| Description |
Previous studies of cancer-related pain and fatigue guidelines adoption by nurses demonstrated low adoption. The purposes of this study was to follow-up and determine current levels of adoption for pain/fatigue guidelines by outpatient oncology nurses, determine factors that affect adoption, compare results to previous studies, and evaluate effect of survey mode on estimates of adoption rates. A correlational descriptive survey research design was guided by Rogers' Diffusion of Innovation model. Direct care outpatient nurse members of the Oncology Nursing Society (n=8100) were invited to participate in a Web survey (n=8000) or a mailed survey (n=100). The overall response rate was 7% with 563 useable surveys. Response was 18% (n=18) for mail and 7% (n=545) for Web surveys. Cost per useable survey was $20.51 for Web and $75.66 for mail surveys. Mann-Whitney U tests found no differences in guideline adoption by survey mode for pain (p=.450) and fatigue (p=.660). Measures included: Oncology Nursing Practice Questionnaire (ONPQ), Research Utilization in Nursing (RU-N), and Perceived Characteristics of Innovating (PCI). Pain guidelines and individual pain practices adoption levels were categorized as use sometimes. Fatigue guidelines adoption was categorized as awareness, but individual fatigue practices was categorized as use sometimes. Mann Whitney U tests indicated guidelines adoption for advanced practice nurses was greater iv than staff nurses for pain (p=<.001) and fatigue (p=<.001). Multiple regression found opinion leadership, experience, education, climate for change, context, policies, and perceptions accounted for 21.4% of variance in pain adoption (R2=.23, F(7,500)=20.77, p<.001). Cosmopoliteness, experience, education, climate for change, policies, and perceptions accounted for 21.1% of variance in fatigue adoption (R2=.22, F(6,495)=23.33, p<.001). Compared to previous studies, pain guideline scores have improved (M=1.3, SD=1.5), t(519)=8.43, p=<.001, but pain/fatigue practices remain at use sometimes. Adequate instrument reliabilities were obtained for RU-N (α = .67 to .91), ONPQ (α = .68 to .75), and PCI (α = .85 to .94). The RU-N, ONPQ, and PCI can be successfully converted to Web surveys, cost less, but lower response. Results indicate that pain/fatigue guidelines adoption has not substantially improved, suggesting current strategies to encourage adoption are ineffective and require new approaches. |
