Background: A commonly recommended strategy for increasing research use in clinical practice is to identify barriers to change and then tailor interventions to overcome the identified barriers. In nursing, the BARRIERS scale has been used extensively to identify barriers to research utilization. Aim and objectives: The aim of this systematic review was to examine the state of knowledge resulting from use of the BARRIERS scale and to make recommendations about future use of the scale. The following objectives were addressed: To examine how the scale has been modified, to examine its psychometric properties, to determine the main barriers (and whether they varied over time and geographic locations), and to identify associations between nurses' reported barriers and reported research use. Methods: Medline (1991 to September 2009) and CINHAL (1991 to September 2009) were searched for published research, and ProQuest® digital dissertations were searched for unpublished dissertations using the BARRIERS scale. Inclusion criteria were: studies using the BARRIERS scale in its entirety and where the sample was nurses. Two authors independently assessed the study quality and extracted the data. Descriptive and inferential statistics were used. Results: Sixty-three studies were included, with most using a cross-sectional design. Not one study used the scale for tailoring interventions to overcome identified barriers. The main barriers reported were related to the setting, and the presentation of research findings. Overall, identified barriers were consistent over time and across geographic locations, despite varying sample size, response rate, study setting, and assessment of study quality. Few studies reported associations between reported research use and perceptions of barriers to research utilization. Conclusions: The BARRIERS scale is a nonspecific tool for identifying general barriers to research utilization. The scale is reliable as reflected in assessments of internal consistency. The validity of the scale, however, is doubtful. There is no evidence that it is a useful tool for planning implementation interventions. We recommend that no further descriptive studies using the BARRIERS scale be undertaken. Barriers need to be measured specific to the particular context of implementation and the intended evidence to be implemented.

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The Barriers scale - the barriers to research utilization scale : a systematic review

Aim: Iran's health-care system has witnessed profound changes in the last decades. Despite its progress, the system has currently faced many challenges in one of the important subsystems, nursing. The present review article aimed to present an overview of the opportunities and challenges of the Iranian nursing system, based on recent literature.

Methods:  A broad search of the English and Persian-language literature was carried out, incorporating both electronic and manual components from 1999 to 2009. The results of the investigations among the searched literature are summarized.

Results:  The major challenges are nursing shortages, job dissatisfaction, poor social position of nurses, the gap between theory and practice, lack of community-based nursing care, lack of an appropriate student recruiting system, and shortages in the nursing educational curriculums.

Conclusion:  The authors believe that media, political and public support play a pivotal role in improving the image of nursing in society, increasing motivation among Iranian nurses, and promoting the sociocultural climate and the welfare of nurses, which will result in higher levels of quality of care as well as greater patient satisfaction.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1742-7924.2010.00137.x

Nursing profession in Iran: an overview of opportunities and challenges.

Objectives Evidence-based practice (EBP) may help improve healthcare quality. However, not all healthcare professionals and managers use EBP in their daily practice. We systematically reviewed the literature to summarise self-reported appreciation of EBP and organisational infrastructure solutions proposed to promote EBP. Design Systematic review. Two investigators independently performed the systematic reviewing process. Information sources MEDLINE, EMBASE and Cochrane Library were searched for publications between 2000 and 2011. Eligibility criteria for included studies Reviews and surveys of EBP attitude, knowledge, awareness, skills, barriers and facilitators among managers, doctors and nurses in clinical settings. Results We found 31 surveys of fairly good quality. General attitude towards EBP was welcoming. Respondents perceived several barriers, but also many facilitators for EBP implementation. Solutions were proposed at various organisational levels, including (inter)national associations and hospital management promoting EBP, pregraduate and postgraduate education, as well as individual support by EBP mentors on the wards to move EBP from the classroom to the bedside. Conclusions More than 20 years after its introduction, the EBP paradigm has been embraced by healthcare professionals as an important means to improve quality of patient care, but its implementation is still deficient. Policy exerted at microlevel , middlelevel and macrolevel, and supported by professional, educational and managerial role models, may further facilitate EBP.

https://bmjopen.bmj.com/content/bmjopen/3/1/e001881.full.pdf

Framework of policy recommendations for implementation of evidence-based practice: a systematic scoping review

Aims 
This survey aims to describe the perception of barriers to and facilitators of research utilization by registered nurses in Sichuan province, China, and to explore the factors influencing the perceptions of the barriers to and facilitators of research utilization.


Methods 
A cross sectional survey design and a double cluster sampling method were adopted. A total of 590 registered nurses from 3 tertiary level hospitals in Sichuan province, China, were recruited in a period from September 2006 to January 2007. A modified BARRUERS Scale and a Facilitators Scale were used. Data were analyzed with descriptive statistics, rank transformation test, and multiple linear regression. 


