Building capacity for nurse-led research

Dedicated Research Seed Funding to Support High-Priority Clinician-Led Research: A Survey of Clinician-Researchers

BACKGROUND AND OBJECTIVES

Developing research capacity and supporting research engagement among health professionals are essential parts of bridging the evidence-to-practice gap. The objective of this study was to describe and assess the impact of research seed funding in promoting the engagement of nursing and allied health professionals in leading practice-based research studies within a health care organization.

METHODS

An impact assessment survey was administered to health professional grant recipients (n = 30) to collect self-reported observations of changes related to clinical practice, patient care, and organizational priorities as a result of the funded research projects. The electronic survey was developed in collaboration with an interprofessional advisory committee and contained 23 closed- and open-ended questions. Survey data were analyzed descriptively, and responses to open-ended survey questions were used to characterize the funded research activities and the perceived successes and challenges experienced by the research teams.

RESULTS

A large proportion of health professional grant recipients reported observing impact from their research studies on clinical practice, organizational priorities, and external networks. The grant funds were used to carry out knowledge dissemination activities such as conference presentations, publications, and sharing findings at professional meetings and networks. The majority of grant expenditures were used for research personnel, and the most common challenge to conducting research was related to the need for protected research time. Most grant recipients were interested in participating in another grant-funded research project in the future.

CONCLUSION

Organizational funding and support for research led by health professionals have potential impact on clinical practice, patient care, and organizational priorities. This study provides evidence to support the value of investing in continued and expanded research funding programs for health professionals.

Addressing the Gap in Research Methodologies Education in Pediatric Oncology in the Eastern Mediterranean Region

PURPOSE

Formal training in clinical research methodologies is limited in limited-resource countries. Through collaboration among high- and middle-resource settings and in response to an identified need verbalized by regional pediatric oncology practitioners, Pediatric Oncology East & Mediterranean Group and St Jude Global developed a workshop focused on capacity building in research skills. Here, we describe its structure, implementation, and early results.

METHODS

Leveraging virtual capabilities, the format included lectures and small group breakout exercise sessions, for 3 hours per day on 2 consecutive days per week for 2 consecutive weeks. Topics included basics of study design, introduction to health care statistics, research ethics, data registries, and scientific writing. Applicants were required to submit an abstract for a potential research project. Each breakout group selected one abstract for further development and presented the final version in a groupwide session. The participants' experience was evaluated through an online survey.

RESULTS

Attendance included 29 registrants from 12 countries and six disciplines. Each breakout group was assigned a themed category: cohort studies, clinical trials, or registries. Critical feedback from the breakout sessions helped strengthen the selected projects, which included a retrospective study, a prospective observational study, a prospective interventional study, and a registry proposal. After the workshop, participants were invited to further develop their original abstracts, and three proposals received additional mentoring, one of which was a multi-institutional prospective study that was subsequently submitted through the Pediatric Oncology East & Mediterranean Group network for implementation. The postworkshop survey revealed an overall highly positive experience, and feedback provided potential themes for future workshops.

CONCLUSION

This workshop demonstrated the potential for collaborative network partnerships in targeting research training gaps in pediatric oncology. Lessons learned will be applied to future workshops to strengthen research in limited-resource settings.

Capacity building among nursing and midwifery professional associations in East Africa

Background

Despite improvements in educational opportunities, policy changes, and pay raises in the nursing and midwifery professions in East Africa, poor working conditions, few professional development opportunities, and a general lack of respect for these professions predominate. These issues contribute to a low quality of care among a population with a high burden of communicable diseases. Health professional associations may help to address these challenges by providing a voice for nurses and midwives.

Objective

This study evaluated the impact of a 5-year programme focused on strengthening nurses’ and midwives’ professional associations in East Africa.

Methods

This study used a mixed methods design. Quantitative, cross-sectional descriptive data were captured via surveys (n = 1,266) distributed to association members. In-depth interviews (n = 65) were used to obtain qualitative data and complement the survey responses. Quantitative and qualitative data collection occurred concurrently. The results were compared to assess the impact of the programme across Uganda, Kenya, and Tanzania.

Results

The programme successfully built capacity in four of five organisational capacity areas: resource mobilisation, financial management, strategy, and monitoring and evaluation. Marketing and communications, the fifth targeted area, did not show improvement. Capacity in both research and service delivery was also improved, despite the programme not providing training in these areas. In addition, collaboration among associations and their members was improved.

Conclusion

These results support existing evidence on the impact of capacity building among professional nursing associations and coincide with the World Health Organization’s objectives for nursing. Future capacity building programmes should consider replicating the successful activities from this programme and investigate ways to reach more rural branches and provide tailored content. This study contributes to a small but growing body of knowledge that supports capacity building among the African health workforce.

Exploration of knowledge, attitudes, and perceived benefits towards nurse managers' participation in the health policy-making process: a qualitative thematic analysis study

Background

Participation of nurse managers in policy-making could help policy-makers to propose relevant and effective policies and support other policy actors involved with these processes.

Objective

This study aimed at exploring the attitudes and perceived benefits of nurse managers' participation in the health policy-making process.

Methods

In this descriptive qualitative research, semi-structured interviews were conducted with 16 nurse managers, government officials, and faculty members. Recruitment was based on purposive sampling from different regions across Iran. A thematic analysis was performed in MAXQDA (version 2012).

Results

After analysis of the qualitative data, four themes and 13 sub-themes emerged. The themes were feelings about nurse managers' participation, advantages of nurse managers' participation, problems due to the non-participation of nurse managers, and recommendations for improvement of the policy-making process.

Conclusion

The outcomes provided new insights into the perceived benefits of and attitudes towards nurse managers' participation in health policy making in the Iranian setting. It is crucial to strengthen the capacity for nurse managers' participation in health policy making to develop effective healthcare policies.

Midwifery-led researches for evidence-based practice: Clinical midwives engagement in research in Ethiopia, 2021

Introduction

Health workers involvement in research had an impact on studies and whole system. They influence the clinical practice and help to implement evidences. Although International Confederation of Midwives (ICM) put research as one of the midwifery competencies and professional development activity, clinical midwives are poorly involved in research. Therefore, this study is aimed to assess clinical midwives engagement in research and bridge the gap through applicable strategies.

Method

Institution-based cross-sectional study was conducted among clinical midwives working at public health facilities of Central and North Gondar Zone, Ethiopia from September to October, 2020 G.C. A structured and pre-tested self-administered questionnaire was used to collect data and entered into Epi-info version 7. Descriptive statistics was used to describe study population. Bi-variable and multi-variable logistic regression analysis was performed using STATA Version 14 and significance level declared at 95% confidence interval, p-value ≤ 0.05 and respective odds ratios.

Result

Out of 335 clinical midwives, 314 were participated making the response rate 93.7%. Among the midwives, one hundred seventy two (54.8%) (95% CI: 49.08%, 60.37) have good skill on conducting a research. Clinical midwives with mothers with formal education [AOR: 1.90, 95% CI: (1.03, 3.51), currently work on referral hospitals [AOR: 2.33, 95% CI: (1.19, 4.53)] and having good level of knowledge on research [AOR: 2.19, 95% CI: (1.25, 3.82)] have significant association with having good research skill. Forty eight (15.2%) (95% CI: 11.5%, 19.7%) ever participated in research during their clinical practice. Clinical midwives who have good knowledge on research [AOR: 0.31, 95% CI: (0.14, 0.70)] are about 0.3 times less likely to participate on research than who have poor knowledge [AOR: 0.31, 95% CI: (0.14, 0.70)].

