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The mean total Facilitator Score was compared across various demographics to assess the association between nurses’ demographics and mean total Facilitator Scores. These mean scores were compared across various levels of nursing education to assess whether nurses with various education levels differed on their mean total Facilitator Scores for research utilisation (Table 5.25). Results indicated that nurses with the highest mean total Facilitator Score were nurses with a Masters qualification, whilst Diploma qualified nurses had the lowest perceived mean Facilitator Score. This is consistent with the perceived mean total Barrier Score of these nurses and can be explained by the differences in the education programs as discussed earlier.

Table 5.25. Mean total Facilitator Score for various qualifications of nurses

Qualification n Mean SD

Diploma 269 24.20 21.32

Bachelor 1508 26.30 3.88

Masters 33 29.20 4.02

Hypothesis testing using one-Way ANOVA showed significant differences in mean perceived total Facilitator Scores amongst the levels of nursing qualifications (F (2,1807) = 22.34, p <.001). These results indicate that nurses’ perceptions of facilitators of research utilisation differed according to their nursing qualification (Table 5.26). A Dunnett T3 pairwise comparison showed significant differences in mean perceived total Facilitator Scores between nurses with Diploma and those with Bachelor qualifications (p<.001, 95% CI: -3.03, -1.3) and between those with Diploma and those nurses with a

compared to those with a Master’s degree (p < .001, CI: -4.8, -1.01) (Table 5.26). This indicates that as education increased, the mean perceived Facilitator Scores tended to increase as well.

Table 5.26. Comparison of mean total Facilitator Score across nurse qualifications Qualification Comparison Qualification ANOVA p-value Pairwise p-value Mean Difference 95% CI Diploma Bachelor F (2,1807) =22.34 p<.001 <.001 (-3, -1.3) Masters <.001 (-7.1, -3) Bachelor Masters <.001 (-4.8, -1.01)

Mean total Facilitator Scores were compared across various experience levels using one-way ANOVA (Table 5.27). The aim was to assess whether nurses’ mean perceptions on required facilitations to doing research utilisation differed by experience levels. Results show that there was a significant difference in the mean perceived total Facilitator Scores between nurses with various experience levels F (4,1391) =8.9,

p<.001).

Table 5.27. Mean total Facilitator Score for nurses’ experience levels

Years of experience n Mean SD

2-5 369 25.40 5.76

6-10 544 25.20 6.99

11-15 418 26.70 3.13

16-20 175 26.70 4.81

>20 318 27.10 5.34

Dunnett T3 pairwise comparison follow up tests were conducted to determine which pairs differ significantly from each other. The results indicated that nurses with 2 to 5 years of experience perceived less required facilitations than those with 11 to 15 years of experience (p=0.011, 95% CI: (-2.4, -1.83), and those with greater than 20

years of experience (p < .001, 95% CI: -2.8, -0.54). Likewise, those with 6 to 10 years of experience also perceived less facilitation to doing research than those with 11 or more years of experience (p = .001. 95% CI: -2.4, -0.4) and those with 16 to 20 years of experience (p= 0.039, 95% CI: -2.92, - 0.04), as well as those with 20 or more years of experience (p<.001, 95% CI: -2.9, - 0.8). However, mean perceived total facilitation scores did not differ significantly from that of nurses with 16 years or more of experience. The remaining comparisons were not statistically significant (Table5.28).

Overall, results show that the mean total Facilitator Score increased with nurses’ experience; that is, the more experience the nurses had, the higher was the mean total Facilitator Score (Table 5.27). This trend clearly suggests that the more experienced nurses (according to years of experience) tended to perceive/ require more facilitation in general for research utilisation. This could be explained by the fact that most experienced nurses who have practised for a long period of time are farther from their initial nursing education. Furthermore, they are less likely to have knowledge or limited skills in EBP and critical appraisal of research as the nature of the education programs have changed over time to place more emphasis in these areas. In contrast, the newly graduated nurses are more likely to have had increased exposure to the scientific method, and EBP concepts in curricula that include an understanding of research and methodological procedures required for the appraisal of evidence. The time from qualification is also an influence as information of EBP becomes more distant as the day to day practice of nursing takes priority.

Table 5.28. Comparison of mean total Facilitator Score across nurses’ experience levels Work Experience (years) Comparison Work Experience (years) ANOVA p-value Pairwise p-value Mean Difference 95% CI 2-5 6-10 F (4,1391) =8.9 p<.001 1.000 (-1,1.2) 11-15 0.011 (-2.4, -1.8) 16-20 0.125 (-2.8, 0.18) >20 <.001 (-2.8, -0.54) 6-10 11-15 0.001 (-2.4, -0.4) 16-20 0.039 (-2.9, -0.04) >20. <.001 (-2.9, - 0.8) 11-15 16-20 1.000 (-1.5,1.3) >20 0.969 (-1.5,0.7) 16-20 >20 0.999 (-1.8,1.1)

The mean total Facilitator Scores were compared across various regions where nurses obtained their qualifications. The aim was to assess whether nurses’ perceptions of required facilitators of research utilisation differed according to the region where nurses attained their qualification (Table 5.29). Results indicated that nurses who received their qualification from a Western region had the highest mean total Facilitator Score whilst nurses who qualified from the Middle East and India/Pakistan had the lowest mean total Facilitator Scores.

