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EBP Research News

Recent articles (2023.7.1)

2023.07.01 04:00

論文のtitleやabstractにEBP, evidence-based interventionのimplementation & disseminationに関するキーワードが含まれている文献の書誌情報を掲載していきます.

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Effectiveness of differentiated instruction on learning outcomes and learning satisfaction in the evidence-based nursing course: Empirical research quantitative

Liou SR, et al.  Nurs Open. 2023;10.1002/nop2.1926. doi:10.1002/nop2.1926 [published online ahead of print, 2023 Jun 28].
https://pubmed.ncbi.nlm.nih.gov/22310560/

Objectives: This study proposes methods for blending design components of clinical effectiveness and implementation research. Such blending can provide benefits over pursuing these lines of research independently; for example, more rapid translational gains, more effective implementation strategies, and more useful information for decision makers. This study proposes a "hybrid effectiveness-implementation" typology, describes a rationale for their use, outlines the design decisions that must be faced, and provides several real-world examples.
Results: An effectiveness-implementation hybrid design is one that takes a dual focus a priori in assessing clinical effectiveness and implementation. We propose 3 hybrid types: (1) testing effects of a clinical intervention on relevant outcomes while observing and gathering information on implementation; (2) dual testing of clinical and implementation interventions/strategies; and (3) testing of an implementation strategy while observing and gathering information on the clinical intervention's impact on relevant outcomes.
Conclusions: The hybrid typology proposed herein must be considered a construct still in evolution. Although traditional clinical effectiveness and implementation trials are likely to remain the most common approach to moving a clinical intervention through from efficacy research to public health impact, judicious use of the proposed hybrid designs could speed the translation of research findings into routine practice.

Effectiveness of the flipped classroom methodology on the learning of evidence-based practice of nursing students: Quasi-experimental design. 

Ruzafa-Martínez M, et al.  Nurse Educ Today. 2023;128:105878. doi:10.1016/j.nedt.2023.105878 [published online ahead of print, 2023 Jun 18].

https://pubmed.ncbi.nlm.nih.gov/37352765/

Background: International organizations recognize the importance of evidence-based practice (EBP) for nurses. The objective of teaching EBP in the Nursing degree is to train future nurses on this subject. Different teaching models exist for this, from less active traditional models to more active ones such as the flipped classroom.
Objective: To compare the degree of EBP competence of undergraduate nursing students after an EBP course, through the application of a traditional methodology versus a flipped classroom methodology.
Design: Quasi-experimental study of non-equivalent groups.
Setting: The study was composed by a group of students who received training on EBP with the traditional model (face-to-face), and another intervention group with whom the flipped classroom model was utilized, using the online teaching platform EBP-eToolkit.
Participants: The study was conducted with 4th-year Nursing degree students enrolled in the course evidence-based practice, in academic years 2019/20 and 2021/2022.
Methods: Before and after the course, the students completed a questionnaire about EBP competence (EBP-COQ), and an objective test was given at the end of the year.
Results: A sample of 152 students in the face-to-face group (control), and 143 students in the flipped classroom group (intervention) participated. The intervention group significantly improved its competence on attitude (p = 0.01, η2 = 0.022), skills (p = 0.019, η2 = 0.018), and global competence in EBP (p = 0.003, η2 = 0.030), with respect to those who were taught using the traditional method. However, there were no significant differences in the impact on knowledge, neither through the self-report dimension of the EBP-COQ (p = 0.188) nor the final test score, control group 6.89 (SD: 1.35) and flipped classroom group 7.12 (SD: 1.53) (p = 0.206).
Conclusions: The flipped classroom model is adequate for the teaching of EBP to undergraduate nursing students. It produced a slight increase in attitude, as well as in skills and global competence in EBP. Nevertheless, this increase was not significantly different from face-to-face learning in terms of impact on EBP knowledge.



Professional empowerment and evidence-based nursing: A mixed-method systematic review. 

