Lust Caution by Eileen Chang Essay

In the novel Lust, Caution by Eileen Chang, there are debates of the reason why Wang Jiazhi made the decision to warn Yi and to let him go, which is not only a betrayal to her mission but also a suicidal action which eventually led to her death. This action of hers involves multiple psychological origins from Wang’s childhood memory and family structure through out her experience of being a student with her peers to her subtle relationship with Yi during her spying mission. Such experiences formed significant psychological defenses within her according to the psychoanalysis of Freud. The movie Lust, Caution provides a much fuller explanation and details about what the author of book did not offer thoroughly, which is the family background of Wang Jiazhi. There is a scene in the movie that Wang is sitting in a shabby room and trying to organize her word for the wedding greetings to her father who moved oversea years ago with her little brother when she was a child. The experience of her father’s leaving at her young age leads to her fear of abandonment after she grows up, the unshakable belief that her friends and loved ones cannot be trusted. The fact that her father brought her little brother with him but left her at home creates a further belief that she is less worthy than other people and, therefore, does not deserve attention, love, or any other life’s rewards, which is called low self-esteem in the psychoanalysis. Her fear of abandonment and low self-esteem add together and form her most essential mental defense: fear of intimacy, the chronic and overpowering feeling that emotional closeness will seriously hurt or destroy her and that she can remain emotionally safe only remaining at an emotional distance from others at all times. These mental defenses of Wang appear in different areas in her personal and social life, and largely affect Wang in her processes of decision making. In Wang’s social life, the main part of the cause of her solitude does not come from her peers but rather from her prejudice to herself and hatred of her own life and identity. Within a patriotism student division, the members of the division are supposed to have an extremely strong and tight emotional bond. However, as the key factor of this operation, Wang and her view of her peers and coworkers are strangely biased and distanced. When she thinks  about them, she sees the â€Å"detestable eyes† and â€Å"meaningful smile† appear on her friends’ face. Her belief of how her friends in fact hate her and laugh at her at behind reflects on the definition of fear of abandonment in the theory of the psychoanalysis. During her spying mission, Wang’s interaction with Yi, a married â€Å"short man in his forties or fifties† according the description in the novel, revealed another psychological defense of Wang: oedipal fixation, a dysfunctional bond with a parent of the opposite sex that she does not outgrow in adulthood and that does not allow her to develop mature relationship with her peers. Despite the fact that Wang’s relationship with Yi is based on a conspiracy, Wang has certainly developed some kind of emotion that is beyond her position as a spy toward her role and her target, Mr. Yi. Although the fact that Yi is in his forties or fifties may impair his charm in many ways, for Wang the age of Yi provides her a sense of fatherhood, which has been absent from her life since she was a young girl. Also, having a love affair with a married man gives her the feeling of competing with another woman, which reflects her being influenced by her father’s marriage. Being chosen to play the role of the mistress of Yi, Wang Jiazhi not only is an extremely skilled actress, but also has putted her full passion and dedication into her character even beyond the expectation of her job. Such a strong emotional attachment to her target and her life as Wang, the character, contributed largely to her excellence at the job; however at the same time, made it very hard for her to distinguish her own life as a spy and the life as Wang Jiazhi, who lives a luxury life and has no relation with the life of her own, the life filled with confusion, self doubt, and fear of betrayal. Wang’s small actions unconsciously depict a strong sense of hatred to her own life. She hates her family, her friends, and most importantly, herself. Her life is pointless except â€Å"when she is with Yi, she finds the meaning and purpose of living.† Wang feels truly alive only when she is acting as someone else, someone who could be anyone but herself. Therefore, Wang becomes so attached to her character that has forgotten that the original intention of this mission is to end it. When she is in the jewelry store with Yi, she realizes that this is her final plot of being  Wang Jiazhi. However, she can still control her ending pose. Wang chooses to warn Yi and to release him. As the result of her decision, she dies, and the Wang Jiazhi the character leaves the stage, but the play continues without Wang Jiazhi. In this way she does not have to return to her own life which she thinks is not worth of living. She, as an actress, has devoted her life for acting and has chosen to end her life as Wang Jiazhi for her stage and her own masterpiece. Her death has no direct relation with her affection to Yi. She has lived in her art and she died for her acting.

Cultural determinants of Latin Americans

The Latino population in the US is about 14 % (in 2006) and would rise to about 25 % within a few years. This population has very important healthcare needs, and they cannot be ignored as they form a very important part of the population of the US (Caballero, 2006). The incidence rates of diabetes are very high in the Latin American population that resides in the US. Hispanics have a high chance of developing diabetes due to genetic predisposition. The occurrence of type I diabetes is similar in Hispanic and Whites, but the prevalence of type II diabetes is almost twice higher.Environmental factors (associated with urbanization, lifestyle and leading a sedentary lifestyle) tend to impact the manner in which the disease develops and progresses in Hispanics. The outcome of diabetes of Latinos who reside in the US is particularly poor (Caballero, 2006). These rates are especially high in those above the age of 60 year. About 33 % of the female population and about 31 % of the male popul ation suffer from diabetes. The incidence rates could be higher due to a number of unreported cases. At the moment, the Hispanic population is experiencing a lot of problems with relation to accessing the healthcare services in the US.These include a reduced provision of healthcare services, poor knowledge about the availability of the healthcare services, poor insurance coverage, poor policies framed to cover the healthcare needs of the immigrants, absence of procedures in order to secure the healthcare services, inability to afford the high cost of healthcare, poor transportation facilities, cultural problems that are experienced whilst interacting with the healthcare professionals (difference in language, culture, ethnicity, values, etc), discrimination, fear, etc (Sotomayor, Pawlik & Dominguez, 2007).Healthcare services are provided at rather inconvenient hours and the transportation facilities, to and fro the healthcare unit is very poor. Some individuals belonging to the Latin Communities fear using the healthcare system as they feel that they get discriminated and deported to their home nation. Individuals belonging to the Latin communities are unable to build a rapport with the healthcare professional (Kaleidoscope). The CDC began to understand that the Latin Communities were unable to obtain effective healthcare services in the US.Hence, it launched the Latin Education Project in the year 2000 to educate the Latin Communities, make them understand their health problems, encourage health promotion and prevent the development of chronic diseases. The incidences, complications and mortality of diabetes were high in the Texas region of the Latin Communities. The communities had very poor knowledge of their health problems, as they were basically illiterate, uneducated, lived in villages and worked as farmers. Their economic situation was also very poor in the US.About 42 % of the population that reside in the Coastal Bend Area of Texas is basically Hispan ic and a sizeable amount belongs to the elder age group. In some areas, the Hispanic population is about 80 to 90 %, and this would mean that the health problems that arise due to not using the healthcare facilities are even higher. About 28 % of the elder aged-group Hispanic population lives below the poverty line. The unemployment rates are also very high in the Hispanic population (about 6 %).About 50 % of the population that live in Texas meets with fatal outcomes due to a chronic disease such as diabetes and CVS disease (Sotomayor, Pawlik & Dominguez, 2007). The Latin populations also have a lot of beliefs about healthcare, which affects the manner in which they seek healthcare services in the US. In 4 different parts of the World, Weller et al performed a study in 1999, to determine the beliefs the Latin communities had about diabetes. It was performed in Latin Communities in Connecticut, Texas, Mexico and Guatemala.A survey tool in the form of a questionnaire was utilized tha t had about 130 items regarding their beliefs about the cause, characteristics and the management of diabetes. Different populations were utilized to determine the consistency patterns. The study