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- Boström, Anne-Marie, et al.
(författare)
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Barriers to research utilization and research use among registered nurses working in the care of older people. Does the BARRIERS Scale discriminate between research users and non-research uses on perception of barriers?
- 2008
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Ingår i: Implementation Science. - : Springer Science and Business Media LLC. - 1748-5908. ; 3:24
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundOne strategy to enhance research use and change current practice is to identify barriers and then implement tailored interventions to reduce these barriers. In nursing, the BARRIERS scale has been frequently used to identify nurses' perceptions of barriers to research utilization. However, this scale has not been applied to care of older people, and only one study has investigated how identified barriers link to research utilization. Therefore, the purpose of this study was twofold: to describe RNs' perceptions of barriers to and facilitators of research utilization and to examine the validity of the BARRIERS scale in relation to research use.MethodsA cross-sectional survey design was used and registered nurses (RNs) working in the care of older people participated (response rate 67%, n = 140/210). Two questionnaires, the BARRIERS scale and the Research Utilization Questionnaire (RUQ), were used. Data were analyzed using descriptive and bivariate inferential statistics.ResultsCharacteristics of the organization and the presentation of research findings were rated as the most prominent barriers. The three items most frequently reported as barriers were: the nurse is isolated from knowledgeable colleagues with whom to discuss the research (89%); the facilities are inadequate for implementation (88%); and, the relevant literature is not compiled in one place (81%). Surveyed RNs suggested more support from unit managers and better availability of user-friendly reports in Swedish to enhance research use.The RNs reported a modest use of research. A weak but significant correlation was found between the Research Use index in RUQ and the Presentation subscale in the BARRIERS scale (r = -0.289, p < 0.01), suggesting that the RNs reporting more research use were less likely to perceive presentation of research as a barrier. Dividing the sample into research users (n = 29) and non-research users (n = 105), the research users rated significantly lower on the subscales Presentation, Nurse and Research in the BARRIERS scale.ConclusionThe BARRIERS scale revealed differences in the perception of barriers between research users and non-research users. Thus, methodologically the scale appears useful in identifying some types of barriers to research utilization but not organizational barriers. The identified barriers, however, are general and wide-ranging, making it difficult to design useful specific interventions.
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- Estabrooks, Carole A, et al.
(författare)
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Towards better measures of research utilization : a collaborative study in Canada and Sweden
- 2011
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Ingår i: Journal of Advanced Nursing. - : Wiley-Blackwell. - 0309-2402 .- 1365-2648. ; 67:8, s. 1705-18
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: This paper is a report of a study examining research utilization in nursing. The specific aims were to (1) clarify the construct of research utilization, and (2) identify observable indicators of research utilization.BACKGROUND: Robust measures of research utilization do not exist despite steadily increasing numbers of studies in the field. One reason for this is theoretical confusion surrounding the central concepts in the field.METHOD: A qualitative (focus group) design was used to explore the construct of research utilization in two countries: Canada and Sweden. A systematic and sequential (three phases) approach to expert sampling framed the study. Phase 1 consisted of initial construct clarification by the research team (2005). In Phase 2, a face-to-face meeting with a panel of international research utilization nursing experts was held (2005). Phase 3 consisted of a series of focus groups with nursing care (direct and non-direct) providers (2005-2007). Data were analysed using content analysis.FINDINGS: The nursing care providers did not commonly use the term 'research utilization'. Several examples of research utilization were provided; a majority of these examples related to instrumental research utilization and became increasingly concrete as one moved from non-direct to direct care participants. Participants identified several indicators of research utilization (instrumental and conceptual). From these indicators, a measurement schematic was derived.CONCLUSIONS: The construct of research utilization is multi-faceted. Several indicators of research utilization were identified, which can be used to augment existing or develop a new and improved measure that taps both instrumental and conceptual use.
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- Gardulf, Ann, et al.
(författare)
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Factors of importance for work satisfaction among nurses in a university hospital in Sweden
- 2008
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 22:2, s. 151-160
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Tidskriftsartikel (refereegranskat)abstract
- The shortage of registered nurses in the healthcare sector is a problem in most countries. Swedish nurses tend to leave or seek new positions. However, few Swedish studies have addressed questions regarding what factors are of importance for nurses to perceive work satisfaction although satisfied nurses are linked to many positive organizational outcomes, e.g. improved quality of patient care. The aim of this study was to investigate what factors are of importance for nurses at a university hospital to perceive work satisfaction. Eight hundred and thirty-three nurses responded to the mailed Quality Work Competence questionnaire and the Huddinge University Hospital Model Questionnaire. Regression analyses identifies five factors linked to the head nurses leadership contributing to the nurses' feelings of work satisfaction: 'professional competence is made good use of', 'feeling of satisfaction with immediate superior regarding support for nursing research and development', 'opportunities for developing one's own competence for the current job', 'career opportunities in one's own profession' and 'yearly dialogue for performance appraisal with immediate superior'. The nurses also reported work-related exhaustion. Few saw opportunities for making a career as a nurse. In conclusion, the study identified specific amenable factors linked to the head nurses leadership that are of importance in creating attractive workplaces for nurses.
