Öz
Amaç: Kanıta dayalı uygulama (KDU), konuyla ilgili mevcut en güncel
araştırmalarla birlikte kaliteli kararlar almak ve kişisel klinik uzmanlığa
dayalı hemşirelik bakımı sağlamak için bir yaklaşımdır. KDU, mortalite ve
morbidite oranlarını önemli ölçüde etkileyebilir ve coğrafi farklılıkların
azaltılmasında önemli bir rol oynayabilir. On-on beş yıl önce ülkemizde, sağlık
hizmetlerinin kalitesini artırmak amacıyla “Sağlıkta Dönüşüm Programı"
başlatılmıştır. Türkiye'deki Sağlıkta Dönüşüm Programı ile organizasyon yapısı
ve sağlık bakım sisteminde köklü değişiklikler yapılmıştır. Bu değişim
hemşirelerin araştırma kullanımındaki algıladıkları engelleri etkilemiş
olabilir. Bu çalışmada, sağlık bakım sistemindeki değişiklikler sonrasında
hemşirelerin araştırma kullanımının önündeki engellerin araştırılması
amaçlanmıştır.
Materyal ve Metot: Bu araştırma
tanımlayıcı tipte bir çalışmadır. Bu çalışma Şubat-Mayıs 2018 tarihleri
arasında bir hastanede yapılmıştır. Çalışmaya katılmaya gönüllü olan ve formu
eksiksiz tüm katılımcıların verileri değerlendirilmiştir. Örneklem seçiminde
basit rastgele örnekleme yöntemi kullanılmıştır. Veriler, araştırmacılar
tarafından geliştirilen anket formu ve Araştırma Kullanım Bariyer Ölçeği Türkçe
versiyonu ile toplanmıştır. Funk tarafından geliştirilen ölçek toplam 29 madde
ve 4 alt gruptan oluşmaktadır. Ölçeğin alt grupları hemşirenin bireysel
özellikleri, organizasyonun özellikleri (kurumsal sınırlamalar, engeller)
inovasyonun özellikleri (araştırmanın kalitesi) ve iletişim özellikleri
(araştırmanın sunumu, erişilebilirliği) 'dir. Ölçekten alınan puan artıkça
algılanan engel artmaktadır.
Bulgular: Bu çalışma 350 hemşire ile
yapılmıştır. Katılımcıların çoğu lisans mezunudur. Ortalama olarak, hemşirelik
mesleğinde 8,6 yıldır (1-30 yıl) çalışmaktadırlar. Hemşirelerin %75,15'inin
araştırma hakkında bilgisi yoktu ve %73,42'si pratikte yapılacak
değişikliklerin yararlarının sınırlı olduğuna inanıyordu. Organizasyon alt
grubunda en yüksek skorlu engel “hekimlerin klinikte iş birliği yapmaması (%76,85)
idi. İnovasyon alt grubunda ise belirlenen en yüksek engelin “hemşirelerin
araştırma sonuçlarına inanıp inanmama konusunda yaşadıkları belirsizlik (%72,57)
olduğu saptandı. İletişim alt boyutundaki bildirilen en büyük engel
“araştırmaların tek merkezde toplanmamış (%66,85) olmasıydı.
Sonuç: Hemşirelerin klinikte
araştırma sonuçlarını kullanmada ciddi engelleri vardır. Bu engeller,
hemşirelerin bireysel özelliklerinden örgütsel faktörlere kadar uzanmaktadır.
Bu nedenle, yalnızca hemşirelere odaklanmak, sorunu çözmede doğru yaklaşım
değildir. Tek çözüm, erken çocukluk döneminden itibaren tüm bireyler için laik,
rasyonel ve bilimsel eğitim sağlamaktır. Ancak bu şekilde hem bireysel hem de
yönetimden kaynaklanan örgütsel engellerin üstesinden gelinebilir.
Anahtar Kelimeler
Hemşirelik araştırmaları araştırma kullanımı BARRIERS ölçeği
Kaynakça
- Brown CE, Ecoff L, Kim SC et al. Multi-institutional study of barriers to research utilisation and evidence-based practice among hospital nurses. JCN 2010;19:944-51.
- ICN “International Council of Nurses (2012). Closing the gap: From evidence to action. http://www.old.icn.ch/publications/2012-closing-the-gap-from-evidence-to-action/, Date of access: 01.02.2019.
