A qualitative investigation of influences on occupational therapists’ research involvement in Ireland

Background:

To fulfil the desire for evidence-based practice, there is impetus for occupational therapy (OT) to make research a priority and to encourage research engagement.

Purpose:

This study’s aim was to explore occupational therapists’ reasons for and for not getting involved in research and to determine potential barriers and enablers to engaging in research.

Methods:

Three focus groups were conducted with five participants each. Data were thematically analysed.

Findings:

Occupational therapists’ reasons for expressing interest in getting involved in research were having an interest in the condition and/or the symptoms being studied; promoting client support and service development; and ‘upskilling’. Three themes emerged from the thematic analysis: (1) motivation to get involved in research can be influenced; (2) ‘firefighting’: barriers and organisational culture; and (3) The nature of research needs consideration from an occupational therapist perspective.

Implications:

Findings suggest that though occupational therapists are able to get involved in research, it remains that there are difficulties in doing so (e.g., organisational culture); and such difficulties may outweigh both reasons and enablers to such involvement. Reasons for expressing interest, enablers, barriers and the relationships among them warrant further investigation and consideration with respect to involving occupational therapists in research.

Therapists' Perceptions of Participating in a Large Research Study: Benefits, Challenges, and Impact on Practice

Aims: Clinician participation in research is important to expand clinical research. However, there is limited understanding of the impact of such participation. The purpose of this survey-based study was to describe school-based physical therapists' perceptions of the impact, benefits, and challenges of research participation.Methods: Participants were school-based physical therapists (n = 67) who had been research personnel in a year-long study. Participants completed a questionnaire regarding their experiences participating in the study.Results: Most therapists (59%) perceived that participating in the study improved their competency as a school-based PT a small extent. Participation impacted some therapists a moderate to a great extent in their student assessments (43%), decision-making (28%), and team collaboration (25%). Almost all therapists (96%) responded that they would participate in research again. Researchers identified three themes regarding benefits of participating in research: 1) research and promoting the growth of the profession, 2) support for and expansion of my school-based practice, and 3) reflective practitioner. Researchers identified four themes regarding challenges of participating in research: 1) administrative aspects; 2) time; 3) training; and 4) implementing the tools.Conclusions: Findings from this study support therapist participation in research, and have implications for clinicians, supervisors, and researchers.

Occupational Therapy and Clinical Research in Mental Health Rehabilitation

Practitioners working in Australian mental health services are faced with the challenge of providing appropriate evidence-based interventions that lead to measurable improvement and good outcomes. Current government policy is committed to the development of strategic mental health research. One focus has been on under-researched practice areas, which include the development of psychosocial rehabilitation systems and models that facilitate recovery.

To meet this challenge, an Australian rehabilitation service formed a collaborative partnership with a university. The purposes of the collaboration were to implement new forms of service delivery based on consumer need and evidence and to design research projects to evaluate components of the rehabilitation programme. This article examines the process of developing the collaboration and provides examples of how research projects have been used to inform practice and improve the effectiveness of service delivery. Challenges to the sustainability of this kind of collaboration are considered.

Meanings of ‘Research’ and ‘Researcher’—The Clinician Perspective

This study used an open-ended self-report survey to define ‘research’ and ‘researcher’ from the clinician's perspective. Seventy-five occupational therapists working in 6 acute care metropolitan hospitals in Sydney, Australia participated in this study (75% response rate). There were four key findings. First, a profile of therapist research revealed variations in levels of involvement with most (75%) having none. This was not related to postgraduate qualifications or study, years of experience, age, clinical specialty or seniority. Second, the nature of activities identified to be research by clinicians varied: project names, specific research tasks, input, output-related activities such as thinking and professional development activities. Third, research was defined in terms of its attributes, process, and outcomes. Fourth, researchers were described as being engaged in specific research tasks, other general tasks that progressed the research, and they were identified as producers of research outcomes. Differences were identified in responses between those therapists who were involved in research and those who were not.

Evidence-based practice supports among Canadian occupational therapists

Background.

Supports for evidence-based practice (EBP) and research utilization are needed for moving evidence into practice.

Purpose.

The purpose of this study was to identify the presence of individual and organizational EBP supports (based on a previous scoping review) and the attitudes toward the supports in a convenience sample of Canadian occupational therapists.

Method.

A cross-sectional survey was used to collect data from members of the Canadian Association of Occupational Therapists.

Findings.

