Barriers to the Adoption of Evidence Based Practice in Nursing: a Focus Group Study.

Background: Evidence Based Practice is considered a complex process with many factors hindering its implementation. The use of focus groups to detect barriers to its application can provide an in-depth investigation of the phenomenon. Objective: The investigation of nurses' views regarding the obstacles connected to the implementation of Evidence Based Practice. Methods: This is a qualitative study carried out using focus groups and constitutes the continuation of a quantitative study. Deliberate sampling was used to recruit a total of 31 nurses. Results: The main categories that emerged regarding the obstacles in the implementation of Evidence Based Practice in nursing, concerned the lack of logistical support, the difficulty of accessing data, the insufficient knowledge of nurses as well as their attitude, the nature of the work, the decision-making process and the impossibility of safeguarding decisions made. Conclusion: In this study, various factors were identified that affect the application of Evidence Based Practice, in the nursing environment of Cyprus. Identifying these factors can be the basis for discussions and finding ways to resolve the problems that exist by health care managers.

Disentangling prescribing behaviour of Cypriot physicians, within a complex framework of interacting.

The purpose of the study is to investigate how physicians' prescribing behaviour in Cyprus adopts to the fragmented healthcare system and to the inadequacies of pharmaceutical market in times of economic crisis. A survey was carried out in using a postal questionnaire administered to a stratified sample of 320 physicians. The questionnaire used was the same with the one used in 2007 survey carried out in Greece and Cyprus, along with complementary questions for prescribing within economic crisis. The comparative analysis and assessment of the findings from the two surveys revealed that the current system and the inadequacies of pharmaceutical market in Cyprus expose physicians to a contrasting environment of public and private sector in terms of incentives, governance principles, financing and market structure. In contrast to public sector prescribers who have behaved in accordance with the governance principles, there is a strong motivation for private sector physicians to favour new branded products, and generally rejecting any ideas that could limit their clinical autonomy. Economic crisis seems to be unilaterally influential, as public sector physicians became more cost conscious while private sector prescribing is still resisting due to strong financial incentives.

Factors Affecting the Application and Implementation of Evidence-based Practice in Nursing.

BACKGROUND: Even though Evidence-Based Practice is a complex process, it's application has been recognized worldwide as a lever of improvement of the provided health services. OBJECTIVE: This study investigates the factors which influence the implementation of Evidence-Based Practice and their correlation with nurses' socio-demographic characteristics. METHODS: This is a cross-sectional study for which data were collected through an anonymous questionnaire. The study sample included 302 nurses from six public hospitals in Cyprus. Data collection was conducted from April 2018 to July 2018. RESULTS: According to the nurses, the biggest obstacle for the application of Evidence-Based Practice is the lack of authority/power to change care procedures (83.8%), followed by the view that the results were not applicable in the nurses' environment (81.5%). CONCLUSION: The identification of factors affecting the implementation of Evidence-Based Practice can serve as a basis for improving the quality of healthcare, as well as for developing strategies for resolving existing problems. This study showed that there is a need to create opportunities for the use of Evidence-Based Practice by nurses.

Mapping variability in allocation of Long-Term Care funds across payer agencies in OECD countries.

INTRODUCTION: Long-term care (LTC) is organized in a fragmented manner. Payer agencies (PA) receive LTC funds from the agency collecting funds, and commission services. Yet, distributional equity (DE) across PAs, a precondition to geographical equity of access to LTC, has received limited attention. We conceptualize that LTC systems promote DE when they are designed to set eligibility criteria nationally (vs. locally); and to distribute funds among PAs based on needs-formula (vs. past-budgets or government decisions). OBJECTIVES: This cross-country study highlights to what extent different LTC systems are designed to promote DE across PAs, and the parameters used in allocation formulae. METHODS: Qualitative data were collected through a questionnaire filled by experts from 17 OECD countries. RESULTS: 11 out of 25 LTC systems analyzed, fully meet DE as we defined. 5 systems which give high autonomy to PAs have designs with low levels of DE; while nine systems partially promote DE. Allocation formulae vary in their complexity as some systems use simple demographic parameters while others apply socio-economic status, disability, and LTC cost variations. DISCUSSION AND CONCLUSIONS: A minority of LTC systems fully meet DE, which is only one of the criteria in allocation of LTC resources. Some systems prefer local priority-setting and governance over DE. Countries that value DE should harmonize the eligibility criteria at the national level and allocate funds according to needs across regions.

