Journalof Clinical Nursing 1992; 1: 315-322

The measurement of nurses' attitudes towards nursing research andthe research environment in clinical settings

GENE W. MARSH RN, PhDAssistant Professor and Assistant Director, Center for Nursing Research, University ofColorado Health Sciences Center, School of Nursing C-288, 4200 East Ninth Avenue, Denver,CO 80262, USA

TERRI L. BROWN BSNStaff Nurse, Srvedish Medical Center, Englemood, CO 80110, USA

Accepted for publication 14 May 1992

Summary

• Professional nurses in newly developed clinical nurse researcher roles mayinitially need to focus on determining the climate for research within the clinicalsetting. The purposes of this descriptive study were to describe the attitudes ofnurses towards nursing research and the research environment, and to determinethe strengths and weaknesses among nurse attitudes that could be used to

.. — , ; . . ! ) , li,, ,, • implement more effectively a clinical nursing research programme.

• Nurses employed at an urban private hospital (/;= 144) completed a demo-graphic profile. Attitudes Towards Nursing Research Scale and Nursing Re-

• , search Environment Scale (present and future). The typical respondent was 39years old, female, BSN prepared, and had been employed full time in nursing forabout 12 years. Sixty-two nurses (43%) had some previous experience withresearch.

iiiLi. ' • Nurses' attitudes towards research were moderately positive, significantlyhigher by educational degree, and higher for nurses with research experience. Asignificant difference existed in nurses' perceptions of the present and desired

I;, stf h'ii; future research environment. Nurses desired an environment that would be moreconducive to conducting research than their current environment. The greatestperceived discrepancies between present and future environments were related totime and funding for conducting research. The findings are the basis forpresenting implementation strategies for clinical nursing research programmes.However, due to a 29% response rate, findings must be interpreted with caution.

Keywords: nurse researcher, clinical nursing research, research attitudes, researchenvironment.

. responded to the challenge of integrating research-gener-ated knowledge into nursing practice by developing clini-

The need to develop a scientific base for practice is the cal research programmes within the service setting. Indriving force for promoting research in the clinical setting addition, the clinical nurse researcher role has been added(Smeltzer&Hinshaw, 1988). Departments of nursing have to service settings to facilitate developing and directmg

315

316 G.W. Marsh and T.L. Brown

clinical research programmes (Hagle et al.., 1986). Thestructure of clinical research programmes (MacKay et al..,1984; Marchette, 1985; Lawson, 1987; Smeltzer & Hin-shaw, 1988; Keefe & Biester, 1988) and the role of theclinical nurse researcher (Cronenwett, 1986; Knafl et al.,1987; Lawson, 1988) are well documented in the nursingliterature. Literature, advocating effective strategies fornurse researchers to use in developing clinical researchprogrammes, addresses issues of conducting research andincreasing research utilization among practising nurses(Chance & Hinshaw, 1980; Hefferin et al., 1982; Krone &Loomis, 1982; Kirchoff, 1984; Stetler, 1985; Cronenwett,1987; Goode et al., 1987; Hinshaw & Smeltzer, 1987;Keefe et al., 1988; Rempusheski & Chamberlain, 1989;Renner, 1989).

However, each clinical facility presents a unique re-search environment. The clinical nurse researcher with themission of developing a clinical research programme, mustidentify the characteristics of the environment that willboth promote and inhibit successful implementation of theresearch programme. Fostering responsibility for the nurs-ing research process is dependent upon adapting attitudesappropriate to the researcher role as well as a satisfactoryresearch environment (Young & Rice, 1983). Therefore,the clinical nurse researcher may need to focus initially ondetermining the climate for research within the clinicalsetting, that is, assessing the attitudes of nurses towardsresearch and their perceptions of the clinical setting as aresearch environment.

The purposes of this study were (i) to describe theattitudes of nurses towards nursing research and towardsthe nursing research environment, and (ii) to determinethe strengths and weaknesses among nurse attitudes to-wards research and the research environment that could beused to implement more effectively a clinical nursingresearch programme.

