Psychiatry Nurses’ knowledge base, perceptions on research and research utilization in Calabar, Nigeria.

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  Evidence-based practice depends on factors such as practitioners’ knowledge and perceptions of research and research utilization including access to relevant research reports. Little is known about these issues with regard to Psychiatry Nurses in
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   1 † Edet, O. B. 1 (RN,PhD), Ella, R. 2 (RN, PhD) & Esienumoh, E.E 3 (RN, PhD) (2011). Psychiatry Nurses’ knowledge base, perceptions on research and research utilization in Calabar, Nigeria. International Professional Nursing Journal. 9(1): 112-119.   1, 2, 3 University of Calabar, Nigeria † bamideleedet@yahoo.com   Abstract Evidence- based practice depends on factors such as practitioners’ knowledge and perceptions of research and research utilization including access to relevant research reports. Little is known about these issues with regard to Psychiatry Nurses in Nigeria. The study examined psychiatry nurses’ knowledge base for research conduct, perceptions of research and perceived barriers to research utilization. Responses to a 41-item self-reporting structured questionnaire, administered to psychiatric nurses with current employment in the only Psychiatry hospital in Calabar provided the source of data, for this descriptive cross-sectional survey. A total population study of 84 psychiatry nurses with current employment in the only Federal psychiatry hospital in Cross River State, Nigeria was undertaken. Results show that 52 (87.0%) of the respondents had received formal instruction on research, 42 (70.0%) attended research workshop previously, 36 (60.0%) have conducted research of their own and only 9 (15.0%) have collaborated with others. Significant difference (p < 0.05) was found between the Psychiatric nursing service managers and non-managers with respect to conduct of previous research. Educational level has a significant effect on frequency of utilization, ability to cope with issues surrounding presentation and accessibility of research findings (p<0.05). Fifty eight percent 35 (58.0%) of the respondents held positive outlook towards research conduct and utilization, 20 (33.0%) reported utilizing research findings frequently in their practice. The barriers identified by most of the respondents are unavailability of research reports / articles, inaccessibility of research reports and that implication for practice is not usually made clear.  The Federal Ministry of Health should  take urgent steps to make research reports accessible to nurses employed in Psychiatry Hospitals while Psychiatric Nursing Services Managers and educators should plan and implement educational interventions aimed at empowering psychiatry nurses with relevant knowledge, appropriate disposition and skills in conducting research, collaborating with other researchers, locating and evaluating research reports. Keywords: research, research utilization, psychiatric nurses   2 Psychiatry Nurses’ perceptions on research and research utilization in Calabar, Nigeria  Introduction Research utilization (RU) as a concept come into view in nursing in the early 1970s (Stetler & Marram [as cited in Stetler, 2001]; Krueger [as cited in Stetler, 2001]; Horsley, Crane & Bingle [as cited in Stetler, 2001]). In the 1980s evidence-based practice (EBP) emerged as a new concept as clinicians recognized the value of scientific evidence in clinical decision-making (Beyea, 2006; Jennings & Loan [as cited in Stetler, 2001]). A variety of definitions of evidence-based practice (EBP) have appeared in literature, but the most commonly used is “the conscientio us, explicit and judicious use of the current best evidence in making decisions about care of individual patients” (Sackett, Rosenberg, Gray, Hayes & Richardson, 1996). Nursing at Baystate Medical Center (Stetler, Brunell & Giuliano et al [as cited in Stetler, 2001]) developed an EBP model that discourages practice based on tradition and emphasizes use of research findings in addition to other sources of reliable data or information. This model has been clarified further by Stetler (2001) by differentiating  between external and internal evidence. Accordingly external evidence refers primarily to research findings though also includes consensus of national experts. Internal evidence include the earlier mentioned other sources of reliable data. Notably, the reliability of the latter data is ascertained through the use of the research process. Although the two concepts differ, research utilization is an integral part of EBP in nursing (Stetler, 2001; Fajemilehin, 2004). Research utilization (RU) refers to the process by which specific research-based knowledge is applied in practice (Estabrooks, Wallin & Milner, 2003). RU by nurses have received greater attention in literature in the recent past leading to its’ conceptualization and measurement in terms of four types of research use namely: instrumental, conceptual, persuasive / symbolic and overall (Squires, Eastabrooks, Gustavsson & Wallin, 2011). Instrumental RU refers to tangible application of research   3 findings in clinical practice while conceptual RU means cognitive use of research in which instance, the research is used to change a persons’ view about a specific practice, which may or may not lead to a change in action. Persuasive/ symbolic RU connotes the use of research as a political tool to legitimize a view/position or influence peoples