demonstrated that there were homogeneous beliefs in all the four communities with regards to Diabetes. As the incidence of diabetes was higher in the population, so were their knowledge levels of the disease. The cultural knowledge of diabetes was associated with greater educational levels.Sharing and transmission of knowledge was higher in populations living in developed areas. The cultural knowledge of diabetes seemed to be true and proven through modern medicine. However, there were some wrong beliefs, which existed in the population regarding diabetes. This may be due to a lack of information in a particular area, and could be easily corrected through education. The population was aware that diabetes developed due to the lack or a problem of insulin in the body.There were also aware of the frequent symptoms of diabetes such as tiredness, frequent urination, dizziness, excessive thirst, visual disturbances, etc (Weller, Baer, Pacher, et al 1999). The Latin populations do not belief in preventive care (which is given a lot of priority and importance in the US). Economic and spiritual factors influence the need to seek preventive medical care. The population may not like to seek unnecessary medical check-ups, as it may be very costly for them. Only if the patients were sick and terribly unwell, would he/she seek medical care.Hence, they are at a very high risk of developing serious complications that may arise in association with several chronic diseases. Many people end up with fatal outcomes in the hospitals. Hence, they soon begin not to trust the local healthcare providers, and tend to lose confidence in the US healthcare system. The uninsured rates are also very high in the Latino populations. The Latin population believes that curses and spiritual issues could result in the development of illness, and hence, would first seek care from a spiritual healer.Rituals, local herbs and medicines are utilized to treat the disease, frequently without much success (Kaleidoscope). The Healthcare system in the US is beginning to change in order to meet the needs of the Latino population. Awareness programs are being launched by the CDC, American Diabetic Association, etc, to educate the Latino population of their health problems and the manner in which it is to be addressed. Physicians in certain parts of the US get extra academic benefits if they serve the minority population.Several organizations in the US are conducting relevant research and studies to identify the factors that could accelerate disease and worsen their health problems. Accordingly, the health system is being modified. Physicians and other healthcare personnel belonging to Latin origins are being recruited in the healthcare system to ensure that the patients can speak in their nativ e language to the professionals. Many organizations are also visiting the Latin populations to identify their health problems and develop a solution for them.The government and local agencies are also making an effort to provide health insurance coverage for these Latin populations. Transportation facilities that serve the Latin populations are also being improved. The communities are being reassured that they would not be discriminated, abused or deported to their home nation whilst accessing healthcare services. Pictures are frequently utilized at the healthcare unit to ensure proper communication. Brochures and graphics in local languages are utilized to create greater awareness for the Latin populations.The CDC and other health organizations in the US are creating a separate segment in their websites that would help the Latin population access health information (Kaleidoscope). References: Caballero, A. E. (2006), Culturally Competent Diabetes Care and Education for Latinos, Ame rican Diabetic Association, 3(12), 3. http://docnews. diabetesjournals. org/cgi/content/full/3/12/3 Kaleidoscope – Latinos / Hispanics, Retrieved on June 22, 2007, from Kaleidoscope Website: http://cnnc. uncg. edu/pdfs/latinoshispanics. pdf Nelson, K. , Geiger, A. M. & Mangione, C. M.(2002), Effect of Health Beliefs on Delays in Care for Abnormal Cervical Cytology in a Multiethnic Population, J Gen Intern Med, 17(9), 709–716. http://www. pubmedcentral. nih. gov/articlerender. fcgi? artid=1495105 Sotomayor, M. , Pawlik, F. & Dominguez, A. (2007), Building Community Capacity for Health Promotion in a Hispanic Community, Prev Chronic Dis, 4(1), A16. http://www. pubmedcentral. nih. gov/articlerender. fcgi? artid=1832126 Weller, S. C. , Galzer, M. , Baer, R. D. (1999), Latino Beliefs about Diabetes, Diabetes Care, 22(5), 722-728. http://care. diabetesjournals. org/cgi/reprint/22/5/722. pdf

Barriers of Research Utilization for Nurses

C L I N I C A L N U R S I N G IS S U E S Bridging the divide: a survey of nurses’ opinions regarding barriers to, and facilitators of, research utilization in the practice setting Alison Margaret Hutchinson BAppSc, MBioeth PhD Candidate, Victorian Centre for Nursing Practice Research, School of Nursing, University of Melbourne, Australia Linda Johnston BSc, PhD, Dip N Professor in Neonatal Nursing Research, Royal Children’s Hospital, Melbourne, and Associate Director, Victorian Centre for Nursing Practice Research, Melbourne, Australia Submitted for publication: 4 March 2003 Accepted for publication: 29 August 2003Correspondence: Alison M. Hutchinson School of Nursing University of Melbourne 1/723 Swanston St Carlton, VIC 3053 Australia Telephone: ? 61 3 8344 0800 E-mail: [email  protected] com H U T C H I N S O N A . M . & J O H N S T O N L . ( 2 0 0 4 ) Journal of Clinical Nursing 13, 304–315 Bridging the divide: a survey of nurses’ opinions regarding barriers to, and facilitators of, research utilization in the practice setting Background. Many researchers have explored the barriers to research uptake in order to overcome them and identify strategies to facilitate research utilization.However, the research–practice gap remains a persistent issue for the nursing profession. Aims and objectives. The aim of this study was to gain an understanding of perceived in? uences on nurses’ utilization of research, and explore what differences or commonalities exist between the ? ndings of this research and those of studies that have been conducted in various countries during the past 10 years. Design. Nurses were surveyed to elicit their opinions regarding barriers to, and facilitators of, research utilization.The instrument comprised a 29-item validated questionnaire, titled Barriers to Research Utilisation Scale (BARRIERS Scale), an eight-item scale of facilitators, provision for respondents to record additional barriers and /or facilitators and a series of demographic questions. Method. The questionnaire was administered in 2001 to all nurses (n ? 761) working at a major teaching hospital in Melbourne, Australia. A 45% response rate was achieved. Results. Greatest barriers to research utilization reported included time constraints, lack of awareness of available research literature, insuf? ient authority to change practice, inadequate skills in critical appraisal and lack of support for implementation of research ? ndings. Greatest facilitators to research utilization reported included availability of more time to review and implement research ? ndings, availability of more relevant research and colleague support. Conclusion. One of the most striking features of the ? ndings of the present study is that perceptions of Australian nurses are remarkably consistent with reported perceptions of nurses in the US, UK and Northern Ireland during the past decade. Relevance to clinical practice.If the use of res earch evidence in practice results in better outcomes for our patients, this behoves us, as a profession, to address issues surrounding support for implementation of research ? ndings, authority to 304 O 2004 Blackwell Publishing Ltd Clinical nursing issues Barriers to, and facilitators of, research utilization change practice, time constraints and ability to critically appraise research with conviction and a sense of urgency. Key words: barriers to research utilization, facilitators of research utilization, research dissemination, research implementation, research utilizationIntroduction and background For over 25 years research utilization has been discussed in the nursing literature with growing enthusiasm and amid increasing calls for the use of research ? ndings in practice. Additionally, the evidence-based practice movement, which emanated in the early 1990s (Evidence-Based Medicine Working Group, 1992) has highlighted the importance of incorporating research ? ndings into pra ctice. Furthermore, controversy surrounding the achievement of professional status has resulted in an increased awareness of the need for a research-based body of knowledge to underpin nursing practice.Gennaro et al. (2001, p. 314) contend: Using research in practice not only bene? ts patients but also strengthens nursing as a profession. If nursing is truly a profession, and not just a job or an occupation, nurses have to be able to continually evaluate the care they give and be accountable for providing the best possible care. Evaluating nursing care means that nurses also have to evaluate nursing research and determine if there is a better way to provide care. Twelve years prior, Walsh & Ford (1989) warned that the professional integrity of nursing was threatened by dependence upon experience-based practice.Similarly, Winter (1990, p. 138) cautioned that conduct of nursing practice in this manner is ‘the antithesis of professionalism, a