- Funk SG, Champange MT, Tornquist EM, Wiese RA. Administrators' views on barriers to research utilization. Appl Nurs Res 1995;8:39-45.
- Yava A, Tosun N, Çiçek H, Yavan T, Terakye G, Hahipoğlu S. Nurses’ use of research results of validity and reliability of the Barriers Scale. Gulhane Medical Der 2007;5:72-80.
- Lapierre E, Ritchey K, Newhouse R. Barriers to research use in the PACU. J Perianesth Nurs 2004;19:78-83.
- O'Nan CL. The effect of a journal club on perceived barriers to the utilization of nursing research in a practice setting. JNPD 2011:27;160-4.
- Kocaman G, Seren S, Lash AA et al. Barriers to research utilisation by staff nurses in a university hospital. JCN 2010;19:1908-18.
- Uysal A, Temel AB, Ardahan M, Ozkahraman S. Barriers to research utilisation among nurses in Turkey. JCN 2010;19:3443-52.
- Mehrdad N, Salsali M, Kazemnejad A. The spectrum of barriers to and facilitators of research utilization in Iranian nursing. JCN 2008;17:2194-202.
- Wang LP, Jiang XL, Wang L, Wang GR, Bai YJ. Barriers to and facilitators of research utilization: a survey of registered nurses in China. Plos One 2013;8:1908.
- Parahoo K. Barriers to, and facilitators of, research utilization among nurses in Northern Ireland. JAN 2000;31:89-98.
- Lacey EA. Research utilization in nursing practice – a pilot study. JAN 1994;19:87-995.
- Oranta O, Routasalo P, Hupli M. Barriers to and facilitators of research utilization among Finnish registered nurses. JCN 2002;11:205-13.
- Panagiari D. Barriers and facilitators for implementing evidence-based practice among German nurses working in a general hospital Master’s thesis, University of Twente, Enschede-the Netherlands),2008:1-47.
- Bryar RM, Closs SJ, Baum G, et al. The Yorkshire BARRIERS project: diagnostic analysis of barriers to research utilisation. IJNS 2003;40:73-84.
- Heydari, A., Zeydi, AE. Barriers to and Facilitators of Research Utilization among Iranian Nurses: a Literature Review. J Caring Sci 2014;3:265–75.
- Buhaid N, Lau R, O’Connor M. A survey of nurses' perceived barriers to research utilization in Bahrain in comparison to other countries. MEJN 2014;8:3-9.
- Chien WT, Bai Q, Wong WK, Wang H, Lu X. Nurses' perceived barriers to and facilitators of research utilization in mainland china: a cross-sectional survey. OJN 2013;7:96-106.
- Chau JP, Lopez V, Thompson DR. A survey of Hong Kong nurses' perceptions of barriers to and facilitators of research utilization. Res Nurs Health 2008;31:640-649.
- Atkinson M, Turkel M, Cashy J. Overcoming barriers to research in a Magnet community hospital. J Nurs Care Qual 2008;23:362-8.
- Yava A, Tosun N, Ciçek H et al. Nurses' perceptions of the barriers to and the facilitators of research utilization in Turkey. Appl Nurs Res 2009;22:166-75.
- Sezer S. Native Pisa Model 'ABİDE (Monitoring and Evaluation of Academic Skills) Ministry of Education: Anatolian Agency; 2019:1-11.
- Cronenwet LR. Effective methods for disseminating research findings to nurses in practice. Nurs Clin N Am 1993;30:429-38.
- Luker KA. Nursing research: coming of age? JAN 2006;54:526–27.
- Turkey Reading Culture Map. http://www.kygm.gov.tr/Eklenti/56,yonetici-ozeti-engpdf.pdf?0, Date of access: 21.02.2019.
- Chan GK, Barnason S, Dakin CL et al. Barriers and perceived needs for understanding and using research among emergency nurses. J Emerg Nurs 2011;37:24-31.
- Schoonover H. Barriers to research utilization among registered nurses practicing in a community hospital. JNSD 2009;25:199-212.
- Dalheim A, Harthug S, Nilsen RM, Nortvedt MW. Factors influencing the development of evidence-based practice among nurses: a self-report survey. BMC Health Services Research 2012;24:363-7.