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- Heiwe, Susanne, et al.
(författare)
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Evidence-based practice : attitudes, knowledge and behaviour among allied health care professionals
- 2011
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Ingår i: International Journal for Quality in Health Care. - : Oxford University Press. - 1353-4505 .- 1464-3677. ; 23:2, s. 198-209
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore dieticians', occupational therapists' and physical therapists' attitudes, beliefs, knowledge and behaviour concerning evidence-based practice within a university hospital setting. Design: Cross-sectional survey. Setting. University hospital. Participants: All dieticians, occupational therapists and physical therapists employed at a Swedish university hospital (n = 306) of whom 227 (74%) responded. Main Outcome Measures: Attitudes towards, perceived benefits and limitations of evidence-based practice, use and understanding of clinical practice guidelines, availability of resources to access information and skills in using these resources. Results: Findings showed positive attitudes towards evidence-based practice and the use of evidence to support clinical decision-making. It was seen as necessary. Literature and research findings were perceived as useful in clinical practice. The majority indicated having the necessary skills to be able to interpret and understand the evidence, and that clinical practice guidelines were available and used. Evidence-based practice was not perceived as taking into account the patient preferences. Lack of time was perceived as the major barrier to evidence-based practice. Conclusions: The prerequisites for evidence-based practice were assessed as good, but ways to make evidence-based practice time efficient, easy to access and relevant to clinical practice need to be continuously supported at the management level, so that research evidence becomes linked to work-flow in a way that does not adversely affect productivity and the flow of patients. © The Author 2011. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.
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- Kajermo Nilsson, Kerstin, et al.
(författare)
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The BARRIERS scale - the barriers to research utilization scale : A systematic review
- 2010
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Ingår i: Implementation Science. - : Springer Science and Business Media LLC. - 1748-5908. ; 5, s. 32-
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Tidskriftsartikel (refereegranskat)abstract
- 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(R) 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.
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- Nilsson Kajermo, Kerstin, et al.
(författare)
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Predictors of nurses' perceptions of barriers to research utilization
- 2008
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 16:3, s. 305-314
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To identify predictors of nurses' self-reported barriers to using research findings in clinical practice. Background Several studies have shown that nurses perceive barriers to research utilization but to our knowledge predictors of nurses perceptions of barriers to research utilization have not been identified before. Methods Three questionnaires were answered by 833 nurses: the Barriers Scale, the Quality Work Competence questionnaire and a questionnaire including questions on professional issues. Results Dissatisfaction with support from immediate superiors for participating in research and/or development projects, having no academic degree and unclear and unrealistic workplace goals were identified as factors increasing the risk of perceiving barriers to the use of research findings in clinical practice. Conclusions The results imply that head nurses, nursing managers and other health care leaders should create strategies for supporting nurses' professional development and possibilities to implement research findings in clinical practice. Implications for nursing management To support research utilization and evidence-based care health care leaders, head nurses and nurse managers should create clear and realistic goals for the work place including demands on evidence-based care. It is also important for head nurses and nurse managers to create strategies for supporting nurses' professional development and possibilities to implement research findings in clinical practice.
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- Nilsson Kajermo, Kerstin, et al.
(författare)
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Psychometric evaluation of a questionnaire and primary healthcare nurses' attitudes towards research and use of research findings.
- 2014
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 28:1
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This article investigates attitudes towards and awareness of research and use of research findings among primary healthcare nurses, determinants of attitudes and evaluation of psychometric properties of an instrument measuring nurses' attitudes.BACKGROUND: The production of new knowledge is ongoing and the amount of research of relevance for health care has increased, but there remains a gap between what is known and what is done in practice. To enhance evidence-based practice and patient safety, the use of research findings needs to be encouraged and promoted.METHOD: An explanatory study using a cross-sectional survey was conducted in 2005-2006. The survey included items about background data and the instrument attitudes towards and awareness of research and development in nursing. 1054 nurses participated in the study. Factor analyses and Cronbach's alpha were used to evaluate internal structure and internal consistency of the instrument.RESULT: The nurses generally held positive attitudes towards research. Although most of the nurses reported using research in practice, 37% claimed that they never or rarely used research findings. Half of the respondents perceived they had the ability to analyse scientific reports/articles. This ability and research use were significant determinants of attitudes. Factor analysis of the scale resulted in a three-factor solution, which differs from the seven-factor structure previously identified by the originators of the instrument.CONCLUSION: Our results support the view that implementation of research is a complex process involving several factors. The different factor structure identified suggests that further work is needed on this instrument.