Previous studies

The study was modelled after two previous studies. First,Young & Rice (1983) identified the researcher role and theresearch environment as major concepts in the socializ-ation process of nurse researchers. Two instruments,measuring nurse attitudes towards research and nurseperceptions of the research environment, were developedand tested in an educational setting (Young, 1981; Young& Rice, 1983). Second, using Young's instruments,Chenitz et al. (1986), investigated nurse attitudes towardsresearch and the research environment within the clinicalsetting. They found that nurses had positive attitudestowards research and that attitudes were positively related

to previous experience with the research process. Time toconduct research was a major concern related to theclinical environment. In addition, the study instrumentswere found to be reliable and valid tools for assessing adepartment's readiness for research, developing a researchprogramme, and evaluating change over time.

Research questions

Similar to that of Chenitz et al. (1986), this study wasdesigned to address certain research questions.• What are the attitudes of the nursing staff towards

nursing research?• Do nurses perceive the clinical setting as an environment

conducive to the conduct of nursing research?• What is the relationship between perceptions about the

present nursing research environment and attitudesabout how the future nursing research environmentshould be?

• Do personal characteristics and experience infiuence (a)nurses' attitudes towards nursing research and (b) per-ceptions of the clinical facility as an environment con-ducive to the conduct of nursing research?

Methods

The study was carried out at a 300-bed urban privatehospital in the Western United States. A descriptivedesign was used to address the research questions.

INSTRUMENTS

Demographic data form

Information about subjects' personal characteristics, pro-fessional, and research activities was obtained from ademographic data form.

Attitudes Towards Nursing Research Scale (Young, 1981)

A 26-item, Likert-type scale was used to measure attitudestowards nursing research. The original scale was adaptedfor use in the clinical setting by deleting two items thatwere applicable to an educational setting, resulting in a 24-item scale.

Reliability estimates from Chenitz et al. (1986) resultedin a Cronbach's alpha of 0 96. Scale reliability in thisinvestigation was 0-94 (Cronbach's alpha).

Research Environment Scale (Young (^ Rice, 1983)

The Research Environment Scale is a 24-item, six-point

Nurses' attitudes towards nursing research 317

Likert-type scale. Items indexed aspects of the clinicalresearch environment, such as educational opportunitiesfor nurses to learn about the research process. Subjectswere instructed to respond to two parallel item sets. Thefirst set tapped perceptions about how conducive thepresent clinical setting is to the conduct of nursing re-search. The second set tapped how nurses felt the clinicalnursing research environment should be in the future.Each set of responses ranged from one (strongly disagree)to six (strongly agree). The higher the summated score, themore favourable the perception of the research environ-ment. The two sets of responses facilitated comparing thepresent and desired future research environments.

The internal consistency of the scale ranged fromCronbach's alphas of 0-92 to 0-96 (Young & Rice, 1983;Chenitz et al., 1986). Six items that were not applicable tothe clinical research setting were deleted from the scale,resulting in an 18-item scale. Reliability and validity werere-estimated using data from this investigation. Cron-bach's alpha for the present scale was 0-89, and for thefuture scale 0 98. The degree to which scale revisioncompromised construct validity is unknown.

PROCEDURE

All staff nurses employed by the acute care facility at thetime of data collection (« = 500) were invited to participatein the study. A packet of study instructions and instru-ments was placed in the nurses' mail receptacles on theirrespective units. The exact number of nurses actuallyreceiving the study packets was undetermined.

Subjects were informed that completing and returningquestionnaires represented consent to participate. Partici-pation was confidential. Envelopes were collected atweekly intervals for the 3 weeks following distribution.

One-hundred forty-four study packets were completedand returned, representing a conservatively estimated 29%response rate. Respondents were demographically similarto the total nursing staff.

