Joumal of Advanced Nurstng, 1992,17,1151-1152
Guest editorial RESEARCH AND DEVELOPMENT IN NURSING In recent years there has been a growmg recognihon of the saentific ment and high quabty of much nursmg research Despite this, nurses have become concemed beeause researeh aehvity within nursmg has not had the expeeted positive impaet on nursmg praehee Leavmg ciside the issues of whether the findings of nursing researeh, without further replication, should be incorporated into prachce, m theory at least research has the potential to inform practice, but, in many instances, there is a gap between what is known and what is practised, in bnef there is a diffusion and utilization problem Henee eoneem with uhbzahon has become a preoccupahon withm nursing internationally (Champion & Leach 1989, Hunt 1987, MacGuire 1990) The way the problem is presented vjuies between settings and may be expressed by edueators as a theory— praetiee gap, or by managers as a problem of diffiision and paekagmg of infoimahon It eould be argued that a fundamental difficulty for nursmg in many European countnes is that, m the mam, the teachers of nursing are loeated in mono-teehnies and usually are not heuned as researehers In eonhast, the teaehers of medieme are often actually engaged m researeh themselves and as a result are
obliged to keep up to date with the relevant bterature Hence in theory, if not in reality, there is an opportumty for researeh to permeate through the eumeulum mto praetiee However, physieians like nurses often have shongly held views based on beliefs or tradition, and m many eases their clinical deasions are relahvely uninformed by the results of research It IS suggested that the preoeeupahon with researeh utilization m nursmg has served to exaggerate the problem withm nursmg, through the use of terms like 'researeh mindedness' and 'research appreciation' It is suggested that usmg the term 'research-based practice' has in itself been a redundant professionalizing shategy, which has served to divide the profession into those who know about researeh and those who do not The more shaightforward approaeh, which has been precipitated by the recent focus on evaluahon and quality assurance, would be simply to talk of significant dmical fads which are iUushahve of good praetiee This approaeh would assist in the demystificahon of research by presenting it as a servant to prachce In cases where practice is informed by research, it is likely that the nurses view what they do as simply good prachce, rather than research-based
praetiee, in these eases, the researeh findmgs have beeome reelassified as professional knowledge (Luker & Kennek 1992) For whatever reason, there has been a refoeusing of effort from the research aetivity itself towards the question of researeh utilization by praetihoners An mdustnal model of health eare implies the investment of sigmfieant monies m the development of staff and the organization, with the goal of improving the produet or serviee to the eonsumer In the United Kingdom for example, this has led to nursing experimenting with ebmeal development units, and other eountnes sueh as Finland have direeted effort towards researeh and development programmes (Sorvettula 1991) It seems that development work and not the researeh aehvity itself are popular approaehes, and are put forward as the means to improve pahent eare m the 1990s
Action research The linkage of researeh to development or a focus on marketing the produet, in this ease dmical facts (Luker & Kennek 1992), involves a eoneeptualizahon of the problem of researeh utilization withm the eonfmes of ehange theory, henee the foeus on the implementation of orgaruzational change based on research findings usmg a vanety of methods, often refened to as aehon researeh Aetion researeh has enjoyed a high profile m reeent years beeause, in its most useful form, it is eapable of eombmmg development with research There are both weak and shong versions of this aehvity (Susman & Evered 1978) Depending on onentation, more emphasis ean be plaeed on the researeh side, if this is the ease, then adion researeh may be abnost mdistmguishable from evciluation researeh On the other hand, more emphasis may be placed on the process of development, and if this occurs then the activity ean easily be eonfused with aetion leammg Whatever one's persuasion vts-a-Dis aehon researeh, approaehes to researeh cmd methods of eanng m nursing cire either m or out of vogue It is likely that adion research will be with us at least to the year 2000 It will be interesting to see whether it lives up to its promise as the vehicle through which researeh findings will be put mto praetiee Whilst supportive of this approaeh to research and development work m nursing, it is important that suffiaent funding IS available for research adivities which will provide the foundahon for a secure future Whilst there should 1151
Guesi editonal
always be a eenhal plaee for nursing m 2Uiy health eare research agenda, it is not necessanly the case that nursing researeh, and more of it, is the way forward The provision of health care in developed countnes is a eompbeated organizational proeess The goal is health for all, and multidisaplmary team work is the preferred method of eare debvery Agamst this baekdrop questions may reasonably be asked eoneemmg the utibty or life expedaney of smgle disapbne research For the first time m the United Kingdom an lntiative has been taken by the Department of Health, London, to formulate a eoherent researeh and development strategy for the National Health Service (DOH I99I) There will be many opportunities for nurses to participate in shaping the strategy through their professional organizations and regional health authonty networks Nursing eare is elearly an important dimension in maximizing the population's potential for health gam, and nurses are major eontnbutors to consumer satisfaction Managers think nursing is important because it consumes 46% of the health serviee budget Henee researeh mto nursing praetiee is an indispensable ingredient in any eomprehensive researeh strategy The ehallenge for nurses is to ensure that the nursing dimension in any multidiseiplmary project is clearly defined and is adequately funded