Data from 368 clinicians (21%) indicated that although factors that have been shown to support EBP, such as student supervision and participation in research and mentoring, were not common practice, attitudes toward these EBP supports were positive.

Implications.

EBP supports, although viewed favourably by clinicians, have yet to be integrated fully into clinical practice. These findings provide researchers with an opportunity to design studies to support clinicians who view EBP in a positive light in integrating evidence into their practice.

A systematic review of the psychometric properties of self-report research utilization measures used in healthcare

BACKGROUND

In healthcare, a gap exists between what is known from research and what is practiced. Understanding this gap depends upon our ability to robustly measure research utilization.

OBJECTIVES

The objectives of this systematic review were: to identify self-report measures of research utilization used in healthcare, and to assess the psychometric properties (acceptability, reliability, and validity) of these measures.

METHODS

We conducted a systematic review of literature reporting use or development of self-report research utilization measures. Our search included: multiple databases, ancestry searches, and a hand search. Acceptability was assessed by examining time to complete the measure and missing data rates. Our approach to reliability and validity assessment followed that outlined in the Standards for Educational and Psychological Testing.

RESULTS

Of 42,770 titles screened, 97 original studies (108 articles) were included in this review. The 97 studies reported on the use or development of 60 unique self-report research utilization measures. Seven of the measures were assessed in more than one study. Study samples consisted of healthcare providers (92 studies) and healthcare decision makers (5 studies). No studies reported data on acceptability of the measures. Reliability was reported in 32 (33%) of the studies, representing 13 of the 60 measures. Internal consistency (Cronbach's Alpha) reliability was reported in 31 studies; values exceeded 0.70 in 29 studies. Test-retest reliability was reported in 3 studies with Pearson's r coefficients > 0.80. No validity information was reported for 12 of the 60 measures. The remaining 48 measures were classified into a three-level validity hierarchy according to the number of validity sources reported in 50% or more of the studies using the measure. Level one measures (n = 6) reported evidence from any three (out of four possible) Standards validity sources (which, in the case of single item measures, was all applicable validity sources). Level two measures (n = 16) had evidence from any two validity sources, and level three measures (n = 26) from only one validity source.

CONCLUSIONS

This review reveals significant underdevelopment in the measurement of research utilization. Substantial methodological advances with respect to construct clarity, use of research utilization and related theory, use of measurement theory, and psychometric assessment are required. Also needed are improved reporting practices and the adoption of a more contemporary view of validity (i.e., the Standards) in future research utilization measurement studies.

Research Knowledge, Attitudes, Practices and Barriers among Paediatric Occupational Therapists in the United Kingdom

Evidence-based practice and research utilisation are promoted to enable clients to receive the most current care; however, there is limited research evaluating the use of these approaches within the occupational therapy profession. This study aimed to investigate the knowledge, attitudes, practices and barriers to evidence-based practice and research utilisation of a group of paediatric occupational therapists in the United Kingdom. Questionnaires were received from 145 participants (response rate 30%), who completed the Research Knowledge, Attitudes and Practices of Research Survey (KAP Survey), the Edmonton Research Orientation Survey (EROS) and the Barriers to Research Utilisation Scale (BARRIERS).

The results indicated that the respondents held positive attitudes towards research and were willing to access new information and implement research findings to guide clinical practice. However, they were less confident in their research knowledge and practices, and perceived multiple barriers associated with the organisation, accessibility and quality of research. The respondents reported limited engagement in conducting research studies; however, the majority of the sample reported implementing the findings of research in their clinical practice to some extent.

Additional research education and support within organisations would be beneficial to ensure that children and families are receiving occupational therapy services that are based on sound research evidence.

Predictors of Research Utilization among Pediatric Occupational Therapists

Evidence-based practice and research utilization activities by clinicians enable clients to receive the best, most current health care available. This study investigated the factors predicting pediatric occupational therapists' attitudes toward evidence-based practice and research utilization in Australia, the United Kingdom, and Taiwan. Questionnaires were received from 696 participants (response rate = 56.58%) who completed the Edmonton Research Orientation Survey (EROS), the Research Knowledge, Attitudes and Practices of Research Survey (KAP Survey), and the Barriers to Research Utilization Scale (BARRIERS). The results of the multiple linear regression analysis indicated the strongest predictor of research utilization was “level of academic occupational therapy qualification,” which was found to be predictive of all of the EROS subscales. The second EROS subscale, “research involvement,” had the largest number of predictive factors. To increase research utilization among pediatric occupational therapists, it is important to be mindful of which aspects of research require improvement so that strategies with the greatest impact and influence can be implemented.