To determine if response failure was related to negativeresearch attitudes, 22 nurses (representing all participatingunits) were asked why they had failed to return studypackets. Responses were optional and confidential.Answers were categorized and depicted as failure to receivestudy packet, 27%; apathy, 27%; lack of time, 18%;forgetfulness, 14%; and dislike of the instrument format,14%. While the apathy category may have representedindividuals with less positive research attitudes, responsefailure could not be solely attributed to negative attitudes.

SAMPLE

The sample of 144 nurses consisted of 142 females and twomales. Respondents' age ranged from 23 to 63 years with amean age of 39 years. Forty-two per cent (K = 60) wereBSN prepared nurses; 22% (« = 31) were diploma pre-pared nurses; 16% (« = 22) had received associate degreesin nursing. Ten per cent (n= 15) were masters preparednurses, and nine per cent (« = 14) had received a bachelorsor masters degree in a field other than nursing. Twosubjects did not report their degrees.

Seventy-six subjects (53%) had worked full time for lessthan 1 year and 34 subjects, with a mean of 11-6 years,worked full time. Subjects also reported having worked anaverage of 3 part-time years with part-time work rangingfrom less than 1 year to 25 years. Thus, the typicalrespondent was a 39-year-old BSN-prepared female whohad been employed full time in nursing for about 12 years.

Subjects were asked to respond to eight questions aboutprevious experience with the research process. Sixty-twonurses (43%) had some previous experience with research.Seventy-six (52%) had taken at least one course in nursingresearch and 58 nurses (40%) had participated in someaspect of the research process such as data collection.Eighteen nurses (12%) indicated that they had served asprincipal investigators of research studies. This finding isquestionable because subjects may have misinterpreted thedefinition of a principal investigator. Twenty-six nurses(18%) had actively participated in committee work thatfocused on research, 38 (26%) regularly read researchstudies in nursing, six nurses (4%) had presented researchfindings at conferences, and no nurses had publishedresearch findings.

The subjects identified the nursing journals that theyread regularly. The most frequently read journals wereNursing (n = 38, 26%), Attierican Journal of Nursing(« = 28, 19%), RN (« = 15, 10%), AORN (n = 8, 6%), andCritical Care Nursing (n = 5, 3-5%). Nine nurses (6-3%)reported reading research journals (five nurses (3-5%) readItnage and four (2-8%) read Nursing Research. No othernursing research journals were identified. Because 38(26%) nurses indicated that they regularly read researchstudies in nursing, the assumption was made that thenurses derived research information primarily from prac-tice journals.

Results

The description of the study participants was based on asample size of n = 144. In the following analyses of theAttitudes Towards Nursing Research Scale and the

318 G.W. Marsb and T.L. Brown

Research Environment Scales, missing data were deletedcasewise, tbus resulting in sample size variation acrossanalyses.

QUESTION 1 WHAT ARE THE ATTITUDES OF THE NURSES

TOWARDS NURSING RESEARCH.'

The possible attitude towards research score range wasfrom 24 to 144 witb tbe actual range from 47 to 144. Tbescale mean was 102-5 witb a standard deviation of 17-7.Tbe average item mean of 4-27 fell between the scaleanchors, 'slightly agree' and 'agree', indicating tbat tbenurses bad a moderately positive attitude towards research(Fig. 1).

25

20

15

10

0 "1—"—1—"—r—•-'—r—"—T—"-̂ —t—" I-20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99

Present environment scale scores

Figure 2 Histogram of Present Environment Scale scores(« = 83).

QUESTION 2 DO NURSES PERCEIVE THE CLINICAL

SETTING AS AN ENVIRONMENT CONDUCIVE TO THE

CONDUCT OF NURSING RESEARCH.'

The Present Environment Scale score range was from 18to 108, witb tbe actual scores ranging from 28 to 90. Thescale mean was 56-9 (average item mean 3-16), with astandard deviation of 13-6. Tbe findings corresponded tothe nurses' perceived view of tbe research setting asneutral, that is, neither conducive nor inhibitory towardsconducting nursing research (Fig. 2).