Table 5.29. Mean total Facilitator Score for region of nurses’ qualification Region

n Mean SD

Middle East 292 25.40 5.12

Asia: Philippines & Malaysia 913 26.50 6.04

India & Pakistan 535 25.40 6.93

Western 84 27.90 4.58

Hypothesis testing using one-Way ANOVA demonstrated statistically significant differences in mean total Facilitator Scores based on the region where the

nurses’ attained their qualification (F (3, 861.5) = 8.9, p<.001). Dunnett’s T3 pairwise comparisons were used to identify which nurses’ qualifying regions differed significantly in mean total Facilitator Scores (Table 5.30).

Table 5.30. Comparison of mean total Facilitator Score across region of nurses’ qualification

Region Qualifying Region. ANOVA

p-value Pairwise p-value Mean difference (95% CI) Middle East Asia

F

(3,861.5) =8.9

p<.001

0.008 (-2, -0.2) India & Pakistan 1.0 (-1.1, 0.92)

Western <.001 (-4, -0.99)

Asia: Philippines &

Malaysia. India & Pakistan 0.008 (0.18, 1.9)

Western 0.050 (-2.8, 0.001)

India & Pakistan. Western <.001 (-3.9, -0.95)

Nurses who qualified in the Middle East differed significantly in the perceived mean total Facilitators Scores compared to nurses who qualified in the Asia region (p=0.008, 95% CI: (-1.97, -0.2)) and to those who qualified in the Western region (p<.001, 95% CI: (-4, - 0.99). Nurses who qualified in the Asia region differed significantly in perceived mean total Facilitator Scores compared to nurses who qualified in India/Pakistan (p=0.008, 95% CI: (0.18, 1.85)), In addition, nurses who qualified in India/Pakistan differed significantly in perceived mean total Facilitator Scores compared to those who qualified in the Western region (p <.001, 95% CI: -3.9, - 0.95). However, nurses who qualified in the Middle East did not differ significantly from those qualified in India/Pakistan when contrasted (p=1.0). Furthermore, there was no statistically significant difference in perceived mean total Facilitator Scores between those who qualified in the Asia and Western regions perceived mean total Facilitator Scores (p=0.05). Nonetheless, these results reflect the potential differences in education

more emphasis in their nursing curricula in other areas, such as English language, religion and culture.

The mean total Facilitator Scores were compared across the various clinical roles. The aim was to assess whether nurses’ perceptions of required facilitators of research utilisation differed depending on their clinical role. These results indicate that nurse educators had the highest mean total Facilitator score while the clinical nurses had the lowest mean total Facilitator score (Table 5.31).

Table 5.31. Mean total Facilitator Score for clinical roles of nurses

Role n Mean SD

Clinical Nurse 1,504 25.70 5.90

Nurse Manager 231 26.80 5.92

Nurse Educator 89 28.60 4.71

Hypothesis testing using one-way ANOVA revealed that nurses occupying different clinical roles had significantly different mean total Facilitator Scores (F (2, 365.1), p < .001). Dunnett’s T3 pairwise comparisons were performed to determine which clinical roles differed significantly on mean scores. As illustrated in Table 5.32, nurse educators had significantly higher mean total Facilitator Scores than nurse managers (p=0.016, 95% CI: 0.27, 3.33) and clinical nurses (p<0.001, 95% CI: 1.6, 4.1). Clinical nurses and nurse managers also demonstrated statistically significant difference in their mean Facilitator Scores (p=0.041, 95% CI: (-2.04, -0.033). These results may reflect the greater emphasis placed on the role of the nurse educator to promote research and EBP as well as the fact that they are more likely to have a higher qualification compared to nurse managers and clinical nurses. This was discussed in more detail earlier.

Table 5.32. Comparison of mean total Facilitator Score across clinical roles of nurses

Clinical Role Clinical Role ANOVA p-value Pairwise p-value Mean Difference (95% CI) Nurse

Educator Nurse Manager F (2, 365.1) =14.4

p<.001

0.016 (0.3 ,3.3) Clinical Nurse <.001 (1.6, 4.1) Clinical Nurse Nurse Manager 0.041 (-2, -0.033)

The mean total Facilitator Scores were compared across the various age categories of nurses. The aim was to assess whether nurses’ perceptions of facilitators of research utilisation differed depending on their age category. These results indicate that nurses aged 41-50 years had the highest mean total Facilitator Score whilst the youngest age group of 20-30 years had the lowest mean total Facilitator Score (Table 5.33).

Table 5.33. Mean total Facilitator Score for nurses’ age categories

Age (years) n Mean SD

20-30 616 25.30 5.7

31-40 669 26.20 5.7

41-50 413 26.80 4.9

51-64 126 26.50 6.2

A One-Way ANOVA was conducted to assess whether the differences in mean total Facilitator Scores were significantly different across various age categories of nurses. A one -way ANOVA showed a significant difference between nurses’ age groups on perceived facilitation (F(3,748.7), p<.001) using the Welch adjustment to counteract lack of homogeneity of variance. Moreover, the pairwise post-hoc comparisons using the Dunnetts T3 test showed that nurses aged 20-30 years significantly perceived less required facilitation than those aged 41-50 and 31-40 years (Table 5. 34).

Table 5.34. Comparison of mean total Facilitator Score across age of nurses’ age categories

Nurse age category

(years)

Comparison age category

(years) ANOVAp-value

Pairwise p-value Mean Difference 95% CI 20-30 31-40 F (3,1820) =7.3 p<.001 0.016 (-1.7,0.12) 41-50 <.001 (-2.4, -0.7) 51-64 0.204 (-2.8, 0.3) 31-40 41-50 0.330 (-1.5, -0.26) 51-64 0.997 (-1.9, 1.3) 41-50 51-64 0.996 (-1.3,1.9)