Barriers and facilitators in nursing home intervention research

Conducting intervention research in nursing home (NH) settings is particularly challenging because of the advanced age and frailty of the participants and the characteristics of the setting itself. The purpose of this project was to better understand the barriers and facilitators to the research process in NHs. Three primary data sources were used: investigator field notes, guided interviews with the research team and NH staff members, and research assistant (RA) e-mail communications. Data were analyzed using qualitative content and matrix analytic techniques. Barriers to the research process were largely congruent with previously identified NH staff characteristics, such as lack of communication between NH staff and the research team ineffective nursing leadership, decreased staff-to-resident ratios, and high turnover of NH staff. Research facilitators emerged in two overlapping areas, intraresearch team issues such as the flexibility and compatibility of the RAs, effective NH staff-to-research team communication, and the presence of an effective nurse leader in the NH.