Sidani Souraya, Manojlovich Milisa, Doran Diane, Fox Mary, Covell Christine L, Kelly Helen, Jeffs Lianne, McAllister Mary
Professor and Canada Research Chair, School of Nursing, Ryerson University, Toronto, ON, Canada.
Associate Professor, Nursing Business & Health Systems, University of Michigan School of Nursing, Ann Arbor, MI.
Worldviews Evid Based Nurs. 2016 Feb;13(1):66-74. doi: 10.1111/wvn.12129. Epub 2016 Jan 14.
Various barriers and facilitators to implementing evidence-based interventions in practice have been acknowledged. Nurses' perspectives on these interventions were overlooked as potential factors that influence their uptake in practice. The purpose of this study was to explore nurses' perception of evidence-based interventions targeting patient-oriented outcomes.
A mixed method design involving concurrent application of quantitative and qualitative approaches was used. Nurses (n = 56) working in acute and rehabilitation care settings completed the Intervention Acceptability scale and responded to open-ended questions. The scale presented information on the components, activities, dose, and mode of delivering evidence-based interventions targeting each patient-oriented outcome (fatigue, nausea and vomiting, dyspnea, pain, physical function, self-care) and items to rate the interventions on five attributes (relevance, applicability, frequency of use, likelihood, and comfort in implementation). The open-ended questions inquired about the appropriateness and resources needed to use the interventions in practice.
The quantitative results indicated favorable perceptions of most interventions. Nurses rated acupressure, guided imagery, massage, and relaxation as having limited appropriateness and they reported low levels of comfort in applying them. The qualitative themes clarified the reasons underlying nurses' ratings.
This study's findings highlight the importance of examining nurses' perceptions of evidence-based interventions as an initial step toward promoting the adoption of interventions in practice. Effective interventions that are considered of limited relevance are unlikely to be implemented in practice. Nurses' perceptions can guide the design or selection of dissemination strategies to clarify any misconception about the effectiveness and risk of evidence-based interventions.
在实践中实施循证干预存在各种障碍和促进因素。护士对这些干预措施的看法作为影响其在实践中采用的潜在因素而被忽视。本研究的目的是探讨护士对以患者为导向的结果的循证干预措施的看法。
采用定量和定性方法同时应用的混合方法设计。在急性和康复护理环境中工作的护士（n = 56）完成了干预可接受性量表，并回答了开放式问题。该量表提供了针对每个以患者为导向的结果（疲劳、恶心和呕吐、呼吸困难、疼痛、身体功能、自我护理）的循证干预措施的组成部分、活动、剂量和实施方式的信息，以及对干预措施在五个属性（相关性、适用性、使用频率、可能性和实施舒适度）上进行评分的项目。开放式问题询问了在实践中使用这些干预措施的适当性和所需资源。
定量结果表明对大多数干预措施的看法良好。护士认为指压、引导想象、按摩和放松的适用性有限，并且他们报告在应用这些措施时舒适度较低。定性主题阐明了护士评分背后的原因。
本研究的结果强调了检查护士对循证干预措施的看法作为促进在实践中采用干预措施的第一步的重要性。被认为相关性有限的有效干预措施不太可能在实践中实施。护士的看法可以指导传播策略的设计或选择，以澄清对循证干预措施的有效性和风险的任何误解。
