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护士主导的随机对照试验的范围综述。

A scoping review of nurse-led randomised controlled trials.

机构信息

Clinical and Health Sciences Unit, Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, South Australia, Australia.

Australasian Nursing and Midwifery Clinical Trials Network (ANMCTN), Adelaide, South Australia, Australia.

出版信息

J Clin Nurs. 2023 Sep;32(17-18):5550-5561. doi: 10.1111/jocn.16632. Epub 2023 Feb 3.

Abstract

BACKGROUND

Nurses comprise the largest portion of the healthcare workforce worldwide. However, nurse representation in the leadership of clinical research and research funding is largely unknown. The Australasian Nursing and Midwifery Clinical Trials Network was established to provide a coordinated network, focussed on building research capacity in nursing and midwifery. To support this work, this scoping review of nurse-led randomised controlled trials was conducted to summarise research activity, as well as highlight future research directions, gaps and resources. Midwife-led trials will be reported elsewhere.

AIM

To quantify number, type and quality of nurse-led randomised controlled trials registered between 2000-2021.

DESIGN

A scoping review of RCTs.

DATA SOURCES

Medline, Emcare and Scopus were searched from 2000 to August 2021. ANZCTR, NHMRC, MRFF and HRC (NZ) registries were searched from inception to July 2021.

REVIEW METHODS

This review was informed by the JBI scoping review framework using the PRISMA-ScR.

RESULTS

Our search yielded 188 nurse-led publications and 279 registered randomised controlled trials. Multiple trials had the same nurse leaders. There were more registrations than publications. Publications were predominantly of high methodological quality; however, there was a reliance on active controls and blinding was low. Trial registrations indicate that universities and hospital/healthcare organisations were the major sources of funding, while publications indicate that Governments and the National Health and Medical Research Council were the main funding bodies.

CONCLUSION

A small number of high-quality, large-scale, nationally funded randomised controlled trials were identified, with a larger number of locally funded small trials. There was a disparity between the number of registered trials and those published. Additional infrastructure, funding and career frameworks are needed to enable nurses to design, conduct and publish clinical trials that inform the health system and improve health outcomes.

RELEVANCE TO CLINICAL PRACTICE

Research initiated and led by nurses has the potential to improve the health and well-being of individuals and communities, and current nurse-led research is of high methodological quality; however, there were very few nurse-led RCTs, conducted by a small pool of nurse researchers. This gap highlights the need for support in the design, conduct and publishing of nurse-led RCTs.

PATIENT OR PUBLIC CONTRIBUTION

This is a scoping review; therefore, patient or public contribution is not applicable.

摘要

背景

护士构成了全球医疗保健劳动力中最大的一部分。然而,护士在临床研究和研究资金方面的领导地位在很大程度上是未知的。澳大拉西亚护理和助产临床试验网络的成立旨在提供一个协调的网络,专注于建立护理和助产的研究能力。为了支持这项工作,对护士主导的随机对照试验进行了范围界定审查,以总结研究活动,并突出未来的研究方向、差距和资源。助产士主导的试验将在其他地方报告。

目的

量化 2000 年至 2021 年间注册的护士主导的随机对照试验的数量、类型和质量。

设计

随机对照试验的范围界定审查。

数据来源

从 2000 年到 2021 年 8 月,检索了 Medline、Emcare 和 Scopus。从 2000 年开始,对 ANZCTR、NHMRC、MRFF 和 HRC(新西兰)登记处进行了检索,直到 2021 年 7 月。

审查方法

本综述以 JBI 范围界定综述框架为指导,采用 PRISMA-ScR。

结果

我们的搜索结果产生了 188 篇护士主导的出版物和 279 项注册的随机对照试验。多项试验有相同的护士负责人。注册的试验数量多于出版物。出版物的方法学质量主要较高;然而,它们依赖于主动对照,并且盲法较低。试验登记表明,大学和医院/医疗机构是主要的资金来源,而出版物则表明,政府和国家卫生和医学研究委员会是主要的资金机构。

结论

确定了少数高质量、大规模、由国家资助的随机对照试验,以及更多由当地资助的小型试验。注册试验和已发表的试验数量之间存在差距。需要额外的基础设施、资金和职业框架,以使护士能够设计、进行和发表为卫生系统提供信息并改善健康结果的临床试验。

临床实践的相关性

由护士发起和领导的研究有可能改善个人和社区的健康和福祉,目前护士主导的研究具有较高的方法学质量;然而,只有少数由一小部分护士研究人员进行的护士主导的 RCT。这一差距突出表明需要在设计、进行和发表护士主导的 RCT 方面提供支持。

患者或公众的贡献

这是一项范围界定审查;因此,患者或公众的贡献不适用。

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