Cancer nursing research in Queensland, Australia: barriers, priorities, and strategies for progress

What women want: Women's health in Rural and Regional Australia - Insights from an interprofessional research collaboration between academic researchers, nursing clinicians, and industry professionals

The aim of this study was to (a) investigate community women's knowledge and experiences of women's health community services in northern rural and regional New South Wales, Australia; (b) identify any existing gaps in community women's health programs in this region and (c) to contribute to service provision, strategic planning, and industry professional development of community nurse researchers in collaboration with industry. The research took place in Northern New South Wales Local Health District (NNSWLHD) Australia, which is comprised of Tweed/Byron, Richmond and Clarence Health Service Groups, during May to September 2019. Participants comprised 13 women's health service clients over the age of 18 years and less than 74 years, attending health services clinics within NNSWLHD. The research was undertaken as a partnership between three senior healthcare professionals (Clinical Nurse Consultants), one from each Health Service Group, and academic researchers, who provided the key senior healthcare professionals with research training and guidance. Key themes related to primary healthcare experiences and needs of women living in NNSWLHD, and the quality of women's primary healthcare services in that region. Thematic analysis revealed four key themes and several sub-themes. These were (1) Knowledge and Awareness of Services, (2) Barriers to Access, (3) Personal Issues and (4) A Need for Women-Centred Care. The major issues women experienced were deficits in services, lengthy wait times and poor access. Additional funding is necessary to uphold community women's health nurse positions in rural health to improve women's health outcomes in these locations.

Priorities for Cancer Research From the Viewpoints of Cancer Nurses and Cancer Patients: A Mixed-Method Systematic Review

BACKGROUND

Setting priorities in oncology is a useful way to produce a robust set of research questions that researchers can address.

OBJECTIVE

The aim of this review was to describe cancer nurses and patients' main research priorities and describe their development over time.

METHODS

A mixed-method systematic review was conducted for the period from 2000 to 2018 through a search of multiple databases. The methodological quality of the studies included was assessed using the Mixed-Methods Appraisal Tool, and the process of setting the health research priorities was assessed using Viergever's tool. Each study's top research priorities were extracted and summarized in categories.

RESULTS

Fifteen studies were included: 13 addressed nurses' research priorities, and 2 focused on those of patients. The majority were Delphi and quantitative studies that were conducted in the United States and United Kingdom. The quality criteria score and the quality of the process were considered sufficiently good. The most important research priorities were categorized as disease control and management, patient-related issues, and professional dimensions and issues. Management of symptoms and pain, education, information, and communication were research priorities always present in the articles during the study period.

CONCLUSION

Priorities change over time and depend on several factors; however, some have remained consistent for the last 18 years. Although there is increasing emphasis on including patients in establishing research priorities that inform cancer care, this involvement is still lacking.

IMPLICATIONS FOR PRACTICE

Future studies should describe the primary cancer research priorities of nurses in collaboration with patients.

Clinical research should be a priority in the NHS - but what do genito-urinary medicine clinic staff think?

Clinical research improves patient care and is a government priority. We sought the opinions of genito-urinary medicine clinic staff regarding undertaking research, any barriers they perceived, and methods to optimise study recruitment. Questionnaires were offered to everyone working in the genito-urinary medicine clinic over a one-week period. In addition, four focus groups were held with genito-urinary medicine clinic staff. Forty-three questionnaires were completed. All respondents stated that research was important; however, 14.0% worried that it affected patient care and 16.3% would rather see patients without having to consider research. Doctors were more likely to enjoy discussing studies than other healthcare staff (p = 0.029) and were less likely to think that too many studies were being conducted at one time (p = 0.027). Forty staff attended the focus groups. Time, knowledge of studies, difficulty in broaching the topic of research and patient factors were cited as barriers to recruitment. Suggestions to improve recruitment included: greater multi-disciplinary team involvement; improving staff research knowledge; streamlining the research process; and patient education. Reasons for different attitudes between staff disciplines towards research included different training pathways and incentives to conduct research. The recommendations staff have made to help drive recruitment should be implemented in the genito-urinary medicine clinic.

Identifying research priorities and research needs among health and research professionals in psycho-oncology

AIM

To identify and prioritize the key research questions in psycho-oncology in order to guide the development of large multicenter clinically relevant studies.

METHODS

All members of the Psycho-Oncology Co-operative Research Group (n = 295) were invited to participate in an online survey and 180 responded (response rate = 61%). Participants rated eight priority research areas identified from a previous focus group study on a five-point scale, and ranked their top four priority areas. Within the four ranked research areas, participants selected the three most important specific research questions.

RESULTS

The highest rated research priority areas were distress identification (23.3%), survivorship (22.7%), and distress management (15.3%), followed by issues relating to health services (9.7%) and carers (8.0%). Interventions were commonly nominated among the most important research questions within each priority area. The single most important research question identified by 44% of the sample was to "Determine the most acceptable, reliable and valid screening tool to be administered routinely at diagnosis and at other key transition points to identify distress and psychosocial needs".

CONCLUSION

This is the first Australian study to explore research priorities in psycho-oncology, and the first international study to explore these issues in depth. To ensure that the research effort is strategic, clinically relevant and cost-effective, clear priorities need to be established. The results of this survey will enable limited resources to focus on key research questions of direct clinical benefit.

Promoting evidence-based care through a clinical research fellowship programme

AIM

This paper reports on the development and evaluation of a multidisciplinary critical appraisal and research utilization-training programme at one organization with the aim of demonstrating a potential approach to the challenge of ensuring practice is evidence based.

