Kanıta Dayalı Hemşireliğe Yönelik Tutum Ve Araştırma Kullanım Engelleri: Pediatri Hemşireleri Örneği

Öz

Amaç: Bu araştırma Türkiye’deki pediatri kliniklerinde çalışan hemşirelerin kanıta dayalı hemşireliğe yönelik tutumları ve araştırma kullanım engellerini belirlemek amacıyla gerçekleştirildi.
Yöntem: Bu araştırma, tanımlayıcı ve kesitsel bir çalışmadır. Araştırma Türkiye’nin kuzey bölgesinde büyük bir şehirde kamuya bağlı iki büyük hastanede yer alan pediatri kliniklerinde gerçekleştirildi. Araştırmanın örneklemini 244 hemşire oluşturdu. Veri toplama araçları olarak Kişisel Bilgi Formu, Araştırma Kullanımının Önündeki Engeller Ölçeği (HAYEÖ) ve Kanıta Dayalı Hemşirelik Anketi (KDHYTÖ) kullanıldı.
Bulgular: Hemşirelerin% 67,6'sının herhangi bir bilimsel etkinliğe katılmadığı belirlendi. Çalışmaya dahil edilen hemşirelerin KDHYTÖ toplam puan ortalamasının 46.80 ± 2.99 ve HAYEÖ toplam puan ortalamasının 58.11 ± 16.29 olduğu bulundu. Hemşirelerin araştırmaları kullanmalarında en önemli engelin ‘İş yerinde araştırmaları okumak için yeterli zaman olmaması’ (%46.3) olduğu belirlendi. Araştırmadan yararlanmada engeller ölçeği toplam puan ortalamaları ile çalışma süresi ve sahip oldukları pozisyon arasında istatistiksel olarak anlamlı bir fark olduğu görülmüştür (p <0.05). Ayrıca hemşirelik ile ilgili herhangi bir bilimsel etkinliğe katılma durumu ve bilimsel etkinlik şekli ile kanıta dayalı hemşireliğe yönelik tutum ölçeği toplam puan ortalamaları arasında istatistiksel olarak anlamlı farklılıklar bulundu (p<0.05).
Sonuçlar ve Öneriler: Bu çalışmada hemşirelerin kanıta dayalı hemşireliğe yönelik tutumları ve araştırmalarından yararlanmada algıladıkları engellerin orta düzeyde olmasına rağmen, hemşirelerin çoğunluğunun bilimsel bir etkinliğe katılmadıkları, literatürde kanıt aramadıkları, kanıta dayalı bir uygulamanın çalışma ortamına getirilmesine katkıda bulunmadıkları ve bu konuda kendilerini yeterli bulmadıkları belirlenmiştir. Hemşirelerin en çok araştırma kullanım engellerinin hemşire ve kurum kaynaklı olduğu tespit edilmiştir.

Anahtar Kelimeler

• Kanıta dayalı uygulama;
• Araştırma engelleri;
• Hemşire;
• Pediatri

ATTITUDES TOWARDS EVIDENCE-BASED NURSING AND BARRIERS AGAINST UTILIZING RESEARCH: THE CASE OF PEDIATRICS NURSES

Öz

determining the attitudes of nurses working in the pediatrics clinics towards evidence-based nursing and the barriers they encounter while trying to utilize research.
Methods: This research is a descriptive and cross-sectional study. Study was conducted in the pediatrics clinics of two big public hospitals located in a metropolitan city in the northern region of Turkey. The sample of the study consists of 244 nurses. A Personal Information Form, the Barriers to Research Utilization Scale (BRUS), and the Attitude Towards Evidence-Based Nursing Questionnaire (ATEBNQ) were used as data collection instruments.
Results: It was determined that 67.6% of the nurses did not participate in any scientific event. It was found that the total average BRUS score of the nurses included in the study was 46.80±2.99 and the total average ATEBNQ score was 58.11±16.29. It was determined that the most important barrier in the use of research by nurses was "Not enough time to read scientific studies because of work" (46.3%). It was seen that there is a statistically significant difference between the total score averages of the research utilization scale and the working duration time and the workload they have (p <0.05). In addition, statistically significant differences were found between the level of participation in scientific activities and the type of these activities, and the total mean ATEBNQ scores (p <0.05).
Conclusion and Suggestions: In this study, it was determined that nurses' attitudes towards evidence-based nursing and their perceived barriers against utilizing from their research were moderate; however, the majority of the nurses stated that they did not participate in scientific events, did not review the literature, did not try to bring an evidence-based approach to clinical practice, and that they did not consider themselves competent on this matter. It was determined that most of the barriers against the use of scientific studies in nursing practices stem from nurses and institutions.

