Dissemination and Diffusion of Research in Health Care

Afza.Malik GDA

Research Dissemination in health Care

Dissemination and Diffusion  of Research in Health Care

Whats is Research Dissemination,Dissemination and Diffusion,Diffusion of Innovation,Essentials of Innovation,Focus of Diffusion Process,When Dissemination is Needed,Model of Dissemination,Implicit Dissemination,Research Dissemination in Nursing,Research Dissemination and Pressure on Health Care Provider.

Whats is Research Dissemination

    Research dissemination is the purposeful communication of research, particularly the findings and implications of those findings to members of society who can use them. Dissemination is initiated by those who “know” and extends to those who “do not know” but might apply the findings if they knew (Rogers, E., 1995). 

    As a practice profession, nursing cannot be satisfied with just awareness but is always interested in the application prospects of the research.

Dissemination and Diffusion

    Dissemination is sometimes differentiated from diffusion when the latter term is reserved for spontaneous spread and use of research. Most writers on dissemination and diffusion talk about a purposeful process aimed at spread and use of research. Utilization is another related term. 

    Utilization is specifically focused on application and is more likely to be initiated at the user end, whereas dissemination is focused on knowledge acquisition and more likely is initiated at the researcher end. The two are obviously linked with overlapping phases in their processes.

Diffusion of Innovation

    A principal writer/researcher whose work has directed research dissemination is Rogers, who writes on the “diffusion of innovations.” E. Rogers (1995) noted that in 1962, at the time of his first book, 405 publications were found on innovation diffusion, whereas by 1995 the number approached 4,000. 

    Recently, dissemination/diffusion is seen as a less linear process where the potential users of research have a responsibility to contribute to the dialogue so that the movement from innovation to application can occur (Rogers, E.).E. Rogers's (1995) innovation-decision process has five stages: knowledge, persuasion, decision, implementation, and confirmation. In the knowledge stage, whether the need for the innovation or the innovation occurs first is ambiguous. 

Essentials of Innovation

    Three types of knowledge about innovations are essential: awareness, how-to, and principles. Each type represents a more thorough understanding of the innovation. In the persuasion stage a positive or negative impression of the innovation is formed. Here the potential user clearly engages in more active innovation information seeking, the outcome of this stage being formation of an attitude towards innovation. 

    Although knowledge and attitudes are important factors in the use of the innovation in practice, practice is clearly based on more. Major factors contributing to the knowledge-attitude-practice (KAP) gap include 

(a) whether the practice of the innovation is outside individual control

(b) whether the individual has interpersonal communication from a near peer supporting the adoption

(c) individual characteristics toward being an early or late adopter, perhaps based on a sense of efficacy

(d) whether the nature of the innovation is preventive. Adoption of prevention focused innovations occurs more slowly

Focus of Diffusion Process

    The ultimate focus of this diffusion process is on the application of the innovation (Rogers, E., 1995) as evidenced by the last three stages. The adoption decision is made in the decision stage. At this stage the process begins to have more relevance for research utilization than for research dissemination. 

    In the implementation stage the innovation is put to use. The final stage, confirmation, is where individuals see reinforcement for their decision to adopt. In confirmation the innovation is evaluated, an outcome being continuation or discontinuation. The first two stages can guide dissemination; the latter stages, utilization.

When Dissemination is Needed

    Explicit dissemination occurs as researchers present their findings, implications, and recommendations in articles, papers, and posters. Usually, these communications include details of the research process that facilitates a scholarly critique. 

    The criticism is that too often these communications occur between researchers and that the nurse care-giver is not linked into the research communication networks. Fortunately, some practitioners do attend research conferences and some practice focused conferences devote programming to research.

Model of Dissemination 

    A model for dissemination reported by S. Funk, Tournquist, and Champagne (1989) included practice-oriented research conferences, edited (specifically for practice) monographs of presentations, and an information center. The evaluation of the conference found the general responses extremely positive, but still major communication problems existed in both oral and written reporting. 

    These problems persisted even with a great deal of support to the research communicators. This communication deficit leaves a practitioner, who is unsure, responsible for deciding about practice utility (persuasion). 

    Because the “old way” is usually comfortable, the innovation may not move from knowledge awareness to the more advanced how to or principles knowledge. Consequently, the nurse prepared at the graduate level has an important role in dissemination in a clinical agency. 

    This nurse is usually the reader of research, can interpret the findings, and sees the application possibilities. Through means like continuing education and journal clubs, the nurse from a graduate program can assist in filtering the research literature to match closely the practicing nurses' concerns and interests.

Implicit Dissemination 

    Implicit dissemination also occurs. This dissemination occurs when educators (academe, staff development, and continuing education) incorporate relevant research into their offerings. Audiences frequently trust that presenters have carefully criticized the research they cite. Although this assumption is usually well founded, the scholarly practitioner will seek references and do a personal review.

Research Dissemination in Nursing

    As more nurses are university educated, including nurse administrators, familiarity with the relevant research has become a standard of practice in some organizations. Although this practice is not yet the norm, practice policies, standards, and procedures should be written, with a literature review that includes applicable research from nursing and other relevant disciplines. 

    With a policy or procedure focusing on the “need to know” for the practitioner, the review of relevant research can be productive in practical dissemination by providing a context for considering whether to move into the application/utilization phases of knowledge diffusion.

    An additional means of dissemination is currently evolving, and that is via the Internet. Universities, professional organizations, and individuals have home pages that more and more are including research information. Online journals are also available. Some of the home pages include only researcher names and topics; others include abstracts and findings. 

    The additional caveat needed is that few of the sites have any type of peer review for quality and should be read with that in mind. Sigma Theta Tau's Online Journal of Knowledge Synthesis for Nursing is an example of a site with peer-reviewed content.

Research Dissemination and Pressure on Health Care Provider

    With the pressure on health care providers to be effective and efficient, the responsibility to break the “knowledge creep and decision accretion” situation (Weiss, C., 1980) is incumbent upon providers. 

    To speed the dissemination process and facilitate utilization, the outcomes of any research project must be communicated with clarity, especially for the practice implications and for future research. One approach is to “marker” research findings. This is a persuasive approach and would require more than not speaking solely in “researcher terms” but also addressing the four factors in Rogers's KAP gap. 

    Marketing also addresses who is the persuader; witness the number of nurses selling pharmaceuticals and medical supplies. Clinician partners, especially clinical nurse specialists, are appropriate disseminators of research. A larger proportion of research funds should be spent on dissemination, not just for thebut also for the necessary dialogue for quality research (Backer & Koon, 1995). 

    A “relling” although graduate education makes a substantial contribution to dissemination, students must know how to do more than tell. They should also learn to persuade and dialogue. Educators, administrators, and clinicians must all take responsibility with researchers for strengthening the dissemination process so that research can guide nursing practice.

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