Research is integral to the delivery of best practice diabetes education, care and management and a core component of the diabetes educator (DE) role. However, previous studies and anecdotal evidence suggest that although DEs are ideally placed to undertake research, the majority do not participate in research activities. This article describes a study designed to explore the experiences, skills and attitudes of Australian DEs towards research, and to identify the barriers to, and facilitators of, research.

Research is a challenge for all nurses, including diabetes educators (DEs), and their interest in research activities varies. Although the DE role is primarily clinical, research is a core component and a requirement for the Australian Diabetes Educators Association (ADEA; 2001) and the credentialing programme (ADEA, 2000). In Australia, the term ‘diabetes educator’ describes a number of health professional disciplines. Although the majority are nurses, other health professionals such as dietitians and podiatrists also undertake the role to varying degrees within the scope of their primary discipline.

There is an expectation that nurses will provide clinical leadership, especially in advanced nursing roles such as the DE. Clinical leadership includes a range of research activities, such as being aware of the importance of research to clinical practice, using research findings to provide evidence-based diabetes care, as well as collaborating in and undertaking research. Translating research into clinically usable forms is part of a cycle of knowledge transformation that includes developing policies and guidelines and monitoring outcomes to achieve best practice.Research can therefore be a change agent.

The research–practice gap between undertaking research and incorporating research findings into nursing practice (research utilisation) is well described in the literature (Roycroft-Malone, 2004). Professional nursing bodies such as the International Council of Nurses (ICN) have developed policies and task forces to formulate a worldwide research agenda for nursing (ICN, 1990) but the impact of this initiative is unknown.

Anecdotal comments during research education sessions for DEs suggested that the method of educating nurses about research could be either a barrier to, or facilitator of research utilisation. Most undergraduate nursing courses incorporate research to some degree (Olade, 2004). However, education alone does not encourage nurses to use or participate in research (Dunning, 2004; Jordan, 2004). Active support from employers, research mentors and role models plays a major role (Byrne and Keefe, 2002; Dunning, 2004).

People with diabetes have a right to expect evidence-based care. Jordan (2004) suggested that consumers will have an increasing influence on, and a role in, research utilisation, and therefore the provision of evidence-based practice. Likewise, a survey of people with diabetes on the Australian National Diabetes Services Scheme (NDSS) register, a Government-sponsored scheme to subsidise the cost of blood glucose test strips, insulin syringes and needles and some insulin pump consumables, found that people were interested in hearing about research findings, receiving research updates and information about research projects that they could be eligible to participate in (Diabetes Australia [DA], 2004).

Consumer involvement in clinical decision-making is already occurring, e.g. consumers are being included on policy-making and guideline development committees and research fundraising committees. In addition, consumers are expected to actively participate in their care, especially when they have a chronic disease such as diabetes. Being informed about relevant research findings enables people to participate in management decisions more effectively and to make relevant, informed self-care decisions (Heater et al, 1988).

Research utilisation

Research utilisation is a complex process: clinicians need to possess strong research knowledge and skills, including the ability to critically analyse and understand published research, in order to be able to apply the findings generally in their particular practice context and to individual patients.

A number of factors affect nurses’ ability to utilise research besides their knowledge and skills; these include the social and historical context in which they work, their own and colleagues’ beliefs and attitudes about research, and the philosophy of the employing organisation (Roycroft-Malone, 2004).

Furthermore, everybody concerned needs to understand and value the contribution that the different research paradigms make to patient care. Controlled trials provide evidence of safety and benefit (the science of care) and qualitative studies provide important information about the social and human aspects that affect whether and how research will be utilised (the art of care). Together they constitute the yin and yang of research. Evaluation studies provide information about the outcomes of using research to guide practice. Considered together, the research paradigms provide a holistic picture of research development and utilisation.