Teixeira AC, et al. J Clin Nurs. 2023;32(13-14):3046-3057. doi:10.1111/jocn.16507

https://pubmed.ncbi.nlm.nih.gov/36039039/


Aims and objectives: To review, synthesise and integrate primary research on the relationship between professional empowerment and evidence-based practice (EBP) in nursing.
Background: Professional empowerment research exposes an association between empowerment and positive work behaviours and attitudes. Empowerment is associated with nurses' productivity, autonomy and resources. However, implementing evidence into practice is not easy due to barriers to EBP, namely organisational and cultural. Research demonstrating the relationship between professional empowerment and EBP will provide direction for future interventions aimed at the development of an effective healthcare sector.
Design: A mixed-methods systematic review, according to the Joanna Briggs Institute approach, with results reported according to PRISMA. The associated checklist for systematic reviews was also used.
Method: The electronic databases searched for relevant studies included: Medline, Cumulative Nursing and Allied Health Literature (CINAHL), JBI Database of Systematic Reviews and Implementation Reports, and The Cochrane Library; thesis and dissertation databases; and Web pages of reference organisations and Scientific Events programs. Quality assessments, data extraction and analysis were completed on all included studies, according JBI. Thematic analysis was used to synthesise the data.
Results: We identified 477 studies. After removing duplicates and reviewing title and abstract following the inclusion and exclusion criteria, 26 papers were evaluated for eligibility. The review included 9 articles. The literature was categorised into three themes: (a) organisational and leadership characteristics, (b) individual characteristics, and (c) outcomes/consequences.
Conclusion: This review highlights the importance of empowering environments in EBP. A relationship was evident between leadership, organisation, empowerment, individual characteristics and the use and implementation of evidence, resulting in tangible and measurable gains. However, more robust studies are needed. This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42018086414).




Differences in evidence-based nursing practice competencies of clinical and academic nurses in China and opportunities for complementary collaborations: A cross-sectional study.

Chen Q,et al. J Clin Nurs. 2023;32(13-14):3695-3706. doi:10.1111/jocn.16488

https://pubmed.ncbi.nlm.nih.gov/35988036/

Aims and objectives: To explore the evidence-based nursing practice (EBNP) competencies of clinical and academic nurses and their collaboration needs for supporting EBNP.
Background: Academic-practice partnerships have strong potential to overcome the key barriers to EBNP. However, there is little known about the collaboration needs of clinical and academic nurses for EBNP.
Design: A cross-sectional study.
Methods: We recruited clinical and academic nurses online during November 2021 to January 2022. Using a reliable and validated scale and adapted questionnaires, data were collected relating to demographic information, EBNP-related resources availability, EBNP competencies and EBNP collaboration needs. These data were described using descriptive statistical methods. The t test, χ2 test and Mann-Whitney U test were used to evaluate if the different responses between clinical and academic nurses were statistically significant. This study was reported following the STROBET checklist.
Results: Two 240 clinical nurses and 232 academic nurses submitted questionnaires. There was no difference in overall EBNP competence between clinical and academic nurses. However, clinical nurses reported lower levels of competence and stronger intentions to collaborate with academic nurses when searching for, appraising, and synthesising evidence. Academic nurses reported lower levels of competence and stronger intentions to collaborate with clinical nurses for disseminating and implementing evidence.
Conclusion: Clinical and academic nurses both reported high needs for collaborating to overcome their perceived role limitations. Clinical and academic nurses have different strengths and limitations in EBNP. These role differences and intentions to collaborate for different dimensions of EBNP competence suggest that clinical and academic nursing roles could be complementary to each other, offering opportunities for synergistic collaborations to better support overall EBNP.
Relevance to clinical practice: Healthcare and academic institutions should promote academic-practice partnerships as opportunities to gain complementary expertise on different dimensions of EBNP, and to improve nurses' competencies and confidence in EBNP overall.



Instruments to Assess Evidence-Based Practice Among Health Care Professionals: A Systematic Review.

Silva AMD, et al. Health Educ Behav. 2023;10901981231170154. doi:10.1177/10901981231170154  [published online ahead of print, 2023 Jun 1].
https://pubmed.ncbi.nlm.nih.gov/37264545/

