Evidence-based practice barriers and attitudes: an exploratory study in communitarian setting in the north of Portugal

Abstract

Objectives: Identify potential barriers and attitudes to nursing practice based on evidence in the communitarian context; Describe the current attitudes in face of evidence-based practice; Rank the identified barriers, by creating a system built based on different frequencies allocated; Methods: The study was developed in the context of one investigation project designed with the support of a research grant from the Northern Section of the Portuguese Nurse Association (Ordem dos Enfermeiros) in 2010. In terms of design, this was a cross-sectional, exploratory and descriptive study, developed in a Local Health Unit of the North of Portugal. The participants were all the nurses (N=129) that work at communitarian settings in this Unit. The instrument used to collect data was the Portuguese version of the Attitudes to Evidence-Based Practice Questionnaire (University of Ulster©). We assure the authorizations to use the questionnaire and to apply it in the institution. The data collection occurs between December 2010 and March 2011. To conduct statistic analysis, we use SPSS 19.0. Results: Our sample (n = 95), was mostly composed of women, the most representative age was between 21-30 years old. More than 80% successfully completed a full-time undergraduate nursing program with the duration of 4 academic years. 43.16% holds a nursing specialization and 28.4% has already been involved in research projects. In terms of the Internet access, only 53,7% uses on-line journals; 45,3% uses databases; 37,9% recourses to evidence-based project sites and 36,8% access to government sites. The results also include the main sources of information / knowledge they use to support practice. In this dimension and among other results, 78,9% uses protocols in first place and in second, they refer courses with 70,5%. Never the less, only 22,1% support their practices according with their own judgments. In addition, the personal estimation of daily evidence-based practice on average was, 62.6% (n = 82). Finally we built a 15 research barrier ranking based on the aggregated scores, considering the averages higher than 50%. Implications for practice: An evidence-based nursing it's necessary to correspond to the social obligation of the profession, sustaining and increasing the credibility among health disciplines and, through the construction of nursing based in knowledge it's possible to influence positively health policies, increasing value to the health care developed by nurses worldwide. In this sequence, it's fundamental to identify, in terms of evidence-based practice, barriers and attitudes, independently if they have a personal, professional, scientifically or organizational origin.