barrier to independence, and a detrim ent to quality care. ’ Winter therefore, recommended that nurses ‘evaluate their status as research consumers, to identify problems in this area, and to develop means to better use research ? ndings’ (p. 138). Evidence-based practice, which should comprise the use of broad ranging sources of evidence, including the clinician’s expertise and patient preference (Sackett et al. , 1996), includes the use of research evidence as a subset (Estabrooks, 1999).Consistent with the classi? cation of knowledge utilization, three types of research use have been outlined (Stetler, 1994a,b; Berggren, 1996). The ? rst is described as ‘instrumental use’ and involves acting on research ? ndings in explicit, direct ways, for example application of research ? ndings in the development of a clinical pathway. The second is termed ‘conceptual use’ and involves using research ? ndings in less speci? c ways, for example changing thinking. The ? nal type o f research use, described as ‘symbolic use’, involves the use of research results to support a predetermined position.The nursing literature is replete with examples of limited use of research in practice and discussion surrounding perceived barriers to research utilization (Hunt, 1981; Gould, 1986; Closs & Cheater, 1994; Lacey, 1994). Despite this, the phenomenon of the research–practice gap, the gap between the conduct of research and use of that research in practice, remains an issue of major importance for the nursing profession. Many researchers have explored the barriers to research uptake in order to overcome them and identify strategies to facilitate research utilization (Kirchhoff, 1982; MacGuire, 1990; Funk et al. 1991a,b, 1995b; Closs & Cheater, 1994; Hicks, 1994, 1996; Lacey, 1994; Rizzuto et al. , 1994; Hunt, 1996; Walsh, 1997a,b). Hunt (1981) suggested that nurses fail to utilize research ? ndings because they do not know about them, do not understa nd them, do not believe them, do not know how to apply them, and are not allowed to use them. According to Hunt (1997), the barriers to research utilization and, therefore, to evidence-based practice fall into ? ve main categories: research, access to research, nurses, process of utilization and organization.Self-reported utilization of research is one method that has frequently been implemented to elicit the extent of research utilization. Responses to selected research ? ndings have been used to elicit and explore respondents’ awareness and use of respective ? ndings (Kete? an, 1975; Berggren, 1996). Numerous researchers have also undertaken to investigate, through self-reporting, the opinions of nurses’ in regard to barriers to research utilization in the practice setting. Funk et al. (1991b) explored research utilization in the US using a postal questionnaire titled the Barriers to Research Utilization Scale (BARRIERS Scale).Their purpose was to develop a tool to a ssess the perceptions of clinicians, administrators and academics in regard to barriers to research utilization in clinical practice. Rogers’ (1995) model of ‘diffusion of innovations’, a theoretical framework, which describes the process of communication, through certain channels within a social network, of an idea, practice or object over time, was used to develop a 29-item scale. The questionnaire was sent out to a random sample of 5000 members of the American Nurses’ Association with a resulting response rate of 40%. 305O 2004 Blackwell Publishing Ltd, Journal of Clinical Nursing, 13, 304–315 A. M. Hutchinson and L. Johnston On the data generated, Funk et al. (1991b) undertook an exploratory factor analysis, to elicit a four-factor solution which closely corresponded with Rogers’ (1995) ‘diffusion of innovations’ model. The factors translated into characteristics of the adopter comprising the nurse’s research values, s kills and awareness; the organization incorporating setting barriers and limitations; the innovation including qualities of the research; and communication including accessibility and presentation of the research.Items associated with the clinical setting, a characteristic of the organization, were perceived as the main barriers to research utilization. These included the views that nurses lack suf? cient authority to implement change; nurses have insuf? cient time to implement change; and there is a lack of cooperation from medical staff. Approximately 21% of the respondents in this study were classi? ed as administrators. Over three quarters of the items on the BARRIERS Scale were rated as great or moderate barriers by over half the administrators. The administrators identi? d factors relating to the nurse, the organizational setting and the presentation of research among the greatest barriers. Overall, they cited the organizational setting as the greatest barrier to research use. Approximately 46% of the respondents were classi? ed as clinicians (nurses working in the clinical setting). The clinicians overwhelmingly identi? ed factors associated with the organizational setting as being the greatest barriers to research utilization. They rated all eight factors associated with the setting in the top 10 barriers to research utilization.The clinicians rated perceived ‘lack of authority to change patient care procedures’, ‘insuf? cient time on the job to implement new ideas’ and being ‘unaware of the research’ as the top three barriers to research utilization. The BARRIERS Scale (Funk et al. , 1991b) has been used extensively since it was developed in 1991, as one method to explore the perceived in? uences on nurses’ utilization of research ? ndings in their practice. At least 17 studies that employed the BARRIERS Scale to elicit opinions of nurses regarding barriers to research utilization in practice have been rep orted in the nursing literature.Most studies reported the barriers in ranked order according to the percentage of respondents who rated items as moderate or great barriers. Insuf? cient time to read research and/or implement new ideas was rated in the top three barriers in 13 studies (Funk et al. , 1991a, 1995a; Carroll et al. , 1997; Dunn et al. , 1997; Lewis et al. , 1998; Nolan et al. , 1998; Rutledge et al. , 1998; Retsas & Nolan, 1999; Closs et al. , 2000; Parahoo, 2000; Retsas, 2000; Grif? ths et al. , 2001; Marsh et al. , 2001; Parahoo & McCaughan, 2001).A perceived lack of authority to change patient care procedures was reported in the top three barriers in eight studies (Funk et al. , 1991a; Walsh, 1997a; Nolan 306 et al. , 1998; Closs et al. , 2000; Parahoo, 2000; Retsas, 2000; Marsh et al. , 2001; Parahoo & McCaughan, 2001). In eight studies, the item ‘statistical analyses are not understandable’, was cited in the top three barriers (Funk et al. , 1995b; Dunn et al. , 1997; Walsh, 1997a,b; Rutledge et al. , 1998; Parahoo, 2000; Grif? ths et al. , 2001; Marsh et al. , 2001). ‘Inadequate facilities for implementation’ was cited in the top three barriers in ? e studies (Kajermo et al. , 1998; Nolan et al. , 1998; Retsas, 2000; Grif? ths et al. , 2001; Marsh et al. , 2001). Finally, the item ‘lack of awareness of research ? ndings’ was reported in the top three barriers in four studies (Funk et al. , 1991a, 1995a; Carroll et al. , 1997; Lewis et al. , 1998; Retsas & Nolan, 1999). It is acknowledged that these studies comprised varying populations of nurses, employed differing sampling methods, used sample sizes ranging from 58 to 1368 respondents and resultant response rates ranged from 27 to 76%.In some studies, minor rewording of a limited number of items in the tool had been undertaken. Furthermore, some studies included only 28 of 29 barrier items included in the original BARRIERS Scale. Factor analysis, a stat istical technique aimed at reducing the number of variables by grouping those that relate, to form relatively independent subgroups (Crichton, 2001; Tabachnick & Fidell, 2001), was undertaken in a limited number of these studies. In the UK, Dunn et al. (1997) tested the factor model proposed by Funk et al. (1991b), using con? rmatory factor analysis, a complex statistical technique used to test a heory or model (Tabachnick & Fidell, 2001). Attempts to load each item onto a single identi? ed factor were found to be unsuccessful and they concluded that the US model was inappropriate for their data. Closs & Bryar (2001) further explored the appropriateness of the BARRIERS Scale for use in the UK through exploratory factor analysis. The model identi? ed included the following four factors: bene? ts of research for practice, quality of research, accessibility of research, and resources for implementation. Finally, Marsh et al. (2001) tested, using con? matory factor analysis, a revised v ersion of the BARRIERS Scale. The revision comprised minor changes in wording such as substitution of the term ‘administrator’ with the term ‘manager’. A factor structure that was not possible to interpret resulted and they concluded that the model proposed by Funk et al. (1991b) was not supported and had limited subscale validity in the UK setting. In the light of these ? ndings and those of Dunn et al. (1997), Marsh et al. (2001) suggested that the factor model arising from the original BARRIERS Scale was not sustained in the international context.However, in Australia, Retsas & Nolan (1999) undertook an exploratory factor analysis resulting in a three-factor solution comprising: (i) nurses’ perceptions about the usefulness of research in O 2004 Blackwell Publishing Ltd, Journal of Clinical Nursing, 13, 304–315 Clinical nursing issues Barriers