A thematic analysis of theoretical models for translational science in nursing: Mapping the field

National Institutes of Health, Clinical Center, Bethesda, MD, USA.
Nursing outlook (Impact Factor: 1.59). 11/2010; 58(6):287-300. DOI: 10.1016/j.outlook.2010.07.001
Source: PubMed


The quantity and diversity of conceptual models in translational science may complicate rather than advance the use of theory. This paper offers a comparative thematic analysis of the models available to inform knowledge development, transfer, and utilization. Literature searches identified 47 models for knowledge translation. Four thematic areas emerged: (1) evidence-based practice and knowledge transformation processes, (2) strategic change to promote adoption of new knowledge, (3) knowledge exchange and synthesis for application and inquiry, and (4) designing and interpreting dissemination research. This analysis distinguishes the contributions made by leaders and researchers at each phase in the process of discovery, development, and service delivery. It also informs the selection of models to guide activities in knowledge translation. A flexible theoretical stance is essential to simultaneously develop new knowledge and accelerate the translation of that knowledge into practice behaviors and programs of care that support optimal patient outcomes.

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    • "A recent systematic review of the theoretical literature identified a stable EBP/research utilisation domain which was inclusive of Sackett's definition (Sackett et al., 1996) and which diverged principally around what constitutes evidence and the extent to which patient preference and clinical expertise attained prominence in models (Mitchell, Fisher, Hastings, Silverman, & Wallen, 2010). Further domains located in the review were concerned with: (i) strategic and organisational change theory; (ii) interactional theory around knowledge exchange and synthesis; and (iii) dissemination research (Mitchell et al., 2010). "
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    ABSTRACT: Aim To establish self-reported skill levels, behaviours and barriers in relation to evidence-based practice (EBP) among a representative sample of regional Australian nurses and midwives in senior roles. Background It has been widely established that nurses and midwives continue to face challenges in relation to putting evidence into practice on the clinical floor. Prior to conducting an EBP capacity building activity in a regional Australian Local Health District, a survey assessing needs and skill and barrier areas was conducted. Methods A quantitative descriptive survey which utilised the ‘Developing Evidence Based Practice Questionnaire’ (DEBPQ) was conducted in early 2012 among senior nurses and midwives of a regional New South Wales Local Health District (LHD). The survey results were contrasted with reported DEBPQ results from a sample of UK metropolitan nurses and a sample of Australian general practice nurses (GPNs). Results One hundred and sixty nine nurses completed the survey (response rate 42%). Survey respondents’ reliance on accepted evidentiary knowledge sources was found to be low. Research literature-related knowledge sources were ranked outside of the top 10 sources, compared with numerous personalised and subjective sources, which ranked within the top 10. Access to and understanding of research material was a primary barrier to reviewing evidence in the study sample. Time-related barriers to changing practice on the basis of evidence figured prominently in the study sample and the UK and Australian GPN samples. The study sample rated their EBP skill levels significantly higher than both their UK counterparts and the Australian GPN sample (P < 0.0001). Conclusion Capacity building interventions are needed among senior nurses and midwives in Australian regional LHDs, as the most prominent knowledge sources reported are non-evidentiary in nature and barriers to finding and reviewing evidence, along with barriers to making practice change, remain significant.
    Collegian Journal of the Royal College of Nursing Australia 11/2014; in press. DOI:10.1016/j.colegn.2014.09.011 · 1.18 Impact Factor
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    • "Graham and Logan (2004), o Greenhalgh et al. (2004), p Mendel et al. (2008), q Mitchell et al. (2010), r (Oldenburg and Glanz 2008, Rogers 2003), s Simpson (2002), t Stetler (2001) Adm Policy Ment Health "
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    ABSTRACT: Many theoretical frameworks seek to describe the dynamic process of the implementation of innovations. Little is known, however, about factors related to decisions to adopt innovations and how the likelihood of adoption of innovations can be increased. Using a narrative synthesis approach, this paper compared constructs theorized to be related to adoption of innovations proposed in existing theoretical frameworks in order to identify characteristics likely to increase adoption of innovations. The overall goal was to identify elements across adoption frameworks that are potentially modifiable and, thus, might be employed to improve the adoption of evidence-based practices. The review identified 20 theoretical frameworks that could be grouped into two broad categories: theories that mainly address the adoption process (N = 10) and theories that address adoption within the context of implementation, diffusion, dissemination, and/or sustainability (N = 10). Constructs of leadership, operational size and structure, innovation fit with norms and values, and attitudes/motivation toward innovations each are mentioned in at least half of the theories, though there were no consistent definitions of measures for these constructs. A lack of precise definitions and measurement of constructs suggests further work is needed to increase our understanding of adoption of innovations.
    Administration and Policy in Mental Health and Mental Health Services Research 04/2013; 41(4). DOI:10.1007/s10488-013-0486-4 · 3.44 Impact Factor
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    • "At the beginning of the continuum, adoption is described as a simple decision to accept a practice change (Greenhalgh et al. 2004, van Achterberg et al. 2008, Gale & Schaffer 2009). At the other end of the continuum, adoption has been described as a more complete incorporation of the practice change to the extent that is has become routine (Mitchell et al. 2010). Titler's model for translation research uses the terms 'rate' and 'extent of adoption', suggesting a potential continuum of adoption starting with a decision of a practice change, moving to implementation and sustained, routine use in practice (Titler et al. 2007). "
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    ABSTRACT: AIM: To provide an overview, summary of key features and evaluation of usefulness of six evidence-based practice models frequently discussed in the literature. BACKGROUND: The variety of evidence-based practice models and frameworks, complex terminology and organizational culture challenges nurses in selecting the model that best fits their practice setting. DATA SOURCES: The authors: (1) initially identified models described in a predominant nursing text; (2) searched the literature through CINAHL from 1998 to current year, using combinations of 'evidence', 'evidence-based practice', 'models', 'nursing' and 'research'; (3) refined the list of selected models based on the initial literature review; and (4) conducted a second search of the literature on the selected models for all available years to locate both historical and recent articles on their use in nursing practice. DISCUSSION: Authors described model key features and provided an evaluation of model usefulness based on specific criteria, which focused on facilitating the evidence-based practice process and guiding practice change. IMPLICATIONS FOR NURSING: The evaluation of model usefulness can be used to determine the best fit of the models to the practice setting. CONCLUSION: The Johns Hopkins Model and the Academic Center for Evidence-Based Practice Star Model emphasize the processes of finding and evaluating evidence that is likely to appeal to nursing educators. Organizations may prefer the Promoting Action on Research Implementation in Health Services Framework, Advancing Research and Clinical Practice Through Close Collaboration, or Iowa models for their emphasis on team decision-making. An evidence-based practice model that is clear to the clinician and fits the organization will guide a systematic approach to evidence review and practice change.
    Journal of Advanced Nursing 08/2012; 69(5). DOI:10.1111/j.1365-2648.2012.06122.x · 1.74 Impact Factor
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