Discussion
Assessing over 60 studies using the BARRIERS scale, we
found reported barriers to research use have remained
constant over time and across geographic locations. The
rank order of items was found to be uniform, although
the percentage of agreement varied between studies.
Despite differences in method, our findings were similar
to those of Carlson and Plonczynski [22], who analyzed
correlations between year of publication and mean percentage
of items reported as barriers to research use.
They concluded that perceived barriers have not changed
since the scale's publication. Conversely, we compared
the mean values of the four subscales between two groups
(1991 to 1999 and 2000 to 2009) using Student's t-test and
did not find any significant differences when compared
across time. Using this approach, we confirmed Carlson
and Plonczynski's [22] findings. There are some minor
differences between our results and Carlson and Plonczynski's
[22] when comparing across geographic locations.
Carlson and Plonczynski [22] compared barriers
across three geographic locations: United States of America,
United Kingdom, and other countries. Using vote
counting to calculate differences between countries, they
found differences on five items. We compared barriers
across geographical locations by dividing the studies
based on whether they included subjects from North
America, Europe-English, Europe non-English, or Australia/
Asia. Using ANOVA and Bonferroni post hoc tests
to compare mean percentages for the top ten items and
the subscale means, we did not find any differences in
subscale means, but did find three differences across the
top ten items. Both our results and Carlson and Plonczynski's
suggest that a significantly higher percentage of
nurses outside North America view inadequate facilities
as a barrier to research use than do their North American
colleagues.
The quality of the 63 studies was generally weak to moderate
(22 weak, 38 moderate, and 3 strong), reflecting
trends often reported in systematic reviews. We found no
differences in reported findings between the weak and
stronger studies, however, possibly suggesting that the
general and descriptive nature of the studies was resistant
to methodological flaws. Nonspecific wording limits the
usefulness of the BARRIERS scale as a tool for planning
interventions. For example, the statement 'facilities are
not adequate for implementation,' one of the top ten
items, provides little insight into aspects of facilities that
might be deficient. Facilities could refer to material
resources, such as access to a computer and electronic
databases, or to human resources, such as access to clinical
specialists or facilitators. Nonspecific barrier items
could contribute to the consistent results. Additionally,
two consistently high-ranking items ('lack of time to read'
and 'lack of time to implement research') require further
Discussion
Assessing over 60 studies using the BARRIERS scale, we
found reported barriers to research use have remained
constant over time and across geographic locations. The
rank order of items was found to be uniform, although
the percentage of agreement varied between studies.
Despite differences in method, our findings were similar
to those of Carlson and Plonczynski [22], who analyzed
correlations between year of publication and mean percentage
of items reported as barriers to research use.
They concluded that perceived barriers have not changed
since the scale's publication. Conversely, we compared
the mean values of the four subscales between two groups
(1991 to 1999 and 2000 to 2009) using Student's t-test and
did not find any significant differences when compared
across time. Using this approach, we confirmed Carlson
and Plonczynski's [22] findings. There are some minor
differences between our results and Carlson and Plonczynski's
[22] when comparing across geographic locations.
Carlson and Plonczynski [22] compared barriers
across three geographic locations: United States of America,
United Kingdom, and other countries. Using vote
counting to calculate differences between countries, they
found differences on five items. We compared barriers
across geographical locations by dividing the studies
based on whether they included subjects from North
America, Europe-English, Europe non-English, or Australia/
Asia. Using ANOVA and Bonferroni post hoc tests
to compare mean percentages for the top ten items and
the subscale means, we did not find any differences in
subscale means, but did find three differences across the
top ten items. Both our results and Carlson and Plonczynski's
suggest that a significantly higher percentage of
nurses outside North America view inadequate facilities
as a barrier to research use than do their North American
colleagues.
The quality of the 63 studies was generally weak to moderate
(22 weak, 38 moderate, and 3 strong), reflecting
trends often reported in systematic reviews. We found no
differences in reported findings between the weak and
stronger studies, however, possibly suggesting that the
general and descriptive nature of the studies was resistant
to methodological flaws. Nonspecific wording limits the
usefulness of the BARRIERS scale as a tool for planning
interventions. For example, the statement 'facilities are
not adequate for implementation,' one of the top ten
items, provides little insight into aspects of facilities that
might be deficient. Facilities could refer to material
resources, such as access to a computer and electronic
databases, or to human resources, such as access to clinical
specialists or facilitators. Nonspecific barrier items
could contribute to the consistent results. Additionally,
two consistently high-ranking items ('lack of time to read'
and 'lack of time to implement research') require further
การแปล กรุณารอสักครู่..