to, and facilitators of, research utilization clinical practice, (ii) generating change to practice based on research, and (iii) accessibility of research. Again, in Australia, a four-factor solution arose from another exploratory factor analysis undertaken by Retsas (2000).The resulting factors were conceptualized as: accessibility of research ? ndings, anticipated outcomes of using research, organizational support to use research, and support from others to use research. Given these ? ndings in the Australian context, an exploratory factor analysis was employed in the present study to explore what model would arise from data generated using the BARRIERS Scale. The aim of the present study was to gain an understanding of perceived in? uences on nurses’ utilization of research in a particular practice setting, and explore what differences or commonalities exist between the ? dings of this research and those of studies which have been conducted during the past 10 years in various countries around the world. This study was undertaken as part of a larger study designed to exp lore the phenomenon of research utilization by nurses in the clinical setting. The relative importance of barrier and facilitator items and the factor model arising from this data will in? uence development of future stages of this larger study. who then took responsibility for distribution. It cannot be guaranteed, however, that this process in fact resulted in all nurses receiving the questionnaire.The questionnaire included the 29-item BARRIERS Scale in addition to an eight-item facilitator scale and a series of demographic questions. The respondents were asked to return completed questionnaires in the self-addressed envelope supplied, by either placing them in the internal mail or placing them in the ‘return’ box supplied in their ward or department. Return of completed questionnaires implied consent to participate and all responses were anonymous. Setting The setting for this study was a 310-bed major teaching hospital offering specialist services in Melbourne, Aus tralia. SampleApproximately 960 nurses work in the organization. All Registered Nurses working during the 4-week distribution time frame were invited to complete the questionnaire. This self-selecting, convenience sample therefore, excluded nurses on leave at the time of the study. The study The research question addressed in this study was: What are nurses’ perceptions of the barriers to, and facilitators of, research utilization in the practice setting? Instrument The questionnaire comprised three sections. The ? rst section contained the 29 randomly ordered items from the Barriers to Research Utilization Scale (Funk et al. 1991b), which respondents were asked to rate, on a four-point Likert type scale, the extent to which they believed each item was a barrier to their use of research in practice. The options included 1 ? ‘to no extent’, 2 ? ‘to a little extent’, 4 ? ‘to a moderate extent’ and 5 ? ‘to a large extent’. A â €˜no opinion’ ? 3 option was also given. The respondents were then asked to nominate and rate (1 ? greatest barrier, 2 ? second greatest barrier, and 3 ? third greatest barrier) the items they considered to be the top three barriers.Further to this, the respondents were given the opportunity to list and rate, according to the above-mentioned Likert scale, any additional items they perceived to be barriers. The second section of the survey contained eight items (Table 4), which respondents were asked to rate according to the extent to which they considered them to be a facilitator of research utilization using the Likert scale described above. The respondents were also asked to nominate and rate, from 1 to 3, the items they considered to be the three greatest facilitators of research utilization.Again, the respondents were given the opportunity to list and rate, according to the 307 Method A survey design was chosen to elicit opinions of nurses. This method was selected bec ause the ‘BARRIERS Scale’, a validated questionnaire, based on the work of Funk et al. (1991b), and designed to elicit nurses’ views about barriers to, and facilitators of, research utilization in their practice, was found to have high reliability. Approval to use the tool was gained from the authors. Permission was also given to include questions crafted by the investigators to elicit nurses’ opinions about facilitators of research utilization.Approval to conduct the project was sought and granted by the hospital research ethics committee to ensure the rights and dignity of all respondents were protected. Nurses working during the 4-week survey distribution time frame (n ? 761) were invited to complete the self-administered questionnaire. It was intended that every nurse receive a personally addressed envelope containing the questionnaire and a self-addressed return envelope. To facilitate this, the envelopes were hand delivered to a nominated nurse on ea ch ward or department O 2004 Blackwell Publishing Ltd, Journal of Clinical Nursing, 13, 304–315A. M. Hutchinson and L. Johnston Likert scale, perceived facilitators not listed in the survey. Section 3 of the survey included a series of demographic questions. Validity Content validity, i. e. whether the questions in the tool accurately measure what is supposed to be measured (LoBiondo-Wood & Haber, 1998), of the instrument was supported by the literature on research utilization, the research utilization questionnaire developed by the Conduct and Utilization of Research in Nursing Project (Crane et al. , 1977), and data gathered from nurses. Input was also gained from experts in the ? ld of research utilization, nursing research, nursing practice and a psychometrician to establish face validity, i. e. whether the tool appears to measure the concept intended (LoBiondo-Wood & Haber, 1998), and content validity from an extensive list of potential items. Those items for which face and content validity were established were retained. Further to piloting of the instrument, two additional items were included and some minor rewording of other items resulted. The BARRIERS Scale has been found to have good reliability, with Cronbach’s alpha coef? ients of between 0. 65 and 0. 80 for the four factors, and item-total correlations from 0. 30 to 0. 53 (Funk et al. , 1991b). Cronbach’s alpha is a measure of internal consistency, which is related to the reliability of the instrument. A Cronbach’s alpha of †¡0. 7 is considered to be good. Internal consistency is the extent to which items in the scale measure the same concept (LoBiondo-Wood & Haber, 1998). Item total correlations refer to the relationship between the question or item and the total scale score (LoBiondo-Wood & Haber, 1998). Data analysisData analysis was performed using Statistical Package for the Social Sciences (version 10. 0; SPSS Inc. , Chicago, IL, USA) software. Frequency and descriptive statistics were employed to describe the demographic characteristics of respondents. Analysis of these data indicated that a wide cross section of nursing staff responded to the questionnaire. Factor analytic procedures were employed to reduce the 29 barrier items to factors. The ‘no opinion’ responses (coded to be in the centre of the scale) were included in the factor analytic procedure, on the basis of statistical advice.Suitability of the data for undertaking factor analysis is determined by testing for sampling adequacy and sphericity. The Kaiser–Meyer–Olkin Measure of Sampling Adequacy at 0. 83 was in excess of the recommended value of 0. 6 (Kaiser, 1974), indicating that the 308 correlations or factor loadings, which re? ect the strength of the relationship between barrier items, were high. The Bartlett test of sphericity at 2118. 3 was statistically signi? cant (P < 0. 001). On the basis of these results, factor analysis was considered appropriate.The factor analysis method employed consisted of principal component analysis (PCA), a method of reducing a number of variables (barrier items) to groupings to aid interpretation of the underlying relationships between the variables (Crichton, 2000) whilst capturing as much of the variance in the data as possible. PCA revealed eight components with an eigenvalue exceeding one, indicating that up to eight factors could be retained in the ? nal factor solution. Inspection of the scree plot, a plot of the variance encompassed by the factors, failed to provide a clear indication for the number of factors to include.Eight factors were considered too many to be meaningful, thus factor solutions from two to seven factors were explored. A solution comprising four factors was considered most meaningful. Examination of the factor loadings was then undertaken to determine which items belonged to each factor. Consistent with the procedure employed by Funk et al. (1991b), items were considered to have loaded if they had a factor loading of 0. 4 or more. Varimax rotation, a statistical method employed to simplify and aid interpretation of factors, was then applied.Whilst factor analysis assists in reducing the number of variables to groupings and aids in interpretation of the underlying structure of the data, it does not identify the relative importance of individual items. Thus, while one factor may account for the largest amount of variance in the factor solution it does not mean that the items within that factor are the greatest barriers to research utilization. In order to determine the relative signi? cance of each barrier item, the number of respondents who reported them as a moderate or great barrier was calculated and items were ranked accordingly.Additional barriers recorded by participants were grouped thematically. Similarly, to determine the relative signi? cance of each facilitator item, the number of respondents who reported them as a moderate or great facilitator was calculated and items were ranked accordingly. Additional facilitators recorded by participants were grouped thematically. Results Demographics A total of 317 nurses returned the questionnaires, representing a 45% response rate, assuming that all nurses did, in fact, receive a personally addressed envelope. The age range of respondents was 43 years (minimum ? 