Biomedical subjects

Shannon Scott-Findlay

Publications and source records attributed to Shannon Scott-Findlay.

16 recordsLinked to original sources

PubMed2006

Mapping the organizational culture research in nursing: a literature review.

AIM: This paper reports a critical review of nursing organizational culture research studies with the objectives of: (1) reviewing theoretical and methodological characteristics of the studies and (2) drawing inferences specific to the state of knowledge in this field. BACKGROUND: Organizational culture is regarded as significant in influencing research use in clinical practice yet it is not understood how culture shapes practitioners' behaviours. Only one review of this empirical literature in nursing has been completed. METHOD: Using selected computerized databases, published nursing research studies in English that examine organizational culture were accessed. Organizational culture studies were categorized using Hatch's three perspectives on organizational culture: (1) modern, (2) symbolic-interpretive and (3) postmodern. The review was conducted in 2005. RESULTS: Twenty-nine studies were in the final data set. Results pointed to variations in cultural definitions and incorporation of organizational sciences theory. In classifying the studies, modern perspectives dominated (n = 22), symbolic-interpretive approaches were an emerging group (n = 6) and one study was unclassifiable. Our results expand current cultural instrument reviews by pinpointing tools that have been previously overlooked and by identifying ongoing theoretical and methodological challenges for researchers. CONCLUSION: An exclusive reliance on modernistic approaches in organizational culture research cannot yield a complete understanding of the phenomenon. Rather, the field could benefit from a variety of cultural approaches. In a similar vein, researchers need to be mindful of the terminology and the unit of analysis they use in their research, as these are the two largest research challenges.

Humans↗

PubMed2006

Understanding work contextual factors: a short-cut to evidence-based practice?

BACKGROUND: It has become increasingly clear that workplace contextual factors make an important contribution to provider and patient outcomes. The potential for health care professionals of using research in practice is also linked to such factors, although the exact factors or mechanisms for enhancing this potential are not understood. From a perspective of implementing evidence-based nursing practice, the authors of this article report on a study examining contextual factors. AIM: The objective of this study was to identify predictors of organizational improvement by measuring staff perceptions of work contextual factors. METHOD: The Quality Work Competence questionnaire was used in a repeated measurement survey with a 1-year break between the two periods of data collection. The sample consisted of 134 employees from four neonatal units in Sweden. FINDINGS: Over the study period significant changes occurred among staff perceptions, both within and between units, on various factors. Changes in staff perceptions on skills development and participatory management were the major predictors of enhanced potential of overall organizational improvement. Perceived improvement in skills development and performance feedback predicted improvement in leadership. Change in commitment was predicted by perceived decreases in work tempo and work-related exhaustion. CONCLUSIONS AND IMPLICATIONS: These findings indicate the potential for organizational improvement by developing a learning and supportive professional environment as well as by involving staff in decision-making at the unit level. Such initiatives are also likely to be of importance for enhanced use of research in practice and evidence-based nursing. On the other hand, high levels of work tempo and burnout appear to have negative consequences on staff commitment for improving care and the work environment. A better understanding of workplace contextual factors is necessary for improving the organizational potential of getting research into practice and should be considered in future implementation projects.

Adult↗

PubMed2005

Sources of practice knowledge among nurses.

Several studies have been published listing sources of practice knowledge used by nurses. However, the authors located no studies that asked clinicians to describe comprehensively and categorize the kinds of knowledge needed to practice or in which the researchers attempted to understand how clinicians privilege various knowledge sources. In this article, the authors report findings from two large ethnographic case studies in which sources of practice knowledge was a subsidiary theme. They draw on data from individual and card sort interviews, as well as participant observations, to identify nurses' sources of practice knowledge. Their findings demonstrate that nurses categorize their sources of practice knowledge into four broad groupings: social interactions, experiential knowledge, documents, and a priori knowledge. The insights gained add new understanding about sources of knowledge used by nurses and challenge the disproportionate weight that proponents of the evidence-based movement ascribe to research knowledge.

Adult↗

PubMed2005

Mapping the journey of cancer patients through the health care system. Part 3: An approach to staging.

This is the third in a series of articles relating results from a line of research whose intent was to construct a complete history of patient interactions with the health care system using available data sources for all patients diagnosed in 1990 with a primary breast, colorectal, or lung tumour in Manitoba. This article presents details of the development and application of methods to produce TNM staging data on the roughly 2,000 patients in this population. The operational definitions constructed for this research can be adapted for other tumour sites and data sources. Findings include methods developed to overcome the sometimes ambiguous and inconsistent available documentation, which ultimately produced reliable TNM staging data. Survival data for this population by stage of disease are given.

Breast Neoplasms↗

PubMed2004

Evidence, research, knowledge: a call for conceptual clarity.