QUESTION 3 WHAT IS THE RELATIONSHIP BETWEEN

ATTITUDES ABOUT THE PRESENT RESEARCH ENVIRONMENT

AND ATTITUDES ABOUT HOW THE FUTURE NURSING

RESEARCH ENVIRONMENT SHOULD BE?

Scores on the future scale ranged from 37 to 108 witbin apossible range from 18 to 108. Tbe scale mean was 93-36

•( 35

30

25

I 15

040-49 60-69 80-89 100-09 120-29 140-49

50-59 70-79 90-99 110-19 130-39Attitude scale scores

Figure 1 Histogram of Attitude Towards Research Scale scores(«=116). -f ••n • pi is inic iv retai'i-y

with a standard deviation of 12-4. The average item meanon the six-point Future Environment Scale was 5-19.

The relationship between tbe nurses' perception of thepresent researcb environment and tbe desired future re-searcb environment approximated zero (r = 0-097,P = 0-20). A paired /-test between tbe present and futurescale means revealed tbat Future Environment Scalescores were significantly higher than Present EnvironmentScale scores (?= 17-78, df=74, P<0-001). Nurses feltthat the future environment should be more conducive toresearch than the current environment.

To identify which characteristics of the research en-vironment resulted in the greatest difference betweenPresent and Future Environment Scale scores, a discre-pancy score was determined by calculating tbe differencebetween the Present Environment Scale score and theFuture Environment Scale score for eacb of tbe 18 En-vironment Scale items. Table 1 depicts the mean discre-pancy score for eacb of the Environment Scale items. Thesix items with the largest mean discrepancy scores wererelated to:• time for writing or publishing results;• time allowed for data collection;• time allowed for analysis of findings;• encouraging nurses to seek funding for research;• availability of information on researcb funding;• availability of funding for nurses to conduct researcb.Thus, nurses perceived availability of time and funding forconducting researcb to be the priority areas for environ-mental change.

Nurses' attitudes towards nursing researcb 319

Table 1 Present-future environment;mean discrepancy scores (MDS) (n = 92) Item MDS

1. Time is allowed for writing/publishing results2. Time is allowed for data collection3. Time is allowed for analysis of findings4. Nurses are encouraged to seek research funding5. Information on research funding is available6. Money is available for nurses to participate in research7. Mechanisms exist to facilitate nurses' involvement in research8. Reviewers are available to evaluate the scientific merit of research projects9. Funding exists to participate in research conferences

10. Consultation is available on interpretation of research findings11. Nurses have qualified mentors for conducting research12. Consultation services for research are available13. Nurses with established research skills are among the nursing staff14. Nurses are encouraged to co-author research articles15. Nurses publish/present their research16. Educational opportunities exist to learn about the research process17. It is possible to do research in one's own interest area18. This hospital is available as a nursing research setting

2-912-682-722-552-362-282-172-081-981-981-891-801-711-691-681-551-391-06

QUESTION 4 DO PERSONAL CHARACTERISTICS AND

EXPERIENCE INFLUENCE (A) NURSES' ATTITUDES

TOWARDS NURSING RESEARCH AND ( B ) PERCEPTIONS OF

THE CLINICAL SETTING AS AN ENVIRONMENT CONDUCIVE

TO THE CONDUCT OF NURSING RESEARCH.'

Attitudes . . ., • • .

Type of educational degree was tbe only personal cbarac-teristic related to nurse attitudes towards research. A one-way analysis of variance revealed significant differences inattitudes about research that were related to type of degree(/'=5-64; df= 3,101; P<0-001). In addition, the higherthe degree, the higher the mean attitude score, and themore positive the attitudes towards research (see Table 2).Tbe relationsbip between age and attitudes towards re-search (r = 0-08, P = 0-24), the number of years workedfull time (r = 0-09, P = 0-24), or part time ( r = - 0 - 0 5 ,P = 0-36), all approximated zero.