Background: The use of measurement instruments to assess the use of Evidence-Based Practice by health professionals has been frequently reported in studies.
Aims: This systematic review aimed to summarize, describe, and evaluate the measurement properties of the instruments that evaluate the use of Evidence-Based Practice in health professionals.
Methods: The search was carried out in four databases considering three groups of search terms: evidence-based practice, evaluation, and measurement proprieties. Studies were included that described the use of instruments to assess Evidence-Based Practice in health professionals, with the full-text publication, which analyzed the measurement properties, in English. The methodological quality of the studies was evaluated using COnsensus-based Standards for the selection of health Measurement INstruments.
Results: In total, 6,429 were found and only 92 were eligible for data analysis. Forty new instruments were identified most were developed for nursing and physical therapist. The investigators performed at least 1 type of validity test on 73% of the instruments. Reliability was tested at 90%, through internal consistency. Responsiveness was tested on less than half of the instruments (30%). Most of the instruments identified are reliable and valid to measure evidence-based practice in health professionals.
Conclusion: Although the Fresno Test remains the most complete instrument, and adequate for use. The COnsensus-based Standards for the selection of health Measurement INstruments checklist classified 7 (seven) instruments as suitable for the target audience.



Incorporating evidence-based practice education in nursing research curriculum of undergraduate nursing students: A quasi-experimental study

Du S, et al.  Nurse Educ Pract. 2023;70:103671. doi:10.1016/j.nepr.2023.103671  [published online ahead of print, 2023 May 22].

https://pubmed.ncbi.nlm.nih.gov/37245347/

Aim: To examine the effect of incorporating evidence-based practice (EBP) in Nursing Research curriculum on undergraduate nursing students.
Background: The competence of EBP is essential for nurses and it is an essential task for educators to implement EBP education in nursing students.
Design: A quasi-experimental study.
Methods: Based on Astin's Input-Environment-Outcome model, the study was conducted among 258 third-grade students of a four-year nursing bachelor's program between September through December 2022. The students were divided into two groups. Students in the intervention group received innovative teaching where EBP elements were incorporated in Nursing Research course in a natural, gradual and spiral way, while students in the control group attended conventional teaching. Effect of EBP teaching was examined in terms of students' EBP competence, learning experience and satisfaction and score of team-based research protocol assignment.
Results: Compared with conventional teaching, the innovative teaching characterized by EBP improved students' EBP competence in terms of attitudes and skills and enhanced student's comprehensive ability in nursing research. Students' learning experience and satisfaction were similarly favorable between the two groups.

Conclusions: For undergraduate nursing students, the teaching strategy characterized by EBP is an appropriate and effective way to improve their EBP competence of attitudes and skills, as well as their nursing research ability.




Study protocol: Type III hybrid effectiveness-implementation study implementing Age-Friendly evidence-based practices in the VA to improve outcomes in older adults. 

Piazza KM, et al. Implement Sci Commun. 2023;4(1):57. Published 2023 May 25. doi:10.1186/s43058-023-00431-5

https://pubmed.ncbi.nlm.nih.gov/37231459/

Background: Unmet care needs among older adults accelerate cognitive and functional decline and increase medical harms, leading to poorer quality of life, more frequent hospitalizations, and premature nursing home admission. The Department of Veterans Affairs (VA) is invested in becoming an "Age-Friendly Health System" to better address four tenets associated with reduced harm and improved outcomes among the 4 million Veterans aged 65 and over receiving VA care. These four tenets focus on "4Ms" that are fundamental to the care of older adults, including (1) what Matters (ensuring that care is consistent with each person's goals and preferences); (2) Medications (only using necessary medications and ensuring that they do not interfere with what matters, mobility, or mentation); (3) Mentation (preventing, identifying, treating, and managing dementia, depression, and delirium); and (4) Mobility (promoting safe movement to maintain function and independence). The Safer Aging through Geriatrics-Informed Evidence-Based Practices (SAGE) Quality Enhancement Research Initiative (QUERI) seeks to implement four evidence-based practices (EBPs) that have shown efficacy in addressing these core tenets of an "Age-Friendly Health System," leading to reduced harm and improved outcomes in older adults.
Methods: We will implement four EBPs in 9 VA medical centers and associated outpatient clinics using a type III hybrid effectiveness-implementation stepped-wedge trial design. We selected four EBPs that align with Age-Friendly Health System principles: Surgical Pause, EMPOWER (Eliminating Medications Through Patient Ownership of End Results), TAP (Tailored Activities Program), and CAPABLE (Community Aging in Place - Advancing Better Living for Elders). Guided by the Pragmatic Robust Implementation and Sustainability Model (PRISM), we are comparing implementation as usual vs. active facilitation. Reach is our primary implementation outcome, while "facility-free days" is our primary effectiveness outcome across evidence-based practice interventions.
Discussion: To our knowledge, this is the first large-scale randomized effort to implement "Age-Friendly" aligned evidence-based practices. Understanding the barriers and facilitators to implementing these evidence-based practices is essential to successfully help shift current healthcare systems to become Age-Friendly. Effective implementation of this project will improve the care and outcomes of older Veterans and help them age safely within their communities.




