The challenges of communicating research evidence in practice: perspectives from UK health visitors and practice nurses

Abstract

BackgroundHealth practitioners play a pivotal role in providing patients with up-to-date evidence and health information. Evidence-based practice and patient-centred care are transforming the delivery of healthcare in the UK. Health practitioners are increasingly balancing the need to provide evidence-based information against that of facilitating patient choice, which may not always concur with the evidence base. There is limited research exploring how health practitioners working in the UK, and particularly those more autonomous practitioners such as health visitors and practice nurses working in community practice settings, negotiate this challenge. This research provides a descriptive account of how health visitors and practice nurses negotiate the challenges of communicating health information and research evidence in practice.MethodsA total of eighteen in-depth telephone interviews were conducted in the UK between September 2008 and May 2009. The participants comprised nine health visitors and nine practice nurses, recruited via adverts on a nursing website, posters at a practitioner conference and through recommendation. Thematic analysis, with a focus on constant comparative method, was used to analyse the data.ResultsThe data were grouped into three main themes: communicating evidence to the critically-minded patient; confidence in communicating evidence; and maintaining the integrity of the patient-practitioner relationship. These findings highlight some of the daily challenges that health visitors and practice nurses face with regard to the complex and dynamic nature of evidence and the changing attitudes and expectations of patients. The findings also highlight the tensions that exist between differing philosophies of evidence-based practice and patient-centred care, which can make communicating about evidence a daunting task.ConclusionsIf health practitioners are to be effective at communicating research evidence, we suggest that more research and resources need to be focused on contextual factors, such as how research evidence is negotiated, appraised and communicated within the dynamic patient-practitioner relationship.

Parentally reported barriers to seeking help and advice for child sleep from healthcare professionals

“…This resulted in parents perceiving that many HCPs lacked flexibility in the scope of information and advice they could, or would, offer. Therefore, similar to previous studies, results of the current study suggest that HCPs face challenges in delivering evidence‐based information to parents in everyday practice (van Bekkum & Hilton, ).…”

What are the beliefs and perceptions of practice nurses’ influence about the uptake of the measles, mumps, and rubella vaccine?: An integrative literature review

“…Of these studies, eight were conducted in the UK, two in New Zealand, one in Australia, and one in the Republic of Ireland (Table , Supporting Information Table S2). In every study, practice nurses were either identified as the sole participant group (Desmond, Grant, Goodyear‐Smith, Turner, & Petousis‐Harris, ; Lamden & Gemmell, ; Petousis‐Harris, Goodyear‐Smith, Turner, & Soe, ) or a discrete group in the sample (BMRB Social Research, ; Cotter, Ryan, Hegarty, McCabe, & Keane, ; Kennedy et al., ; Leask et al., ; Macdonald et al., ; Smith, McCann, & McKinlay, ; van Bekkum & Hilton, , ). Four themes addressing the question guiding this integrative review were identified, which were parental immunization influencing factors; practice nurse characteristics; information and communication, and personal views and concerns (Figure ).…”

“…Practice nurses reported using different sources of information to inform their consultations, as identified in over half of the included papers (BMRB Social Research, ; Cotter et al., ; Leask et al., ; Macdonald et al., ; Petrovic et al., ; van Bekkum & Hilton, , ). Different sources of information accessed included the media; TV; the immunization co‐ordinator; the Department of Health website; the Green Book (This is an online publication that has the latest immunization information for vaccine preventable diseases in the UK), and Chief Medical Officers’ letters or updates on immunization (BMRB Social Research, ).…”

“…These studies revealed how the media influenced both patients and healthcare staff involved in national immunization programmes (van Bekkum & Hilton, , ). Three themes were identified from their telephone semistructured interviews: communicating evidence to the critically minded patient, confidence in communicating evidence, and maintaining the integrity of the patient practitioner relationship (van Bekkum & Hilton, ). The participants also identified how the mass media influenced front line health care in relation to their impact on patients and nurses, in particular nurses’ ability to develop media literacy to support patients’ understanding (van Bekkum & Hilton, ).…”

Confronting Confirmation Bias About Breast Cancer Screening With the Four Cs

“…In a survey of British nurses who regularly communicate scientific evidence to patients, nurses reported feeling less confident in their ability to convey information when patients challenged the evidence. The researchers concluded that a collaborative plan that integrates a woman's personal experience into the plan for screening may improve acceptance of evidence‐based guidelines (van Bekkum & Hilton, ). Based on their suggestions, I developed the four Cs framework to facilitate difficult discussions when evidence‐based practice is challenged (see Box ).…”