. This up-to-date picture of NBTs will provide useful baselines for the implementation of the National Service Framework, and may be used by the Department of Health, education providers and services.

METHOD

A postal survey (using the same template for categories of information as the two earlier surveys) was used and questionnaires were sent to 237 of the 274 trained NBTs whose name appears on the Central NBT Register, maintained at the Institute of Psychiatry/Maudsley Training Centre.

RESULTS

One hundred and five of 230 eligible respondents (45.6%) returned questionnaires and additional data were obtained from 27 NBTs who provided information to the Register in the year before the survey. Thus, some data were available for 57% of the sample. As in earlier surveys, it was found that the majority of therapists remain in clinical practice, undertake substantial further education and training and are involved in research and teaching as part of their overall role. The two central developments are an increasing move towards working in primary care and an increased emphasis on cognitive interventions. NBTs complete a substantial number of treatments per year and increasingly treat clients with difficulties not encountered during their basic training. NBTs now receive much more supervision than in previous surveys and continue to use valid and reliable measures of change in practice. However, the number of NBTs remains small and the impact on potential populations who would benefit from effective psychological interventions is minimal. This paper discusses the implications for service delivery.