title: The concept of research utilization as understood by Swedish nurses: demarcations of instrumental, conceptual, and persuasive research utilization.
abstract: OBJECTIVE
  The literature implies research utilization (RU) to be a multifaceted and complex phenomenon, difficult to trace in clinical practice. A deeper understanding of the concept of RU in a nursing context is needed, in particular, for the development of instruments for measuring nurses' RU, which could facilitate the evaluation of interventions to support the implementation of evidence-based practice. In this paper, we explored nurses' demarcation of instrumental RU (IRU), conceptual RU (CRU), and persuasive RU (PRU) using an item pool proposed to measure IRU, CRU, and PRU.
  
  
  METHODS
  The item pool (12 items) was presented to two samples: one of practicing registered nurses (n = 890) in Sweden 4 years after graduating and one of recognized content experts (n = 7). Correlation analyses and content validity index (CVI) calculations were used together with qualitative content analysis, in a mixed methods design.
  
  
  RESULTS
  According to the item and factor analyses, CRU and PRU could not be distinguished, whereas IRU could. Analyses also revealed problems in linking the CRU items to the external criteria. The CVIs, however, showed excellent or good results for the IRU, CRU, and PRU items as well as at the scale level. The qualitative data indicated that IRU was the least problematic for the experts to categorize, whereas CRU and PRU were harder to demarcate.
  
  
  CONCLUSIONS
  Our findings illustrate a difficulty in explicitly demarcating between CRU and PRU in clinical nursing. We suggest this overlap is related to conceptual incoherence, indicating a need for further studies. The findings constitute new knowledge about the RU concepts in a clinical nursing context, and highlight differences in how the concepts can be understood by RNs in clinical practice and experts within the field. We suggest that the findings are useful for defining RU in nursing and further development of measures of RU.
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Strandberg
authors.forename: Ann
authors.initials: A
authors.lastname: Catrine Eldh
authors.forename: Henrietta
authors.initials: H
authors.lastname: Forsman
authors.forename: Ann
authors.initials: A
authors.lastname: Rudman
authors.forename: Petter
authors.initials: P
authors.lastname: Gustavsson
authors.forename: Lars
authors.initials: L
authors.lastname: Wallin
mesh_terms: D015400:Clinical Nursing Research / Q000706:statistics & numerical data*; D003625:Data Collection; D003627:Data Interpretation, Statistical; D055318:Evidence-Based Nursing / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research / Q000706:statistics & numerical data*; D006801:Humans; D015404:Nursing Methodology Research / Q000706:statistics & numerical data*; D009740:Nursing Staff / Q000523:psychology / Q000706:statistics & numerical data*; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: concept demarcation; expert panel; mixed methods; nursing; research utilization; survey