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Disseminating Research Evidence To Breast Care Nurses: The Case Of Exercise For Breast Cancer Patients

Kirshbaum, Marilyn (2004) Disseminating Research Evidence To Breast Care Nurses: The Case Of Exercise For Breast Cancer Patients. Doctoral thesis, University of Manchester.

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      Abstract

      Background: Historically, nursing has struggled to introduce researchbased
      interventions into routine clinical practice. Reasons for this difficulty
      range from poor communication between clinically and academically based
      nurses to limitations within organisations that obstruct the implementation of
      new ideas.
      Aims: To identify the barriers to research utilisation and the preferred
      methods of research dissemination amongst breast care nurses (BCNs), to
      develop a dissemination intervention for BCNs and to evaluate a
      dissemination intervention for BCNs.
      Method: The study was conducted in three stages. In Stage 1, a national
      survey was conducted using the Barriers to Research Utilisation Scale
      (Funk et al. 1991), questions about dissemination preferences and a
      demographic questionnaire. In Stage 2, the Conceptual Framework for
      Selecting a Targeted Experimental Dissemination Method based on social
      interactionalist theory was developed. In Stage 3, a pre-test/post-test
      randomised controlled design was used to evaluate the dissemination
      method developed in Stage 2; the unit of randomisation and analysis were
      hospital clusters of BCNs.
      Sample: 263 BCNs from 13 regions within the U.K. comprised the sample
      in Stage 1. In Stage 3, the sample consisted of 92 BCNs from 62 hospitals
      in the north of England.
      Analysis: In Stage 1 analysis was undertaken using descriptive and nonparametric
      statistics. In Stage 3, analysis consisted of descriptive statistics
      19
      and clustered regression techniques with estimation of robust standard
      errors: clustered logistic regression for knowledge items, clustered linear
      regression for knowledge scores, ologit for attitude and reported practice
      items and clustered multiple regression for paired and multiple variable
      analyses.
      Findings: The results from the Barriers Scale revealed ‘statistical analyses
      not understandable’, ‘insufficient time on the job to implement new ideas’,
      ‘facilities inadequate for implementation’, ‘research not reported clearly and
      readably’ and ‘no time to read research’ as the greatest barriers to research
      utilisation. Free text responses revealed additional problems with
      communication and conditions within provider organisations and identified
      facilitators for research utilisation and dissemination. These data led to the
      selection and production of a targeted information booklet, entitled Exercise
      and Breast Cancer: A Booklet for Breast Care Nurses, specifically designed
      to be accessible, time efficient, understandable and relevant to the target
      audience. In evaluation, the booklet was shown to overcome the perceived
      barriers of the sample associated with accessing and understanding
      research. A statistically significant increase in knowledge and changes of
      reported practice and attitudes were found. Robust variables affecting
      knowledge acquisition were identified as the promotion of health, promotion
      of exercise and understanding of how exercise can reduce cancer-related
      fatigue.
      Implications: This study has demonstrated that printed materials can be
      used as an effective dissemination method provided that they are developed
      in line with the needs, values and context of a target audience. The
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      Conceptual Framework can be followed to develop similar booklets on
      different topics and could provide a purposeful contribution to the promotion
      of evidence-based practice for all nurses.

      Item Type: Thesis (Doctoral)
      Subjects: R Medicine > R Medicine (General)
      R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
      R Medicine > RT Nursing
      Schools: School of Human and Health Sciences
      School of Human and Health Sciences > Centre for Health and Social Care Research
      Related URLs:
      Depositing User: Sara Taylor
      Date Deposited: 07 Jun 2011 12:35
      Last Modified: 11 Oct 2011 11:17
      URI: http://eprints.hud.ac.uk/id/eprint/10717

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