1 years, O 2004 Blackwell Publishing Ltd, Journal of Clinical Nursing, 13, 304–315 Clinical nursing issues Barriers to, and facilitators of, research utilization maximum ? 64 years) while the range in years since registration was 42 years. The demographic characteristics of the nurses (Table 1) were consistent with those of the State of Victoria’s nursing workforce (The Australian Institute of Health and Welfare, 1999). Factor analysis A four-factor solution was selected as the most appropriate model arising from PCA of the 29 barrier items. This accounted for 39. % of the total variance in re sponses to all barrier items. The factor groupings including the loading for each barrier item and the titles allocated to each factor are included in Table 2. According to the correlation coef? cient or factor loading measure of †¡0. 4, two items, ‘research reports/articles are not published fast enough’, and ‘the research has not been replicated’, failed to load on any of the four factors. Table 1 Nurse demographics (n ? 317) Variable Gender Male Female Missing Age (years) Experience Registered Nurse (years) Clinical experience (years) Years since most recent quali? ation Highest quali? cation Division 2 certi? cate for registration Division 1 hospital certi? cate for registration Tertiary diploma/degree for registration Specialist nursing certi? cate Graduate diploma Masters by coursework Masters by research Others (including education and management quali? cations) Missing Principle job function Clinical Administrative Research Education Others Mis sing Research experience Yes No Missing N (%) Mean (SD) 24 (7. 6) 291 (91. 8) 2 (0. 6) 33. 8 (9. 73) 12. 6 (9. 95) 11. 35 (8. 8) 4. 28 (6. 52) 14 (4. 4) 23 (7. 3) 104 (32. 8) 26 34 9 1 87 (8. 2) (10. 7) (2. 8) (0. 3) (27. ) Factor 1, comprising eight items with loadings of 0. 73 to 0. 43, includes items relating to characteristics of the organization that in? uence research-based change. Eight items loaded onto factor 2 with loadings of 0. 66 to 0. 40. These items are associated with qualities of research and potential outcomes associated with the implementation of research ? ndings. Factor 3 with seven items loading 0. 60 to 0. 41, relates to the nurse’s research skills, beliefs and role limitations. Factor four refers to communication and accessibility of research ? ndings onto which ? ve items loaded 0. 67 to 0. 42.The four factor groupings comprising setting, nurse, research and presentation, generated in the US study 10 years ago (Funk et al. , 1991b), were similar to gr oupings that arose from factor analysis in the present study (Table 2). Cronbach’s alphas were calculated for each factor generated. For factors 1–3 the alpha coef? cients were 0. 75, 0. 74 and 0. 70, respectively, demonstrating good reliability. The alpha coef? cient for factor 4 was lower at 0. 54. The total scale alpha was 0. 86, which indicates that the scale can be considered reliable with this sample. Item-total correlations ranged from 0. 1 to 0. 60. Although a low correlation between some items and the total score was evident, deleting any of these items would have resulted in a reduction in reliability of the scale. Relative importance of barrier and facilitator items The percentages of items perceived by nurses’ as great or moderate barriers are summarized in Table 3. The respondents were also given the opportunity to list and rate any additional perceived barriers not included in the questionnaire. About 27% (85) of respondents documented a total of 1 74 barriers. However, analysis revealed that only 11% (36) of respondents actually identi? d additional barriers. The remainder had reiterated or reworded barrier items already included in the tool. The additional barrier items listed by respondents were grouped into themes, which included funding, organizational commitment, research training, implementation strategy and professional responsibility. The percentages of items perceived by nurses’ as great or moderate facilitators are summarized in Table 4. The respondents were also given the opportunity to list and rate additional perceived facilitators. Eighteen per cent (57) of respondents took the opportunity to record a total of 90 facilitators. Of these, 7. % (24) actually identi? ed additional facilitators whereas the remainder had rephrased or repeated items already included in the tool. Consistent with the themes identi? ed for the additional barriers were funding, organizational commitment, active participation in rese arch 309 19 (6. 0) 252 28 6 10 15 6 (79. 5) (8. 8) (1. 9) (3. 2) (4. 7) (1. 9) 207 (65. 3) 105 (33. 1) 5 (1. 6) O 2004 Blackwell Publishing Ltd, Journal of Clinical Nursing, 13, 304–315 A. M. Hutchinson and L. Johnston Table 2 BARRIERS Scale factors and factor loadings US factor groupings Factor loadings Communalities Factor 1 Factor 2 Factor 3 Factor 4Barrier item Factor 1: Organizational in? uences on research-based change Physician will not cooperate with implementation Administration will not allow implementation The nurse does not feels she/he has enough authority to change patient care procedures The facilities are inadequate for implementation Other staff are not supportive of implementation The nurse feels results are not generalizable to own setting The nurse is unwilling to change/try new ideas Factor 2: Qualities of the research and potential outcomes of implementation The research has methodological inadequacies The literature reports con? cting results The conclu sions drawn from the research are not justi? ed The research is not relevant to the nurse’s practice The nurse is uncertain whether to believe the results of the research The research is not reported clearly and readably Statistical analyses are not understandable The nurse feels the bene? ts of changing practice will be minimal Factor 3: Nurses’ research skills, beliefs and role limitations The nurse sees little bene? for self The nurse does not feel capable of evaluating the quality of the research There is not a documented need to change practice The nurse does not see the value of research for practice The amount of research information is overwhelming The nurse is isolated from knowledgeable colleagues with whom to discuss the research There is insuf? cient time on the job to implement new ideas Factor 4: Communication and accessibility of research ? dings Research reports/articles are not readily available Implications for practice are not made clear The nurse is unaware of the research The relevant literature is not compiled in one place The nurse does not have time to read research Setting Setting Setting Setting Setting Setting Nurse 0. 55 0. 52 0. 42 0. 42 0. 34 0. 39 0. 36 0. 73 0. 71 0. 56 0. 54 0. 53 0. 49 0. 43 0. 09 0. 10 0. 06 0. 11 0. 17 0. 30 0. 01 A0. 02 A0. 01 0. 31 A0. 04 0. 19 0. 23 0. 41 0. 09 A0. 04 0. 05 0. 33 0. 02 0. 01 A0. 09 Research Research Research Presentation Research Presentation PresentationNurse 0. 46 0. 38 0. 44 0. 43 0. 46 0. 33 0. 33 0. 46 0. 17 0. 11 0. 11 0. 22 0. 27 0. 11 A0. 04 0. 36 0. 66 0. 59 0. 57 0. 55 0. 53 0. 49 0. 47 0. 40 0. 03 0. 12 0. 30 A0. 13 0. 32 0. 18 0. 03 0. 38 0. 00 0. 04 A0. 05 0. 25 0. 07 0. 19 0. 32 A0. 14 Nurse Nurse Nurse Nurse * Nurse Setting Presentation Presentation Nurse Presentation Setting 0. 57 0. 45 0. 35 0. 55 0. 29 0. 31 0. 38 0. 45 0. 47 0. 33 0. 25 0. 31 0. 23 A0. 04 A0. 04 0. 15 0. 05 0. 31 0. 28 0. 01 0. 06 A0. 04 0. 13 0. 22 0. 39 0. 26 0. 14 0. 47 A0. 01 0. 11 A0. 17 0. 00 0. 31 0. 09 0. 3 A0. 14 0. 60 0. 58 0. 57 0. 55 0. 51 0. 42 0. 41 0. 00 A0. 09 0. 16 0. 13 0. 26 0. 04 0. 21 0. 09 A0. 04 0. 15 0. 16 0. 31 0. 67 0. 60 0. 54 0. 45 0. 42 Two items, ‘research reports/articles are not published fast enough’ and ‘the research has not been replicated’, did not load at the 0. 