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First published in 1992: Luker K.A. (1990) Research and development in nursing. Journal of Advanced Nursing 17, 1151–1152

  1. Top of page
  2. First published in 1992: Luker K.A. (1990) Research and development in nursing. Journal of Advanced Nursing 17, 1151–1152
  3. Action research
  4. Development work
  5. References

In recent years there has been a growing recognition of the scientific merit and high quality of much nursing research. Despite this, nurses have become concerned because research activity within nursing has not had the expected positive impact on nursing practice. Leaving aside the issues of whether the findings of nursing research, without further replication, should be incorporated into practice, in 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 brief there is a diffusion and utilization problem. Hence concern with utilization has become a preoccupation within nursing internationally (Champion & Leach 1989, Hunt 1987, MacGuire 1990).

The way the problem is presented varies between settings and may be expressed by educators as a theory–practice gap, or by managers as a problem of diffusion and packaging of information. It could be argued that a fundamental difficulty for nursing in many European countries is that, in the main, the teachers of nursing are located in mono-technics and usually are not trained as researchers. In contrast, the teachers of medicine are often actually engaged in research themselves and as a result are obliged to keep up to date with the relevant literature. Hence in theory, if not in reality, there is an opportunity for research to permeate through the curriculum into practice. However, physicians like nurses often have strongly held views based on beliefs or tradition, and in many cases their clinical decisions are relatively uninformed by the results of research.

It is suggested that the preoccupation with research utilization in nursing has served to exaggerate the problem within nursing, through the use of terms like ‘research mindedness’ and ‘research appreciation’. It is suggested that using the term ‘research-based practice’ has in itself been a redundant professionalizing strategy, which has served to divide the profession into those who know about research and those who do not.

The more straightforward approach, which has been precipitated by the recent focus on evaluation and quality assurance, would be simply to talk of significant clinical facts which are illustrative of good practice. This approach would assist in the demystification of research by presenting it as a servant to practice. In cases where practice is informed by research, it is likely that the nurses view what they do as simply good practice, rather than research-based practice; in these cases, the research findings have become reclassified as professional knowledge (Luker & Kenrick 1992).

For whatever reason, there has been a refocusing of effort from the research activity itself towards the question of research utilization by practitioners. An industrial model of health care implies the investment of significant monies in the development of staff and the organization, with the goal of improving the product or service to the consumer. In the United Kingdom for example, this has led to nursing experimenting with clinical development units, and other countries such as Finland have directed effort towards research and development programmes (Sorvettula 1991). It seems that development work and not the research activity itself are popular approaches, and are put forward as the means to improve patient care in the 1990s.

Action research

  1. Top of page
  2. First published in 1992: Luker K.A. (1990) Research and development in nursing. Journal of Advanced Nursing 17, 1151–1152
  3. Action research
  4. Development work
  5. References

The linkage of research to development or a focus on marketing the product, in this case clinical facts (Luker & Kenrick 1992), involves a conceptualization of the problem of research utilization within the confines of change theory, hence the focus on the implementation of organizational change based on research findings using a variety of methods, often referred to as action research.

Action research has enjoyed a high profile in recent years because, in its most useful form, it is capable of combining development with research. There are both weak and strong versions of this activity (Susman & Evered 1978). Depending on orientation, more emphasis can be placed on the research side; if this is the case, then action research may be almost indistinguishable from evaluation research. On the other hand, more emphasis may be placed on the process of development, and if this occurs then the activity can easily be confused with action learning.

Whatever one's persuasion vis-à-vis action research, approaches to research and methods of caring in nursing are either in or out of vogue. It is likely that action 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 research findings will be put into practice.

Whilst supportive of this approach to research and development work in nursing, it is important that sufficient funding is available for research activities which will provide the foundation for a secure future. Whilst there should always be a central place for nursing in any health care research agenda, it is not necessarily the case that nursing research, and more of it, is the way forward.

The provision of health care in developed countries is a complicated organizational process. The goal is health for all, and multidisciplinary team work is the preferred method of care delivery. Against this backdrop questions may reasonably be asked concerning the utility or life expectancy of single discipline research.

For the first time in the United Kingdom an intiative has been taken by the Department of Health, London, to formulate a coherent research and development strategy for the National Health Service (DoH 1991). There will be many opportunities for nurses to participate in shaping the strategy through their professional organizations and regional health authority networks. Nursing care is clearly an important dimension in maximizing the population's potential for health gain, and nurses are major contributors to consumer satisfaction. Managers think nursing is important because it consumes 46% of the health service budget. Hence research into nursing practice is an indispensable ingredient in any comprehensive research strategy. The challenge for nurses is to ensure that the nursing dimension in any multidisciplinary project is clearly defined and is adequately funded.

Development work

  1. Top of page
  2. First published in 1992: Luker K.A. (1990) Research and development in nursing. Journal of Advanced Nursing 17, 1151–1152
  3. Action research
  4. Development work
  5. References

It is noteworthy that development work including the dissemination and utilization of research findings will be an integral part of the research and development strategy. Here, nurses may be able to take a lead since they have acquired considerable expertise in the area, and others could profit from this.

In conclusion, it is suggested that nursing research has made a substantial contribution to our understanding of nursing as a distinct discipline. It has also produced a sound knowledge base which has encountered problems diffusing into practice, and in cases where it has diffused it has contributed to improvements in patient care.

For the future, it is suggested that single discipline research should be viewed as an interim activity, which in some European countries is already giving way to multidisciplinary health care research where nurses have an equal voice. However, if nurses are to contribute as equals, in future research activities related to the nursing component of health care, then they need to be afforded the same opportunities as members of other occupations to obtain further education and training in research. For this reason, in countries where there is little or no access to higher education and few nurse researchers, nursing research should remain a separate activity until the discipline has come of age.

References

  1. Top of page
  2. First published in 1992: Luker K.A. (1990) Research and development in nursing. Journal of Advanced Nursing 17, 1151–1152
  3. Action research
  4. Development work
  5. References
  • Champion V.L. & Leach A. (1989) Variables related to research utilization in nursing: an empirical investigation. Journal of Advanced Nursing 14, 705710.
  • Department of Health (DoH) (1991) Research for Health a Research and Development Strategy for the NHS. HMSO, London.
  • Hunt M. (1987) The process of translating research findings into nursing practice. Journal of Advanced Nursing 12, 101110.
  • Luker K.A. & Kenrick M. (1992) An exploratory study of the sources of influence on the clinical decisions of community nurses. Journal of Advanced Nursing 17(4), 457466.
  • MacGuire J. (1990) Putting nursing research findings into practice: research utilization as an aspect of the management of change. Journal of Advanced Nursing 15, 614620.
  • Sorvettula M. (1991) A Retrospective Evaluation of a Nursing Research and Development Programme in Finland. Nursing Midwifery in Europe newsletter, 8(2), WHO, Geneva.
  • Susman G.I. & Evered R.O. (1978) As assessment of the scientific merits of action research. Administrative Science Quarterly 23, 582601.