Anahtar Kelimeler

• Evidence-based practic;
• Research utilization;
• Nurse;
• Pediatric.

Kaynakça

1. Al Khalaileh, M., Al Qadire, M., Musa, AS.,Al-Khawaldeh, OA., Al Qudah, H., HRN., & Alhabahbeh, A.(2016). Closing the gap between research evidence and clinical practice: Jordanian nurses’ perceived barriers to research utilisation. Journal of Education and Practice, 7(8), 52-57.
2. Alsulami, Z., Choonara. I., & Conroy. S. (2013). Pediatric nurses' adherence to the double-checking process during medication administration in a children's hospital: An observational study. Journal of Advanced Nursing, 70(6), 1404–1413. doi: 10.1111/jan.12303.
3. Ayhan, Y., Kocaman, G.,& Bektaş, M. (2015). The validity and reliability of attitude towards evidencebased nursing questionnaire for Turkish. Hemşirelikte Araştırma Geliştirme Dergisi. 17(2-3), 21-35.
4. Bahar, Z., Gözüm, S., Beşer, A., Çapık, C., Kıssal, A.,& Gördes, N. (2015). Barriers to and factors affecting use of research findings by nurses ın university hospitals ın two different regions of Turkey. Dokuz Eylul University E-Journal of Nursing Faculty, 8 (4), 232-240.
5. Başbakkal, Z., Beytut. D., Muslu. GK., Ersun. A.,& Özçelik. M. (2013). An analysis of the effects of job attitudes of pediatric ıntensive care nurses on barriers to research utilization. Dokuz Eylul University E-Journal of Nursing Faculty. 6 (2), 75-81.
6. Bayık, TA., Uysal, A., Ardahan, M., & Özkahraman, Ş. (2009). Barriers to research utilization scale: psychometric properties of the Turkish version. Journal of Advanced Nursing, 66, 456464. doi:10.1111/j.1365-2648.2009.05162.
7. Centre for Evidence-Based Practice. University of Toronto Health Network. 2013.http://www.cebin.u.torontocal/syllas/nur/intro/htm.
8. Cidoncha-Moreno, MÁ., & Alegría-Fernandez de Retana, BR. (2017). Barriers to the implementation of research perceived by nurses from Osakidetza. Enfermería Clínica. 27 (5), 286–293. doi: 10.1016/j.enfcli.2017.03.015.