Nurses' evidence-based practice competence and hospital practice environment after specific training under the Best Practice Spotlight Organization® Programme. A cross sectional study. 

Fernández-Castro M, et al. Nurse Educ Today. 2023;126:105808. doi:10.1016/j.nedt.2023.105808

https://pubmed.ncbi.nlm.nih.gov/37086500/

Background: Barriers to implementing training strategies for the improvement of evidence-based practice competence of nurses in hospital practice environments still persist.
Objective: The aim of the study was to evaluate the impact of a specific training within the framework of the Best Practice Spotlight Organization® programme, on nurses' evidence-based practice competence and the practice environment in two hospitals.
Design: This is a observational cross-sectional study assessing evidence-based practice competence and perceptions of Practice Environments.
Participants: The study sample were 204 nurses working at medical and surgical inpatient units at two hospitals involved in the Best Practice Spotlight Organization® programme.
Methods: The study was conducted from February 2020 to May 2020. Three questionnaires were used to collect data: a sociodemographic/occupational questionnaire, a questionnaire exploring evidence-based practice skills, and a questionnaire exploring nurses' perceptions of their hospital practice environments.
Results: A total of 204 nurses participated. They were classified into two groups: those who had received specific training within the framework of the programme, called trained-champions (n = 66), and those who had not yet received training, control group (n = 138). The trained-champions exhibited better evidence-based practice competence values than the control group in all dimensions (p < 0.001), with a higher difference in means in the "Utilisation" dimension (-0.80; CI:-0.99,-0.60) and the "Knowledge" dimension (-0.63; CI:-0.88,-0.38). Trained-champions also had a more positive perception of the practice environments than the controls in all dimensions (p ≤ 0.001). The largest differences in means were in the "Participation" dimension (-0.48; CI:-0.66,-0.31) and in the "Leadership" dimension (-0.41; CI:-0.59,-0.23).
Conclusions: Specific EBP training within the framework of the Best Practice Spotlight Organization® programme has succeeded in nurses (trained-champions) obtaining better EBP competence than others without this training. This could have contributed to increase nurses' abilities to integrate evidence into decision making in their clinical practice, while positively influencing them to perceive their PEs more favorably.

The Problem With the PICO Question: Shiny Object Syndrome and the PURPOSE Statement Solution. 

Cullen L, et al.  J Perianesth Nurs. 2023;38(3):516-518. doi:10.1016/j.jopan.2023.01.024
https://pubmed.ncbi.nlm.nih.gov/37019810/


Exploration of nursing students' views on the theory-practice gap in surgical nursing education and its relationship with attitudes towards the profession and evidence-based practice. 

Şimşek P, et al. Nurse Educ Pract. 2023;69:103624. doi:10.1016/j.nepr.2023.103624

https://pubmed.ncbi.nlm.nih.gov/37018997/

Aim: The aim of this study was to explore nursing students' views on the theory-practice gap in surgical nursing education and determine its relationship with attitudes towards the profession and evidence-based practice.
Background: In nursing education, the discrepancy between the theoretical knowledge and clinical practices is known as the "theory-practice gap". Although this problem was defined many years ago, scientific information on the subject is very limited in terms of surgical nursing.
Method: This descriptive-analytical and cross-sectional study was carried out in three different universities in the Black Sea Region of Türkiye. The sample consisted of 389 nursing students. The data collection was carried out in May-July 2022 through the use of the following tools: The Attitude Scale for the Nursing Profession (ASNP), the Knowledge, Attitudes and Behaviors Questionnaire for Evidence-Based Practice (KABQ-EBP) and the researchers made form to determine students' views on the theory-practice gap. The data were analysed with Student's t-test, multiple linear regression analysis.
Results: 72.8% of the students stated that they thought there was a discrepancy between their theoretical surgical nursing courses and clinical practice. While the total ASNP score of students who thought that there was a discrepancy between theoretical education and clinical practice was lower than that of the other students (p = 0.002), no difference was found among the students in terms of the total KABQ-EBP score (p > 0.05). In the multiple linear regression analysis, it was determined that thinking about gap (β = -0.125, p = 0.009), gender (β = -0.134, p = 0.006), willingness to choose the profession (β = 0.150, p = 0.002) and KABQ-EBP score (β = 0.247, p < 0.001) had significant effects on nursing students' attitudes towards the profession. In the model, %12 of the total variance was explained by the variables.
Conclusion: The study shows that the gap between theory and practice for the surgical nursing course is a problem perceived by most students. Also, students who thought that there was a theory-practice gap for the surgical nursing course had a more negative attitude towards the profession, while their attitudes towards evidence-based nursing were not different from others. The results of this study encourage further research to gain a better understanding of the impact of the gap between theory and practice on nursing students.

