Does research help to inform a district health board's purpose? A qualitative thematic analysis of clinician researcher views.

AIM: The outcomes from research should guide the decisions of healthcare providers, policymakers and funders. This study sought the perspectives of senior hospital clinicians and researchers from a New Zealand district health board (DHB). METHOD: A series of interviews asked participants about the purpose and benefits of research to the DHB, and to reflect upon the enablers and barriers they had experienced in conducting and translating research in a DHB context. RESULTS: Three key themes were identified. The first theme suggested research should inform the DHB's purpose. The second theme identified how the general busyness, lack of research funding and the differing motivations of clinicians and business leaders doesn't make it easy to do research in a DHB. The third theme suggested that research barriers could be seen as opportunities. Participants placed importance on an environment that inspires enquiry; that permits staff to stop and question what they do; that overtly informs its community that research is done to improve the delivery of care; that communicates a purposeful research agenda; and that regularly discusses the intersection of research and the purpose of the DHB. CONCLUSION: This study found the absence of an organisation-wide research ethos affected staff engagement in and with research. As a consequence, the effective transfer and translation of knowledge from research was disrupted. Key recommendations were for the DHB to integrate research activity into practice, regularly discuss research evidence and celebrate research achievements.

The Auckland Breast Cancer Register: a special project of the Auckland Breast Cancer Study Group.

AIMS: The Auckland Breast Cancer Register (ABCR) has been established in response to the need for a comprehensive database of breast cancer cases from the Auckland area. METHODS: The database records patient demographics, diagnosis, treatment options, prognosis and long-term outcome (annual follow up). Data from 1204 cases, recorded between June 2000 and June 2002 are reported. RESULTS: The major findings are that 34% of women had breast cancer detected by screening only (47% in the group eligible for free screening within the Breast Screen Aotearoa screening programme); 84% of patients had invasive carcinoma; 13% had ductal carcinoma in situ (DCIS); and 3% fine needle aspiration only. Forty nine per cent of invasive tumours were < or =2 cm. Grade 3 tumours were found in 53% of patients under 40 years old compared with 26.8% 40 years or older. Mastectomy was performed in 56% of patients with invasive cancer and 33% of those with DCIS. Axillary surgery was performed in 94% of patients with invasive cancer and 39% had involved nodes. Seventy nine per cent of patients were referred for an opinion from an oncologist. Radiotherapy was given to 77% of these patients, chemotherapy to 33%, and hormone therapy to 57%. CONCLUSIONS: The ABCR will provide essential healthcare information that will lead to better understanding of breast cancer in Auckland and more effective delivery of the clinical resources available in the Auckland region.