OBJECTIVE: To dispel some of the conceptual confusion in the field of evidence-based practice that has resulted from the overlapping use of the terms research, evidence, and knowledge. APPROACH: Theoretical discussion. FINDINGS: Often the terms research and knowledge are used as synonyms for evidence, but the overlap is never complete. The term evidence has long been understood to mean the findings of research. DISCUSSION: Recent attempts to broaden the definition of evidence to include clinical experience and experiential knowledge have been misguided. Broadening our understanding of the basis for clinical decision making and conceptualizing evidence are quite different tasks. Other factors (not other forms of evidence) do shape the clinical decision-making process, but they are not evidence. We might better term them knowledge. Confusing evidence with these other factors has hindered research and the improvement of clinical decision making in health care. We argue that this confusion results from the use of the term evidence when we really mean either research findings or knowledge. CONCLUSIONS: In this article, we have argued for specificity in the use of the term evidence. We urge the restriction of the term evidence to research findings, and while we acknowledge the importance of other influences on the clinical decision-making process, we insist that they are not evidence. The time has come to value personal experience and experiential knowledge for what they are-we should not have to disguise them as types of evidence for them to be deemed of any value. Being specific to language, the goal is to improve clinical decision making by increasing practitioners' reliance on research findings (evidence) while acknowledging (and valuing) the important part played by other forms of knowledge in the decision-making process. The distinctions are important.

Clinical Competence↗

PubMed2004

Mapping the journey of cancer patients through health care system. Part 1: developing the research question.

This is the first in a series of articles relating results from research which constructed a complete history of interactions with the health care system from available data sources for all patients diagnosed in 1990 with primary breast, colorectal, or lung tumours in Manitoba from one year prior to diagnosis through to two years post-diagnosis. This article presents the motivation and genesis for this line of research. The study evolved from the question of "What happens to a person who is diagnosed with cancer?" into a major research endeavour encompassing a broad spectrum of philosophic and clinical research questions. A large interdisciplinary team collaborated on developing operational methods to combine existing data sources into unified cancer patient histories.

Adaptation, Psychological↗

PubMed2004

Mapping the journey of cancer patients through the health care system. Part 2: Methodological approaches and basic findings.

This is the second in a series of articles from a line of research whose intent was to construct a complete history of interactions with the health care system. This paper provides details of the methods developed to collect and collate the scattered information regarding the event history (trajectory) that a cancer patient experiences in traveling through the Manitoba health care system from one year prior to diagnosis through to two years post-diagnosis. Survival data were obtained through 1994. Basic population data obtained from this work are also presented, including survival information through to four years post-diagnosis. Issues regarding standardized data recording and detail level of clinical events in the chart record are discussed. This part of the research demonstrates that diverse data sources in the health care system can be linked with a high degree of accuracy and completeness of data.

Aged↗

PubMed2003

Individual determinants of research utilization: a systematic review.

CONTEXT: In order to design interventions that increase research use in nursing, it is necessary to have an understanding of what influences research use. OBJECTIVE: To report findings on a systematic review of studies that examine individual characteristics of nurses and how they influence the utilization of research. SEARCH STRATEGY: A survey of published articles in English that examine the influence of individual factors on the research utilization behaviour of nurses, without restriction of the study design, from selected computerized databases and hand searches. INCLUSION CRITERIA: Articles had to measure one or more individual determinants of research utilization, measure the dependent variable (research utilization), and evaluate the relationship between the dependent and independent variables. The studies also had to indicate the direction of the relationship between the independent and dependent variables, report a P-value and the statistic used, and indicate the magnitude of the relationship. RESULTS: Six categories of potential individual determinants were identified: beliefs and attitudes, involvement in research activities, information seeking, professional characteristics, education and other socio-economic factors. Research design, sampling, measurement, and statistical analysis were examined to evaluate methodological quality. Methodological problems surfaced in all of the studies and, apart from attitude to research, there was little to suggest that any potential individual determinant influences research use. CONCLUSION: Important conceptual and measurement issues with regard to research utilization could be better addressed if research in the area were undertaken longitudinally by multi-disciplinary teams of researchers.

Attitude of Health Personnel↗

PubMed2002

Critical issues in interviewing people with traumatic brain injury.

People with cognitive impairments often cannot effectively recall and articulate experiences, feelings, and perceptions. Therefore, interviewing them can be fraught with pragmatic and methodological difficulties. Given this situation, the authors' experience in a study on the allocation of rehabilitative services to survivors of traumatic brain injury is discussed. Participants had physiological impairments affecting their ability to focus on interview questions. The authors discuss the unique challenges, including participants' recall of events, intolerance to stimuli, and image management and offer strategies for mitigating these concerns. The traditional view that reality is captured only in the subjective accounts of articulate people who can remember events in a precise and reflective manner is challenged.

Brain Injuries↗

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