Professional knowledge development and evidence-based practice in confusing vs. supportive work organizations: A grounded theory situational analysis of Swedish elderly care. 

Öhman A, et al. Physiother Theory Pract. 2023;39(5):994-1006. doi:10.1080/09593985.2022.2033370
https://pubmed.ncbi.nlm.nih.gov/35089102/

Background: This article focuses on knowledge development and health professionals' opportunities to use evidence-based practice (EBP). We studied registered physiotherapists (PT), occupational therapists (OT) and nurses (RN) in Swedish elderly-care institutions, a sector known for high turnover and shortages of competent staff.
Objective: To examine the perspectives of healthcare providers on professional knowledge development and EBP in their organization.
Methods: We conducted on-site qualitative interviews with a purposive sample of PTs, OTs and RNs, in six elderly care institutions. Situational analysis was used to analyze the material.
Results: Three discursive professional positions were found: 1) Professional ambition in confusing work organization; 2) Professional ambition in a knowledge-promoting work organization; and 3) Professional indifference with few aspirations for knowledge development. Professional aspirations toward knowledge development were high in two of these positions, whereas the third represents a slightly different approach with fewer aspirations for knowledge development. Linked to these professional approaches to knowledge development is a continuum of aggravating or facilitating factors within the work organization, including varying degrees of support from leadership of the organization, as well as few opportunities for rewards.
Discussion and conclusions: It is concluded that elderly care needs to develop strategies for evidence-based practice in order for the sector to become a sustainable arena for health professionals' career development, and in order to improve the quality of care for the elderly.





Budgetary investment in evidence-based practice by chief nurses and stronger EBP cultures are associated with less turnover and better patient outcomes. 

Melnyk BM, et al. Worldviews Evid Based Nurs. 2023;20(2):162-171. doi:10.1111/wvn.12645

https://pubmed.ncbi.nlm.nih.gov/37042488/

Background: Hospitals and healthcare systems strive to meet benchmarks for the National Database of Nursing Quality Indicator (NDNQI) measures, Centers for Medicare & Medicaid Services (CMS) Core Measures, and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) outcome indicators. Prior research indicates that Chief Nursing Officers and Executives (CNOs, CNEs) believe that evidence-based practice (EBP) is important for ensuring the quality of care, but they allocate little funding to its implementation and report it as a low priority in their healthcare system. It is not known how EBP budget investment by chief nurses affects NDNQI, CMS Core Measures, and HCAHPS indicators or key EBP attributes and nurse outcomes.
Aims: This study aimed to generate evidence on the relationships among the budget devoted to EBP by chief nurses and its impact on key patient and nurse outcomes along with EBP attributes.
Methods: A descriptive correlational design was used. An online survey was sent to CNO and CNE members (N = 5026) of various national and regional nurse leader professional organizations across the United States in two recruitment rounds. Data collected included CNO/CNE EBP Beliefs, EBP Implementation, and perceived organizational culture of EBP; organizational culture, structure, personnel, and resources for EBP; percent of budget dedicated to EBP; key performance measures (NDNQI, CMS Core Measures, HCAHPS); nurse satisfaction; nurse turnover; and demographic questions. Descriptive statistics were used to summarize sample characteristics. Kendall's Tau correlation coefficients were calculated among EBP budget, nursing outcome measures, and EBP measures.
Results: One hundred and fifteen CNEs/CNOs completed the survey (a 2.3% response rate). The majority (60.9%) allocated <5% of their budget to EBP, with a third investing none. An increase in EBP budget was associated with fewer patient falls and trauma, less nursing turnover, and stronger EBP culture and other positive EBP attributes. A greater number of EBP projects were also associated with better patient outcomes.
Linking evidence to action: Chief nurse executives and CNOs allocate very little of their budgets to EBP. When CNEs and CNOs invest more in EBP, patient, nursing, and EBP outcomes improve. System-wide implementation of EBP, which includes appropriate EBP budget allocation, is necessary for improvements in hospital quality indicators and nursing turnover.