A one-way ANOVA estimated the difference in attitudescores between nurses wbo reported baving previous ex-perience witb research activities and nurses who reportedno such experience. Nurses' attitudes towards researchscores were significantly higher for nurses who had takenat least one course in research (/"= 17-34; df= 1,104;/•< 0-001), had participated in conducting research(F = 22-67; df= 1,104; /'<0-001), had served as a princi-pal investigator (/'=8-42; df= 1,104; P<O-Ol), had parti-cipated on a research committee (i^= 10-87; df= 1-104;

Table 2 Summary of attitude scale scores by highest degreeearned

Degree

DiplomaADNBSN

MS

Total sample

Mean

93-0596-56

104-56114-94

102-97

SD

13-3019-4016-6017-86

17-84

Range

67-11447-12349-13680-144

47-144

n

18165417

105

P<0-01), had regularly reviewed nursing research litera-ture (7^=13-40; df= 1,104; P<0-001), had presentedfindings at a research conference (/'=5-95; df= 1,104;P<0-05). Because no nurses had publisbed findings, thisvariable was dropped from tbe analysis.

Environment

The relationships between how nurses viewed the presentnursing research environment and age (;- = 0-10, P = 0-20),number of years worked full time (;=0-10, P = 0-19), orpart time (?- = 0-09, P = 0-21), approached zero. No dif-ference occurred between tbe type of degree and bownurses viewed tbe present environment {F= 1-80;df=5,77; F = Q-12). Nurses wbo bad previous experiencewith research activities viewed the present research

320 G.W. Marsh and T.L. Brown

environment statistically the same as nurses who had noprevious experience with research.

Findings from the Future Environment Scale differedby type of degree (7^= 2-31; df=5,87; F = 0-05). Therelationship between bow nurses tbougbt tbe future en-vironment sbould be and age (r = 0-02, P = 0-44), numberof years worked full time (r = 0-04, / ' = 0-36), or part time(r = 0-05, F = 0-3l) approximated zero.

One-way ANOVAs were calculated to examine dif-ferences in bow nurses perceived tbe future researcbenvironment based on previous researcb experience.Nurses who had conducted research participated on aresearch committee, or who regularly reviewed researchfelt the future environment should be more conducive tothe conduct of nursing research than did nurses who hadno experience with research {F= 5-96; df= 1,92; / '<0-05:F=4-16; df=l,92; P<O-OS: /'=4-24; df=l,92;F<0-05, respectively). However, no statistically signifi-cant differences occurred in the perceived future environ-ment for nurses who had taken at least one research course,had served as a principal investigator, or had presentedresearch findings at a conference.

Finally, the relationship between attitude towards re-search and perceived environment was examined by corre-lating nurse attitudes towards research with present andfuture environment. The relationship between nurse atti-tudes and how nurses viewed the present research environ-ment (r = 0-18, P = 0-08) was negligible. However, tbemore positive tbe attitudes towards nursing research, themore conducive to nursing research the nurses felt thefuture environment should be (/- = 0-68, P<O-OOl).

Discussion ^ ^ .̂ ^ .̂

ATTITUDES TOWARDS NURSING RESEARCH

The current findings on nurse attitudes towards researcbare consistent with those of Chenitz et al. (1986). Nurses inbotb studies beld moderately positive attitudes aboutnursing research. While Chenitz et al. (1986) found nodifference in nurses' attitudes based on education, tbefindings of tbis study revealed significant differences inattitudes towards researcb by degree. Tbe bigber tbeeducational degree, tbe more positive tbe mean attitudescores. Similar to this study, Chenitz et al. (1986) foundthat nurses who had collected data on nursing research hadmore positive attitudes than nurses with no experience inresearch. In this study, attitude scores were significantlyhigher for nurses who had previous experience withresearch activities than for nurses with no research ex-perience. Because experience with research activities was

associated with more positive attitudes towards research, itis imperative to provide opportunities for nurses in clinicalsettings to participate in the research experience. Threeproposed strategies follow.

