Beyond publication


  • Professor Margaret I. Fitch RN PhD

    1. Head of Oncology Nursing and Supportive Care, Co-Director Psychosocial and Behaviorial Research Unit, Toronto Sunnybrook Regional Cancer Centre, Toronto, Ontario, Canada. E-mail:
    Search for more papers by this author

When research reveals new knowledge or understanding, researchers want their discovery to be shared with those who can make use of it. Publication – in a scholarly journal such as JAN– is the usual first step in that all-important process of research dissemination. However, the process of sharing research results effectively, and getting nursing colleagues to pay attention to the new knowledge and subsequently use it in their work, is not accomplished by publication alone. ‘Dissemination’ and ‘utilization’ of research are complex and challenging activities. In trying out new ways of disseminating research results – not just to each other, but also to patients and the wider public as well – we need to address the challenges creatively, these falling into three arenas: the nature of the evidence; the attitudes and values of the target audiences; and the context in which the research results are to be used.

Firstly, the nature of the evidence will have a bearing on both the process and the desired outcome of dissemination. For example, in my research unit, we had accumulated rich data about the experiences of cancer patients and we wanted to share these data with health care providers in such a way that the emotional reactions and viewpoints of the patients would be clearly conveyed. We decided to create a theatre play to be performed at local hospitals. It was a marvellous way to communicate these research results and to achieve the outcome of increasing healthcare professionals’ sensitivity to the patient experience. However, research resulting in a new assessment tool that merits systematic uptake in day-to-day practice would need to be communicated quite differently, and with directive intervention and ongoing support, if the expectation of behaviour change on the part of practitioners is to be achieved. In other words, to design an appropriate format for delivering a specific message from research, you have to be clear about the nature of the evidence and what outcome is expected in terms of its uptake.

Secondly, the target audiences– their attitudes, values and preferences – and the manner in which they will use the new research information needs to be clearly understood. What do they currently know about the issue? How do they perceive their role? What types of messages do they pay attention to? In a recent project we used a combination of a video and a book to disseminate information about ovarian cancer. The video allowed women who were living with ovarian cancer to tell their own stories. You could see their faces and hear their voices. The book provided background content about the disease, treatments and management of side-effects, and is organized to enable patients to dip in and out of the book because this is what women had told us would be most useful. Finally, we wanted to share information about the signs and symptoms of ovarian cancer with the wider community of well women. After consultation with women's groups we developed bookmarks that can be given out in a wide variety of settings and, using pictures rather than words, they are targeted at various segments of the population – older, lesbians, Jewish, non-English speaking – and we gathered input about the values, preferences and attitudes of the intended audiences so that the message could be matched appropriately.

Finally, the context, circumstances or environment in which we want our research results to be used needs to be understood if the utilization of research is to have any chance of success. Failing to consider the environment in which practitioners work may lead to significant barriers emerging in the use of the research. I sometimes refer to the need to think about the ‘hassle’ factor in using research results to change practice. For example, if a new assessment tool means that it will take longer with the patient, this will become a ‘hassle’ to the practitioner and to other members of the healthcare team. Planning the introduction of the new tool needs to overcome this ‘hassle’ factor and practitioners need to be persuaded of significant gain in exchange for the additional time and energy involved.

When publishing their research, researchers usually offer clear recommendations for its uptake but they rarely tell us how this might be done in the real – and complex – world of everyday nursing practice and the patient's journey through care. Should we be asking researchers, such as those who write for JAN, to tell us how their research can be taken beyond publication rather than simply leaving us, as individual readers, to speculate about how this might be done?