Achieving Knowledge Translation in Nursing Care: The Need for Greater Rigor in Applying Evidence to Practice
Greater effort to build rigorous evidence is necessary to accelerate knowledge translation into clinical nursing care. Evidence-based practice (EBP) incorporates the best research evidence, clinical expertise, and patients' expectations into the process of making decisions about individual patient care (Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996). EBP requires that clinicians use thorough searches of the relevant literature to answer clinical questions. Five clinical questions-meaning, diagnosis, etiology, treatment, and prognosis-are the common problems for nurses taking care of patients and their families. Therefore, research design should be based on answering the clinical questions appropriately. The best research evidence refers to clinically relevant, well-performed research that has been conducted using appropriate, proven methodologies. Methodologies typically fall into one of two categories: quantitative and qualitative. Quantitative research uses a deductive process to investigate phenomena through the inquiry of specific questions or hypotheses and uses reliable and valid measurements that are objective, rigorous, and reductionist. Quantitative analysis involves descriptive and inferential statistics. The experimental study design is used to examine the effect of nursing intervention to answer the treatment clinical question, whereas the nonexperimental one always is used to answer the etiology or related factors of some health-relative indicator. In contrast, qualitative research is a naturalistic inquiry approach that uses an inductive process and describes phenomena in a narrative fashion that is subjective, broad, and thematic to interpret the meaning of the experiences of patient and families. Qualitative analysis most often identifies themes and categories.
Furthermore, a systematic review approach attempts to answer a specific research question through a review of the relevant literature. This review involves the identification, search, appraisal, and synthesis of all high-quality research evidence relevant to the question at hand (Higgins & Green, 2011). Moving up the pyramid of evidence, more rigorous study designs such as the systematic review and the meta-analysis of randomized controlled trails work to minimize bias in order to reflect the truth.
Based on the various research questions, authors design the appropriate study in order to build up the evidences in nursing science. Articles in the current issue include a literature review with meta-analysis to examine the effects of propolis on oral health; three correctional studies to explore the relationship between relative factors or predictors on the health behaviors (self-care, exercise) of the health outcomes (hyperphagia); and three qualitative methods studies to explore the experiences of patients in surgical process and those newly diagnosed with multiple sclerosis, and the newly graduated novice nurses' strategies to gain their self-confidence.
The use of an increasingly diverse range of study designs is an exciting and beneficial trend in nursing research. In conclusion, it is necessary to implement and disseminate precise primary studies and systematic review studies in order to integrate the best evidence with clinical expertise and with patient preferences and then apply the results in practice.
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