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- Nilsson Kajermo, Kerstin
(författare)
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Research utilisation in nursing practice : barriers and facilitators
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Research utilisation in nursing practice - barriers and facilitators To improve and develop nursing practice it is important that research findings are utilised by the nurses. The main purpose of this thesis was to explore barriers to and facilitators of research utilisation in nursing practice and to identify factors that might be of importance for that. Data were collected by means of three questionnaires; one regarding barriers to and facilitators of research use in practice (I, II, III); two work environment questionnaires (III) and by means of focus groups (IV). Study I included registered nurses in clinical practice (n = 237). Characteristics of the organisation as lack of time for reading, lack of time and resources for implementation of research findings and nurses' lack of authority together with the way the research findings are presented and its accessibility were seen as major barriers to research utilisation by the nurses. In study II the clinical nurses' perceptions (1) were compared with a group of nursing teachers' (n = 37), nursing students' (n = 166), nursing administrators' (n = 33) and physicians' (n = 127) perceptions. The teachers and the students perceived almost the same barriers as the clinical nurses did. The physicians perceived barriers to a lesser extent than the other groups did. Education to increase the nurses knowledge of research methods and to develop their skills in evaluating research findings, the allocation of resources for implementation of research findings, more staff, and research presented in a user-friendly way, were suggested as facilitators of research utilisation (I, II. In study III registered nurses' (n=833) perceptions of barriers to research utilisation were explored. These nurses reported on the whole the same barriers as mentioned in study I. Moreover multiple and logistic regression analyses were used to identify factors of importance for perceiving barriers. Unclear and unrealistic workplace goals, being dissatisfied with support from superiors for quality improvement and/or research activities and having no academic degree increased the risk of perceiving barriers. In study IV ten registered nurses participated in a researchorientated educational program with the aim of facilitating research utilisation in clinical practice. The program contained different activities to disseminate and implement research findings at the participants' wards. The nurses' experiences of disseminating and implementing research findings were explored and a qualitative content analysis was performed. Organisational and leadership issues and nurses' interest in research and the nurses reading habits were perceived as important factors for research utilisation. In consideration with the participants' new role as "change agents", support and feed back from head nurses, colleagues and physicians were perceived as important. This thesis shows that there are barriers to research utilisation and confirm that the change to a research-based nursing care is a complex issue. Support and engagement from head nurses and managers, education for head nurses as well as for clinical nurses in research subjects and the development and evaluation of models to increase the uptake of research are of utmost importance for the development of evidence based nursing care.
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- Nilsson Kajermo, Kerstin, et al.
(författare)
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Swedish Translation, Adaptation and Psychometric Evaluation of the Context Assessment Index (CAI)
- 2013
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Ingår i: Worldviews on Evidence-Based Nursing. - : Wiley-Blackwell. - 1545-102X .- 1741-6787. ; 10:1, s. 41-50
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The strength of and relationship between the fundamental elements context, evidence and facilitation of the PARIHS framework are proposed to be key for successful implementation of evidence into healthcare practice. A better understanding of the presence and strength of contextual factors is assumed to enhance the opportunities of adequately developing an implementation strategy for a specific setting. A tool for assessing context-The Context Assessment Index (CAI)-was developed and published 2009. A Swedish version of the instrument was developed and evaluated among registered nurses. This work forms the focus of this paper. PURPOSE: The purpose of this study was to translate the CAI into Swedish, adapt the instrument for use in Swedish healthcare practice and assess its psychometric properties. METHODS: The instrument was translated and back-translated to English. The feasibility of items and response scales were evaluated through think aloud interviews with clinically active nurses. Psychometric properties were evaluated in a sample of registered nurses (n = 373) working in a variety of healthcare organisations in the Stockholm area. Item and factor analyses and Cronbach's alpha were computed to evaluate internal structure and internal consistency. RESULT: Sixteen items were modified based on the think aloud interviews and to adapt the instrument for use in acute care. A ceiling effect was observed for many items and the originally identified 37 item five-factor model was not confirmed. Item analyses showed an overlap between factors and indicated a one-dimensional scale. DISCUSSION: The Swedish version of the CAI has a wider application than the original instrument. This might have contributed to the differences in factor structure. Different opportunities for further development of the scale are discussed. CONCLUSIONS: Further evaluation of the psychometric properties of the CAI is required.
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