- Estabrooks CA, Rutakumwa W, O’Leary KA, et al. Sources of practice knowledge among nurses. QHR 2005;15:460–76.
- Gerrish K, Ashworth P, Lacey A, Bailey J. Developing evidence-based practice: experiences of senior and junior clinical nurses. JAN 2008;62:62–73.
- Yavan T, Terakye G, Hatipoğlu S. Nurses' perceptions of the barriers to and the facilitators of research utilization in Turkey. Appl Nurs Res 2009;22:166-75.
- Spenceley SM, O'Leary KA, Chizawsky LL, Ross AJ, Estabrooks CA. Sources of information used by nurses to inform practice: An integrative review. IJNS 2008;45:954-70.
- Hundley M, Milne J, Leighton-Beck L, Graham W, Fitzmaurice A. Raising research awareness among midwives and nurses: does it work? JAN 2000;31:78-88.
Öz
Objectives: Evidence-based
practice (EBP) is an approach to making quality decisions and providing nursing
care based upon personal clinical expertise in combination with the most
current, relevant research available on the topic. EBP can significantly affect
mortality and morbidity rates and play an important role in the reduction of
geographic differences. Ten/fifteen years ago in our country, “Health
Transition Project” was launched to improve the quality of health care. Thus it
should be investigated to better understand nurses’ current perceived barriers
to research utilization. This study aim to investigate barriers of research
utilization among nurses at a public hospital and radical changes of its health
care system.
Materials and Methods: This study
was planned as a descriptive research. This study was conducted between the
dates of February-May 2018 at a Public Hospital in Turkey. All participant who
volunteered to participate in the survey and who completed fully form were
evaluated. Simple random sampling method was used. Data were collected using a
face-to-face interview technique with the questionnaire developed by the
researchers and Barriers to Research Utilization Scale Turkish version. The
BARRIER scale developed by Funk consists of 29 items and four subgroups. These
four factors were labeled nurse, organization, innovation and communication. As
obtained the scale score increases obstacle is increasing.
Results: A total of 350 nurses
participated in this survey. Most of participants were undergraduate. On
average, they had been employed in the nursing profession for 8.6 years (range
1-30 years). A large part of the nurses was not following the publications
related to the profession (75.15%) and believed that the practical changes
would provide minimal benefit (73.42%). For the organizational factors, the biggest
barriers reported were “physicians will not cooperate with implementation” (76.85%).
For the innovation factors the biggest barriers determined were “the nurse is
uncertain whether to believe the results of the research (72.57%). For the
communication factors, the biggest barriers reported were “literature is not
compiled in one place” (66.85%).
Conclusion: Nurses have serious
barriers to using research results in clinics. These barriers range from
individual characteristics of nurses to organizational factors. Therefore,
focusing only on nurses is not the right approach in solving the problem. The
only solution is to ensure secular, rational and scientific education for all
individuals from the early childhood. Only in this way can both individual and
from management organizational barriers arising can be overcome.
Anahtar Kelimeler
Kaynakça
- Brown CE, Ecoff L, Kim SC et al. Multi-institutional study of barriers to research utilisation and evidence-based practice among hospital nurses. JCN 2010;19:944-51.
- ICN “International Council of Nurses (2012). Closing the gap: From evidence to action. http://www.old.icn.ch/publications/2012-closing-the-gap-from-evidence-to-action/, Date of access: 01.02.2019.
- Funk SG, Champange MT, Tornquist EM, Wiese RA. Administrators' views on barriers to research utilization. Appl Nurs Res 1995;8:39-45.
- Yava A, Tosun N, Çiçek H, Yavan T, Terakye G, Hahipoğlu S. Nurses’ use of research results of validity and reliability of the Barriers Scale. Gulhane Medical Der 2007;5:72-80.
- Lapierre E, Ritchey K, Newhouse R. Barriers to research use in the PACU. J Perianesth Nurs 2004;19:78-83.
- O'Nan CL. The effect of a journal club on perceived barriers to the utilization of nursing research in a practice setting. JNPD 2011:27;160-4.
- Kocaman G, Seren S, Lash AA et al. Barriers to research utilisation by staff nurses in a university hospital. JCN 2010;19:1908-18.
