Gifford Wendy, Zhang Qing, Chen Shaolin, Davies Barbara, Xie Rihua, Wen Shi-Wu, Harvey Gillian
1School of Nursing, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5 Canada.
Nursing Best Practice Research Center, 451 Smyth Road, Ottawa, ON K1H 8M5 Canada.
BMC Nurs. 2018 Jun 20;17:26. doi: 10.1186/s12912-018-0295-x. eCollection 2018.
Research into evidence-based practice has been extensively explored in nursing and there is strong recognition that the organizational context influences implementation. A range of barriers has been identified; however, the research has predominantly taken place in Western cultures, and there is little information about factors that influence evidence-based practice in China. The purpose of this study was to explore barriers and facilitators to evidence-based practice in Hunan province, a less developed region in China.
A descriptive qualitative methodology was employed. Semi-structured interviews were conducted with staff nurses, head nurses and directors ( = 13). Interviews were translated into English and verified for accuracy by two bilingual researchers. Both Chinese and English data were simultaneously analyzed for themes related to factors related to the evidence to be implemented (Innovation), nurses' attitudes and beliefs (Potential Adopters), and the organizational setting (Practice Environment).
Barriers included lack of available evidence in Chinese, nurses' lack of understanding of what evidence-based practice means, and fear that patients will be angry about receiving care that is perceived as non-traditional. Nurses believed evidence-based practice was to be used when clinical problems arose, and not as a routine way to practice. Facilitators included leadership support and the pervasiveness of web based social network services such as Baidu () for easy access to information.
While several parallels to previous research were found, our study adds to the knowledge base about factors related to evidence-based practice in different contextual settings. Findings are important for international comparisons to develop strategies for nurses to provide evidence-based care.
循证实践的研究在护理领域已得到广泛探索，人们强烈认识到组织环境会影响其实施。已确定了一系列障碍；然而，相关研究主要在西方文化背景下开展，关于影响中国循证实践的因素的信息较少。本研究旨在探讨中国欠发达地区湖南省循证实践的障碍和促进因素。
采用描述性定性研究方法。对护士、护士长和主任（共13人）进行了半结构式访谈。访谈内容被翻译成英文，并由两位双语研究人员核实准确性。对中文和英文数据同时进行分析，以找出与待实施证据相关的因素（创新）、护士的态度和信念（潜在采用者）以及组织环境（实践环境）相关的主题。
障碍包括缺乏中文的可用证据、护士对循证实践含义的理解不足，以及担心患者会因接受被视为非传统的护理而生气。护士们认为，循证实践应在出现临床问题时使用，而非作为一种常规的实践方式。促进因素包括领导支持以及诸如百度等基于网络的社交网络服务的普及，便于获取信息。
虽然发现了与先前研究的一些相似之处，但我们的研究增加了关于不同背景下循证实践相关因素的知识库。研究结果对于开展国际比较以制定护士提供循证护理的策略具有重要意义。