Conclusion and recommendation

Although more than half have good research skill, only a small proportion of midwives were involved in research. Capacity building activities are crucial to strengthen midwives skill on research and ensure their involvement.

Motivation and Barriers to Research among Nursing Professionals in Southeast Spain

Background: Nursing research promotes quality care and is essential. Thus, it is important to acknowledge the main motivations and barriers that nursing professionals find in their work, the aim of this study was to establish the main aspects that motivate and make nursing research difficult, for nursing professionals; Methods: a descriptive cross-sectional study was carried out on 91 nursing professionals. A validated structured questionnaire composed of 42 items that defined five domains was used. Descriptive and bivariant analyses were performed; Results: the highest scores were obtained for the domain of Knowledge and Preparation (33.79 ± 3.38), while the domain of Available Resources and Support obtained lower mean values (22.60 ± 5.61). Significant differences were found in two domains: Knowledge and Preparation and Professional Development domains, when regarding the service in which the participants were working (p < 0.05); in the Available Resources and Support domain, when regarding sex (p < 0.05), in the Motivations domain, regarding the number of children (p < 0.05); Conclusions: nursing professionals show a positive attitude towards nursing research. The nurses find motivation in their work environment, in the economic incentives, or in the possibility to improve their curriculum vitae. The main barriers are the lack of time, the lack of institutional support, and the lack of training, especially in languages, such as English. These findings could be useful to design programs to overcome these barriers.

Development of a blended emergent research training program for clinical nurses (part 1)

BACKGROUND

Nursing research training is important for improving the nursing research competencies of clinical nurses. Rigorous development of such training programs is crucial for ensuring the effectiveness of these research training programs. Therefore, the objectives of this study are: (1) to rigorously develop a blended emergent research training program for clinical nurses based on a needs assessment and related theoretical framework; and (2) to describe and discuss the uses and advantages of the ADDIE model (Analysis, Design, Development, Implementation, Evaluation) in the instructional design and potential benefits of the blended emergent teaching method.

METHODS

This intervention development study was conducted in 2017, using a mixed-methods design. A theoretical framework of blended emergent teaching was constructed to provide theoretical guidance for the training program development. Nominal group technique was used to identify learners' common needs and priorities. The ADDIE model (Analysis, Design, Development, Implementation, Evaluation) was followed to develop the research training program for clinical nurses based on the limitations of current nursing research training programs, the needs of clinical nurses, and the theoretical foundation of blended emergent teaching.

RESULTS

Following the ADDIE model, a blended emergent research training program for clinical nurses to improve nursing research competence was developed based on the needs of clinical nurses and the theoretical framework of blended emergent teaching.

CONCLUSIONS

This study indicates that nominal group technique is an effective way to identify learners' common needs and priorities, and that the ADDIE model is a valuable process model to guide the development of a blended emergent training program. Blended emergent teaching is a promising methodology for improving trainees' learning initiative and educational outcomes. More empirical studies are needed to further evaluate blended emergent teaching to promote the development of related theories and practice in nursing education.

Research ability and research motivation of postgraduate nursing students in traditional Chinese medicine colleges

Aim

To investigate the relationship between research ability and research motivation of postgraduate nursing students in traditional Chinese medicine colleges and identify other factors that may have an impact on the research ability of postgraduate nursing students.

Design

A cross‐sectional electronic survey was used to collect data from 191 postgraduate nursing students.

Methods

A total of 191 postgraduate nursing students from seven traditional Chinese medicine colleges were investigated from October to November 2020 using self‐rated scales for research ability and research motivation. The relationship between the variables affecting the research ability of postgraduate nursing students in traditional Chinese medicine colleges was determined.

Results

There was a positive correlation between the score of self‐rated research ability and research motivation among 191 postgraduate nursing students in traditional Chinese medicine colleges. Multiple stepwise regression analysis showed that grade, research motivation, age and active participation in class discussions were the main factors affecting the self‐rated research ability.

Conclusion

The self‐rated research ability of postgraduate nursing students in traditional Chinese medicine colleges is positively correlated with research motivation. According to the research motivation orientation, adopting targeted training methods and establishing correct professional understanding may improve the research ability of postgraduate nursing students.

Pediatric Oncology Nursing Research in Low- and Middle-Income Countries: Exemplars from Three Regions

OBJECTIVE

This study examined the status of pediatric oncology nursing research in three low- and middle-income countries (LMICs) as examples across three World Health Organization regions: East Africa, Eastern Mediterranean region, and Latin America.

DATA SOURCES

Published literature was identified from Google Scholar, PubMed, Scielo, Virtual Health Library, and reference lists of some articles.

CONCLUSION

The experiences of the three LMIC pediatric oncology nurses illustrate the situation of nurse research in their setting and identify relevant published literature. The authors highlight the challenges for nurses to conduct research (eg, lack of training, mentors, funding, and opportunities). Local evidence to inform nursing practice in LMICs is needed. Recommendations for ameliorating the situation include increased advanced practice nurse education, physician and hospital support, funding, and protected time.

IMPLICATIONS FOR NURSING PRACTICE

Pediatric oncology nursing practice is culturally and context-driven and requires locally acquired evidence to support best practices. Only when sufficient, sustainable, and local nursing research training and education is available in LMICs, will this evidence be generated. Nursing research training (eg, master's and PhD programs), funding, and protected time are three key steps to guide and motivate staff nurses as well as academic nurses to participate in research that informs the care of children and adolescents with cancer across all countries and not only those with significant resources.

Participation of nurse managers in the health policy process: a qualitative study of barriers and facilitators

AIM

To explore the barriers and facilitators concerning nurse managers' participation in the health policy-making process.

BACKGROUND

Despite encouragement for participation in policy-making, nurse managers are seldom involved in this process.

METHODS

A qualitative descriptive research design based on purposive sampling was conducted. Semi-structured one-to-one interviews were conducted with nurse managers and key informants (n = 16). Interviews were digitally recorded, transcribed verbatim, and analyzed by thematic analysis. The Standards for Reporting Qualitative Research (SRQR) checklist was applied to study reporting.

FINDINGS

Three levels of barriers were found to nurse managers' participation in health policy-making. The individual level included weakness in characteristics of nurse managers, and the organizational level constituted the inefficient structure. In addition, the environment-related level encompassed external barriers to the organization. Finally, three facilitators with the potential were identified for improving nurse managers' participation in the policy-making process, including improvements in collaboration and communication, governmental and non-governmental organizational activities, and reforms in the health policy-making process.

CONCLUSION

Nurse managers need to use the window of opportunity to participate in health policy-making. More importantly, they should be informed about health policy in order to meet the demands of the rapidly changing healthcare environment. Drawing upon their professional organizations and positions, nurse leaders require to network and make a space to stimulate their participation in the policy.

