Evidence-based practice and determinants of research use in elderly care in Sweden.
OBJECTIVE
Evidence-based practice is a strategic ingredient in today's health care. Despite extensive efforts to produce and disseminate clinical guidelines, research uptake is still a difficult task. In Sweden, elderly care (EC) has shifted from hospital care to community-based care, and the major nursing-staff group in EC has no university education. These and other factors make implementation of evidence-based care particularly challenging in EC settings. The purpose of this study was to identify determinants of research utilization in EC.


METHODS
Two questionnaires that cover research utilization and organizational climate were mailed to all staff (n = 132) working in seven EC units. The response rate was 67%.


RESULTS
Of all respondents, 28% reported that they used research findings in daily practice (the RU group). Remaining respondents constituted the non-RU group. Significant differences existed between the RU group and the non-RU group as per six individual and six organizational factors. Using logistic regression models, four factors were significantly related to research utilization, namely: attitudes toward research (OR = 5.52, P = 0.004); seeking research that is related to clinical practice (OR = 5.56, P = 0.019); support from unit manager (OR = 4.03, P = 0.044) and access to research findings at work place (OR = 6.65, P = 0.005).


CONCLUSIONS
Individual and organizational factors were associated with the use of research in EC. Despite distinguishing conditions in EC settings, identified factors reflect well-known determinants of research use that, as in many other health care contexts, should be considered in the endeavours of evidence-based practice.
Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden. anne-marie.bostrom@ki.se
Anne-Marie
AM
Boström
Lars
L
Wallin
Gun
G
Nordström
D000368:Aged; D001291:Attitude of Health Personnel; D003153:Community Health Services / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D006302:Health Services Research / Q000458:organization & administration*; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D007857:Leadership; D015279:Organizational Culture; D017410:Practice Guidelines as Topic; D012959:Socioeconomic Factors; D013548:Sweden