A Synthesized Model for Applying Stress Management and Biofeedback Interventions in Research Utilization: A Systematic Review and Meta-analysis.

Background: Stress management and biofeedback interventions have been shown to be effective in improving mental and physical health outcomes. However, previous research studies and synthesized models for applying these interventions in research utilization are insufficient. Objective: This study aimed to synthesize a model for applying stress management and biofeedback interventions in research utilization. Methods: A systematic review and meta-analysis were conducted according to the PRISMA guidelines.Multiple studies were used to assess the effectiveness of applying stress management and biofeedback interventions published from 2017 to 2023. The process included identifying the research questions, conducting a comprehensive literature search, assessing study quality, extracting data, synthesizing the data, analyzing and interpreting the findings, drawing conclusions, and making recommendations. Results: The results indicated a significant mean effect size without evidence of publication bias. The effect sizes of the subgroups among the study variables were not significantly different [Q = 4.02, p = .26]. However, there were significant differences regarding the mean effect sizes among the studies [Q = 63.59, p < .001] and also in terms of the test of subgroups among the participants [Q = 8.49, p = .04]. Conclusion: The results emphasize the importance of evidence-based practice and highlight the need for ongoing evaluation and refinement of interventions. The proposed model was supported by related theories and research studies in order to ensure the robustness and reliability to guide practice and future research in the field of biofeedback interventions. By following this model, researchers and practitioners can ensure that stress management and biofeedback interventions are evidence-based and are effective in improving mental and physical health outcomes.

A compendium of evidence-based practice instruments for nursing education, practice and research.

BACKGROUND: Evidence-based practice (EBP) is a cornerstone for safe, high-quality care. Implementation science recognizes that many factors influence the successful use of EBP, from attitudes and beliefs, self-efficacy, and knowledge and skills to contextual factors related to unit and organizational culture. This integrative review aimed to identify valid and reliable instruments measuring critical EBP domains with nursing professionals. METHODS: A systematic search of the literature was conducted. CINAHL, PubMed, EMBASE, Cochrane, and Joanna Briggs were searched to identify original research publications testing the reliability and validity of EBP nursing instruments. RESULTS: Of 347 records, 48 studies representing 50 instruments were identified as having undergone psychometric testing, thus meeting the inclusion criteria. Most instruments were validated in English-speaking countries. Content validity, construct validity, and internal consistency standards were met for 70%, 62%, and 94% of instruments, respectively. Limited testing was found for other types of validity, test-retest reliability, acceptability, feasibility, or responsivity and sensitivity, thus representing gaps in psychometric validation. Less than 20% of instruments have been translated to other languages limiting their use to advance EBP worldwide. LINKING EVIDENCE TO ACTION: Eighty-two percent of instruments met minimal psychometric standards and are sound for education, practice, and research. Expanding psychometric testing and utilizing validated EBP instruments will further the EBP movement to improve global population health.

Registered nurses' self-rated research utilization in relation to their work climate: Using cluster analysis to search for patterns.

AIM: To describe and study the association between registered nurses' self-rated research utilization and their perception of their work climate. BACKGROUND: Research utilization is an important part of evidence-based nursing, and registered nurses value a work climate that supports the possibility to work evidence-based. METHOD: This cross-sectional study was conducted using the Creative Climate Questionnaire together with three questions measuring instrumental, conceptual and persuasive research utilization. The analysis was done using variable- and pattern-oriented approaches. RESULTS: An association was found between research utilization and experience of dynamism/liveliness. Women reported higher use of conceptual research utilization. Regarding work climate, younger registered nurses and registered nurses with less work experience gave higher scores for playfulness/humour and conflicts. The results showed an association between having a Bachelor's or Master's degree and higher instrumental research utilization. DISCUSSION: Research utilization was higher in registered nurses with higher academic education. Low users of research tended to experience a lack of dynamism and liveliness, which indicates the importance of improving the work climate by creating a climate that allows opinions and initiate discussions. CONCLUSION: The findings support the importance of creating a work climate that encourages reflection and discussion among registered nurses, and to promote academic education for nurses plus an optimal work-place staffing-mix. SUMMARY STATEMENT: What is already known about this topic? Research utilization is an important part of evidence-based nursing. Registered nurses value a work climate that supports the possibility to work evidence-based. Little is known about the association between how nurses use research in clinical work and how they perceive their work climate. What this paper adds? Low research users tended to experience low dynamism and liveliness in their work climate, showing the importance of improving the work climate in health care organizations to support clinical nurses' ability to express opinions and initiate discussions. The association between work climate and the use of research among nurses needs further investigation. Our findings support previous research showing that a higher academic level is associated with increased research among registered nurses working clinically, and therefore benefits patient outcomes. The implications of this paper: The association between low research utilization and experience of low dynamism and liveliness indicates the importance of improving the work climate by creating an atmosphere where nurses can express their opinions and initiate discussions. There is a need to support clinical registered nurses to maintain their research utilization throughout their working career. The health care sector and the individual workplace should support registered nurses in furthering their academic level.