9. Daştan, B.,& Hintistan, S. (2018). Determination of the attitudes of nurses working in ınternal clinics for evidence based nursing: Rural region example. Ordu University Journal of Nursing Studies, 1(1),1-9.
10. Ding, S., Lin, F., Marshall, AP.,& Gillespie, BM. (2017). Nurses' practice in preventing postoperative wound infections: An observational study. Journal of Wound Care 26(1),28–37. doi: 10.12968/jowc.2017.26.1.28.
11. Donald, F., Martin‐Misener, R., Carter, N., Donald, EE., Kaasalainen, S., Wickson‐ Griffiths, A., …… , DiCenso, A. (2013). A systematic review of the effectiveness of advanced practice nurses in long‐term care. Journal of Advanced Nursing, 69(10):2148–61. doi: 10.1111/jan.12140.
12. Funk, S., Champagne, M., Wiese, R., & Tornquiest, E.(1991). Barriers: the barriers to research utilization scale. Applied Nursing Research, 4(1), 39-45. DOI: 10.1016/s0897-1897(05)80052-7.
13. Heydari, A., Mazlom, SR., Ranjbar, H., & Scurlock-Evans, L. (2014). A study of Iranian nurses’ and midwives’ knowledge, attitudes, and implementation of evidence-based practice: The time for change has arrived. Worldviews on Evidence-Based Nursing, 11(5), 325-331.doi: 10.1111/wvn.12052.
14. Hweidi, IM., Tawalbeh, LI., Al-Hassan, MA., Alayadeh, RM., & Al-Smadi, AM. (2017). Research use of nurses working in the critical care units: barriers and facilitators. Dimensions of Critical Care Nursing, 36(4), 22 6–233. doi: 10.1097/DCC.0000000000000255.
15. Jun, J., Kovner, CT., Dickson, VV., Stimpfel, AW., & Rosenfeld, P. (2020). Does unit culture matter? The association between unit culture and the use of evidence-based practice among hospital nurses. Applied Nursing Research, 53,151251. doi: 10.1016/j.apnr.2020.151251
16. Maaskant, JM., Knops, AM., Ubbink, DT.,& Vermeulen, H. (2013). Evidence-based practice: A survey among pediatric nurses and pediatricians. Journal of Pediatric Nursing, 28(2),150-157. doi: 10.1016/j.pedn.2012.05.002.
17. Mahmouda, MH., Abdelrasol, Z.(2019). Obstacles in employing evidence-based practice by nurses in their clinical settings: A descriptive study. Frontiers of Nursing, 6(2),123-33. doi: 10.2478/FON-2019-0019
18. Moe, A., & Enmarker, I. (2020). Research utilization in municipality nursing practice in rural districts in Norway: A cross-sectional quantitative questionnaire study. BMC Nursing, 19(1),1-10. doi: 10.1186/s12912-020-00475-1.
19. Mohamed, NA., Mohamed, HA., & Mohamed, SH. (2015). Evidence-based practice: Barriers and facilitators among nurses. Zagazig Nursing Journal, 11(1), 174–191. Mörelius, E., Foster, M, & Gill, MJ. (2020). A scoping review of nursing research priorities in pediatric care. Journal of Pediatric Nursing, 52:e57-69. doi: 10.1016/j.pedn.2020.01.006.
20. Öztürk Yıldırım, T., & Karadağ, M. (2016). The perceptions of nurse managers on their critical thinking skills and research utilization barriers and facilitators. Journal of Health and Nursing Management, 2(3),73-85. doi:10.5222/SHYD.2016.073
21. Pereira, F., Victoria Pellaux, V., & Verloo, H. (2018). Beliefs and implementation of evidence‐based practice among community health nurses: A cross‐sectional descriptive study. Journal of Clinical Nursing, 27(9-10), 2052–61. doi: 10.1111/jocn.14348.
22. Rossi, S., Bagnasco, A., Barisone, M., Bianchi, M., Bressan, V., Timmins, F., …Sasso,L. (2020). Research awareness among children's nurses: An integrative review, Journal of Clinical Nursing, 29(3-4), 290-304. doi: 10.1111/jocn.15068.
23. Ruzafa-Martinez, M., Lopez-Iborra, L., & Madrigal-Torres, M. (2011). Attitude towards evidence-based nursing questionnaire: development and psychometric testing in Spanish community nurses. Journal of Evaluation in Clinical Practice, 17(4), 664–70. doi: 10.1111/j.1365-2753.2011.01677.x.
24. Sawin, KJ., Lewin, LC., Niederhauser, VP., Brady, MA., Jones, D.,…. Trent, CA. (2012). A survey of NAPNAP members' clinical and professional research priorities. Journal of Pediatric Health Care, 26(1), 5–15. doi: 10.1016/j.pedhc.2010.04.012.
25. Stavor, DC., Zedreck-Gonzalez, J., & Hoffmann, RL. (2017). Improving the use of evidence-based practice and research utilization through the ıdentification of barriers to ımplementation in a critical access hospital. The Journal of Nursing Administration, 47(1), 56-61. https://doi.org/10.1097/NNA.0000000000000437
26. Tume, LN., Coetzee, M., Dryden-Palmer, K., Hickey, P. A., Kinney, S., Latour, J. M., & Curley, M. A. (2015). Pediatric critical care nursing research priorities-initiating international dialogue. Pediatric Critical Care Medicine, 16(6), e174–e182. https://doi.org/10.1097/PCC.0000000000000446.
27. Yılmaz, D., Düzgün, F., & Dikmen, Y. (2019). An ınvestıgatıon ınto nurses’ attıtudes towards evıdence-based nursıng. Acıbadem University Health Sciences Journal, 10(4),713-719. doi:10.31067/0.2018.