Professional Cultural Variables
Nursing policy promotes practice based on research evidence (Hicks & Hennessy, 1997):
All clinical practice should be founded on up-to-date information and research findings; practitioners should be encouraged to identify the needs and opportunities for research presented by their work. (Department of Health, 1993)
The profession of nursing cannot reach a consensus regarding what counts as the “best available evidence” for decisions. Often nursing appears almost closed off to the possibilities of certain forms of research knowledge. As can be clearly seen in Hicks and Hennessy’s (Hicks & Hennessy, 1997) argument that:
“[if nursing research is dominated by quantitative studies]…the profession will once again become emasculated handmaidens of the medical profession, but this time in the research domain…nursing is in grave danger of losing its very special and complementary identity… [the author’s] growing experience of the world of health care research has, however, produced a change of heart tantamount to a conversion and a belief that the contributions of experience, intuition and gut-feeling are of unquantifiable value in the quest for greater understanding of the mechanisms of effective health care. (p. 600)”
If the types and trends of published nursing research are examined, it is clear that some authors’ (Rafferty, 1998) fears of quantitative3 domination in nursing are ill- founded. Specifically, if the numbers of RCTs relative to the numbers of qualitative studies are examined then it is clear that qualitative research dominates and the gap is widening (Cullum, 1998). This disparity is significant, as there is some evidence that the meaning of research
itself is poorly understood by most health care professionals (Hicks & Hennessy, 1997). Given this confusion, it is unlikely that most practitioners will be able to readily tease out the strengths and weaknesses of the two broad approaches. Clinical decisions that are then professed to be research-based may very well be informed by the rich and vivid description of qualitative evidence but may therefore not be the most clinically effective decisions.
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