IMPLICATIONS FOR NURSING POLICY AND HEALTH POLICY

Nurse managers need to develop political skills and utilize strategies to help their participation in health policy-making, leading to better implementation of policies, efficiency, and effectiveness in the health system.

A Model for Building Research Capacity and Infrastructure in Oncology: A Nursing Research Fellowship

OBJECTIVE

This article describes how one comprehensive cancer center in the Northeast United States reorganized their nursing research fellowship (NRF) with the goals of engaging nurses in research processes, developing a culture of inquiry, building nursing research capacity, and sustaining infrastructures for facilitating high-quality, nurse-led oncology research studies.

METHODS

The basis for the curriculum, course work, and research practicum is derived from academic courses taught at the undergraduate, graduate, and doctoral levels. Evidence from the current literature, expertise of nurse-scientists, and feedback from former fellows provided the background for a fellowship model that included: (1) amending curriculum timeframes; (2) incorporating protected time; (3) improving access to resources; (4) enhancing the protection, data sharing, and accessibility of data; and (5) involving nurse-scientists as mentors and facilitators of research processes. These factors were incorporated over 3 years. Metrics included individual class and overall course evaluations and ongoing assessments.

RESULTS

In three cohorts from 2016 to 2019, a total of 21 nurses were accepted, and 18 (86%) nurses completed the NRF. In cohort 1 through cohort 3, 17 fellows presented their research findings internally, and a total of nine projects were presented at external forums. There were seven fellows whose manuscript submissions resulted in 21 journal publications. Of the 18 fellows, 15 (83%) conducted institutional review board-approved studies and three (17%) fellows developed studies involving one concept analysis and two systematic reviews.

CONCLUSIONS

Utilizing technology, the fellowship improved access beyond the classroom setting. Improved application processes, the inclusion of protected time for nurses, and mentoring from nurse-scientists demonstrate a commitment to fostering a culture supporting new knowledge and innovation for improving patient care.

A Bibliometric Analysis of Cirrhosis Nursing Research on Web of Science

The aims and objectives of this study were to (1) analyze the bibliometric characteristics of articles on Web of Science from 1986 to the present using literature mining and information visualization technologies developed by CiteSpace software, (2) reflect the current situation in this field as far as possible, and (3) provide evidence for improving research on nursing and clinical liver cirrhosis in Mainland China. No bibliometric analysis exists on Web of Science regarding cirrhosis nursing research. The status of current research, including hotspots and trends, has been assessed in this study through a bibliometric analysis. Literature related to cirrhosis and nursing was identified via Web of Science. Data were then analyzed using CiteSpace software. From 1986 to 2018, a total of 179 articles were published in 109 journals by 830 researchers in 36 countries/regions. The terms "cirrhosis," "management," and "quality of life" emerged most frequently and indicated the hotspots in liver cirrhosis nursing literature. Among all countries/regions, the United States contributed the most research overall; Asia also played an important role in the field of liver cirrhosis nursing research. The journal Gastroenterology Nursing published the greatest number of articles. Liver cirrhosis nursing research has attracted increasing amounts of attention around the world, although it remains less robust than other fields. Cirrhosis nursing research is still in its infancy in Mainland China, and there is an urgent need for additional support from government or research institutions to improve this research focus and promote international acceptance of the research outcomes.

A bibliometric analysis of core articles of international nursing research frontiers based on the Web of Science database

Objective

To review and analyze the basic information and distribution of core articles in the global research frontier of nursing, so as to ascertain the current trend in the field.

Methods

A total of 37 highly cited essential science indicator (ESI) papers in the nursing discipline were retrieved, which were compared with the core article collection of the ESI research frontier in January 2019 to understand the current nursing research frontiers. Subsequently, a statistical analysis of the core articles that constituted the nursing research frontiers was performed using a bibliometric method. The analysis was conducted with multiple aspects including the number of core articles, total number of citations, average publication year, issuing country, participating institution, citing paper, journal distribution, and core researcher.

Results

At present, the two international research frontiers of nursing are patient-centered care (Research Frontier 1) and missed care (Research Frontier 2). These two frontiers include a total of 12 core articles, 6 of which are highly cited Web of Science-indexed nursing papers. Research Frontier 1 includes three core articles that were cited 389 times. Research Frontier 2 includes nine core articles that were cited 841 times. Articles in the two frontiers were cited by 454 and 841 papers, respectively, most of which are in the United States. In addition, the 12 core articles were published across eight journals, the impact factors of which are all relatively high. Lastly, Research Frontier 1 involves 11 authors, whereas Research Frontier 2 involves 49 authors, of which seven authors have published more than two articles.

Conclusions

The core articles in the frontier of international nursing research demonstrate distinctive features in their issuing country/region, journal distribution, and participating institution. Review and analysis of the core articles of international nursing research frontiers can help nursing staff understand the current research hotspots and consequently perform corresponding scientific research to promote the development of the nursing discipline.

Assessing research capacity in Victoria's south-west health service providers

OBJECTIVE

To investigate the research interest, capacity and culture in individuals, teams and health organisations across south-western Victoria.

DESIGN

Cross-sectional survey.

SETTING

Eight public health services in the south-western region of Victoria.

PARTICIPANTS

All staff were invited to participate.

INTERVENTION

Hospital staff survey.

MAIN OUTCOME MEASURE

The Research Capacity and Culture tool.

RESULTS

The survey was completed by 776 staff including nurses, allied health staff and doctors. Half of the respondents were currently involved in research, while most wanted to be more involved. Respondents reported having moderate research skills and success at individual, team and organisation levels. Women and nurses reported having lower skills than comparable groups. Motivators for undertaking research were skill development (increased job satisfaction and brain stimulation) while the most commonly selected barriers were lack of time, other work taking priority and lack of funding.

CONCLUSION

Health organisations in regional and rural Victoria could harness opportunities to enable staff participation in research by supporting identified strengths, addressing barriers and providing "permission" for staff to get involved in research. Efforts to improve research capacity among women and nurses could lead to the greatest overall improvement in organisations' research capacity and output-and translation of evidence into practice.

Research capacity in nursing: a concept analysis based on a scoping review

OBJECTIVE

As the discipline of nursing has advanced, research capacity in nursing has become increasingly important to the discipline's development. However, research capacity in nursing is still commonly used as a buzzword, without a consistent and clear definition. The purpose of this study is to clarify the concept of research capacity in nursing by identifying its conceptual components in the relevant nursing literature using the Pragmatic Utility method.

DESIGN

A Pragmatic Utility concept analysis based on a scoping review.

DATA SOURCES

Academic literature retrieved from PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Scopus, Web of Science and ProQuest Dissertations and Theses (PQDT).

ELIGIBILITY CRITERIA

Qualitative studies, quantitative studies, mixed method studies or literature reviews focusing on research capacity in nursing published in English between 2009 and 2019.

RESULTS

Competence, motivation, infrastructure and collaboration for nursing research are the antecedents of research capacity in nursing. The attributes of research capacity in nursing are 'non-individual level', 'context-embeddedness' and 'sustainability'. The direct outcome of research capacity in nursing is nursing research. The allied concepts identified are nursing research competency, nursing research capability and evidence-based practice capacity in nursing.