Developing Algorithm Based on Activity and Mobility for Pressure Ulcer Risk Among Older Adult Residents: Implications for Evidence-Based Practice.

BACKGROUND: A pressure ulcer (PU) is a localized injury to the skin or underlying tissue usually over a bony prominence. The prevention PU per patient per day is costly; therefore, the detection of a PU at its earliest stage is imperative to afford timely interventions. Currently, there are very few clinically useful tools to assist with early PU detection and prevention. AIM: There were two primary aims of this study: (1) to investigate the relationship between activity, mobility, and PU development; and (2) to ascertain the next steps for delineating an algorithm based on activity and mobility for detecting PU risk among older adult residents in long-term care. METHOD: This quantitative, prospective, descriptive, non-experimental study was conducted between July 2019 and March 2020 among 53 older adult residents who were followed for 4 consecutive days. Participants' Braden score, Elderly Mobility Scale (EMS) score, Movement Level, and 6-item Cognitive Impairment Test score were assessed. Further, the sacrum and heels were assessed daily using a non-invasive subepidermal moisture (SEM) scanner and visual skin assessment (VSA). SEM values > 0.5 were considered as indicative of the presence of an SEM-PU. RESULTS: The incidence rate of VSA-PU was 15.1% (N = 8). There was an incidence of 87.5% (N = 42) of SEM-PU damage. According to the Braden subscale, Mobility Braden, most of the participants (62.2%, N = 33) were assessed as having no limitations/slightly limited mobility, while the EMS indicated that most of the participants (67.9%, N = 36) were classed in an independent category. From the 42 SEM-PUs observed, 62% (N = 26) occurred among the low movers, and 38% (N = 16) occurred among the high movers. LINKING EVIDENCE TO ACTION: Using traditional methods for the assessment of movement does not provide insight into the protective nature of the movement. Given that both low- and high-moving patients can develop tissue damage, it is important to focus on the assessment of movement using more objective measures and algorithms, which enable real-time assessment of the protective nature of the movement. This would enable development of person-centered PU prevention strategies to reduce the burden of this significant healthcare problem.

Structural barriers to knowledge transfer and exchange among men and women in low-, middle- and high-income countries: an international cross-sectional study with vaccine researchers in 44 countries.

BACKGROUND: Globally, women constitute 30% of researchers. Despite an increasing proportion of women in research, they are still less likely to have international collaborations. Literature on barriers to knowledge transfer and exchange (KTE) between men and women remains limited. This study aimed to assess perceived gender barriers to KTE activities in vaccination-related research in low-, middle- and high-income countries. METHODS: This was a cross-sectional data assessment from a self-administered questionnaire distributed to researchers in the field of vaccination research. The administered questionnaire was developed and validated by WHO and McMaster University. Descriptive statistics were carried out. Structural factors of KTE were assessed using 12 statements measured with a five-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). An index ranging from 12 to 60 points was created to assess structural factors of KTE, with higher score indicating fewer perceived barriers. Multivariable linear regression modelling was applied to examine the association between KTE barriers and gender. RESULTS: A total of 158 researchers were included in the analysis. Regardless of gender and country of affiliation, researchers experienced challenges with respect to KTE activities; particularly factors related to the availability of human and financial resources and level of technical expertise among their target audience. We were also able to identify perceived facilitators among men and women, such as the presence of structures that link researchers and target audiences, the investment of target audiences in KTE efforts and the presence of stable contacts among target audiences. Our linear regression analysis showed that women perceived more barriers than men (R2 = 0.014; B = -1.069; 95% CI -4.035; 1.897). CONCLUSIONS: Men and women shared common perspectives on barriers to KTE. KTE activities could be strengthened by improving structural efforts to reduce gender differences and increase collaborations between researchers and their target audience.