4 level in this analysis. *The item, ‘the amount of research information is overwhelming’ failed to load on any factor in the Funk et al. model. process – experience, strategy to ensure project completion, implementation strategies, and professional attitude.Discussion The present study generated a four-factor solution with similarities to that produced in the US by Funk et al. (1991b) and in the UK by Closs & Bryar (2001). The ? rst factor comprises characteristics of the organization and re? ects health professional and other resource support for change 310 associated with the implementation of research ? ndings. More broadly , the theme ‘organizational commitment’ identi? ed following analysis of the additional perceived barriers listed by respondents, appears to be associated with this factor.Organizational commitment, many respondents felt, would facilitate mobilization of resources to promote change. Factor 2 relates to qualities of research and potential outcomes associated with the implementation of research ? ndings. This factor re? ects the nurse’s reservations about reliability and validity of research ? ndings and conclusions, O 2004 Blackwell Publishing Ltd, Journal of Clinical Nursing, 13, 304–315 Clinical nursing issues Table 3 BARRIERS Scale items in rank order Barriers to, and facilitators of, research utilization Barrier items The nurse does not have time to read research There is insuf? ient time on the job to implement new ideas The nurse is unaware of the research The nurse does not feel she/he has enough authority to change patient care procedures Statistica l analyses are not understandable The relevant literature is not compiled in one place Physicians will not cooperate with the implementation The nurse does not feel capable of evaluating the quality of the research The facilities are inadequate for implementation Other staff are not supportive of implementation Research reports/articles are not readily available The nurse feels results are not generalizable to own setting The amount of research information is overwhelming Implications for practice are not made clear The research is not reported clearly and readably The research has not been replicated The nurse is isolated from knowledgeable colleagues with whom to discuss the research Administration will not allow implementation The research is not relevant to the nurse’s practice The literature reports con? icting results The nurse feels the bene? s of changing practice will be minimal The nurse is uncertain whether to believe the results of the research Research reports/ar ticles are not published fast enough The nurse is unwilling to change/try new ideas The research has methodological inadequacies The nurse sees little bene? t for self There is not a documented need to change practice The nurse does not see the value of research for practice The conclusions drawn from the research are not justi? ed Reporting item as moderate or great barrier (%) 78. 3 73. 8 66. 2 64. 7 64. 1 58. 7 56. 1 55. 8 52 52 50. 8 50. 8 45. 7 45. 5 43. 3 41. 3 41 35 34. 4 34 31. 9 30. 9 30. 6 29. 4 25. 5 23. 3 22. 1 17 13. 8 Item mean score (SD) 4. 06 3. 9 3. 64 3. 51 3. 56 3. 51 3. 41 3. 3 3. 23 3. 16 3. 19 3. 09 3. 07 3. 0 3. 01 3. 16 2. 76 2. 88 2. 67 2. 87 2. 52 2. 58 2. 81 2. 34 2. 85 2. 25 2. 27 1. 9 2. (1. 21) (1. 3) (1. 4) (1. 39) (1. 32) (1. 26) (1. 33) (1. 39) (1. 3) (1. 29) (1. 35) (1. 26) (1. 35) (1. 22) (1. 25) (1. 14) (1. 49) (1. 18) (1. 28) (1. 11) (1. 3) (1. 29) (1. 21) (1. 34) (1. 0) (1. 26) (1. 24) (1. 21) (1. 02) Responding ‘no opinion’ or non- response (%) 0. 9 1. 6 1. 6 0. 9 3. 8 13 7. 6 3. 5 8. 8 6. 3 6. 3 3. 5 6. 9 5 8. 2 26. 1 3. 8 19. 6 4. 4 18. 9 3. 5 4. 7 25. 2 2. 2 32. 5 3. 5 8. 5 1. 6 21 Table 4 Facilitator items in rank order Reporting item as moderate or great facilitator (%) 89. 6 89. 5 84. 8 82. 3 82. 0 81. 4 81. 3 78. 2 Number (%) responding ‘no opinion’ or non-response 8 (2. 5) 6 9 6 10 (1. 8) (2. 8) (1. 8) (3. 2)Facilitator item Increasing the time available for reviewing and implementing research ? ndings Conducting more clinically focused and relevant research Providing colleague support network/mechanisms Advanced education to increase your research knowledge base Enhancing managerial support and encouragement of research implementation Improving availability and accessibility of research reports Improving the understandability of research reports Employing nurses with research skills to serve as role models Item mean score (SD) 4. 52 (0. 93) 4. 39 4. 21 4. 11 4. 15 (0. 94) (1. 02) (1. 13) (1. 08) 4. 12 (1. 11) 4. 16 (1. 1) 4. 04 (1. 22) 5 (1. 5) 8 (2. 5) 9 (2. 9)O 2004 Blackwell Publishing Ltd, Journal of Clinical Nursing, 13, 304–315 311 A. M. Hutchinson and L. Johnston in addition to bene? ts of use of ? ndings in practice. Factor 3 focuses on characteristics of the nurse. In particular, this factor is associated with the nurse’s beliefs about the value of research and their research skills, in addition to the limitations of their role. The fourth factor is concerned with characteristics of communication. The focus of this factor centres on access to research ? ndings and understanding of the implications of ? ndings. The issues encompassed within this factor re? ect organizational barriers to access, and research presentation barriers.These factors are congruent with the concepts characterized in Rogers’ (1995) model of ‘diffusion of innovations’, including characteristics of the adopter, organization, innovation and communication , on which the BARRIERS Scale was developed. Two barrier items, ‘research reports/articles are not published fast enough’ and ‘the research has not been replicated’, failed to load suf? ciently onto a factor and were subsequently discarded. Exclusion of these items from the model re? ects their minimal signi? cance in relation to the underlying dimensions of the factors. That these items were ranked 23 and 16, respectively, is not surprising because they become less relevant when there is a perceived lack of time to read research and implement change as re? cted in the top two nominated barriers to research utilization. It is also important to note that over one quarter of respondents selected the ‘no opinion’ option or failed to respond to both of these items, which further suggests their lack of importance to respondents. The majority of respondents in this study rated approximately 40% of the barriers items as moderate or great barriers. Thi s is compared with the majority of nurse clinicians in the US (Funk et al. , 1991a) and nurses in the UK (Dunn et al. , 1997), who rated about 65% of the barrier items as moderate or great barriers. Overall, this group of Australian nurses perceived there to be fewer barriers to esearch utilization than their colleagues in the UK or US, with a mean score of 43. 7% of respondents rating all the barriers as moderate or great. In the UK (Walsh, 1997a) and the US (Funk et al. , 1991a) mean scores of 59. 8 and 55. 7%, respectively, re? ect the proportion of respondents who rated all barriers as moderate or great. Possible in? uences such as time, population, nursing education programmes should be acknowledged when considering these comparisons. Content analysis of the data comprising additional perceived barriers elicited ? ve new themes respondents associated with barriers to research utilization. Revision of the instrument to re? ect the themes identi? d and changes that have occurred over the past 10 years may be warranted to achieve a more valid scale for the setting in which it was used in this study. The addition of items consistent with changes in the availability of technological resources, information availability and use, and education may enhance the content validity of the scale. The ranking of perceived barriers in practice resulting from this study showed considerable consistency with rankings reported in other studies, as previously discussed. The top three barriers reported in 12 other studies fell within the top 10 barriers identi? ed in this study. Furthermore, two of the top three barriers in an additional two studies fell within the top 10 barriers identi? ed in the present study. The barrier item ‘there is insuf? ient time on the job to implement new ideas’ was reported within the top three barriers in 13 studies, including this and another Australian study (Retsas, 2000). When Spearman’s rank order correlation coef? cients were generated to compare the rank ordering of perceived barriers, a strong positive correlation between this and several other studies was evident (Table 5). Whilst acknowledging differences in nursing populations, sample size, sampling methods, response rates, and minor variations in item wording and number, this suggests a large degree of consistency regarding Study Funk et al. (1991a) Funk et al. (1995a) Dunn et al. (1997) Rutledge et al. (1998) Lewis et al. (1998) Kajermo et al. (1998) Retsas & Nolan (1999) Parahoo (2000) Retsas (2000) Closs et al. 2000) Parahoo & McCaughan (2001) Grif? ths et al. (2001) Location USA USA UK USA USA Sweden Australia Northern Ireland Australia UK Northern Ireland UK r 0. 866 0. 779 0. 835 0. 816 0. 879 0. 719 0. 884 0. 837 0. 801 0. 762 0. 799 0. 912 P 0. 000 0. 000 0. 000 0. 000 0. 000 0. 000 0. 000 0. 000 0. 000 0. 000 0. 000 0. 000 Coef? cient of determination (%) 75 61 70 66 77 52 78 70 64 58 64 83 Table 5 Barrier rank order correlations 312 O 2004 Blackwell Publishing Ltd, Journal of Clinical Nursing, 13, 304–315 Clinical nursing issues Barriers to, and facilitators of, research utilization nurses’ perceptions of the relative importance of the barrier items. Marsh et al. 2001) however, caution against international comparisons with the original US data because changes in nursing education and roles, technology, funding and collaboration with other disciplines since then, may invalidate such comparisons. Nonetheless, despite these changes, the ? ndings of the present study have consistencies with not only the US data of 1991 but also more recent studies in the US, UK, Sweden, Northern Ireland and Australia (Table 5). Thus, notwithstanding the increasing momentum of the evidence-based practice movement in recent years, the pursuit of professional status by the nursing profession, the move of nursing education to the tertiary sector, increased access to systematic reviews and research databases, the research – practice gap persists.In the light of the plethora of research and theoretical literature on the research–practice gap and issues surrounding research utilization, it is of concern that nurses’ perceptions of the barriers to research utilization appear to remain consistent. In particular, issues surrounding support for implementation of research ? ndings, authority to