CONCLUSIONS

Research capacity in nursing is the ability to conduct nursing research activities in a sustainable manner in a specific context, and it is normally used at a non-individual level. Research capacity in nursing is critical for the development of the nursing discipline, and for positive nurse, patient and healthcare system outcomes. More studies are needed to further explore the allied concepts of research capacity in nursing, and to better understand relationships among these allied concepts.

Self-Efficacy and Research Capacity of Clinical Nurses in China

BACKGROUND

Research capacity is essential to nursing profession development. Literature about the research capacity of Chinese nurses is scarce, especially regarding self-efficacy.

METHOD

A cross-sectional design with a cluster random sample of 780 clinical nurses was recruited from five tertiary hospitals in China. Self-reported data were collected with a Demographic Data Form, General Self-Efficacy Scale, and Self-Rating Scale of Nurses' Research Capacity.

RESULTS

The majority (60.9%) of the nurses' research capacity was at a low level. A positive correlation was found between self-efficacy and research capacity among clinical nurses (r = .287, p < .01). Multiple linear regression analyses indicated that educational level, self-efficacy, support level, and position were predictors that explained 31.9% of the variance of research capacity.

CONCLUSION

Chinese nurses' research capacity is insufficient. Educational level, self-efficacy, support level, and position contributed to nurses' research capacity. Nurse administrators should engage in improving Chinese nurses' self-efficacy to facilitate research capacity. It is necessary to develop continuing education to enhance Chinese nurses' research capacity. [J Contin Educ Nurs. 2019;50(11):509-516.].

Lessons learned from a health authority research capacity-building initiative

Health systems worldwide are under pressure to deliver better care to more people with increasingly complex needs within constrained budgets. Research capacity building has been shown to help alleviate these challenges and is underway at hospitals and health authorities across the country; however, approaches vary widely and little exists in the Canadian literature to share experience and best practices. This article describes how a health authority in British Columbia, Canada, implemented and evaluated a 5-year research capacity-building program in partnership with a provincial health research funder. We offer lessons learned for those leading similar innovation-focused change management initiatives, including vision and buy in, complexity thinking, infrastructure, leadership, and coalition development. We suggest that collective learning and building a more robust research capacity-building literature can help health organizations and their partners take significant steps toward integrating research and care for a more effective, efficient, and patient-centred health system.

Nursing and Midwifery Research Output in Africa: A Review of the Literature

BACKGROUND

Nurses and midwives form the backbone of health service delivery and satisfaction with care often depends on the competencies of nurses and midwives who provide the care (World Health Organization [WHO], 2002). Healthcare has become complex, challenging, and demanding across diverse sociocultural and socioeconomic changes and environments. To optimize their impact, nurses and midwives therefore need to be prepared with evidence-based competences. Nursing research therefore, is the cornerstone for evidence-based practice and for establishing the professional status of nursing and building research capacity. However, although nursing research began in the 19th century, it is limited in Africa, with little evidence generated to inform policy and practice. Although nursing and midwifery education in the region has advanced with graduate and postgraduate level education, little is known about nursing and midwifery research conducted in universities and where to find such research.

OBJECTIVES

The literature review aimed at quantifying and identifying the types and gaps in nursing and midwives' research and publications in Africa.

METHODS

Articles published between January 1, 2007 and January 31, 2017 were retrieved from PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) with a search strategy that employed four sets of terms: (a) terms identifying published research done by nurses or midwives, or both; (b) terms identifying types of publications; (c) terms identifying filters for African countries; and (d) filters for publication dates. We also searched Google Scholar to capture nonindexed sources.

RESULTS AND CONCLUSIONS

There is evidence of an increasing number of African nurses and midwives publishing research; however, much of this research may not be readily available. The promotion of nursing research and capacity building/mentorship in research for nurses and midwives is recommended to increase nurses' and midwives' skills to critically evaluate research and apply the best evidence to their practice.

Uncovering the mechanisms of research capacity development in health and social care: a realist synthesis

BACKGROUND

Research capacity development (RCD) is considered fundamental to closing the evidence-practice gap, thereby contributing to health, wealth and knowledge for practice. Numerous frameworks and models have been proposed for RCD, but there is little evidence of what works for whom and under what circumstances. There is a need to identify mechanisms by which candidate interventions or clusters of interventions might achieve RCD and contribute to societal impact, thereby proving meaningful to stakeholders.

METHODS

A realist synthesis was used to develop programme theories for RCD. Structured database searches were conducted across seven databases to identify papers examining RCD in a health or social care context (1998-2013). In addition, citation searches for 10 key articles (citation pearls) were conducted across Google Scholar and Web of Science. Of 214 included articles, 116 reported on specific interventions or initiatives or their evaluation. The remaining 98 articles were discussion papers or explicitly sought to make a theoretical contribution. A core set of 36 RCD theoretical and conceptual papers were selected and analysed to generate mechanisms that map across macro contexts (individual, team, organisational, network). Data were extracted by means of 'If-Then' statements into an Excel spreadsheet. Models and frameworks were deconstructed into their original elements.

RESULTS

Eight overarching programme theories were identified featuring mechanisms that were triggered across multiple contexts. Three of these fulfilled a symbolic role in signalling the importance of RCD (e.g. positive role models, signal importance, make a difference), whilst the remainder were more functional (e.g. liberate talents, release resource, exceed sum of parts, learning by doing and co-production of knowledge). Outcomes from one mechanism produced changes in context to stimulate mechanisms in other activities. The eight programme theories were validated with findings from 10 systematic reviews (2014-2017).

CONCLUSIONS

This realist synthesis is the starting point for constructing an RCD framework shaped by these programme theories. Future work is required to further test and refine these findings against empirical data from intervention studies.

African and Caribbean Nurses' Decisions about HIV Testing: A Mixed Methods Study

Nurses in Jamaica, Kenya, South Africa, and Uganda are at risk for occupational exposure to HIV. Little is known about the experiences and policy supports related to nurses having themselves tested for the virus. This article reports a mixed-methods study about contextual influences on nurses' decision-making about HIV testing. Individual and focus group interviews, as well as a questionnaire on workplace polices and quality assurance and a human resource management assessment tool provided data. Fear of a positive diagnosis and stigma and lack of confidentiality along with gaps in the policy environment contributed to indecision about testing. There were significant differences in policy supports among countries. Institutional support must be addressed if improvements in HIV testing for health care workers are going to be effectively implemented. Future work is required to better understand how HRM policies intersect to create conditions of perceived vulnerability for HIV positive staff.

Implementing an innovative intervention to increase research capacity for enhancing early psychosis care in Indonesia

WHAT IS KNOWN ON THE TOPIC?: In low- and middle-income settings (LMICs) such as Indonesia, the burden from psychotic illness is significant due to large gaps in treatment provision Mental health workers and community nurses are a growing workforce requiring new evidence to support practice and enhanced roles and advanced competencies among UK mental health nurses also requires greater research capacity Research capacity building projects can strengthen research institutions, enhance trial capacity, improve quality standards and improve attitudes towards the importance of health research. WHAT THIS PAPER ADDS?: Delivering innovative, cross-cultural workshops to enhance research capacity to multidisciplinary, early career researchers in Indonesia and the UK are rated highly by attendees Supporting people in this way helps them to gain competitive grant funding to complete their own research which can improve the health of the population To our knowledge, there are no other studies reporting the attainment of grant income as a successful outcome of international research partnerships for mental health nursing so our finding is novel. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This method could be implemented to improve networking and collaboration between UK academics and early career researchers in other lower- and middle-income settings This strategy can also strengthen existing partnerships among early career researchers in the UK to meet the demands for greater research mentorship and leadership among mental health nurses and enhance nurses capabilities to contribute to evidence for practice.