Measuring organizational context in Australian emergency departments and its impact on stroke care and patient outcomes.

BACKGROUND: Emergency departments (ED) are challenging environments but critical for early management of patients with stroke. PURPOSE: To identify how context affects the provision of stroke care in 26 Australian EDs. METHOD: Nurses perceptions of ED context was assessed with the Alberta Context Tool. Medical records were audited for quality of stroke care and patient outcomes. FINDINGS: Collectively, emergency nurses (n = 558) rated context positively with several nurse and hospital characteristics impacting these ratings. Despite these positive ratings, regression analysis showed no significant differences in the quality of stroke care (n = 1591 patients) and death or dependency (n = 1165 patients) for patients in EDs with high or low rated context. DISCUSSION: Future assessments of ED context may need to examine contextual factors beyond the scope of the Alberta Context Tool which may play an important role for the understanding of stroke care and patient outcomes in EDs.

The Importance of Context and Organization Culture in the Understanding of Nurses' Barriers Against Research Utilization: A Systematic Review.

BACKGROUND: Numerous studies have explored nurses' perceived barriers to research utilization. In this study, considerations of how to break down the barriers are discussed in order to find new ways to develop and strengthen evidence-based practice. AIMS: The objective of the study was to identify nurses' perceptions of barriers to research utilization in clinical practice between the years of 2000 and 2018 and across continents by reviewing studies that used the Barriers to Research Utilization (BARRIERS) scale (Appl Nurs Res, 4, 1991, 39). DESIGN: A systematic review of observational studies based on Joanna Briggs specific guidelines. METHODS: A systematic search to identify and select eligible studies was conducted in PubMed, CINAHL, PsycInfo, and SCOPUS during January 2019. Google Scholar was also searched to identify additional studies using the Funk et al. (Appl Nurs Res, 4, 1991, 39) BARRIERS scale. An instrument for quality appraisal was constructed for this paper by combining two similar and previously used cross-sectional study checklists (Int J Sociol Soc Policy, 23, 8, 2003; Implement Sci, 5, 32, 2010). Descriptive statistics were performed using IBM SPSS Statistics (version 25). RESULTS: The 27 included studies were conducted in 16 countries across five continents and 11,276 nurses participated. Seven of the top 10 barriers were comprised of organizational factors. These organizational barriers were consistent over time and the five continents, with 56% of the listed top 10 barriers falling under the organizational category. From the year 2000 to 2008, the majority of the studies were conducted in Europe and Australia. However, for the next 10 years (2008-2018), the majority of studies were conducted in Asia, Africa, and North America. LINKING EVIDENCE TO ACTION: To break down the nurses' barriers to research utilization, our future practice and research focus will be to conduct intervention studies focusing on the effect of facilitators and contextual environment, as well as developing nursing research cultures in clinical practice with support from the nursing management.

Creating room for evidence-based practice: Leader behavior in hospital wards.

The integration (routinizing and sustaining) of evidence-based practice (EBP) into hospital management is a key element for improving patient safety and ensuring better patient outcomes. Hospital managers and clinical leaders play crucial roles in this integration. Interactions between leaders and integration context influence the improvement's quality, but leader-based actions that are effective for improving nursing practice remain unclear. The relationship between leaders could also either hinder or enable this implementation process. The aim of this study was to generate a theory about patterns of leader behavior that leaders are engaged in when attempting to integrate EBP in a clinical setting. We used a classic grounded theory methodology to generate a substantive EBP theory. In this study, through participant observation, we observed 63 nurses (15 specialist, 39 registered, and 9 assistant nurses). From these, five ward leaders (two head nurses, one assistant head nurse, and two teaching nurses) participated in individual interviews, and 18 clinical nurses participated in four focus groups. "Creating room for EBP" emerged as a theory for explaining the way in which the leaders attempted to resolve their main concern: How to achieve EBP treatment and care with tight resources and without overextending the nurses. Creating room for EBP encompasses a process of interactions, including positioning for, executing, and interpreting responses to EBP.

