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Despite calls over several decades for theory development, there remains no overarching knowledge-translation theory. However, a range of models and theoretical perspectives focused on narrower and related areas have been available for some time. We provide an overview of selected perspectives that we believe are particularly useful for developing testable and useful knowledge-translation interventions. In addition, we discuss adjuvant theories necessary to complement these perspectives. We draw from organizational innovation, health, and social sciences literature to illustrate the similarities and differences of various theoretical perspectives related to the knowledge-translation field.A variety of theoretical perspectives useful to knowledge translation exist. They are often spread across disciplinary boundaries, making them difficult to locate and use. Poor definitional clarity, discipline-specific terminology, and implicit assumptions often hinder the use of complementary perspectives. Health care environments are complex, and assessing the setting prior to selecting a theory should be the first step in knowledge-translation initiatives. Finding a fit between setting (context) and theory is important for knowledge-translation initiatives to succeed. Because one theory will not fit all contexts, it is helpful to understand and use several different theories. Although there are often barriers associated with combining theories from different disciplines, such obstacles can be overcome, and to do so will increase the likelihood that knowledge-translation initiatives will succeed.

BackgroundA commonly recommended strategy for increasing research use in clinical practice is to identify barriers to change and then tailor interventions to overcome the identified barriers. In nursing, the BARRIERS scale has been used extensively to identify barriers to research utilization.Aim and objectivesThe aim of this systematic review was to examine the state of knowledge resulting from use of the BARRIERS scale and to make recommendations about future use of the scale. The following objectives were addressed: To examine how the scale has been modified, to examine its psychometric properties, to determine the main barriers (and whether they varied over time and geographic locations), and to identify associations between nurses' reported barriers and reported research use.MethodsMedline (1991 to September 2009) and CINHAL (1991 to September 2009) were searched for published research, and ProQuest® digital dissertations were searched for unpublished dissertations using the BARRIERS scale. Inclusion criteria were: studies using the BARRIERS scale in its entirety and where the sample was nurses. Two authors independently assessed the study quality and extracted the data. Descriptive and inferential statistics were used.ResultsSixty-three studies were included, with most using a cross-sectional design. Not one study used the scale for tailoring interventions to overcome identified barriers. The main barriers reported were related to the setting, and the presentation of research findings. Overall, identified barriers were consistent over time and across geographic locations, despite varying sample size, response rate, study setting, and assessment of study quality. Few studies reported associations between reported research use and perceptions of barriers to research utilization.ConclusionsThe BARRIERS scale is a nonspecific tool for identifying general barriers to research utilization. The scale is reliable as reflected in assessments of internal consistency. The validity of the scale, however, is doubtful. There is no evidence that it is a useful tool for planning implementation interventions. We recommend that no further descriptive studies using the BARRIERS scale be undertaken. Barriers need to be measured specific to the particular context of implementation and the intended evidence to be implemented.

Background: There has been considerable interest recently in developing and evaluating interventions to increase research use by clinicians. However, most work has focused on medical practices; and nursing is not well represented in existing systematic reviews. The purpose of this article is to report findings from a systematic review of interventions aimed at increasing research use in nursing.

This study used the Wechsler Adult Intelligence Scale and an expanded Halstead-Reitan Battery (HRB) to assess neuropsychological functioning in 100 patients who had relapsing-remitting or chronic-progressive courses of multiple sclerosis (MS). The patients were representative of a regional MS clinic population and were clinically stable at the times of testing. Both MS subgroups showed significant neuropsychological impairment, relative to a normal comparison group (N = 100), but chronic-progressive MS was associated with greater impairment in each major ability domain (cognitive, sensory, motor). In particular, only minimal cognitive impairment was noted in the relapsing-remitting MS subgroup, whereas the chronic-progressive subgroup showed impairment on virtually all cognitive test measures from the expanded HRB. Degree of neuropsychological impairment was significantly correlated with MS duration but was unrelated to medication status. The MS subgroup differences on the test battery could not be attributed to duration of illness, indicating that disease course is an important independent determinant of neuropsychological impairment in MS. Disability ratings from clinical neurological examinations were highly correlated with motor and sensory performances on neuropsychological testing, but clinical exams were inadequate in predicting the patients' cognitive status.