Development and psychometric testing of the Clinician Readiness for Measuring Outcomes Scale

BACKGROUND

If allied health professionals are to begin measuring outcomes routinely, a change in attitudes and behaviour is necessary. However, individuals need to be ready to change and often move through several stages before practice change is observed.

AIM

To develop and test the psychometric properties of a questionnaire that determines clinicians' readiness to measure outcomes.

METHODS

A study of instrument development, validation and reliability. Ten expert allied health professionals were involved in content validity testing. A further 396 allied health professionals completed the questionnaire to establish content and construct validity, internal consistency and temporal reliability (or stability). Of these 396 allied health professionals, 70 participated in the temporal reliability assessment. Content validity was established using the Content Validity Index (CVI). Construct validity was determined using confirmatory factor analysis (CFA) and internal consistency was ascertained using Cronbach's alpha. Temporal reliability was confirmed using intraclass correlation coefficients (ICC 3,1).

RESULTS

A 30-item questionnaire was developed, reflecting the five stages of change from the Transtheoretical Model of Change, and commonly cited barriers to outcome measurement. Content validity was excellent (CVI = 0.96). Using CFA, a two-factor model provided best fit. Based on CFA results, four items were dropped resulting in a 26-item questionnaire (range 26-156). Internal consistency reliability was excellent (alpha = 0.94). Temporal (stability) reliability ICC (3,1) was very good (r = 0.86, P = 0.0001).

CONCLUSIONS

The final 26-item questionnaire takes 10 minutes to complete and 5 minutes to score. The Clinician Readiness for Measuring Outcomes Scale provides educators with useful information about clinician readiness and helps identify strategies for affecting behaviour change.

Iranian nurses' attitudes toward research utilisation

Research utilisation poses significant challenges for the nursing profession in Iran. Nurses' attitudes toward research and their motivation to engage in research utilisation have repeatedly been identified as potential barriers. Yet little is known about the attitudes of Iranian nurses' regarding research. Therefore, there is a need for a study that focuses particularly on Iranian nurses' attitudes toward research utilisation. The objective was to assess the attitude of Iranian clinical nurses and nurse educators towards nursing research. A self-administered questionnaire based on a cross-sectional survey conducted on 410 respondents from 15 educational hospitals and nursing schools affiliated to Tehran Medical Sciences University, Iran. According to the self-report, nurses generally held positive attitudes toward research. Education, professional role and research activities had a statistically significant relationship with their research attitudes. Although the attitudes towards research were positive, they do not perceive that research is relevant to the day-to-day work of nursing and research is not applicable to nursing as well. The majority of nurses are still not convinced of the importance of research to nursing practice and to the nursing profession. This, in turn, means that nurses do not implement research findings in clinical practice. There is an immediate need to improve research training in our teaching hospital to facilitate the development of the local literature both in terms of research utilisation and production.

Evidence-based practice and rehabilitation: occupational therapy in Australia and New Zealand experiences

Evidence-based practice has become the dominant paradigm in the delivery of rehabilitation programme. However, occupational therapists in Australia and New Zealand have been slow in making the transition to become evidence-based practitioners. Collaboration between the university/tertiary institute and clinical setting is one way that clinicians can be assisted with incorporating research into their practice. Two case examples are presented outlining how collaborative practice can result in improved outcomes for all concerned.

Association between nurses' education about research and their research use

Knowledge about research methods, skills for critical appraisal of research reports, and a positive attitude towards research have been identified as means to potentially overcome barriers to individual nurses' research utilization, and ultimately improve nursing practice. The objective of this study was to examine independent relationships between nurses' education about research and research use and their attitudes towards research, knowledge about research and research utilization. Research utilization and attitude towards research were measured using the Edmonton Research Orientation Scale. One hundred and seventy-five nurses working in a pediatric hospital responded to the survey. Higher levels of education were associated with both (1) positive attitudes towards research and (2) higher levels of self-reported research utilization. Whether or not nurses had university education, completing a course about research design or a course about how to read and use research was associated with positive attitudes towards research. Having completed a course about how to read and use research was not associated with self-reported research utilization. The association between having completed a course about research design and self-reported research utilization was not independent of the association between level of education and research utilization. The findings indicate that education about research may be one way to overcome negative attitudes towards research as a barrier to research utilization.

