INTRODUCTION
The use of relevant research findings to inform clinical practice is important for nurses, regardless of setting. Although there have been studies addressing the use of research among various practitioners, little is known about how nurses in rural areas access health information (specifically research findings), nor how such findings are incorporated into daily practice. The purpose of this study was to explore rural nurses' access, use and perceived usefulness of research for rural practice.
METHODS
The study was conducted in a sparsely populated state located in the western part of the USA. An ethnographic method was chosen to answer the research questions for this descriptive study. Semi-structured interviews were conducted with 29 rural nurses from nine communities by graduate nursing students enrolled in a rural nursing course following in-class instruction and practice. Field notes taken by the students supplemented the interview data. The students' notes included a windshield survey or description of the context and location within which the participants lived and/or practiced as well as the interviewers' observations, thoughts and impressions about the research project. Interviews were audiotaped and transcribed verbatim. Once transcribed, the interview narratives, windshield data and field notes were analyzed by the students for common themes; the students then wrote and submitted papers to the faculty addressing the themes that emerged from their interviews. The analysis conducted by the faculty members included four sources of data: transcriptions of interviews; field notes; windshield data; and students' papers. The process of identifying themes was facilitated by using the software program NUD*IST (QSR International; Melbourne, VIC, Australia). Demographic information was entered into the Statistical Package for Social Scientists (SPSS Inc; Chicago, IL, USA) to compile descriptive information about the sample.
FINDINGS
Twenty-seven female and two male nurses participated in the study. The nurses' ages ranged from 31-72 years and their experience in nursing spanned 3-50 years with a range of 1 to 35 years in rural nursing. The interviews revealed that most of the nurses used the term 'research' to mean 'gathering information'. When asked how often they used 'research' the responses ranged from 2-3 times per day to 2-3 times per month. The preferred means of obtaining information was asking a colleague. Additional resources included work-place journals, books, in-services, conferences and the internet. Twenty-three of the nurses reported having internet access at work; 25 had internet access at home. Supportive supervisors and articles in general nursing journals were identified as helpful. Barriers to using research included: lack of knowledge of research methods; lack of time at work or at home to look up information; and the lack of computers and internet access on the nursing units. When computers were available, the nurses reported that poor computer literacy decreased their ability to quickly find and evaluate information. Additional barriers included diminishing financial support from employers and the long travel distances required to attend conferences. The nurses reported finding little clinical research specifically related to rural practice.
CONCLUSIONS
Education and mentorship is needed about how to evaluate the types and strength of evidence, access research using the internet, interpret findings, and incorporate evidence in clinical practice. Interventions that foster the appreciation and use of research by staff nurses and managers are needed in order to build an evidence based culture. Research is needed, specifically as related to rural clinical practice.
[1]
J. Fitzpatrick.
FINDING THE RESEARCH FOR EVIDENCE-BASED PRACTICE
,
2007
.
[2]
David L. Sackett,et al.
Evidence based medicine: What it is and what it isn't (reprinted from BMJ, vol 312, pg 71-72, 1996)
,
2007
.
[3]
J. Kosteniuk,et al.
Central and peripheral information source use among rural and remote Registered Nurses.
,
2006,
Journal of advanced nursing.
[4]
K. Golden-Biddle,et al.
Understanding How Organizational Culture Shapes Research Use
,
2005,
The Journal of nursing administration.
[5]
R. Olade.
Evidence-based practice and research utilization activities among rural nurses.
,
2004,
Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing.
[6]
Alison M. Hutchinson,et al.
Bridging the divide: a survey of nurses' opinions regarding barriers to, and facilitators of, research utilization in the practice setting.
,
2004,
Journal of clinical nursing.
[7]
R. Olade.
Attitudes and factors affecting research utilization.
,
2003,
Nursing forum.
[8]
L. Caramanica,et al.
Evidence-based Nursing Practice, Part 2: Building Skills Through Research Roundtables
,
2002,
The Journal of nursing administration.
[9]
H. Martín.
The rural and urban realities of family medicine
,
2001
.
[10]
I Diamond,et al.
A multilevel analysis of the effects of rurality and social deprivation on premature limiting long term illness
,
2001,
Journal of epidemiology and community health.
[11]
E. Bethune,et al.
Learning issues for nurses in renal satellite centres.
,
2000,
The Australian journal of rural health.
[12]
R. Maljanian.
Supporting nurses in their quest for evidence-based practice. Research utilization and conduct.
,
2000,
Outcomes management for nursing practice.
[13]
M. Patton,et al.
Enhancing the quality and credibility of qualitative analysis.
,
1999,
Health services research.
[14]
Jean J. Schensul,et al.
Essential Ethnographic Methods: Observations, Interviews, and Questionnaires
,
1999
.
[15]
S. Sheps,et al.
Effectiveness of community-directed diabetes prevention and control in a rural Aboriginal population in British Columbia, Canada.
,
1999,
Social science & medicine.
[16]
K. Morin,et al.
Using research to establish protocols for practice: a statewide study of acute care agencies.
,
1999,
Clinical nurse specialist CNS.
[17]
M. MacLeod,et al.
Issues for nurses in rural and remote Canada.
,
1998,
The Australian journal of rural health.
[18]
J. Morse.
Qualitative data analysis (2nd ed): Mathew B. Miles and A. Michael Huberman. Thousand Oaks, CA: Sage Publications, 1994. Price: $65.00 hardback, $32.00 paperback. 238 pp
,
1996
.
[19]
D. Sackett,et al.
Evidence based medicine: what it is and what it isn't
,
1996,
BMJ.
[20]
M. Sandelowski.
Rigor or rigor mortis: the problem of rigor in qualitative research revisited.
,
1993,
ANS. Advances in nursing science.
[21]
M. Sandelowski,et al.
The problem of rigor in qualitative research
,
1986,
ANS. Advances in nursing science.
[22]
E. Guba,et al.
Lincoln, Yvonna, and Egon Guba, "Postpositivism and the Naturalist Paradigm," pp. 14-46 in Yvonna Lincoln and Egon Guba, Naturalistic Inquiry . Beverly Hills, CA: Sage, 1985.*
,
1985
.
[23]
Anna De Fina,et al.
The ethnographic interview
,
2019,
The Routledge Handbook of Linguistic Ethnography.