Research utilization in municipality nursing practice in rural districts in Norway: a cross-sectional quantitative questionnaire study.

BACKGROUND: Scientific knowledge and theory constitute part of the nurse's competence and evidence-based nursing practice. To obtain and maintain these skills, nurses require access to research utilization. The aim of the present study was therefore to describe and compare nurses in nursing homes and home-based nursing care and their use of research knowledge in their practice in elderly care in Norwegian rural districts. METHODS: The Research Utilization Questionnaire (RUQ) was employed in cross-sectional quantitative design. One hundred nurses were recruited from ten rural municipalities that participated in the study. Inclusion criteria for participating were registered nurses and employees working in the municipal elderly care service for 6 months or more. RESULTS: Most participants were younger than 55 years old, worked in permanent jobs, and were educated more than 5 years ago. The result showed that nurses in nursing homes were significantly more positive compared to nurses in home-based nursing care when analyzing all three domains in the RUQ together, as well as for attitudes towards research when testing each domain separated. Overall, each item in the domains revealed opinions that were more positive for nurses in nursing homes. The regression analysis showed that attitudes towards research, as well as availability and support of research utilization predicted the use of research in daily practice. CONCLUSIONS: Positive attitudes, availability, and support for research utilization can contribute to greater use of research in nursing practice and improve the quality of service. Younger nurses' knowledge about using research should be shared with senior colleagues, who possess much experience in practice. In collaboration, they can develop evidence-based practice by the implementation of research seen in the context of nurses' experiences, user involvement, and person-centred practice. The i-PARIHS (Promoting Action on Research Implementation in Health Services) framework can be a useful tool in this implementation process.

Registered Nurses' Evidence-Based Practice Revisited: A Longitudinal Study in Mid-Career.

BACKGROUND: To improve patient outcomes and patient safety and to reduce costs in health care, the implementation of evidence-based practice (EBP) is crucial. AIMS: To examine the use of the EBP process in Swedish health care. Specifically, to examine whether professional career development (years of experience, years in current position, specialist education, care setting) is associated with RNs' practice of EBP activities and changes in the extent of practicing the EBP process between early and mid-career. METHODS: In this observational longitudinal study, the extent of EBP activities was investigated in three national cohorts of 2,474 RNs. Nurses rated their own EBP levels 11-15 and three years after graduation. Six items measured the respondents' extent of practicing the EBP process. Comparisons of EBP levels between subgroups were tested using unpaired t-tests or one-way ANOVAs. RESULTS: On average, RNs used the EBP process occasionally every half year. RNs with specialist education reported a higher extent of EBP activities as did RNs who worked in outpatient and home care settings. There was a significant increase in the extent of EBP activities 11 to 13 years after graduation compared to three years after graduation. LINKING EVIDENCE TO ACTION: The findings raise some central questions for practice: How well equipped are RNs to practice the EBP process? What is needed to facilitate EBP in clinical settings? Building on the findings of this study, managers in clinical practice need to develop supportive organizational structures that facilitate EBP. This study suggests that mid-career RNs increased the extent of practicing the EBP process over time compared to previous reported practice in their first years as RNs. However, the level of EBP activities was low to moderate, and this modest increase took 11 to 13 years to achieve. To enhance the practice of EBP in nursing care, educational and organizational factors need to be considered.

Engaging Stakeholders, from Inception and Throughout the Study, is Good Research Practice to Promote use of Findings.

The need for research-informed programming and policy making is well established. However, there is limited evidence that, when researchers actively promote utilization of research findings, stakeholders use such findings for decision making in low- and middle-income countries (LMIC). A common barrier for research uptake in LMIC is that researchers focus on passive dissemination of final findings as the primary vehicle to affect research uptake. A more active approach to facilitating research utilization (RU) is necessary. Project SOAR, a six-year USAID-funded operations research project, recognized this gap and developed an approach to include the end data users in the research process from inception to final results dissemination. In this commentary, we make recommendations for active facilitation of research uptake using emerging lessons from SOAR's RU process that focuses on ongoing engagement of stakeholders throughout the life of the study.