Results 
Barriers related to the setting subscale were more influential than barriers related to other subscales. The lack of authority was ranked as the top greatest barrier (15.7%), followed by the lack of time (13.4%) and language barrier (15.0%). Additional barriers identified were the reluctance of patients to research utilization, the lack of funding, and the lack of legal protection. The top three greatest facilitators were enhancing managerial support (36.9%), advancing education to increase knowledge base (21.1%), and increasing time for reviewing and implementing (17.5%), while cooperation of patients to research utilization, establishing a panel to evaluate researches, and funding were listed as additional facilitators. Hospital, educational background, research experience, and knowledge on evidence-based nursing were the factors influencing perceptions of the barriers and facilitators.


Conclusions 
Nurses in China are facing a number of significant barriers in research utilization. Enhancing managerial support might be the most promising facilitator, given Chinese traditional culture and existing health care system. Hospital, educational background, research experience and knowledge on evidence-based nursing should be taken into account to promote research utilization. The BARRIERS Scale should consider funding and involvement of patients in research utilization.

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Barriers to and Facilitators of Research Utilization: A Survey of Registered Nurses in China

Despite the drive towards evidence-based practice, the extent to which research evidence is being implemented in nursing practice is unclear, particularly in developing countries. This study was to assess the levels of perceived barriers to and facilitators of research utilization in practice among Chinese nurses and inter-relationships between these barriers and facilitators and their socio-demographic characteristics. A cross-sectional, descriptive survey was conducted in 2011 with 743 registered nurses randomly selected from four general hospitals in China. They completed the Barriers to Research Utilization and Facilitators of Research Utilization scales. Correlation tests were used to test the relationships between the nurses' perceived barriers and facilitators, their demographic characteristics and research training and involvement. The Chinese nurses' level of perceived barriers was moderate on average and lower than that in previous research. Among the 10 top-ranked items, six were from the subscale 'Organizational Characteristics'. Their perceived barriers were correlated positively with age and post-registration experience and negatively with research training undertaken. Junior diplomatic nurses reported a significantly higher degree of barriers than those senior ones with post- graduate education. Higher and more diverse barriers to research utilization in practice are perceived by Chinese nurses than those in Western countries and they are associated with a few socio-demographic factors. Future research on these barriers/facilitators and their relationships with occupational and socio-cultural factors in Chinese and other Asian nurses is recommended.

/pdf/nurses-perceived-barriers-to-and-facilitators-of-research-4lwuz1q9dq.pdf

Nurses' perceived barriers to and facilitators of research utilization in mainland china: a cross-sectional survey.

Aim. The focus of the study is the identification of barriers to and facilitators of research utilization in nursing practice from the perspective of Iranian nurses.



Background.  In Iran, research utilization is a new phenomenon thus our knowledge with regard to those factors that promote or discourage research use is limited. No overall picture of the state of research utilization in Iran therefore exists.



Method.  A descriptive design is used. The questionnaire was distributed to 410 nurses from educational hospitals and nursing schools affiliated with Tehran Medical Sciences University in Iran.



Results.  The major barriers to research utilization were that the nurses do not have time to read research; facilities are inadequate for implementation; and nurses do not feel they have enough authority to change patient care procedures. Findings revealed a number of facilitators which were categorised into two main groups of human resources and individual/organisational factors.



Conclusion.  The healthcare system in Iran does not provide the incentive for nurses to engage in research or to avail themselves of research findings. Also, time is the major issue owing to a nursing shortage. If research utilization is to increase in Iran, therefore, the most important organisational change that needs to occur is the provision of available facilities for nurses to use research evidence.



Relevance to clinical practice.  Key factors that need attention in implementing research results into practice are suggested. Clearly, identification of barriers and facilitators is useful potentially to overcome barriers and enforce facilitators and this could ultimately improve nursing practice.

The spectrum of barriers to and facilitators of research utilization in Iranian nursing

Research utilisation poses significant challenges for the nursing profession in Iran. Nurses' attitudes toward research and their motivation to engage in research utilisation have repeatedly been identified as potential barriers. Yet little is known about the attitudes of Iranian nurses' regarding research. Therefore, there is a need for a study that focuses particularly on Iranian nurses' attitudes toward research utilisation. The objective was to assess the attitude of Iranian clinical nurses and nurse educators towards nursing research. A self-administered questionnaire based on a cross-sectional survey conducted on 410 respondents from 15 educational hospitals and nursing schools affiliated to Tehran Medical Sciences University, Iran. According to the self-report, nurses generally held positive attitudes toward research. Education, professional role and research activities had a statistically significant relationship with their research attitudes. Although the attitudes towards research were positive,...

Anooshiravan Kazemnejad

Papers

The spectrum of barriers to and facilitators of research utilization in Iranian nursing

Iranian nurses' attitudes toward research utilisation:

Iranian Nurses' Readiness Toward Research Utilization