Meijers Judith M M, Janssen Maaike A P, Cummings Greta G, Wallin Lars, Estabrooks Carole A, Y G Halfens Ruud
Section of Nursing Science, Universiteit Maastricht, Maastricht, The Netherlands.
J Adv Nurs. 2006 Sep;55(5):622-35. doi: 10.1111/j.1365-2648.2006.03954.x.
This paper reports a systematic literature review examining relationships between contextual factors and research utilization in nursing, examining the strength of these relationships, and mapping the contextual factors to the Promoting Action on Research Implementation in Health Services model of research implementation.
Healthcare organizations have long struggled with how to improve clinical care outcomes. Understanding which contextual factors enhance nursing research utilization may support organizations in creating environments that facilitate the uptake of evidence in nursing practice to improve these outcomes.
A search of five electronic bibliographic databases and a manual search of specific journals were conducted for studies that were published in English and examined contextual factors as independent variables and research utilization as the dependent variable from the perspective of nurses working in clinical practice. The studies were assessed for quality of design, sample, measurement and statistical analysis.
Ten papers met the search criteria. Six contextual factors were identified as having a statistically significant relationship with research utilization, namely the role of the nurse, multi-faceted access to resources, organizational climate, multi-faceted support, time for research activities and provision of education. The contextual factors could successfully be mapped to the dimensions of context in the Promoting Action on Research Implementation in Health Services framework (context, culture, leadership), with the exception of evaluation.
The strength of the relationship between the six contextual factors and research utilization by nurses is still largely unknown as (a) few studies were found of sufficient quality because of methodological limitations and (b) the results in reviewed studies were mixed. More robust methods in future work would yield a better understanding of the full impact of contextual factors on nurses' use of research.
本文报告一项系统的文献综述，该综述考察了护理领域中情境因素与研究应用之间的关系，检验了这些关系的强度，并将情境因素映射到卫生服务研究实施促进行动模型的研究实施情境中。
长期以来，医疗保健机构一直在努力改善临床护理结果。了解哪些情境因素能促进护理研究的应用，可能有助于机构营造有利于在护理实践中采用证据以改善这些结果的环境。
检索了五个电子文献数据库，并对特定期刊进行了手工检索，以查找用英文发表的、从临床实践护士的角度将情境因素作为自变量、研究应用作为因变量进行考察的研究。对这些研究的设计质量、样本、测量和统计分析进行了评估。
十篇论文符合检索标准。确定了六个与研究应用具有统计学显著关系的情境因素，即护士的角色、多方面的资源获取、组织氛围、多方面的支持、研究活动时间和教育提供。除评估外，这些情境因素可以成功地映射到卫生服务研究实施促进行动框架（情境、文化、领导力）中的情境维度。
六个情境因素与护士研究应用之间关系的强度在很大程度上仍然未知，原因如下：（a）由于方法学限制，很少找到质量足够高的研究；（b）综述研究的结果参差不齐。未来工作中采用更有力的方法将有助于更好地理解情境因素对护士研究应用的全面影响。
