An assessment of the state of measurement science underpinning research utilization in nursing

Abstract

Background: Nurses’ use of research findings is essential to the provision of quality patient care. As a result, a need to better understand how to implement research into nursing practice has emerged, triggering requirements for its measurement.

Purpose: The purpose of this thesis was to provide an assessment of the state of measurement science underpinning research utilization in nursing.

Methods: The thesis consisted of four inter-related studies: (1) a systematic review of the psychometric properties of instruments used to measure research utilization in healthcare, (2) a systematic review update of individual factors that are associated research utilization by nurses, (3) an item response theory assessment of the precision of a newly developed research utilization scale (the Conceptual Research Utilization Scale) when completed by unregulated nursing care providers in long-term care (nursing home) settings, and (4) a traditional psychometric assessment (reliability, validity, acceptability) using classical test score theory of the Conceptual Research Utilization Scale when completed by unregulated nursing care providers in long-term care settings. A unitary approach to validity was undertaken following the Standards for Educational and Psychological Testing (the Standards) whereby evidence is accumulated from four sources to build a construct validity argument: (1) content, (2) response processes, (3) internal structure, and (4) relations to other variables.

Findings and Conclusions: Findings revealed that there is significant under development in the measurement of research utilization in nursing and that substantial methodological advances focusing on construct clarity, use of measurement theory, and conducting standard and advanced psychometric assessments is needed. Findings also suggest that: (1) adopting a unitary perspective of validity results in a substantially more comprehensive and accurate validity assessment compared to a traditional perspective of validity (which states that validity exists or not); (2) the Standards provides a useful framework for grouping instruments according to established validity sources, as well as for conducting and reporting findings from an instrument validation study; and, (3) item response theory is an appropriate method for evaluating precision of research utilization instruments, which can provide additional psychometric information that is not provided in traditional classical test score theory assessments.