Background
Methods
Development of the ACT
Concept | Definition | Hypothesis | Sample item |
---|---|---|---|
Leadership 1
| The actions of formal leaders in an organization (unit) to influence change and excellence in practice, items generally reflect emotionally intelligent leadership |
H1: Care providers who perceive more positive (emotionally intelligent) unit leadership report higher research use | Calmly handles stressful situations |
Culture 1
| The way that 'we do things' in our organizations and work units, items generally reflect a supportive work culture |
H2: Care providers who perceive a more positive unit culture report higher research use | My organization effectively balances best practice and productivity |
Evaluation 1
| The process of using data to assess group/team performance and to achieve outcomes in organizations or units |
H3: Care providers who perceive a larger number of unit feedback mechanisms report higher research use | Our team routinely monitors our performance with respect to the action plans |
Social Capital 1
| The stock of active connections among people. These connections are of three types: bonding, bridging, and linking |
H4: Care providers who perceive more positive unit social capital activities report higher research use | People in the group share information with others in the group |
Formal Interactions 2
| Formal exchanges that occur between individuals working within an organization (unit) through scheduled activities that can promote the transfer of knowledge |
H6: Care providers who perceive a larger number of formal unit interactions report higher research use | How often do these activities occur? -Team meetings |
Informal Interactions 2
| Informal exchanges that occur between individuals working within an organization (unit) that can promote the transfer of knowledge |
H5: Care providers who perceive a larger number of informal unit interactions report higher research use | How often do you interact with people in the following roles or positions? - Someone who champions research and its use in practice |
Structural/Electronic Resources 3
| The structural and electronic elements of an organization (unit) that facilitate the ability to assess and use knowledge |
H7: Care providers who perceive a larger number of unit structural and electronic resources report higher research use | How often do you use/attend the following? - A Library |
Organizational Slack | The cushion of actual or potential resources which allows an organization (unit) to adapt successfully to internal pressures for adjustments or to external pressures for changes | ||
• Human Resources (staffing)1
|
H8: Care providers who perceive sufficient unit staffing levels report higher research use | Enough staff to deliver quality care | |
• Time 1
|
H9: Care providers who perceive having sufficient time on their unit report higher research use | Time to do something extra for patients | |
• Space 1
|
H10: Care providers who perceive having sufficient space on their unit report higher research use | Use of designated space |
Design, sample, and data collection
Data analysis
Validity
Results
Sample characteristics
Demographic Characteristic | n (%) | |
---|---|---|
Gender [n, (%)] | Male | 32 (4.3) |
Female | 720 (95.7) | |
Missing Values
| 0 | |
Age [n, (%)] | 20-24 years | 70 (9.3) |
25-29 years | 221 (29.4) | |
30-34 years | 132 (17.6) | |
35-39 years | 73 (9.7) | |
40-44 years | 72 (9.6) | |
45-49 years | 75 (10.0) | |
50-54 years | 63 (8.4) | |
