Challenges of conducting experimental studies within a clinical nursing context

Implementation of a training program to increase knowledge, improve attitudes and reduce nursing care omissions towards patients with dementia in hospital settings: a mixed-method study protocol

INTRODUCTION

There is an evidence showing that when nurses have to allocate their time because of a lack of resources, older patients and especially those with dementia have a secondary care priority. The purpose of this study is to advance the level of knowledge, promote positive attitudes of nurses and reduce care deficits towards people with dementia through the implementation of a training programme. The programme will be enriched by an observational study of the care of patients with dementia to identify areas of missed care.

METHOD AND ANALYSIS

This study will follow a mixed methodology consisting of three stages: (1) evaluation of the level of nurses' knowledge and attitudes towards dementia care through the use of structured questionnaires, (2) observational study to evaluate nursing care in hospital settings, in order to detect any missed care and (3) quasi-experimental study, with a before-and-after design, through the implementation of the training programme in order to increase nurses' knowledge, improve attitudes and consequently to promote care for patients with dementia. The data will be analysed with descriptive and inferential statistics with the use of the SPSS V.24.0 and with content analysis as regard to the observational data.

ETHICS AND DISSEMINATION

The protocol was approved by the National Bioethics committee and other local committees (ΕΕΒΚ: 2018.01.02). The participants will give their informed consent and the anonymity and confidentiality. Also, the protection of data will be respected. The results of the study will be disseminated in peer-reviewed international journals and conferences. If the intervention is successful, the training package will be given to the continuous education unit of the National Professional Association in order to be used on a regular basis.

Randomized Controlled Trials and Quasi-Experimental Studies Published in Nursing Journals: Findings From a Scoping Review With Implications for Further Research

BACKGROUND

Experimental studies are considered capable of generating substantial evidence; therefore, their production and diffusion are continuously encouraged. However, their trends as publication outputs in nursing journals have rarely been evaluated to date.

AIMS

To describe experimental study design features among the highest indexed nursing journals.

METHODS

A scoping review was performed by retrieving and analyzing experimental studies published between 2009 and 2016 in nursing journals with a 5-year impact factor >1.5 according to Thomson's Journal Citation Reports.

RESULTS

A total of 602 studies were reviewed and 340 (56%) were included; in all, 298/340 (87.6%) were randomized controlled trials (RCTs) and 37/340 (10.9%) pilot studies. The publication trend exhibited a fluctuating pattern with a slight decrease over time (from 54 studies in 2009 to 32 in 2016). Researchers working in Asia and Europe have published more frequently in the selected journals. Published studies most often involved oncological (n = 69, 20%), surgical (n = 41, 12%), and elderly patients (n = 38, 11%). Educational and supportive (n = 119, 35%) interventions were mainly tested for effectiveness. Approximately half of studies enrolled <100 patients, and only two-thirds had included an a priori sample size calculation. Less than one quarter (n = 76) of the research teams were multiprofessional, and 70% of studies were funded, generally, by public institutions.

LINKING EVIDENCE TO ACTION

A broad range of research questions has been investigated to date by using experimental study designs. However, study methods and multidisciplinary collaborations must be enhanced with the intent of producing large-scale and methodologically sound studies. Furthermore, reasons for limited funding and, particularly, the lack of support from private funding should be further investigated.