Development work It IS noteworthy that development work includmg the dissemmahon and utilizahon of researdifindingswill be an mtegral part of the researeh and development strategy Here, nurses may be able to take a lead smee they have aequired eonsiderable expertise in the area, and others eould profit from this In eondusion, it is suggested that nursing researeh has made a substantial eontnbution to our understandmg of nursing as a distmet disapbne It has also produced a sound knowledge base which has encountered problems diffusing
1152
into pradiee, and in eases where it has diffused it has eontnbuted to improvements m patient eare For the future, it is suggested that single disapbne researeh should be viewed as an mtenm adivity, which m some European eountnes is already giving way to multidiseipbnary health eare researeh where nurses have an equal voiee However, if nurses are to eontnbute as equals, m future research adivities related to the nursmg component of health care, then they need to be afforded the same opporturuhes as members of other occupations to obtain further edueation and hairung m researeh For this reason, m eountnes where there is bttle or no aeeess to higher edueation and few nurse researehers, nursing researeh should remain a separate activity until the disapbne has come of age Karen A Luker PhD BNurs RGN RHV DNCerhfieate Professor of Commumiy Nursmg Unwerstiy of Liverpool
References Champion V L & Leach A (1989) Vanables related to research utilization m nursing an empincal mveshgation Joumal of Advanced Nursing 14, 705-710 Department of Health (1991) Research for Healih A Research and Development Siraiegyfor the NHS HMSO, London Hunt M (1987) The process of translating research findings into nursmg practice Joumal of Advanced Nurstng 12,101-110 Luker K A & Kennek M (1992) An exploratory study of the sources of influence on the ebmeal decisions of commumty nurses Joumal of Advanced Nursing 17(4), 457-466 MacGuire J (1990) Putting nursmg research findings into practice research utilization as an aspwct of the management of ehange Joumal of Advanced Nursing 15,614-620 Sorvettula M (1991) A Reirospecitve Evaluation of a Nursing Research and Development Programme in Finland Nursing/ Midwifery in Europe newsletter, 8(2), published by WHO, Geneva Susman G I & Evered R O (1978) As assessment of the scientific ments of aehon researeh Admmtsiraiwe Sctence Quarierly 23,
582-601
Guest editorial RESEARCH AND DEVELOPMENT IN NURSING In recent years there has been a growmg recognihon of the saentific ment and high quabty of much nursmg research Despite this, nurses have become concemed beeause researeh aehvity within nursmg has not had the expeeted positive impaet on nursmg praehee Leavmg ciside the issues of whether the findings of nursing researeh, without further replication, should be incorporated into prachce, m theory at least research has the potential to inform practice, but, in many instances, there is a gap between what is known and what is practised, in bnef there is a diffusion and utilization problem Henee eoneem with uhbzahon has become a preoccupahon withm nursing internationally (Champion & Leach 1989, Hunt 1987, MacGuire 1990) The way the problem is presented vjuies between settings and may be expressed by edueators as a theory— praetiee gap, or by managers as a problem of diffiision and paekagmg of infoimahon It eould be argued that a fundamental difficulty for nursmg in many European countnes is that, m the mam, the teachers of nursing are loeated in mono-teehnies and usually are not heuned as researehers In eonhast, the teaehers of medieme are often actually engaged m researeh themselves and as a result are
obliged to keep up to date with the relevant bterature Hence in theory, if not in reality, there is an opportumty for researeh to permeate through the eumeulum mto praetiee However, physieians like nurses often have shongly held views based on beliefs or tradition, and m many eases their clinical deasions are relahvely uninformed by the results of research It IS suggested that the preoeeupahon with researeh utilization m nursmg has served to exaggerate the problem withm nursmg, through the use of terms like 'researeh mindedness' and 'research appreciation' It is suggested that usmg the term 'research-based practice' has in itself been a redundant professionalizing shategy, which has served to divide the profession into those who know about researeh and those who do not The more shaightforward approaeh, which has been precipitated by the recent focus on evaluahon and quality assurance, would be simply to talk of significant dmical fads which are iUushahve of good praetiee This approaeh would assist in the demystificahon of research by presenting it as a servant to prachce In cases where practice is informed by research, it is likely that the nurses view what they do as simply good prachce, rather than research-based