BACKGROUND

Considerable time and attention is devoted to developing and evaluating new clinical innovations. Nevertheless, it is estimated that a quarter of patients continue to receive treatments that are unnecessary or potentially harmful.

DESIGN

A cross-sectional qualitative evaluation survey of nurses and allied health staff participating in the training programme.

METHODS

After running the programme twice at this organization we sought to evaluate the impact of the programme. Participants were asked to write answers to open-ended questions to examine personal and professional outcomes of participation.

RESULTS

All respondents found the programme to be worthwhile and beneficial to their everyday practice. Importantly, participants reported feeling more confident when discussing clinical issues within the multidisciplinary team. The majority have presented their work via oral presentations or in publications and many have gone on to enroll in higher degrees.

CONCLUSIONS

A critical appraisal and research utilization programme, as described here, has benefits for clinicians in terms of building confidence, knowledge and skill acquisition and also for the organization in terms of provision of evidence-based care and quality and safety. It successfully addresses commonly reported barriers to research utilization.

RELEVANCE TO CLINICAL PRACTICE

A programme such as the Clinical Research Fellowship increases clinicians' ability and confidence to generate research questions that are meaningful to practice and then investigate the issue in a rigorous and timely manner.

Research Priorities of Oncology Nurses in the Republic of Ireland

To determine the research priorities of oncology nurses in the Republic of Ireland, a descriptive survey study was undertaken at a national oncology specialist center. The center's nurses (N = 119) were invited to participate in the study, and a 66% (n = 79) response rate was obtained. The research priority areas identified were concentrated around nurse-led care and the effectiveness of nurse-led services in areas such as pain management. Communication, information, and continuity of care issues and stress and burnout in oncology nursing were also among the top priorities selected. Quality of life and radiotherapy were the most important themes that emerged in the open-question section of the questionnaire. The result of this study provides important insights and direction for the development of oncology nursing research in the Republic of Ireland. It also adds to the international literature on research priorities across different jurisdictions.

Finnish nurses’ attitudes towards nursing research and related factors

This study was concerned with Finnish nurses' attitudes to nursing research and with the associations of different background factors with these attitudes. The data were collected with a purpose-designed, structured questionnaire. The study was carried out in one central hospital, one central university hospital and 10 community health centres in Finland. A total of 400 nurses took part. The response rate was 67%. The data were analysed using SPSS statistical software. Attitudes to nursing research were generally quite positive, although over half of the nurses felt their own relationship to nursing science was quite distant. There were also shortfalls with respect to the information value and utilisation of research results. Only one-third took the view that doing research is an important part of the nurse's job. Age, the frequency of reading the professional literature, participation in training courses, training received in research and development, and the type of workplace were associated with attitudes. The results underline the importance of paying closer attention to the choice of research objects in the field of nursing science. Greater effort should also be invested in supporting and developing the application of research results. It is recommended that more courses on research methodology and other relevant training be made available to practical nurses.

Barriers in implementing research findings in cancer care: the Greek registered nurses perceptions

This study explored Greek nurses' perceptions of the barriers to research utilization faced in every day practice. The barriers between nurses working in cancer and general hospitals, as well as between those employed at central and provincial hospitals were compared. The study used a cross-sectional design and data were collected using the "Barriers Scale" (Funk et al., 1991a, Applied Nursing Research, 4, 39-45). A convenience sample of 301 nurses was randomly selected from 12 hospitals in Greece. The two key barriers identified were related to the 'availability of research findings'. English language was perceived to range between moderate and major barrier for the vast majority of participants (n = 231, 78%). Nurses surveyed indicated the presentation of research findings as the greatest barrier while the characteristics of nurses themselves were perceived as the least important one. No significant differences were found between types of hospitals (cancer/general) and geographical areas (central/provincial). Some differences, however, were observed in relation to specific items of the scale such as feeling isolated from 'research-knowledgeable' colleagues and having insufficient time to implement new ideas. The observations reported here appear to agree with the findings in mainstream literature. The results suggest that more emphasis should be given in research methodology, statistics and critical appraisal skills at all levels of nursing education, and that efforts should be made towards increasing research availability and creating supportive environments for implementation of research findings.

Delphi survey of nursing research priorities

PURPOSE/OBJECTIVES

To identify oncology nurses priorities for topics and issues to be addressed by developing a clinical nursing research program at a large comprehensive cancer center.

DESIGN

Delphi survey, completed in two rounds.

SETTING

A large comprehensive cancer center in the southern United States.

SAMPLE

All 1,500 RNs employed at the cancer center. Round I asked nurses to identify topics they believed needed to be studied, and 642 nurses responded. In round II, 567 nurses ranked these priorities.

METHODS

Surveys were distributed to all nurses who work in a variety of settings at the cancer center. Open-ended responses from round I were content analyzed, round II rankings of importance were described, and factor analysis was performed.

MAIN RESEARCH VARIABLES

120 topics were identified from a content analysis of research areas described by nurses in the cancer center.

FINDINGS

120 research priorities were identified. Factor analysis revealed three factors: clinical care, nurses and skills, and administrative aspects.

CONCLUSIONS

The top five research priorities identified at the cancer center were, in rank order, acute and chronic pain, infection rates and control, job satisfaction, nurse-patient ratios and staffing, and nurse retention. This study's survey included items similar to those on the recently conducted Oncology Nursing Society research priority survey. Pain and issues with infection were among the top five priorities in both surveys.

IMPLICATIONS FOR NURSING

Conducting a survey to identify nurses perceptions of research was useful in involving nurses in the conduct of research, and the results were useful guides to beginning a coordinated program of nursing research.