Clinical outcomes research from the occupational therapist's perspective

With increasing costs and scarcity of resources, occupational therapists need to embrace outcomes research to demonstrate the effectiveness of its clinical interventions. To explore clinicians' perspectives on clinical outcomes research a qualitative study was undertaken involving three in-depth group interviews with 15 occupational therapists from the South Western Sydney Area Health Service. Five broad themes permeated participants' perception: (a) defining the process, (b) factors that impact on participation in clinical outcomes research, (c) organizational influences, (d) the value of clinical outcomes research, and (e) potential partnerships with academics. Three conceptual categories are identified: knowledge and understanding about clinical outcomes research, clinicians' experience conducting or participating in clinical outcomes research and the relevance of clinical outcomes research to occupational therapy clinical practice. Similarity to findings in the international literature on occupational therapists' engagement in clinical research suggests that the findings from this small sample of Australian therapists are robust. The implications of the findings for continuing professional education programmes and clinical supervision are presented.

Use of the Edmonton Research Orientation Scale with nurses

Improved understanding of the determinants of research utilization is fundamental to developing and testing strategies to increase research utilization. Inconsistent findings in this field of research about research utilization may be attributable, in part, to lack of development of measures. This research tested the internal consistency and construct validity of the Edmonton Research Orientation Scale (EROS) and its four subscales (Valuing Research, Research Involvement, Being on the Leading Edge, and Evidence-Based Practice), which are promising measures of research utilization and attitudes towards research. One hundred eighty-five registered nurses in a pediatric teaching hospital completed the EROS. Nurses who reported higher levels of education, better understanding of research topics or participation in quality management or research projects also reported higher levels on the EROS and EROS subscales. The Valuing Research and Evidence-Based Practice subscales were associated with having taken courses in research design and statistics. The findings suggest that the EROS and the Valuing Research and Evidence-Based Practice subscales may be used to measure nurses' attitudes towards research and research utilization.

Research utilization among pediatric health professionals

The present study investigated research use and attitudes toward research among pediatric health professionals. All nurses and allied health professionals in a pediatric teaching hospital were surveyed using previously tested and published measures. Over half of the participants had some formal education in research but, for some participants, that education was many years ago. Most participants reported poor or very poor understanding of research design. Two variables were independently associated with a positive attitude towards research: (i) better understanding of how to conduct a literature search; and (ii) higher level of education. Five variables were independently associated with research use: better understanding of research design; having presented at a conference in the past two years; sense of calling to the profession; better understanding of how to conduct a literature search; and attending rounds. A small proportion of variance in both research use and a positive attitude towards research was explained by the independent predicator variables. Further research is required to identify characteristics of the workplace environment that support research use.

Occupational therapy research priorities in mental health

This study used a Delphi survey method to identify research priorities of occupational therapists working in mental health. Twenty-two subjects were initially surveyed for their suggestions regarding research topics they thought were important. These 22 subjects represent a random sample of 12.4% of national OT-Australia membership of occupational therapists working in mental health. After three "rounds" of the Delphi methodology, consensus research priorities were obtained in six areas: research of value to clients (5 topics); research of value to occupational therapists working in mental health (4 topics); research related to providing community care for clients (2 topics); research that facilitates health promotion and disease prevention (6 topics); research that is of value to the profession of occupational therapy (6 topics); and research that is of value to occupational therapy education (4 topics). Implications for occupational therapy practice and re search are discussed.

Involvement of occupational therapy departments in research: a provincial survey

It is increasingly recognized that research is necessary to advance the practice of occupational therapy. The objective of this study was to determine whether occupational therapy departments in Quebec were commonly involved in research, and whether participation varied with the size of department and type of work setting. Secondly, enablers and barriers to participation in research were identified. A random sample of occupational therapy departments, stratified by size, were surveyed by mail. Participation rate was 74.8% (107/143). Participation in research was noted in half of the departments surveyed (51/107), most frequently as collaborator. Involvement in research was associated (p < .001) with a greater number of therapists in the department. Furthermore, occupational therapy departments in rehabilitation centres and in university hospitals were more likely to participate in research (79% and 90% respectively), whereas participation was lower for long-term care facilities (29%) and community health clinics (38%). When asked to rank factors that may facilitate participation in research, the highest rankings were given to: time allotted to research, research as a priority for administration, adequate financial support, and presence of an occupational therapy researcher and a research centre on site. This survey demonstrates that a number of factors can promote or prevent the realization of research activities within the clinical setting. Strategies are proposed to enhance the integration of research into clinical practice.