Commentary on Kocaman G, Seren S, Lash AA, Kurt S, Bengu N & Yurumezoglu HA. Barriers to research usage by staff nurses in a university hospital. Journal of Clinical Nursing 19, 1908–1918

Abstract

The paradigm of evidence-based practice (EBP) has been introduced internationally with the aim of applying research results in practice and deliver care based on sound evidence of what works (Rycroft-Malone et al. 2004, Pravikoff et al. 2005). In nursing, because of the focus of the discipline, evidence comes from an array of sources: an integration of research-based evidence with clinical experience, context characteristic and patients’ preferences (Reavy & Tavernier 2008). However, as many authors, including Kocaman et al. have stressed, decisions on nursing practice principally rely on the nurses’ personal experience and observations, not on research results. Considering its potential benefits for nursing care, there is a growing concern about the development of evidence-based nursing and nurses, at all levels, are increasingly expected to improve the quality of care through the incorporation of relevant research in decision-making (Roxburgh 2006, Hannes et al. 2007). In the literature, this has been called research utilisation, research use or research usage (RU) in Kocaman et al.’s (2010) article. Many authors have tried to clarify the reasons for the existing gap between research production and RU because, despite the increasing amount of research evidence, nursing practice remains reticent to apply its findings in practice (Profetto-McGrath et al. 2007, Reavy & Tavernier 2008). A good example can be found on Kocaman et al.’s article. This article offers interesting insights into the issue because it enlightens the situation in a specific context, the Turkish, which had not been studied before. This is necessary because most of the studies on RU have been conducted in countries with a research tradition such as the UK, the USA, Canada or Nordic countries, and results about the barriers to RU should not be directly translated to other contexts with different backgrounds and situations regarding nursing research, like Turkey (Corchon et al. 2010). In Kocaman et al.’s study, they used the most frequently used instrument in this kind of enquiry, the Barriers’ scale (Funk et al. 1991). Based on Roger’s model of Diffusion of Innovations, it is divided into four subscales to study barriers to RU: 1-Characteristics of the nurse; 2-Characteristics of the setting; 3-Characteristics of the innovation; and 4-Characteristics of the communication. Although this instrument has some limitations, the fact that it has been widely used in different contexts allows the comparison between the situations in different countries regarding the barriers to RU, as they have done in this article. Participants in Kocaman et al.’s study identified as the main barriers to RU the lack of time, lack of facilities and lack of support, together with the language barrier. In other words, in Turkey, they found that, although the characteristics of the nurse were important, the most significant barriers to RU were those related to the organisation, as it happens in the other compared countries, showing consistent results with previous studies (Retsas 2000, Parahoo & McCaughan 2001, Corchon 2009). Therefore, considering the important amount of literature focused on the barriers to RU and the congruent findings achieved along the years across different contexts, it seems that those have been overstudied and it is time to take a step forwards and start intervening on them. Many studies have looked at the barriers for EBP, but few have addressed innovative strategies