ABSTRACT

Aim To strengthen research capacity for nurses and early career researchers in Indonesia and the UK to develop a local evidence base in Indonesia to inform policy and improve the nation's health. These strategies can strengthen research institutions, enhance trial capacity, improve quality standards and improve attitudes towards the importance of health research. Methods Four days of workshops were held in Jakarta, Indonesia developing collaborative groups of academic nurses and early career researchers from the UK and Indonesia (30 people including mentors) to produce competitive grant bids to evaluate aspects of early psychosis care. Qualitative and quantitative evaluations were conducted. Results Participants evaluated the workshops positively finding benefit in the structure, content and delivery. Research impact was shown by attaining several successful small and large grants and developing offshoot collaborative relationships. Discussion These novel findings demonstrate that collaborative workshops can strengthen research capacity by developing partnerships and instigating new collaborations and networks. No other studies of international research partnerships among mental health nurses have reported this outcome to our knowledge. Implications for Practice This method could be implemented to improve networking and collaboration between UK academics and early career researchers and also with external colleagues in other LMICs.

Developing nursing research in the United Arab Emirates: a narrative review

AIM

This article identified, critically analysed and synthesized the literature on international nursing and midwifery research capacity building and standards.

BACKGROUND

The United Arab Emirates is heavily dependent up on expatriate nurses. Only 4% of nurses working within the country are Emirati. The nation is therefore committed to developing nurses and nursing as a profession.

INTRODUCTION

The United Arab Emirates' Nursing and Midwifery Council was formed in 2009 and initially focused on regulation, education and specialization. This review was undertaken to inform the work of the Council's newly established Scientific Research Sub-Committee.

METHODS

A rapid narrative review was conducted using the Cumulative Index of Nursing and Allied Health Literature database, key words, Boolean operators, parameters and a journal-specific search. An inclusion/exclusion criterion was identified.

RESULTS

The search provided 332 articles with 45 included in the final review. The literature on nursing research 'standards' and 'capacity building' is diverse and inconsistent across continents and in approaches.

DISCUSSION

Nursing research has evolved to varying degrees across the globe. Nevertheless, irrespective of the locale, there are similar problems encountered in growing research, for example nursing faculty shortage, lack of collaborative research, funding. There are also specific challenges in the Middle East and North Africa region.

LIMITATIONS

The review was constrained by time and access.

CONCLUSION AND IMPLICATIONS FOR NURSING POLICY

There are specific challenges for the United Arab Emirates. However, the country is well placed to learn from the experiences of colleagues elsewhere. Time and commitment is required to build the solid foundations necessary to ensure robust, sustained growth. Identifying research capacity as both a process and outcome at the outset may also assist. Further, it may be prudent to consider initiating a Gulf Coast Countries' collaborative approach to building research capacity to harness scare resources and create a larger critical mass.

Research in Nursing and Nutrition: Is Randomized Clinical Trial the Actual Gold Standard?

The aim of this study was to assess the quality of reporting of nurse-driven randomized controlled trials involving a direct nutritional intervention. A bibliometric search for randomized controlled trials involving a direct nutritional intervention from 1991 to 2011 in nursing research was conducted. Both quality of the study and design aspects were evaluated. The prevalent randomized controlled trial design used is 2-arm parallel, individual, and randomized with a continuous primary endpoint. Global numbers of randomized controlled trials and the proportion of good-quality randomized controlled trials began a steady and marked rise, more than doubling, from the 1990s to about 2001 and increased slowly thereafter. Studies are overall sufficiently well designed, although there is still room for quality improvement. Additionally, implementation of new randomized controlled trial designs exists and should be advocated.

Community pharmacists' interest in and attitude to pharmacy practice research in Ethiopia: A cross-sectional study

Pharmacy practice-research became an important component in the pharmacy practice. However, limited studies were conducted in sub-Saharan Africa to understand the pharmacists’ interest and attitude towards pharmacy practice-research. We aimed to assess the community pharmacists’ interest and attitude towards pharmacy practice-research in Ethiopia. A cross-sectional survey was conducted among community pharmacists in eight major cities in Ethiopia. A validated 25-item self-administered questionnaire covering interest and attitude related to pharmacy practice-research was distributed. Responses were analysed using descriptive and inferential statistics. A total of 389 community pharmacists responded to the survey (response rate- 88.4%). Most of community pharmacists showed a high level of interest and positive attitude in being involved in all aspects of pharmacy practice-research. The median summary score for interest and attitude were 38 (IQR 20–40) (range possible 10–50) and 30 (IQR 18–39), respectively. Sixty-seven percent of the respondents thought about being involved in research, felt research is important for their career (57.6%), confident to conduct the research (56.2%), and agreed that research is a part of pharmacy practice (48.5%). However, only forty-six percent agreed that they underwent research training. A multivariate analysis showed that females were more interested in pharmacy practice research than males [AOR: 1.50, 95% CI: 0.99–2.27; p<0.05]. Community pharmacists showed high interest towards several areas of research competencies and demonstrated positive attitude towards pharmacy practice-research. Our findings suggest that providing research training to community pharmacists may contribute in undertaking research activities and build the research capacity in Ethiopia.

Describing the implementation of an innovative intervention and evaluating its effectiveness in increasing research capacity of advanced clinical nurses: using the consolidated framework for implementation research

Background

Despite advanced nursing roles having a research competency, participation in research is low. There are many barriers to participation in research and few interventions have been developed to address these. This paper aims to describe the implementation of an intervention to increase research participation in advanced clinical nursing roles and evaluate its effectiveness.

Methods

The implementation of the intervention was carried out within one hospital site. The evaluation utilised a mixed methods design and a implementation science framework. All staff in advanced nursing roles were invited to take part, all those who were interested and had a project in mind could volunteer to participate in the intervention. The intervention consisted of the development of small research groups working on projects developed by the nurse participant/s and supported by an academic and a research fellow. The main evaluation was through focus groups. Output was analysed using thematic analysis. In addition, a survey questionnaire was circulated to all participants to ascertain their self-reported research skills before and after the intervention. The results of the survey were analysed using descriptive statistics. Finally an inventory of research outputs was collated.

Results

In the first year, twelve new clinical nurse-led research projects were conducted and reported in six peer reviewed papers, two non-peer reviewed papers and 20 conference presentations. The main strengths of the intervention were its promptness to complete research, to publish and to showcase clinical innovations. Main barriers identified were time, appropriate support from academics and from peers. The majority of participants had increased experience at scientific writing and data analysis.