55-59 years | 39 (5.2) | |
60-64 years | 6 (0.8) | |
65-70 years | 0 | |
Missing Values
| 1 (0.1) | |
Highest Education Level [n, %] | Diploma/Certificate | 250 (33.2) |
Bachelors Degree | 488 (64.9) | |
Masters Degree | 13 (1.7) | |
Other | 0 | |
Missing Values
| 1 (0.1) | |
Number of Years Worked in Current Position [Mean (SD)] | 8.4 (8.3) | |
Number of Years Worked on Unit [Mean (SD)] | 7.7 (7.4) | |
Overall instrumental research utilization score (mean, SD) | 3.47 (1.213) |
Missing values and descriptive statistics
Validity - Internal structure
Factor analysis
Factor Analysis1 (n = 704) | Cronbach Alpha2
| |||||||
---|---|---|---|---|---|---|---|---|
Survey Concept | No. Items | No. Completed Responses | Mean Response | Standard Deviation | Factor ranks | Factor Loadings (Range) | Eigenvalue | |
Leadership
| 6 | 750 | 3.53 | 0.81 | 2 | 0.753 - 0.842 | 3.825 | 0.91 |
Culture
| 6 | 746 | 3.83 | 0.53 | 7 | 0.389 - 0.701 | 1.725 | 0.72 |
Evaluation
| 6 | 747 | 2.98 | 0.82 | 1 | 0.774 - 0.864 | 9.806 | 0.91 |
Social Capital
| 6 | 742 | 3.90 | 0.47 | 3 | 0.584 - 0.684 | 3.412 | 0.77 |
Formal Interactions*
| 4 | 745 | 1.84 | 1.02 | 10 | 0.369 - 0.702 | 1.286 | 0.60 |
Informal Interactions*
| ||||||||
Type 1- Non-direct Care providers
| 4 | 743 | 1.09 | 0.95 | 4 | 0.550 - 0.768 | 2.519 | 0.75 |
Type 2- Direct Care providers
| 5 | 747 | 4.21 | 0.86 | 5 | 0.339 - 0.798 | 2.460 | 0.70 |
Structural and Electronic Resources*
| ||||||||
Type 1-Formal Resources
| 4 | 745 | 2.74 | 1.00 | 8 | 0.439 - 0.806 | 1.441 | 0.71 |
Type 2- Traditional Resources
| 3 | 745 | 0.72 | 0.68 | 9 | 0.510 - 0.720 | 1.406 | 0.60 |
Type 3- Electronic Resources
| 3 | 751 | 1.36 | 0.86 | 13 | 0.602 - 0.710 | 1.042 | 0.54 |
Organizational Slack
| ||||||||
Time
| 4 | 752 | 2.93 | 0.55 | 6 | 0.606 - 0.717 | 1.836 | 0.74 |
Space
| 3 | 750 | 2.94 | 0.88 | 11 | 0.636 - 0.807 | 1.232 | 0.63 |
Human Resources
| 2 | 750 | 2.92 | 1.03 | 12 | 0.759 - 0.788 | 1.195 | 0.83 |
Culture, Leadership, Evaluation, Structural and Electronic Resources
Social Capital
Interactions
Organizational Slack
Item-total statistics
Construct validity
Mean value (or relative ▽ %) of ACT factors by increasing levels of instrumental research utilization | ||||||||
---|---|---|---|---|---|---|---|---|
Bivariate correlation with IRU* | 1 | 2 | 3 | 4 | 5 | Total†
| P-value for means differences | |
Leadership | 0.090* 1/0.098** 2
| 3.37 (-4.5) | 3.45 (-2.3) | 3.51 (-0.6) | 3.51 (-0.6) | 3.68 (4.2) | 3.53 | 0.0693 (0.0894) |
Culture | 0.145**/0.148** | 3.68 (-3.9) | 3.75 (-2.1) | 3.80 (-0.8) | 3.83 (0.0) | 3.96 (3.4) | 3.83 | 0.002 (0.002)** |
Evaluation | 0.130**/0.145** | 2.64 (-11.4) | 2.85 (-4.4) | 3.06 (2.7) | 2.96 (-0.7) | 3.15 (5.7) | 2.98 | 0.000 (0.000) ** |
Social capital | 0.120**/0.119** | 3.82 (-2.1) | 3.83 (-1.8) | 3.89 (-0.3) | 3.89 (-0.3) | 4.02 (3.1) | 3.90 | 0.009 (0.027) ** |
Formal Interactions | 0.154**/0.156** | 1.49 (-19.0) | 1.65 (-10.3) | 1.91 (3.8) | 1.79 (-2.7) | 2.14 (16.3) | 1.84 | 0.000 (0.000) ** |
Informal Interactions (Type 1- Non-Direct Care Providers) | 0.183**/0.208** | 0.56 (-48.6) | 0.75 (-31.2) | 1.24 (13.8) | 1.10 (0.9) | 1.31 (20.2) | 1.09 | 0.000 (0.000) ** |
Informal Interactions (Type 2- Direct Care Providers) | 0.196**/0.220** | 3.69 (-12.4) | 4.04 (-4.0) | 4.22 (0.2) | 4.24 (0.7) | 4.45 (5.7) | 4.21 | 0.000 (0.000) ** |
Structural and Electronic Resources (Type 1-Formal Resources) | 0.242**/0.240** | 2.32 (-15.3) | 2.37 (-13.5) | 2.76 (0.7) | 2.77 (1.1) | 3.13 (14.2) | 2.74 | 0.000 (0.000) ** |