change practice, time constraints and ability critically to appraise research continue to be perceived by nurses as the greatest barriers to research utilization. This raises important questions. Firstly, do such perceptions re? ect the reality of contemporary nursing? Or rather, do they represent unchallenged, traditionally held and ? rmly entrenched beliefs, which are founded on an understanding of nursing in a socio-historic context that is no longer relevant? If such perceptions do, in fact, re? ct the reality of current day nursing practice, despite the changes and progress that have been ma de in health care and nursing over the last decade, it behoves us, as a profession, to address the issues related to time, authority, support and skills in critical appraisal with conviction and a sense of urgency. Contextual issues including the socio-political environment, organizational culture and interprofessional relations need to be taken into serious consideration when exploring and formulating potential strategies to overcome these barriers. The hospital in which this study was conducted has since undertaken to explore and develop strategies to address and overcome barriers to, and reinforce and strengthen facilitators of research utilization highlighted in the ? ndings. ther studies using the BARRIERS Scale, may re? ect a response bias. That is, nurses with a positive attitude to research may have been more likely to complete the questionnaire. Internal consistency, the extent to which items in the scale measure the same concept (LoBiondo-Wood & Haber, 1998), of the tool w as reasonable, although not as high as that reported by Funk et al. (1991b). For seven items, more than 10% of the respondents nominated ‘no opinion’ or failed to respond. Furthermore, this study was conducted in one organization; the ? ndings are therefore context speci? c, which makes it dif? cult to generalize to other settings. However, there is consistency over ime and between countries in regard to nurses’ perceptions of the barriers to research utilization. Conclusion In order to gain an understanding of perceived in? uences on nurses’ utilization of research in a particular practice setting, nurses were surveyed to elicit their opinions regarding barriers to, and facilitators of, research utilization. Many of the perceived barriers to research utilization reported by this group of Australian nurses are consistent with reported perceptions of nurses in the US, UK and Northern Ireland during the past decade. Time was the most important barrier percei ved by nurses in this study, which is re? ected by responses to the items, ‘the nurse does not have time to read research’ and ‘there is insuf? ient time on the job to implement new ideas’, resulting in them being ranked as the top two barriers to research utilization. Consistent with this ? nding was the ranking of facilitator item ‘increasing the time available for reviewing and implementing research ? ndings’ as the most important facilitator to research utilization. The employment of qualitative research methods, such as observation and interview, will contribute further to our knowledge about barriers to, and facilitators of, research utilization by nurses by allowing deeper exploration of experiences, perception and issues faced by nurses in the utilization of research in their practice.Fundamental questions about whether nurses’ perceptions actually re? ect the reality of the current context of nursing need to be further investiga ted. Future research should also examine issues surrounding the use of time by nurses. Questions exploring how much additional time nurses require in order to read the relevant literature and how nurses can be given more time to implement new ideas, need to be addressed. Issues related to nurses’ perception of their authority to change patient care procedures, the support and cooperation afforded by doctors and others, the facilities and availability of resources, and their skills in critical appraisal, also require further 313 LimitationsReporting bias associated with the self-report method raises questions about the extent to which the responses accurately represent nurses’ perceptions of the barriers to research utilization. The low response rate achieved in this study, although consistent with response rates reported in several O 2004 Blackwell Publishing Ltd, Journal of Clinical Nursing, 13, 304–315 A. M. Hutchinson and L. Johnston exploration. Investigatio n of the information-seeking behaviour of nurses, the means by which they gain and synthesize new research knowledge and the way in which they apply that knowledge to their decision making, will further contribute to our understanding of the research–practice gap phenomenon.Measurement of the actual extent of research utilization by nurses in the practice setting presents a major challenge for researchers in this ? eld. Acknowledgements The authors thank Sandra Funk for her permission to use the BARRIERS Scale for the purpose of this study. We wish to acknowledge and thank the nurses who completed the questionnaire. The authors also wish to acknowledge the statistical assistance provided by Ms Anne Solterbeck, Statistical Consulting Centre, Department of Mathematics and Statistics, The University of Melbourne. Contributions Study design: LJ, AMH; data analysis: AMH; manuscript preparation: AMH, LJ; literature review: AMH. 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Review of Ella Delorias Waterlily Feminist Perspective Essay

Review of Ella Delorias Waterlily Feminist Perspective - Essay Example Ella Cara Deloria is best known for her linguistic and ethnographic work on the Sioux Nation. Though not formally trained as anthropologist, since she was a trained as a teacher, she gained a reputation in the field. She brought a new perspective on her work, as she was born on the Yankton Sioux Reservation and part of a traditional Dakota Sioux family. Deloria was born in the White Swan district of the Yankton Indian Reservation, South Dakota. Her parents were Mary Sully Bordeau Deloria and Philip Deloria, the family having Yankton Sioux, Irish, and French roots. Her father was one of the first Sioux to be ordained as an Episcopalian priest. Although Ella was the first child to the couple, they each had two daughters by previous marriages; her parent had three more children after her. Deloria was brought up on the Standing Rock Indian Reservation, at Wakpala, and was educated first at her father's mission school and All Saints Boarding School in Sioux Falls, and then a brief period at the University of Chicago at Oberlin College, Ohio, to which she had won a scholarship. After two years at Oberlinshe she moved to Teachers College, Columbia University, New York, and graduated with a B.Sc. in 1915. Throughout her professional life she suffered from not having had the money or the free time necessary to take an advanced degree, largely because of her commitment to the support of her family; her parents were elderly, and her sister suffered from brain tumors. In addition to her work in anthropology, Deloria had a number of jobs, including teaching dance and physical education, lecturing and giving demonstrations on Native American culture, working for the Camp Fire Girls and for the YWCA, and holding positions at the Sioux Indian Museum in Rapid City, South Dakota, and (as assistant director) the W.H. Deloria had a stroke in 1970 and died the following year of pneumonia. Her family spoke Dakota and Lakota dialects of the Sioux Language. It was through the understanding of the Dakota and Lakota dialects that Deloria would find her place in history. The Deloria family was devote Christians, but also followed the traditional ways of the Dakota people. Ella Deloria was dedicated to her family, which through extended kinship was great in numbers and this was one of the factors that hindered her professional education. Waterlilly was perhaps the highest of Deloria's achievement; it can be described as a book that guides the outsider into the mental as well as the historical world of the nineteenth century Sioux. Deloria was more focused on kinship, tribal structure, and the role of women in her traditional society and this greatly shaped her work. From a feminist perspective, Deloria's work appears to demonstrate the strength of the women in a traditional structure that is greatly misunderstood. In her efforts to research traditional culture and structure, Deloria conducted vast number of interviews with elders, women and tribal historians. She spent 1962-1966 working at the University of South Dakota, where she did her research, lectured, consulted and continued writing that she became an authority on the Dakota and Lakota Sioux. These, to a large extent, defined the content and perspective of her novel - Waterlilly. Through her extensive research work,

Internship experience Term Paper Example | Topics and Well Written Essays - 750 words