- Uysal A, Temel AB, Ardahan M, Ozkahraman S. Barriers to research utilisation among nurses in Turkey. JCN 2010;19:3443-52.
- Mehrdad N, Salsali M, Kazemnejad A. The spectrum of barriers to and facilitators of research utilization in Iranian nursing. JCN 2008;17:2194-202.
- Wang LP, Jiang XL, Wang L, Wang GR, Bai YJ. Barriers to and facilitators of research utilization: a survey of registered nurses in China. Plos One 2013;8:1908.
- Parahoo K. Barriers to, and facilitators of, research utilization among nurses in Northern Ireland. JAN 2000;31:89-98.
- Lacey EA. Research utilization in nursing practice – a pilot study. JAN 1994;19:87-995.
- Oranta O, Routasalo P, Hupli M. Barriers to and facilitators of research utilization among Finnish registered nurses. JCN 2002;11:205-13.
- Panagiari D. Barriers and facilitators for implementing evidence-based practice among German nurses working in a general hospital Master’s thesis, University of Twente, Enschede-the Netherlands),2008:1-47.
- Bryar RM, Closs SJ, Baum G, et al. The Yorkshire BARRIERS project: diagnostic analysis of barriers to research utilisation. IJNS 2003;40:73-84.
- Heydari, A., Zeydi, AE. Barriers to and Facilitators of Research Utilization among Iranian Nurses: a Literature Review. J Caring Sci 2014;3:265–75.
- Buhaid N, Lau R, O’Connor M. A survey of nurses' perceived barriers to research utilization in Bahrain in comparison to other countries. MEJN 2014;8:3-9.
- Chien WT, Bai Q, Wong WK, Wang H, Lu X. Nurses' perceived barriers to and facilitators of research utilization in mainland china: a cross-sectional survey. OJN 2013;7:96-106.
- Chau JP, Lopez V, Thompson DR. A survey of Hong Kong nurses' perceptions of barriers to and facilitators of research utilization. Res Nurs Health 2008;31:640-649.
- Atkinson M, Turkel M, Cashy J. Overcoming barriers to research in a Magnet community hospital. J Nurs Care Qual 2008;23:362-8.
- Yava A, Tosun N, Ciçek H et al. Nurses' perceptions of the barriers to and the facilitators of research utilization in Turkey. Appl Nurs Res 2009;22:166-75.
- Sezer S. Native Pisa Model 'ABİDE (Monitoring and Evaluation of Academic Skills) Ministry of Education: Anatolian Agency; 2019:1-11.
- Cronenwet LR. Effective methods for disseminating research findings to nurses in practice. Nurs Clin N Am 1993;30:429-38.
- Luker KA. Nursing research: coming of age? JAN 2006;54:526–27.
- Turkey Reading Culture Map. http://www.kygm.gov.tr/Eklenti/56,yonetici-ozeti-engpdf.pdf?0, Date of access: 21.02.2019.
- Chan GK, Barnason S, Dakin CL et al. Barriers and perceived needs for understanding and using research among emergency nurses. J Emerg Nurs 2011;37:24-31.
- Schoonover H. Barriers to research utilization among registered nurses practicing in a community hospital. JNSD 2009;25:199-212.
- Dalheim A, Harthug S, Nilsen RM, Nortvedt MW. Factors influencing the development of evidence-based practice among nurses: a self-report survey. BMC Health Services Research 2012;24:363-7.
- Estabrooks CA, Rutakumwa W, O’Leary KA, et al. Sources of practice knowledge among nurses. QHR 2005;15:460–76.
- Gerrish K, Ashworth P, Lacey A, Bailey J. Developing evidence-based practice: experiences of senior and junior clinical nurses. JAN 2008;62:62–73.
- Yavan T, Terakye G, Hatipoğlu S. Nurses' perceptions of the barriers to and the facilitators of research utilization in Turkey. Appl Nurs Res 2009;22:166-75.
- Spenceley SM, O'Leary KA, Chizawsky LL, Ross AJ, Estabrooks CA. Sources of information used by nurses to inform practice: An integrative review. IJNS 2008;45:954-70.
- Hundley M, Milne J, Leighton-Beck L, Graham W, Fitzmaurice A. Raising research awareness among midwives and nurses: does it work? JAN 2000;31:78-88.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırmalar |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Eylül 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 19 Sayı: 3 |