Comprehensive geriatric assessment in Swedish acute geriatric settings.

PURPOSE: Comprehensive geriatric assessment (CGA) is a widely used approach in geriatric care and involves multidisciplinary assessments focused on determining a frail elderly person's medical, psychological and functional capability to develop an integrated plan for treatment. The purpose of this paper is to describe and scrutinize the CGA implementation process at six acute geriatric departments in three county councils and to study the outcome by the documentation in the patient medical records, and the staff perceptions using CGA. DESIGN/METHODOLOGY/APPROACH: The paper describes the implementation process stages. Outcome measures were based on patient medical records reviews at baseline and follow-ups at year 1 and year 2. Staff perceptions of using CGA were gathered by a questionnaire at the second follow-up. FINDINGS: The implementation had not yet reached sustainability so the implementation process must continue. Results show that documentation on the different areas increased in year 1, as well as the use of standardized assessment tools. However, results from the reviews for year 2 showed some decrease. Staff considered CGA to have high value for the geriatric patient but pointed out the need for continuing education. ORIGINALITY/VALUE: Successful strategies for this implementation were strong support from the managers, small seminars, CGA rounds, good introduction routines for new staff and the use of reminders such as pocket-sized focus cards. A high staff turnover occurred during the study, which probably had a significant negative impact on the results.

Nurse leaders' perceptions and experiences of leading evidence: A qualitative enquiry.

AIM: The aim of this study was to describe nurse leaders' perceptions and experiences of leading evidence-based practices (EBP). BACKGROUND: Leaders can promote EBP in nursing with their own personal example and by striving to renew structures, processes and working cultures. However, previous studies have shown that nurse leaders have tended to be passive with regard to EBP. METHODS: An interview study using general qualitative methods. In total, 33 individual interviews and seven focus groups of leaders were conducted in 2015 and 2017. Data were analysed thematically. RESULTS: The respondents were unfamiliar with EBP as activities that lead to effective patient care. EBP were described as indistinguishable from other practices, lost and random. Overall, they lacked competence with EBP. The activities of nurse leaders do indicate a tentative commitment to EBP, but their main goals seem to be maintaining the status quo. CONCLUSION: Unfamiliarity with EBP reflects adversely on the operations of an entire organisation. The nurse leaders have an opportunity to enhance their understanding with EBP, which will lead to the renewal and improvement of the operating culture and the quality of strategic leadership. IMPLICATIONS FOR NURSING MANAGEMENT: Leaders should take clear responsibility for EBP on the strategic, operational and educational level.

Correlates of Physical Activity During Pregnancy: A Systematic Review with Implications for Evidence-based Practice.

BACKGROUND: Numerous attempts have been made to improve women's physical activity participation during pregnancy, but activity levels remain low. AIM: To examine systematically the associations of physical activity participation during pregnancy with non-modifiable correlates (not subject to change) and modifiable theoretical correlates of physical activity. METHODS: This systematic review followed PRISMA (preferred reporting items for systematic review and meta-analysis) guidelines. It includes cross-sectional and longitudinal studies that assessed non-modifiable correlates and modifiable theoretical correlates of physical activity. Five electronic databases were searched for studies published in the English language between 2010 and 2017. An author-developed data collection tool was used to examine selected variables; effect sizes were determined; and study bias was assessed. RESULTS: Ten studies were included in the final review. Overall, effect sizes for non-modifiable correlates of physical activity were small to moderate, except for mental health (d = 1.35) and prior physical activity (d = 0.63). By contrast, modifiable theoretical correlates of physical activity (e.g., self-efficacy [d = 0.96-1.42] & intention to be physically active [d = 1.62]) had moderate to large effects in the expected direction with physical activity during pregnancy. DISCUSSION: The findings underscore the importance of developing physical activity interventions for pregnant women that are guided by modifiable theoretical correlates, taking into consideration non-modifiable correlates of physical activity. LINKING EVIDENCE TO ACTION: Clinicians should help pregnant women to increase self-confidence in their ability to be physically active and provide anticipatory guidance to overcome barriers to physical activity.