praetiee, in these eases, the researeh findmgs have beeome reelassified as professional knowledge (Luker & Kennek 1992) For whatever reason, there has been a refoeusing of effort from the research aetivity itself towards the question of researeh utilization by praetihoners An mdustnal model of health eare implies the investment of sigmfieant monies m the development of staff and the organization, with the goal of improving the produet or serviee to the eonsumer In the United Kingdom for example, this has led to nursing experimenting with ebmeal development units, and other eountnes sueh as Finland have direeted effort towards researeh and development programmes (Sorvettula 1991) It seems that development work and not the researeh aehvity itself are popular approaehes, and are put forward as the means to improve pahent eare m the 1990s
Action research The linkage of researeh to development or a focus on marketing the produet, in this ease dmical facts (Luker & Kennek 1992), involves a eoneeptualizahon of the problem of researeh utilization withm the eonfmes of ehange theory, henee the foeus on the implementation of orgaruzational change based on research findings usmg a vanety of methods, often refened to as aehon researeh Aetion researeh has enjoyed a high profile m reeent years beeause, in its most useful form, it is eapable of eombmmg development with research There are both weak and shong versions of this aehvity (Susman & Evered 1978) Depending on onentation, more emphasis ean be plaeed on the researeh side, if this is the ease, then adion researeh may be abnost mdistmguishable from evciluation researeh On the other hand, more emphasis may be placed on the process of development, and if this occurs then the activity ean easily be eonfused with aetion leammg Whatever one's persuasion vts-a-Dis aehon researeh, approaehes to researeh cmd methods of eanng m nursing cire either m or out of vogue It is likely that adion research will be with us at least to the year 2000 It will be interesting to see whether it lives up to its promise as the vehicle through which researeh findings will be put mto praetiee Whilst supportive of this approaeh to research and development work m nursing, it is important that suffiaent funding IS available for research adivities which will provide the foundahon for a secure future Whilst there should 1151
Guesi editonal
always be a eenhal plaee for nursing m 2Uiy health eare research agenda, it is not necessanly the case that nursing researeh, and more of it, is the way forward The provision of health care in developed countnes is a eompbeated organizational proeess The goal is health for all, and multidisaplmary team work is the preferred method of eare debvery Agamst this baekdrop questions may reasonably be asked eoneemmg the utibty or life expedaney of smgle disapbne research For the first time m the United Kingdom an lntiative has been taken by the Department of Health, London, to formulate a eoherent researeh and development strategy for the National Health Service (DOH I99I) There will be many opportunities for nurses to participate in shaping the strategy through their professional organizations and regional health authonty networks Nursing eare is elearly an important dimension in maximizing the population's potential for health gam, and nurses are major eontnbutors to consumer satisfaction Managers think nursing is important because it consumes 46% of the health serviee budget Henee researeh mto nursing praetiee is an indispensable ingredient in any eomprehensive researeh strategy The ehallenge for nurses is to ensure that the nursing dimension in any multidiseiplmary project is clearly defined and is adequately funded
Development work It IS noteworthy that development work includmg the dissemmahon and utilizahon of researdifindingswill be an mtegral part of the researeh and development strategy Here, nurses may be able to take a lead smee they have aequired eonsiderable expertise in the area, and others eould profit from this In eondusion, it is suggested that nursing researeh has made a substantial eontnbution to our understandmg of nursing as a distmet disapbne It has also produced a sound knowledge base which has encountered problems diffusing
1152
into pradiee, and in eases where it has diffused it has eontnbuted to improvements m patient eare For the future, it is suggested that single disapbne researeh should be viewed as an mtenm adivity, which m some European eountnes is already giving way to multidiseipbnary health eare researeh where nurses have an equal voiee However, if nurses are to eontnbute as equals, m future research adivities related to the nursmg component of health care, then they need to be afforded the same opporturuhes as members of other occupations to obtain further edueation and hairung m researeh For this reason, m eountnes where there is bttle or no aeeess to higher edueation and few nurse researehers, nursing researeh should remain a separate activity until the disapbne has come of age Karen A Luker PhD BNurs RGN RHV DNCerhfieate Professor of Commumiy Nursmg Unwerstiy of Liverpool
References Champion V L & Leach A (1989) Vanables related to research utilization m nursing an empincal mveshgation Joumal of Advanced Nursing 14, 705-710 Department of Health (1991) Research for Healih A Research and Development Siraiegyfor the NHS HMSO, London Hunt M (1987) The process of translating research findings into nursmg practice Joumal of Advanced Nurstng 12,101-110 Luker K A & Kennek M (1992) An exploratory study of the sources of influence on the ebmeal decisions of commumty nurses Joumal of Advanced Nursing 17(4), 457-466 MacGuire J (1990) Putting nursmg research findings into practice research utilization as an aspwct of the management of ehange Joumal of Advanced Nursing 15,614-620 Sorvettula M (1991) A Reirospecitve Evaluation of a Nursing Research and Development Programme in Finland Nursing/ Midwifery in Europe newsletter, 8(2), published by WHO, Geneva Susman G I & Evered R O (1978) As assessment of the scientific ments of aehon researeh Admmtsiraiwe Sctence Quarierly 23,
582-601