First, conducting studies similar to this one provides anopportunity for all nurses to become involved with theresearch process. The process may be especially belpful inservice settings tbat are just developing clinical nursingresearcb programmes.

Second, to generate more interest in research andincrease research competencies among staff nurses, nursesshould be provided tbe opportunity to participate inresearcb activities when a study is undertaken. Suchactivities can include reviewing literature, collecting data,serving as an expert judge, entering data, and analysingfindings. When possible, researcb sbould involve teams ofnurses working co-operatively rather than in isolation.Working with a hospital's research committee is anotherway for nurses to become involved with current researchstudies and activities.

Third, emphasis needs to be placed on developing thenecessary skills to read, comprehend, evaluate, and usepublished nursing studies. Based on the finding that nursesin this setting do not routinely read nursing researchjournals, priority should be placed on journal reviewgroups. Journal review groups are a common strategy forpromoting research utilization and are more likely to besuccessful if they have a tightly defined clinical or theoreti-cal area, are relevant for all participants, have a convenientmeeting place, and involve a core of participants with skillin research critique (Keefe et al., 1988). Nurses in specificclinical areas should be encouraged to subscribe to aresearcb journal of tbeir choice, tbus, making currentresearch findings available on nursing units.

ENVIRONMENT

The findings related to perception of the present researchsetting were consistent with those of Chenitz et al. (1986).Nurses in both studies viewed the research environment asneutral. Perception of the environment did not differaccording to education or nurses' previous experienceswith research activities. This finding may be expectedwhen nursing research programmes have not yet beendeveloped in the clinical setting.

In the Chenitz et al. (1986) study, the items with thegreatest discrepancy between present and future were allrelated to time to conduct research. In this study, the sixmost discrepant items focused on time and financialresources to conduct research. Unique funding mechan-

Nurses' attitudes towards nursing research 321

isms of the study sites may account for the differences instudy findings. To create an environment that will increas-ingly foster and support the research process, the time andfunding issues must be addressed. Otberwise, a messagemay be communicated that researcb is undervalued.Securing funding tbrougb small external grants may ad-dress initial funding needs to conduct research. However,nurses with previous successful experience in conductingresearch may be more successful in obtaining externalfunding tban nurses with no previous experience.

The possibility of obtaining internal funding sbould beexplored first. Possibly, hospital foundations or volunteergroups can annually award a small amount of researchfunding to a nurse who proposes a meritorious study. Theawardee might also receive a designated number of paidhours for conducting research. The award recipient maygain valuable experience in conducting a funded researchproject that could potentially strengthen that individual'sfuture application for external funding.

Allocating time for conducting research is as importantas securing funding. Conveying the value and importanceof research will not occur when nurses are expected toconduct research during 'time off, or encouraged tosqueeze research activities into an unyielding work sched-ule. Thus, compensated time awards are as appropriate asfunding awards. Time awards can permit the staff nurse toexchange assigned clinical hours for research hours. • < ;

SIGNIFICANCE

Findings from this study and similar studies can bevaluable for nurses wbo are involved in designing andimplementing clinical nursing research programmes. Spe-cifically, study findings form a basis for developing educa-tional programmes tbat address researcb-related learningneeds of nurses, for implementing strategies to enhanceresearch attitudes and skills, for planning positive environ-mental changes that will limit barriers to conductingresearch, and for establishing baseline data that can beused to evaluate changes in attitudes and environment overtime.

In addition, the psychometric properties of the studyinstruments revealed increasing evidence of reliability andvalidity. Most likely, tbe instruments are acceptable for usein other clinical settings.

Finally, the process of conducting the study was valu-able for motivating and involving nurses in research, forteaching research methods and skills, for disseminatingresearch findings, and for imparting visibility to a newclinical research programme.

Acknowledgments

The authors wish to acknowledge Betty Pelbam BSN, ET,Rose Medical Center, Denver, Colorado, for her valuableassistance with data collection and to express tbeir appre-ciation to tbe nurses of Rose Medical Center, for tbeirsupport of this study.

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