Conclusion

This study shows that an intervention, with minor financial resources; a top down approach; support of a hands on research fellow; peer collaboration with academics; strong clinical ownership by the clinical nurse researcher; experiential learning opportunities; focused and with needs based educational sessions, is an intervention that can both increase research outputs and capacity of clinically based nurses. Interventions to further enhance nursing research and their evaluation are crucial if we are to address the deficit of nurse-led patient-centred research in the literature.

Electronic supplementary material

The online version of this article (doi:10.1186/s12912-017-0214-6) contains supplementary material, which is available to authorized users.

Health research capacity development in low and middle income countries: reality or rhetoric? A systematic meta-narrative review of the qualitative literature

OBJECTIVES

Locally led health research in low and middle income countries (LMICs) is critical for overcoming global health challenges. Yet, despite over 25 years of international efforts, health research capacity in LMICs remains insufficient and development attempts continue to be fragmented. The aim of this systematic review is to identify and critically examine the main approaches and trends in health research capacity development and consolidate key thinking to identify a more coherent approach.

METHODS

This review includes academic and grey literature published between January 2000 and July 2013. Using a predetermined search strategy, we systematically searched PubMed, hand-searched Google Scholar and checked reference lists. This process yielded 1668 papers. 240 papers were selected based on a priori criteria. A modified version of meta-narrative synthesis was used to analyse the papers.

RESULTS

3 key narratives were identified: the effect of power relations on capacity development; demand for stronger links between research, policy and practice and the importance of a systems approach. Capacity development was delivered through 4 main modalities: vertical research projects, centres of excellence, North-South partnerships and networks; all were controversial, and each had their strengths and weaknesses. A plurality of development strategies was employed to address specific barriers to health research. However, lack of empirical research and monitoring and evaluation meant that their effectiveness was unclear and learning was weak.

CONCLUSIONS

There has been steady progress in LMIC health research capacity, but major barriers to research persist and more empirical evidence on development strategies is required. Despite an evolution in development thinking, international actors continue to use outdated development models that are recognised as ineffective. To realise newer development thinking, research capacity outcomes need to be equally valued as research outputs. While some development actors are now adopting this dedicated capacity development approach, they are in the minority.

The impact of leadership hubs on the uptake of evidence-informed nursing practices and workplace policies for HIV care: a quasi-experimental study in Jamaica, Kenya, Uganda and South Africa

BACKGROUND

The enormous impact of HIV on communities and health services in Sub-Saharan Africa and the Caribbean has especially affected nurses, who comprise the largest proportion of the health workforce in low- and middle-income countries (LMICs). Strengthening action-based leadership for and by nurses is a means to improve the uptake of evidence-informed practices for HIV care.

METHODS

A prospective quasi-experimental study in Jamaica, Kenya, Uganda and South Africa examined the impact of establishing multi-stakeholder leadership hubs on evidence-informed HIV care practices. Hub members were engaged through a participatory action research (PAR) approach. Three intervention districts were purposefully selected in each country, and three control districts were chosen in Jamaica, Kenya and Uganda. WHO level 3, 4 and 5 health care institutions and their employed nurses were randomly sampled. Self-administered, validated instruments measured clinical practices (reports of self and peers), quality assurance, work place policies and stigma at baseline and follow-up. Standardised average scores ranging from 0 to 1 were computed for clinical practices, quality assurance and work place policies. Stigma scores were summarised as 0 (no reports) versus 1 (one or more reports). Pre-post differences in outcomes between intervention and control groups were compared using the Mantel Haenszel chi-square for dichotomised stigma scores, and independent t tests for other measures. For South Africa, which had no control group, pre-post differences were compared using a Pearson chi-square and independent t test. Multivariate analysis was completed for Jamaica and Kenya. Hub members in all countries self-assessed changes in their capacity at follow-up; these were examined using a paired t test.

RESULTS

Response rates among health care institutions were 90.2 and 80.4 % at baseline and follow-up, respectively. Results were mixed. There were small but statistically significant pre-post, intervention versus control district improvements in workplace policies and quality assurance in Jamaica, but these were primarily due to a decline in scores in the control group. There were modest improvements in clinical practices, workplace policies and quality assurance in South Africa (pre-post) (clinical practices of self-pre 0.67 (95 % CI, 0.62, 0.72) versus post 0.78 (95 % CI, 0.73-0.82), p = 0.002; workplace policies-pre 0.82 (95 % CI, 0.70, 0.85) versus post 0.87 (95 % CI, 0.84, 0.90), p = 0.001; quality assurance-pre 0.72 (95 % CI, 0.67, 0.77) versus post 0.84 (95 % CI, 0.80, 0.88)). There were statistically significant improvements in scores for nurses stigmatising patients (Jamaica reports of not stigmatising-pre-post intervention 33.9 versus 62.4 %, pre-post control 54.7 versus 64.4 %, p = 0.002-and Kenya pre-post intervention 35 versus 51.6 %, pre-post control 34.2 versus 47.8 %, p = 0.006) and for nurses being stigmatised (Kenya reports of no stigmatisation-pre-post intervention 23 versus 37.3 %, pre-post control 15.4 versus 27 %, p = 0.004). Multivariate results for Kenya and Jamaica were non-significant. Twelve hubs were established; 11 were active at follow-up. Hub members (n = 34) reported significant improvements in their capacity to address care gaps.

CONCLUSIONS

Leadership hubs, comprising nurses and other stakeholders committed to change and provided with capacity building can collectively identify issues and act on strategies that may improve practice and policy. Overall, hubs did not provide the necessary force to improve the uptake of evidence-informed HIV care in their districts. If hubs are to succeed, they must be integrated within district health authorities and become part of formal, legal organisations that can regularise and sustain them.

An Audit of Nursing Documentation at Three Public Hospitals in Jamaica

PURPOSE

Nursing documentation provides an important indicator of the quality of care provided for hospitalized patients. This study assessed the quality of nursing documentation on medical wards at three hospitals in Jamaica.

METHODS

This cross-sectional study audited a multilevel stratified sample of 245 patient records from three type B hospitals. An audit instrument which assessed nursing documentation of client history, biological data, client assessment, nursing standards, discharge planning, and teaching facilitated data collection. Descriptive statistics were conducted using IBM SPSS, Version 19 (IBM Inc., Armonk, NY, USA).

FINDINGS

Records from three hospitals (Hospital 1, n = 119, 48.6%; Hospital 2, n = 56, 22.9%; Hospital 3, n = 70, 28.6%) were audited. Documented evidence of the patient's chief complaint (81.6%), history of present illness (78.8%), past health (79.2%), and family health (11.0%) were noted; however, less than a third of the dockets audited recorded adequate assessment data (e.g., occupation or living accommodations of patients). The audit noted 90% of records had a physical assessment completed within 24 hr of admission and entries timed, dated, and signed by a nurse. Less than 5% of dockets had evidence of patient teaching, and 13.5% had documented evidence of discharge planning conducted within 72 hr of admission.

CONCLUSIONS

This study highlights the weakness in nursing documentation and the need for increased training and continued monitoring of nursing documentation at the hospitals studied. Additional research regarding the factors that affect nursing documentation practice could prove useful.

