Shakeshaft A M
Department of Nutrition and Dietetics, Royal Gwent Hospital, Cardiff Road, Newport, Gwent, UK.
J Hum Nutr Diet. 2008 Jun;21(3):225-38. doi: 10.1111/j.1365-277X.2008.00868.x.
Previous studies of National Health Service (NHS) employees have identified barriers to undertaking clinical governance activities. Little of this research has investigated dietitians; however, where dietitians were included, generally positive attitudes towards research and evidence-based practice were reported alongside the identified barriers.
A quantitative, whole population census was undertaken via a questionnaire distributed to 54 dietitians employed by Gwent Healthcare NHS Trust.
Dietitians reported positive attitudes towards clinical governance; however, barriers to undertaking clinical governance activities were identified. The main barriers included lack of time, inadequate funding, the view that direct patient care should always be prioritised over clinical governance activities and inadequate research and critical evaluation skills.
Findings were similar to those reported in previous studies of NHS staff. Where comparison was possible, all of the barriers identified were reported at lower levels than in previous studies. As the study was purely quantitative in nature, no understanding was gained regarding the nature of identified barriers or what factors influenced the dietitians' attitudes and perceptions. For further in-depth analysis of these factors, a qualitative study is recommended. As the study comprised a whole population census, the findings cannot be generalized to the dietetic profession as a whole, or to other staff groups within or outside of the study Trust.
先前对国民保健服务体系（NHS）员工的研究已确定了开展临床治理活动的障碍。这类研究很少涉及营养师；然而，在纳入营养师的研究中，除了已确定的障碍外，通常还报告了对研究和循证实践的积极态度。
通过向格温特医疗保健NHS信托基金雇佣的54名营养师发放问卷进行了一次定量的全人群普查。
营养师报告了对临床治理的积极态度；然而，也确定了开展临床治理活动的障碍。主要障碍包括时间不足、资金不足、认为直接的患者护理应始终优先于临床治理活动以及研究和批判性评估技能不足。
研究结果与先前对NHS员工的研究报告相似。在可能进行比较的情况下，所确定的所有障碍的报告水平均低于先前的研究。由于该研究本质上纯粹是定量的，因此对于所确定障碍的性质或哪些因素影响了营养师的态度和看法没有获得任何了解。为了对这些因素进行进一步的深入分析，建议进行定性研究。由于该研究包括全人群普查，研究结果不能推广到整个营养师职业，也不能推广到研究信托基金内部或外部的其他员工群体。