Occupational Therapists' Self-Reported Research Utilization and Use of Online Evidence Sources.

Research utilization of occupational therapists may positively influence the quality and cost-effectiveness of service delivery; however, previous studies suggest that therapists' overall use of research in clinical practice is limited. This cross-sectional study used survey methodology to investigate the research utilization behaviors of occupational therapists and examine the differences in behaviors between those who had and had not used the Navigator®. The Navigator® online competence assessment platform supports research utilization through recommended readings and access to online databases with full-text articles. Findings showed a low level of research utilization overall, with Navigator® users more likely to use online databases than non-users. Future research should examine if access to online platforms, such as the Navigator®, combined with context-specific training that integrates active learning approaches could improve occupational therapists' research utilization for increased implementation of evidence-based practice.

[Hospital nurses' perspective on academic nursing education: a cross-sectional study in hospitals in the northwestern part of Germany]. / Die Akademisierung der Pflege aus Sicht der Pflegekräfte: eine Querschnittstudie in Krankenhäusern im Nordwesten Deutschlands.

Hospital nurses' perspective on academic nursing education: a cross-sectional study in hospitals in the northwestern part of Germany Abstract. BACKGROUND: Currently, there is an increasing need for highly qualified nurses in Germany. Against this background, an academic nursing education is frequently demanded in order to meet the high level of competences nurses must fulfil. AIM: This cross-sectional study aimed to explore nurses' attitudes towards academic nursing education as well as their self-reported scientific competences. METHODS: Based on a standardized questionnaire, we surveyed 547 hospital nurses from six different hospitals in the northwestern part of Germany. By means of a bivariate analysis and two multivariate regression models, we examined the influence of the independent variables "professional position", "degree of academic education", "age" and "gender" on the dependent variables "attitude towards academic nursing education" and "scientific competences". The multivariate analysis included three co-variates analysing different ways of support of academic nursing education within the hospitals. RESULTS: Especially nursing staff who has completed a study programme, is currently studying or hold executive positions has a more positive attitude towards academic education than its colleagues have. Moreover, opportunities for advancement within the hospitals influence the staff's attitude positively. With regard to the assessment of scientific competences, the analysis shows that a completed or currently conducted study programme as well as an executive position have a positive influence. In addition, male nursing staff, young nursing staff and staff with access to scientific articles assess their scientific skills more positively than their colleagues do. CONCLUSIONS: The attitudes towards academic education are still heterogeneous and influenced by different factors. Accordingly, the worth of academic education needs to be demonstrated.

What do you do with success? The science of scaling up a health systems strengthening intervention in Ghana.

BACKGROUND: The completion of an implementation research project typically signals the end of research. In contrast, the Ghana Health Service has embraced a continuous process of evidence-based programming, wherein each research episode is followed by action and a new program of research that monitors and guides the utilization of lessons learned. This paper reviews the objectives and design of the most recent phase in this process, known as a National Program for Strengthening the Implementation of the Community-based Health Planning and Services (CHPS) Initiative in Ghana (CHPS+). METHODS: A mixed method evaluation strategy has been launched involving: i) baseline and endline randomized sample surveys with 247 clusters dispersed in 14 districts of the Northern and Volta Regions to assess the difference in difference effect of stepped wedge differential cluster exposure to CHPS+ activities on childhood survival, ii) a monitoring system to assess the association of changes in service system readiness with CHPS+ interventions, and iii) a program of qualitative systems appraisal to gauge stakeholder perceptions of systems problems, reactions to interventions, and perceptions of change. Integrated survey and monitoring data will permit multi-level longitudinal models of impact; longitudinal QSA data will provide data on the implementation process. DISCUSSION: A process of exchanges, team interaction, and catalytic financing has accelerated the expansion of community-based primary health care in Ghana's Upper East Region (UER). Using two Northern and two Volta Region districts, the UER systems learning concept will be transferred to counterpart districts where a program of team-based peer training will be instituted. A mixed method research system will be used to assess the impact of this transfer of innovation in collaboration with national and regional program management. This arrangement will generate embedded science that optimizes prospects that results will contribute to national CHPS reform policies and action.