CLINICAL RELEVANCE

The study provides valuable information for the development of strategic risk management programs geared at improving the quality of care delivered to clients and presents an opportunity for nurse leaders to implement structured interventions geared at improving nursing documentation in Jamaica. In light of Jamaica's epidemiologic transition of chronic diseases, gaps in nurses' documentation of client assessment, patient teaching, and discharge planning should be addressed with urgency. Patient teaching and discharge planning enable the clients to participate more effectively in their health maintenance process.

Survey of research activity among multidisciplinary health professionals

Objective The aim of the present study was to describe the research activities being undertaken by health service employees within one Australian health service and explore their experiences with undertaking research. Methods The present mixed-methods study was conducted across one health service in Queensland, Australia, and included a cross-sectional online survey and interviews with healthcare service employees. The anonymous survey was a self-administered online questionnaire, distributed to all 6121 employees at the health service via email, asking about research activity and engagement. Willing participants were also interviewed on their perceptions and experiences with research and capacity building. Results In all, 151 participants responded to the survey and 22 participated in interviews. Three-quarters of respondents reported actively participating in research over the past 6 years and several research outputs, such as publications, conference presentations and competitive grant funding, were displayed. Four concepts emerged from interview findings, namely collaborative partnerships, skilled mentorship, embedding research and organisational support, which represented the overall theme 'opportunities for a research-infused health service'. Conclusion Employees of the health service recognised the importance of research and had a range of research skills, knowledge and experience. They also identified several opportunities for building research capacity in this service. What is known about the topic? Building research capacity among healthcare professionals is important for enabling the conduct of high-quality research in healthcare institutions. However, building research capacity is complex and influenced by the uniqueness of organisational context. In order to successfully build research capacity among employees at any health service, current research activity, skills and experience, as well as staff perceptions around building research capacity in that setting, should first be explored. What does this paper add? Healthcare services should incorporate teaching and research with clinical care to optimise outcomes for consumers. Support for research can be diminished in favour of clinical care and reduced emphasis on the importance of research can negatively influence research activity and expansion of clinician-led research. Highlighting the perceptions and experience of clinicians with enabling research and capacity building is a context-specific but necessary process to ensure that strategies, processes and resources are targeted to maintain support for research activity while overcoming barriers. What are the implications for practitioners? Participants in this study identified several ways to build research capacity in their health service, many of which may be applicable to other settings and contexts. Building research collaborations and academic partnerships are important to enable and drive research. Structural processes, such as organisational support and opportunities for skilled mentorship, may be necessary to build health service employees' research knowledge, skills and confidence. Finally, embedding research into everyday practice is important to foster a positive research culture within health services.

Research is 'a step into the unknown': an exploration of pharmacists' perceptions of factors impacting on research participation in the NHS

OBJECTIVE

This study explored National Health Service (NHS) pharmacists' perceptions and experiences of pharmacist-led research in the workplace.

DESIGN

Semistructured, face-to-face discussions continued until distinct clusters of opinion characteristics formed. Verbatim transcripts of audio-recordings were subjected to framework analysis.

SETTING

Interviews were carried out with 54 pharmacists with diverse backgrounds and roles from general practices and secondary care in the UK's largest health authority.

RESULTS

The purpose and potential of health services research (HSR) was understood and acknowledged to be worthwhile by participants, but a combination of individual and system-related themes tended to make participation difficult, except when this was part of formal postgraduate education leading to a qualification. Lack of prioritisation was routinely cited as the greatest barrier, with motivation, confidence and competence as additional impediments. System-related themes included lack of practical support and pharmacy professional issues. A minority of highly motivated individuals managed to embed research participation into routine activity.

CONCLUSIONS

Most pharmacists realised the desirability and necessity of research to underpin pharmacy service expansion, but a combination of individual and professional level changes is needed to increase activity. Our findings provide a starting point for better understanding the mindset of hospital-based and general practice-based pharmacists towards research, as well as their perceived barriers and supports.

Trends in RCT nursing research over 20 years: mind the gap

Randomised controlled trial (RCT) literature plays a fundamental role in informing evidence-based medicine and nursing. This paper aims to track geographical and temporal trends in the publication of RCTs in nursing over the past 20 years by means of a bibliometric analysis. The PubMed database was searched for articles published from 1 January 1991 to 31 October 2011 and satisfying this search strategy: nursing [MeSH Terms] AND (RCT OR trial* OR 'experimental study' OR randomised OR randomisation) AND (English[lang]). Abstracts were reviewed to assess whether they met the criteria for an RCT. A manual search of information on country of origin was carried out and Journal Citation Reports® was used to allocate journals to subject areas. RCT methodology is increasingly drawing the attention of nursing researchers worldwide. However, there is a large disparity in research productivity, at least in terms of number of published RCTs in the English language and listed on PubMed, between the most productive continents, North America and Europe, and the others.

Assessing nursing student intent for PHD study

BACKGROUND

Nursing faculty shortages threaten a country's ability to produce the amount of nurses necessary to sustain the delivery of healthcare services. Programs that "fast track" graduate education options for registered nurses are one solution to the problem.

OBJECTIVES

To (1) evaluate admission criteria into PhD programs for direct entry from a bachelor's degree; (2) ascertain bachelors and masters degree nursing students' perspectives on pursuing a BSN to PhD course of study; (3) clarify factors that influence students' decision-making processes behind pursuing a PhD and identify characteristics of those who would be likely recruits for PhD study; 4) to test the survey questions to develop an instrument for future use.

DESIGN

A cross-sectional pilot study.

SETTING

A nursing program at a large urban university in the United States of America with an enrollment of over 1400 students.

PARTICIPANTS

Currently enrolled bachelor's, master's, and doctor of nursing practice students.

METHODS

Students were sampled via a 10-question (including one open-ended question) electronic mail survey that included 1385 eligible subjects.

RESULTS

Among the 606 respondents (57% response rate), 63% were between ages 18 and 30 and 87% indicated that full tuition funding with a living stipend would make them more interested in pursuing a PhD. Current program track was a significant predictor of course of study and area of interest (p=.029). Analysis of the 427 respondents to the open-ended question revealed themes around "time" and "money" as the main barriers to study. The desire to gain clinical experience prior to PhD study was the third theme and an unanticipated finding.

CONCLUSIONS

The questionnaire offered some predictive ability for gauging intent to study for a PhD among bachelor's and graduate degree prepared nurses. The results do offer some suggestions for nursing workforce development to help address faculty shortages.

Building reproductive health research and audit capacity and activity in the Pacific Islands (BRRACAP) study: methods, rationale and baseline results

BACKGROUND

Clinical research and audit in reproductive health is essential to improve reproductive health outcomes and to address the Millennium Development Goals 4 and 5. Research training, mentoring and a supportive participatory research environment have been shown to increase research activity and capacity in low to middle income countries (LMIC). This paper details the methods, rationale and baseline findings of a research program aimed at increasing clinical research activity and audit in the six Pacific Islands of Fiji, Samoa, Tonga, Vanuatu, Cook Islands and the Solomon Islands.

METHOD

Twenty-eight clinician participants were selected by the five Ministries of Health and the Fiji National University to undergo a research capacity building program which includes a research workshop and mentoring support to perform research and audit as teams in their country. Data on the participants' characteristics, knowledge and experiences were collected from structured interviews, questionnaires, focus groups, and an online survey. The interviews and the two focus groups were audio-recorded and all replies were analysed in a thematic framework.

