Description

Nurse-led interventions in the concept of randomized controlled trials – critical perspectives on how to handle social contexts

Stinne Glasdam, Bengt Sivberg and Monne Wihlborg

Health Sciences Centre, Division of Nursing, Lund University, Lund, Sweden

ABSTRACT

This article focuses on the randomized clinical trial (RCT) as research method in nursing interventions and problematizes its methodological ability and delimitations considering the use of this method in the healthcare. It aims to examine if and how RCT in nurse-led interventions are handling questions concerned with contextual influences. A systematic literature review was conducted, consisting of 55 RCT from 2006 to 2010. The results show: all interventions were placed in a social arena and address interactions but did reflect the meaning and importance of the social context in the design. RCT operates as if no contextual impact exists, and at the same time, make claims to guide and change actions in the clinical practice. This has implications for the understanding of evidence-based nursing according to the Evidence Hierarchy. Further discussion concerning RCT design and impact in clinical practices are called for.

KEYWORDS: RCT; nursing interventions; social context; evidence-based nursing; interactions; critical reflections