practice. Overall means RU in any form or way (Squires, Eastabrooks, Gustavsson & Wallin, 2011). Research and research related activities have neither been extensively studied nor  published in Nigeria compared to the UK, Canada & USA (Parahoo, 1998; Parahoo, 2000a; Parahoo, 2000b; Parahoo, 2001; Lacey, 1994). Olade (1990) in a survey of nursing research in Nigeria reported a 100% positive response to the question relating to the need for nursing research, although 60% of the nurses were not aware of researches carried out by their colleagues. Filani in 2004 opined that much progress has not been made beyond this level of awareness. Ofi, Sowunmi, Edet & Anarado (2008) in their study of nurses in Southern  Nigeria fou nd that although nurses’ involvement in research conduct and use have improved, there are still remarkable gaps in research knowledge and experience requiring urgent attention. Psychiatric Nurses who constitute a specialty group were not included in the aforementioned Nigerian studies. Review of literature showed a previous study carried among this group of Nurses in Northern Ireland by Parahoo (1999). Evidence-based practice among Psychiatric Nurses would depend on factors such as  practitioners’ knowled ge and perceptions of research including access to relevant research reports and perceived hindrances to research utilization. There is paucity of information about the research activities of nurses in this specialty in Nigeria. The purpose of this study is to examine Psychiatry Nurses’ perceptions of research, research utilization, hindrances to utilization and knowledge base for research conduct, for the purpose of promoting evidence- based psychiatry nursing practice in Calabar.   4 The research questions raised in this study are as follows: 1. What is the knowledge base and experience for research among Psychiatry Nurses in Calabar? 2. How frequently do Psychiatry Nurses access research reports? 3. What is the outlook of Psychiatry Nurses towards research conduct and research utilization? 4. How frequently do Psychiatry Nurses utilize research findings in clinical practice? 5. What are Psychiatric Nurses ’  perceived hindrances to research utilization? The following null hypotheses were formulated and tested at 0.05 level of significance.   1. Educational level of respondents is not statistically significantly associated with frequency of accessing research reports, frequency of utilization of research findings,  perception of research utilization and ability to grasp presentation and access research findings. 2. There is no statistically significant association between occupational category of nurses and previous research conduct experience. Methods The study is a descriptive cross-sectional survey. The only Federal Psychiatry Hospital in Cross River state was the setting for the study. The setting was considered appropriate  because one of the functions of the professional workers in the hospital is to render services to clients and conduct / participate in research activities. The study population consisted of all the professional nurses in current employment at the hospital at the time of study, which numbered eighty four. Hence a total population study was undertaken. Nurses from all the units and the eight nursing cadres participated in the study. The instrument for data collection was a 41-item structured questionnaire. It was divided into six sections. Section A was used to obtain information on socio-demographic   5 characteristics of the respondents. Section B on knowledge base for research, Section C on  perceptions of research and research utilization, Section D on frequency of utilization of research findings in clinical practice. Section E on presentation and accessibility of research. The content and face validity of the instrument was established mainly by experts in the field of research. The perception statements were adapted from the research utilization  barrier scale (Funk, Champagne, Wiese & Tornquist, 1991). This scale has been widely used in studies on barriers to research utilization in the USA and UK. Only items matching with current research objectives were selected. The Likert scale was reduced from five into three options namely: agree, disagree and undecided. In instances where the statements are  positively worded, agreement is an indication of a favourable response and hence attracts a higher score, scores were assigned as follows: agree was 2, disagree was1, while undecided was allotted 0. In instances in which the statements were negatively worded the scores were reversed as follows agree 1, disagree 2, undecided 0. A mean score was calculated which yielded 17; percentage below the mean is regarded as holding less favourable outlook while  percentage above the mean is regarded as holding very positive outlook towards research conduct and utilization. Verbal consent of the Assistant Director of Nursing services, unit Nurse managers as well as the informed consent of participants were obtained (Council for International Organizations of Medical Sciences (CIOMS) and World Health Organization (WHO), 2002). Questionnaires were distributed directly to nurses while on duty and collected within 48 hours. Data collection lasted for a period of one week. Data entry and analysis was performed using the Statistical Package for the Social Sciences (SPSS) Software version 16. The formulated hypotheses were tested using Chi-Square test and Independent t-test at 0.05 level of significance.
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