Corrigendum to methodological approaches for developing, reporting, and assessing evidence-based clinical practice guidelines: a systematic survey.

Yao X, et al.  [Journal of Clinical Epidemiology 146 (2022) 77-85]  J Clin Epidemiol. 2023;S0895-4356(23)00088-4. doi:10.1016/j.jclinepi.2023.04.003. [published online ahead of print, 2023 Jun 9].
https://pubmed.ncbi.nlm.nih.gov/37302874/


作業療法士のための新しいEvidence-Based Practice自己評価尺度(EBPSA)の開発

増田 雄亮, 他.作業療法.2023;42(1):68-79. https://doi.org/10.32178/jotr.42.1_68

Abstract:【目的】本研究の目的は,日本の作業療法士を対象とした新しいEBP自己評価尺度(EBPSA)を開発することである.【方法】全国の回復期リハビリテーション病棟に勤務する作業療法士1,216名を対象として,質問紙による郵送調査を実施した.【結果】531名(回収率43.7%)から回答が得られ,このうち515名のデータを有効回答とした.因子分析の結果,4因子14項目が抽出され,モデル適合度は,CFI=.972,TLI=.965,RMSEA=.048であった.内的整合性の検討では,下位尺度および尺度全体のα係数はいずれも.80以上を示した.【結論】本研究において,良好な尺度特性を有するEBPSAが完成した.





【神経系リハビリテーションの新潮流-機能回復治療に革新をもたらす最新の知見】急性期リハビリテーションのEvidence-Practice Gap克服のために(解説/特集)

百崎 良, 他.  医学のあゆみ. 2023;285(8):740-742. https://www.pieronline.jp/content/article/0039-2359/285080/740

Abstract:急性期リハビリテーションのエビデンスは確立されてきているものの,急性期リハビリテーションの実施割合には地域間格差があり,Evidence-Practice Gapが存在する.急性期リハビリテーションの実施を妨げる障壁には,リハビリテーションに関わる人的資源・機器の不足,離床文化の欠如,医療スタッフの賛同の欠如,急性期リハビリテーションのメリットに関する知識の欠如などがあげられる.また,このような障壁に対する対策として人的資源と離床機材の整備,離床プログラムの整備,医療の質の向上を促進する文化の造成,定期的な多職種ミーティング,医師のサポート,成功体験の共有,安全管理教育などがあげられる.施設ごとに,どのような障壁があるのか評価し,それに対する対策を講じることで,急性期リハビリテーションのEvidence-Practice Gapを克服することができると考える.



精神科看護実践における看護師の研究成果活用に関する全国調査

小久保 知由起, 他.日本看護医療学会雑誌.2022;24(1):28-36. 
https://webview.isho.jp/journal/detail/abs/10.11477/mf.7009200335

Abstract:<文献概要>目的:精神科看護実践に研究成果を活用する上で、看護師がどのような認識を持っているのかを明らかにし、学術的経験の差異に基づく比較を行うことで、臨床での研究成果活用を活性化させるための示唆を得る。方法:82施設4774名の看護師を対象に自記式質問紙調査を実施した。質問紙にて基本属性と「臨床看護に研究成果を活用するためにはどうすればよいか」という問いに自由記載方式で回答を求め、得られた質的データをテキストマイニングで定量的に分析した。結果:有効回答者数829名であった。研究成果活用の認識として、《根拠に基づく説明を行い成果活用の協力体制を構築する》、《組織的に取り組む》、《職場環境を整備する》など11テーマが生成された。学術的経験の差異に基づく分析では、対象者の大半を占める群で共通して「職場」への共起があった。結論:精神科看護師は、研究成果活用の必要性を認識していたが、活用に困難を抱えていた。研究成果活用の促進の第一歩として、組織的なサポート体制の構築が必要である。



看護教育.特集【EBPと看護教育】(2023年64巻2号)