RESULTS

The 28 participants included 9 nurses/midwives, 17 medical doctors of whom 8 were specialists in reproductive health and 2 other health workers. Most (24, 86%) were required to perform research as part of their employment and yet 17 (61%) were not confident in writing a research proposal, 13 (46%) could not use an electronic spreadsheet and the same number had not analysed quantitative data. The limited environmental enablers contributed to poor capacity with only 11 (46%) having access to a library, 10 (42%) receiving management support and 6 (25%) having access to an experienced researcher. Barriers to research that affected more than 70% of the participants were time constraints, poor coordination, no funding and a lack of skills.

CONCLUSION

Building a research capacity program appropriate for the diversity of Pacific clinicians required research evidence and collaborative effort of key stakeholders in the Pacific Islands and the region. The participants had limited research knowledge, skills and experience and would require individualized training and continuous intensive mentorship to realize their potential as clinician researchers for their services in the Pacific.

Shaping the research experiences of graduate students using action research

BACKGROUND

Nursing research capacity is often not optimal in developing countries. Capacity building at the graduate nurse level presents an opportunity for improved research output. Students pursuing a research methods course at a nursing school in Jamaica expressed fear and anxiety towards the course. Action research was used to address this fear and improve learning outcomes.

OBJECTIVE

To determine attitudes towards research and to improve the experience of graduate students pursuing a research methods course at a nursing school in Jamaica.

METHODS

Students (n=44) registered in the Research Methods course of the MScN at a nursing school in Kingston, Jamaica for the academic year 2010/2011, were invited to participate. Each student was assigned a main supervisor and an alternate supervisor and all had equal access to the course leader and content. On completion of the course three focus group discussions of 10-14 students per group were conducted to determine how students felt about the course experience and their attitude towards the course.

RESULTS

Thirty-seven students (mean age of 41.4 ± 1.5 years; 94% female) participated in the exploratory course evaluation exercise. The participants reported that they entered research methods with feelings of apprehension and anxiety. However, these fears were allayed by a combination of factors including interest in students' welfare, affirmation of students, respect for and understanding of students' needs and resourcefulness, and the use of a panel of experts. Barriers included faculty's unrealistic expectations of students' research competencies and the limited time in which to learn and apply concepts. While students thought the course as challenging they felt more confident that they could be successful on completion of the course.

CONCLUSION

Significant improvement in attitudes to research was realized among graduate nursing students using action research at an urban school of nursing in Jamaica.

Advancing the pharmacy practice research agenda: views and experiences of pharmacists in Qatar

BACKGROUND

There is little emphasis on pharmacy practice research in Qatar, with a lack of relevant education and training and a notable lack of exposure to processes of research.

OBJECTIVE

To describe views and attitudes of pharmacists in Qatar to pharmacy practice research prior to and following a 2 day introductory research workshop.

METHOD

All pharmacists (n = 350) were invited to express interest in attending. All participants were required to complete a questionnaire covering views and attitudes relating to research. Workshop sessions were on: research questions; critically appraising literature; developing research methods; collecting and analysing data; and disseminating findings. Participants completed a post-course evaluation questionnaire.

RESULTS

Of the ninety expressing interest, 47 were selected and participated in the first training day, with 40 of these also attending the second day. Participants expressed positive views and attitudes towards research. Most (46/47) strongly agreed/agreed that it was their professional duty to be involved; all strongly agreed/agreed with importance of an evidence base to support practice; but there were issues around time, support and training. The research workshops were positively evaluated by participants.

CONCLUSION

Findings indicate pharmacists' willingness to participate in research training in Qatar. However, there is a need to ensure that views and attitudes translate into research participation thus enhancing the evidence base.

Research involvement, support needs, and factors affecting research participation: a survey of Mental Health Consultation Liaison Nurses

The aims of this study were to identify research involvement and support needs of Mental Health Consultation Liaison Nurses (MHCLN) and the factors that affect participation in research. A self-administered, standardized, anonymous questionnaire was distributed to a convenience sample of MHCLN. Frequencies and univariate analyses were calculated to examine relationships between: (i) involvement in a research study by highest qualification and job designation; and (ii) current enrolment in a higher degree study, research goals, and current research involvement by level of research skill. Open-ended responses were collated and summarized. Of the 34 workshop attendees, 32 participated in the survey (response rate 94%). Seventy-five percent of respondents agreed that involvement in research is an expectation of their role; 75% reported no current involvement in research. Over half (53%) of participants reported having research goals over the next 12 months. Those enrolled in postgraduate degrees were more likely to be currently involved in a research project (P=0.013). Commonly reported barriers to research participation were competing commitments and lack of support, resources, confidence, and motivation. This study showed that access to research support and resources, including mentorship and funding, are required to engage these MHCLN in research and to build capacity.

Nurses' engagement in AIDS policy development

BACKGROUND

A multidisciplinary team of 20 researchers and research users from six countries - Canada, Jamaica, Barbados, Kenya, Uganda and South Africa - are collaborating on a 5-year (2007-12) program of research and capacity building project. This program of research situates nurses as leaders in building capacity and promotes collaborative action with other health professionals and decision-makers to improve health systems for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) nursing care. One of the projects within this program of research focused on the influence of workplace policies on nursing care for individuals and families living with HIV. Nurses are at the forefront of HIV prevention and AIDS care in these countries but have limited involvement in related policy decisions and development. In this paper, we present findings related to the barriers and facilitators for nurses' engagement in policymaking.

METHODS

A participatory action research design guided the program of research. Purposive sampling was used to recruit 51 nurses (unit managers, clinic and healthcare managers, and senior nurse officers) for interviews.

FINDINGS

Participants expressed the urgent need to develop policies related to AIDS care. The need to raise awareness and to 'protect' not only the workers but also the patients were critical reason to develop policies. Nurses in all of the participating countries commented on their lack of involvement in policy development. Lack of communication from the top down and lack of information sharing were mentioned as barriers to participation in policy development. Resources were often not available to implement the policy requirement. Strong support from the management team is necessary to facilitate nurses involvement in policy development.

CONCLUSIONS

The findings of this study clearly express the need for nurses and all other stakeholders to mobilize nurses' involvement in policy development. Long-term and sustained actions are needed to address gaps on the education, research and practice level.

Being global in public health practice and research: complementary competencies are needed

Different sets of competencies in public health, global health and research have recently emerged, including the Core Competencies for Public Health in Canada (CCPHC). Within this context, we believe it is important to articulate competencies for globalhealth practitioners-educators and researchers that are in addition to those outlined in the CCPHC. In global health, we require knowledge and skills regarding: north-south power dynamics, linkages between local and global health problems, and the roles of international organizations. We must be able to work responsibly in low-resource settings, foster self-determination in a world rife with power differentials, and engage in dialogue with stakeholders globally. Skills in cross-cultural communication and the ability to critically self-reflect on one's own social location within the global context are essential. Those in global health must be committed to improving health equity through global systems changes and be willing to be mentored and to mentor others across borders. We call for dialogue on these competencies and for development of ways to assess both their demonstration in academic settings and their performance in global health practice and research.