Structural and Electronic Resources (Type 2- Traditional Resources) | 0.129**/0.137** | 0.51 (-29.2) | 0.69 (-4.2) | 0.69 (-4.2) | 0.73 (1.4) | 0.89 (23.6) | 0.72 | 0.003 (0.006) ** |
Structural and Electronic Resources (Type 3- Electronic Resources) | 0.177**/0.186** | 1.11 (-18.4) | 1.00 (-26.5) | 1.42 (4.4) | 1.42 (4.4) | 1.56 (14.7) | 1.36 | 0.000 (0.000) ** |
Organizational Slack-Human resources
| 0.023/0.037 | 2.76 (-5.5) | 2.84 (-2.7) | 2.94 (0.7) | 3.02 (3.4) | 2.85 (-2.4) | 2.92 | 0.251 (0.289) |
Organizational Slack-Space
| 0.149**/0.158** | 2.63 (-10.5) | 2.84 (-3.4) | 2.91 (-1.0) | 2.95 (0.3) | 3.17 (7.8) | 2.94 | 0.000 (0.001) ** |
Organizational Slack-Time
| 0.137**/0.156** | 2.68 (-8.8) | 2.90 (-1.4) | 2.91 (-1.0) | 2.97 (1.0) | 3.04 (3.4) | 2.94 | 0.000 (0.001) ** |
Internal reliability estimations
Aggregation of the measures to unit level
Dimensions | F | BMS | WMS | ICC(1) | ICC(2) | Eta2 (η2) | Omega2 (ω2) | PROB |
---|---|---|---|---|---|---|---|---|
IRU | 2.6142 | 3.6288 | 1.3881 | 0.0569 | 0.6175 | 0.0918 | 0.0566 | 0.0000 |
Leadership | 8.3876 | 4.3897 | 0.5234 | 0.2164 | 0.8808 | 0.2388 | 0.2101 | 0.0000 |
Culture | 4.2482 | 1.0491 | 0.2470 | 0.1083 | 0.7646 | 0.1377 | 0.1052 | 0.0000 |
Evaluation | 6.5082 | 3.6750 | 0.5647 | 0.1708 | 0.8463 | 0.1964 | 0.1660 | 0.0000 |
Social Capital | 3.1726 | 0.6443 | 0.2031 | 0.0751 | 0.6848 | 0.1071 | 0.0733 | 0.0000 |
Formal Interactions | 6.4236 | 5.5822 | 0.8690 | 0.1686 | 0.8443 | 0.1948 | 0.1643 | 0.0000 |
Informal Interactions (Type 1- Non-Direct Care Providers) | 3.2734 | 2.7100 | 0.8279 | 0.0783 | 0.6945 | 0.1100 | 0.0763 | 0.0000 |
Informal Interactions (Type 2- Direct Care Providers) | 2.7556 | 1.9098 | 0.6931 | 0.0616 | 0.6371 | 0.0938 | 0.0597 | 0.0000 |
Structural and Electronic Resources (Type 1-Formal Resources) | 5.4840 | 4.7133 | 0.8595 | 0.1436 | 0.8177 | 0.1712 | 0.1398 | 0.0000 |
Structural and Electronic Resources (Type 2- Traditional Resources) | 2.1509 | 0.9533 | 0.4432 | 0.0413 | 0.5351 | 0.0749 | 0.0400 | 0.0007 |
Structural and Electronic Resources (Type 3- Electronic Resources) | 5.4422 | 3.4771 | 0.6389 | 0.1424 | 0.8162 | 0.1689 | 0.1377 | 0.0000 |
Organizational Slack-Human Resources
| 8.5578 | 7.1135 | 0.8312 | 0.2203 | 0.8831 | 0.2424 | 0.2139 | 0.0000 |
Organizational Slack-Space
| 9.9498 | 5.8113 | 0.5841 | 0.2507 | 0.8995 | 0.2712 | 0.2437 | 0.0000 |
Organizational Slack-Time
| 3.5132 | 0.9827 | 0.2797 | 0.0859 | 0.7154 | 0.1158 | 0.0828 | 0.0000 |
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ICC(1): The range of ICC(1) values (all greater than 0.00) indicate a degree of perceptual agreement among the nurses about the mean values on the ACT factors within each unit. That is, the nurses' perceptions about context within a particular patient care unit were similar.
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ICC(2): All ACT factors showed statistically significant (p < .05) F statistics and ICC(2) values greater than 0.60 (with the exception of structural and electronic resources type 2 [traditional resources]), that is, were we to draw repeated subsequent samples from the same groups (units) we would obtain similar mean scores.
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η 2 and ω 2 : However, the relative effect sizes for both η2 and ω2 values were smaller, suggesting that, as scores on the ACT factors were aggregated, our ability to assign the same meaning for the factor at the unit level as we had at the individual level lessened.