Involving Nurses in Participatory Action Research: Facilitators and Barriers

Abstract

Involving nurses in research and quality improvement is desirable because nurses are often aware of weaknesses in care or organizational processes. In participatory action research (PAR), practitioners are encouraged to identify problems they encounter and, together with the researcher, develop strategies to solve these problems. This study aimed to evaluate the process of involving nurses in PAR, as well as learn what hampers and facilitates collaboration between the nursing team and the researcher and facilitator. Data collected during a 2.5-year PAR process with a nursing team (15--18 participants) on a geriatric rehabilitation ward was deductively analyzed using seven quality criteria (collaboration, prudent handling of assumptions, accountability, participation, reflection, knowledge sources, and transparency). This study describes how reflection and collective learning as core processes of PAR were facilitated using complementary knowledge sources (theoretical models, knowledge based on practical experiences, and results of empirical research collected during the PAR). The study uncovered that providing the time and setting for reflection and collective learning enables a nursing team to be actively involved in PAR: it helps them diagnose their current practice, plan ahead, and critically experiment with actions. Additionally, a positive learning climate is a prerequisite for this process. However, without a strong link between quality policy and consequent facilitation of participation through earmarked time, these efforts might not lead to sustainable changes. A more permanent link between PAR initiatives and organizational ambitions regarding quality of care is recommended.