Exploration of empathy in Cyprus nursing and health care students: A mixed method study.

Developing professionals who are perceptive to the needs of patients and can respond by expressing empathetic behavior is one of the aims of health care education. The aim of this study was to explore the level of empathy in health care students through a mixed method. The quantitative approach included the use of the Jefferson Scale of Empathy and the qualitative a focus group approach to further deepen into the descriptive results. 869 health care students (RR=81%) participated in the study and the level of empathy ranged from 42 to 139 with a mean score of 100.6 (20-140 scale). Significant statistical differences were found between the disciplines (F=8.6, p-value<0.001) and gender (p-value<0.001) with nursing students and women scoring the higher levels. Two focus groups of ten participants each were conducted with 3rd and 4th year nursing students. Four themes were derived from the analysis of these data a) empathy as an imperative component of care b) contact with the clinical reality c) the influence of family and choice of studies d) gender stereotypes. There is a lack of mixed methodologies in the empathy research and this study provided the opportunity of a better understanding of the health care students' views.

Conflict management among health professionals in hospitals of Cyprus.

AIM: To record the types of conflict management that health professionals in Cyprus hospitals encounter in their daily work and to explore the conflicts, their parameters and causes, and the role ambiguity faced by the hospital employees. MATERIAL AND METHODS: This is a descriptive study in which data were collected with an anonymous self-referral questionnaire. The study population consisted of 300 health professionals from six different hospitals in Cyprus. Data are presented with averages and standard deviations. RESULTS: The health professionals identified the following causes of conflicts in the workplace in descending order: heavy workload, low pay, and varying instructions from different leaders. To deal with the conflict, 73.2% of the participants reported using avoidance, 54.2% engaged in negotiation for mutual benefit, and 40.5% cited compromise as a method. CONCLUSIONS: Identifying the way in which conflicts are managed contributes to the smooth functioning of organisations, and it improves the effectiveness of the services provided. IMPLICATIONS FOR NURSING MANAGEMENT: It is generally known that the high levels of conflict in hospitals are associated with increased mistakes and low employee satisfaction and performance levels. Managers deal with conflict-management issues within organisations on a daily basis. It is therefore essential to comprehend the reasons behind conflicts and provide suitable training for the development of communication skills and conflict-management strategies.

Public engagement in setting healthcare priorities: a ranking exercise in Cyprus.

BACKGROUND: In countries such as Cyprus the financial crisis and the recession have severely affected the funding and priority setting of the health care system. There is evidence highlighting the importance of population' preferences in designing priorities for health care settings. Although public preferences have been thorough analysed in many countries, there is a research gap in terms of simultaneously investigating the relative importance and the weight of differing and competing criteria for determining healthcare priority settings. The main objective of the study was tο investigate public preferences for the relative utility and weight of differing and competing criteria for health care priority setting in Cyprus. METHODS: The 'conjoint analysis' technique was applied to develop a ranking exercise. The aim of the study was to identify the preferences of the participants for alternative options. Participants were asked to grade in a priority order 16 hypothetical case scenarios of patients with different disease and of diverse socio-economic characteristics awaiting treatment. The sample was purposive and consisted of 100 Cypriots, selected from public locations all over the country. RESULTS: It was revealed that the "severity of the disease" and the "age of the patient" were the key prioritization criteria. Participants assigned the smallest relative value to the criterion "healthy lifestyle". More precisely, participants older than 35 years old assigned higher relative importance to "age", while younger participants to the "severity of the disease". The "healthy lifestyle" criterion was assigned to the lowest relative importance to by all participants. CONCLUSION: In Cyprus, public participation in health care priority setting is almost inexistent. Nonetheless, it seems that the public's participation in this process could lead to a wider acceptance of the healthcare system especially as a result of the financial crisis and the upcoming reforms implemented such as the establishment of the General System of Health Insurance.