The Influence of Context on Utilizing Research Evidence for Pain Management in Jordanian Pediatric Intensive Care Units (PICU).

PURPOSE: The purpose of this study was to gain a beginning understanding of the contextual factors that influence the use of research for pain management in Jordanian Pediatric Intensive Care Units (PICUs). DESIGN AND METHODS: A paper or online questionnaire was used to collect data on instrumental research use (IRU) and conceptual research use (CRU) and ten contextual variables from 73 registered nurses working in four Jordanian PICUs. The Pearson product-moment correlation coefficient was used to test the relationship between continuous (demographic and contextual) factors and IRU and CRU. One way ANOVA and independent t-test were used to examine the differences between sociodemographic variables and IRU and CRU. Generalized Estimating Equations (GEE) was used to determine the demographic and contextual factors that influenced research use. We modeled the significant variables identified by bivariate correlation, t-test, and ANOVA at (p≤0.10). RESULTS: Nine of the contextual factors significantly and positively correlated with the IRU for pain assessment, eight with the IRU for pain treatment, and six with the CRU for pain management (including assessment and treatment). Hospital type (public) predicted the IRU for pain assessment. Social capital, structural, and electronic resources predicted the IRU for pain treatment. Social capital predicted the CRU for pain management. CONCLUSION: Context influences Jordanian PICU nurses' use of research for pain management. PRACTICE IMPLICATIONS: Concentrating on modifiable contextual factors may positively influence Jordanian PICU nurses' use of research for pain management. This influence may extend to reduce children's pain in Jordanian PICUs.

A psychometric evaluation of the Swedish version of the Research Utilization Questionnaire using a Rasch measurement model.

Evidence-based practice and research utilisation has become a commonly used concept in health care. The Research Utilization Questionnaire (RUQ) has been recognised to be a widely used instrument measuring the perception of research utilisation among nursing staff in clinical practice. Few studies have however analysed the psychometric properties of the RUQ. The aim of this study was to examine the psychometric properties of the Swedish version of the three subscales in RUQ using a Rasch measurement model. This study has a cross-sectional design using a sample of 163 staff (response rate 81%) working in one nursing home in Sweden. Data were collected using the Swedish version of RUQ in 2012. The three subscales Attitudes towards research, Availability of and support for research use and Use of research findings in clinical practice were investigated. Data were analysed using a Rasch measurement model. The results indicate presence of multidimensionality in all subscales. Moreover, internal scale validity and person response validity also provide some less satisfactory results, especially for the subscale Use of research findings. Overall, there seems to be a problem with the negatively worded statements. The findings suggest that clarification and refining of items, including additional psychometric evaluation of the RUQ, are needed before using the instrument in clinical practice and research studies among staff in nursing homes.

An Integrative Review of Interventions for Enhancing Leadership in the Implementation of Evidence-Based Nursing.

BACKGROUND: The most common barriers to evidence-based nursing (EBN) are related to nurse leadership and to organizational characteristics. Scientific evidence is needed regarding interventions that support nurse leadership. AIMS: The aim was to gather, assess, and synthesize the current empirical evidence regarding interventions for enhancing nursing leadership in EBN implementation. METHODS: We conducted an integrative review of interventions that enhance the roles of nurse leaders in EBN implementation using reporting guidance according to the PRISMA statement. RESULTS: The search identified five studies, which described two intervention types: interventions improving nurse leaders' capabilities for EBN implementation and supporting the activities for EBN implementing. The interventions focused on strategic, teamwork, and individual levels. All interventions produced positive outcomes on primary outcomes, however all not statistically significant. LINKING EVIDENCE TO ACTION: The studies mainly had descriptive designs and short follow-up times, so it was not possible to propose evidence-based recommendations for effective interventions. The certainty of evidence was very low due to the study designs and the risk of bias. Structured clinical education might promote new innovations in evidence-based leadership in nursing. Conclusions about the impact of the interventions must be drawn with caution. They might be useful for promoting the abilities of nurse leaders to implement EBN, but further studies are needed to provide more reliable recommendations.