Dana N. Rutledge

Purpose: The purpose of this study was to investigate predictors of high physical function in people with fibromyalgia (FM). Design: Cross‐sectional descriptive, correlational study of 2,580 persons with FM who responded to an online survey during fall 2005. Methods: The survey indicated self‐reported physical activity levels, functional abilities, symptoms, health care costs, employment status, work productivity, self management strategies. It had adequate validity and reliability. A significant binary logistic regression model of predictors of physical function (individual factors, symptoms, self management strategies) was validated using backwards logistic regression. Findings: Significant explanatory variables of high physical function were: men, greater education, younger age, lower intensity fatigue, spasticity, and balance problems, not using prescription pain medications, using aerobic or strength training exercise, and not using relaxation methods. Conclusions: People with FM suffer from multiple symptoms and use many modalities to control symptoms to remain functional. Given knowledge of predictors of physical function in FM, health care providers might be able to develop strategies to promote better functioning. Prospective trials are needed to track the natural course of study variables, measuring their effect on function, and to test effects of interventions to maximize function.

To describe the development and implementation of the Triad Model of Research Synthesis, developed as a mechanism to produce systematic literature reviews that can serve as sources of evidence for decision making in health care. Authors' recollections of the development and implementation process over a one-year period during 2002. Tracking forms were completed by members of three triad teams as they compiled research syntheses on clinical topics: pharmacologic treatment of dyspnea, assessment of sleep disturbances in patients with cancer, and exercise as an intervention for cancer-related fatigue. The systematic literature review process includes the following steps: (a) organize, search the literature, and focus the research synthesis question; (b) critique the selected literature; (c) synthesize the evidence; and (d) write. On average, triad members spent hours that were equivalent to full-time work during the year (excluding completion of manuscripts) on the synthesis projects. Hours spent varied by member role and with each phase of the process. Performing a research synthesis using the triad model was a productive and resource-intensive experience that points to the need for negotiating resources prior to embarking on such an exercise. Given a group of highly motivated nurses and others with adequate time and resources, this model can be effective when developing systematic reviews about a variety of topics. Literature syntheses developed can be used as evidence for clinicians and others to develop practice protocols and other evidence-based care guidelines.

To describe the implementation and refinement of a yearly research utilization (RU) course for oncology nurses. Formative program evaluation. 22 oncology nurses selected based on competitively reviewed project proposals. The one-day RU course was held five times prior to the annual fall Oncology Nursing Society conference. The course consisted of brief didactic sessions on RU, project presentations by participants, faculty reviews, and discussions of practical issues related to project implementation. Course content, usefulness of course components. Based on immediate postcourse, 6-month, and 12-month feedback, refinements were made to the course. A major change (in year three) was the addition of a "preparation packet," which contained resources about RU and directed students to accomplish specific precourse goals, and access to a faculty mentor. Evaluation scores were good to outstanding for the content and usefulness of the course presentations, critiques by faculty, and discussion sessions. Interviews with participants indicated that a majority completed or were working on their projects within four years of completing the course. RU and some of its components (pursuing a literature search, making a practice change) are not processes that most nurses are familiar with, but these processes can be taught to nurses with focused clinical concerns. An RU course with a low faculty-to-student ratio, adequate course materials, and systematic instruction can lead to research-based changes in practice.