Internship experience - Term Paper Example This report develops a sense of women entrepreneurs on the basis of both current and academic literature reviews. In both cases, limited information and the unavailability of statistical data were the core problem to carry out the project. Gathering information from women is as difficult as MENA (Middle East and North Africa) due to cultural constraints. Many of the businesswomen do not operate their business publicly and cannot register their business officially. Design: Due to the lack of statistical data and difficulties in Arabian society qualitative research based methodology is considered here. The research comprised of 30 in-depth interviews with Saudi women entrepreneurs who were identified through referrals from my supervisor Marwah Asilan (Director of Chamber of Commerce and industry). Moreover the hypothesis of this project is also formed on the basis of some books like Global Empowerment of Women by Carolyn (2013) and Saudi Women by Fatany (2007). Purpose: The empowerment of women in different sectors is my area of interest and the subject of research. However due to lack of information in entrepreneurs’ business practice several questions regarding the survival and growth strategies, their perception of entrepreneurial carriers have yet not answered. To address this gap this study is done by me. The main purpose of this study is to examine their motivating factors, perception and business challenges. Findings: There is a Saudi chamber of Commerce and Industry in each major business center in Saudi Arabia. In Madinah this institution specially focuses on the formation of female oriented jobs. It provides helpful networking opportunities for women to the job market. Being a member of this organization I have also tried to find out some possible job opportunities for them. Here I have considered married women with their children and they operated service business. The business included spas and beauty salons, a computer graphic and repair shop, market consultants, public relations. All women had college education. In these findings some strategies are suggested that will motivate the women to be entrepreneur in Saudi Arabia. This research is evaluated on the basis of some questions. These questions were set up on the basis of their financial achievement and satisfaction from their working experience. The study has also emphasized on the problems faced by them being inhabitants of this country. Implication: The main constraint of this study is the limited source of data. A more extensive research is needed and the research area should have a number of dimensions including the selection of industries and countries. My role as an intern was to help the organization lay the foundation for women empowerment. Some advantages of the women entrepreneurship are as follows. Women become interested to pursue higher education. The females of new generation are more concerned about their valued in the society. The government has taken an initiative step to encourage the entrepreneurial women and has opened separate financial institutions for women. Unlike some countries they can easily get informal credit that helps them to explore their business. There are also some disadvantages. The women need male permission whenever they are going to take participation in the job market. Though the government has already taken some steps but it is not

Paper on engineering failure with guidelines Essay

Paper on engineering failure with guidelines - Essay Example One of the most epic sea engineering failures was seen in the 1912 during the Titanic accident that saw many lives and property perish in helpless circumstances. In 1912, the world ever largest ship sunk deep into the ocean leading to over 1500 deaths due to poor safety designs by the engineers during its construction (Lisbon 36). The impact with the iceberg in the middle of the ocean. The expert expressed their concern that the engineer’s key failure was allowing aesthetic value to take the center of the construction while disregarding safety designs. Research has found that the engineers were the primary cause of the inability to have adequate security infrastructure. In fact, the initial design had included two rows of lifeboats under the deck; however, the designers removed one row in order to create ample space for passengers views. The nature of the error was largely technological and reverse priority. During the accident, the iceberg buckled the popped plates leading to gushing of water into the transverse bulkheads that were reduced to allow for spacious first-class rooms (Lisbon 67). Probably the ship would have withstood the iceberg had the original design been executed. The fundamental principle of the security had been catered for in the original design. Following a disaster, there were changes in policy to increase the heights of the double hulls transverse bulkheads that will reach the sides of ships in the future. The engineers most important lesson was the importance of enhancing security measures in ship designs as number one priority (Lisbon 125). Macdonald & Jones (2006) article on Sustainable Drainage System (SUDs) presents a case study at Glasgow introduces an engineering design of drainage systems in cities and urban centers. The authors use Glasgow as one of the cities in the world with a classical SUDs

Walmart Case Study Example | Topics and Well Written Essays - 500 words

Walmart - Case Study Example Wal-Mart has not been as successful in the e-commerce marketplace as other online vendors such as EBay and Amazon. A third weakness of Wal-Mart is its high operating costs including having the largest private workforce in the world. During the last two fiscal years the company’s operating expenses increased by 2.7% and 1.7% respectively (Walmartstores, 2011). The company is also susceptible to a variety of risks including foreign currency, lawsuits, and impairment of assets. I think that the neighborhood store format is at conflict with the company’s grand strategy of offering its customers the lowest prices in the retail market. The firm has always place high emphasis on running an efficient operation without any unnecessary added costs. The concept of the neighborhood store format goes against Wal-Mart’s strategy of standardizing its stores in the United States. The firm is able to lower its infrastructure costs by using a similar format in all its stores. Economies of scales are achieved at Wal-Mart by purchasing goods in bulk. Economies of scale are a key advantage for a business because it lowers a firm’s cost per unit (Tutor2u, 2012). Wal-Mart has been able to differentiate its product offering by providing its customers with a higher variety of items at lower prices. The neighborhood store format threatens Wal-Mart’s corporate culture and its long term success in the retail industry. The retail industry generated reven ues in the United States of $4,691 billion in 2011 (Plunkettresearchonline, 2012). Wal-Mart should expect a variety of challenges in its international expansion efforts. The first challenge the company faces is being able to carry over its US brand value into the international markets. Wal-Mart has gained its brand value through the accumulative efforts of its founder, managers and employees for over 50 years. Once the company started to operate outside the United States the company had to start from scratch by

Business Plan Assignment Example | Topics and Well Written Essays - 1250 words

Business Plan - Assignment Example The existing capacity of Protrich is not able to meet the demand for the products in its various markets. If the company is not able to expand the capacity for the existing demand and for the anticipated future demands, it will lose the market to other major competitors. Also, the Protrich need to expand as an international brand rather than confining itself to the south Indian and Middle East market. The potential markets for Protrich are China, Europe and USA. In order to compete in China, Europe and USA markets, Protrich will not only have to focus on the quality aspect but also on the cost aspect. For having an edge over the price, Protrich should adopt cost effective manufacturing. This is possible in India only up to a certain limit. Therefore, to have an even lower cost of production, it is better for Protrich to setup manufacturing unit in China. China, along with Netherlands accounts for more than 50% of the exports of white button mushrooms. China’s mushroom producti on has been in question for several times including certain countries imposing even anti-dumping measures on them. But this is mainly based on the fact that there wasn’t much notable technology being used for production process in the country. (Mushroombusiness, 2011) But Protrich being a company with all technological support for production, quality of production will never be in question. This report will analyze the benefits for Protrich to invest in China. Analysis Home Country The home country of the company is India. India as a mushroom market is not well flourished. There are very few established brands in the country. Even for the established brands, the market coverage will be limited. Retail customers are mainly from the upper middle class and above. Even for them, mushroom is not a frequent item on the dining table. But there is huge demand from hotels and restaurant chains. This is the customer group from which Mushroom companies have a steady demand. Dominos Pizz a and US Pizza has been the customers of Protrich for six years and four years respectively. Apart from these established brands, there are also many other mediocre restaurant chains who are frequent customers of Protrich. Protrich’s major market is the southern states of India such as Kerala (the company’s home state), Karnataka, Tamil Nadu and Andhra Pradesh. Protrich’s products are available only in the major cities of these states. It is not distributed widely to include the smaller towns because there is very less demand in the smaller towns and cities. Even in the cities, the products will be available only in supermarkets. Protrich enjoys third position in terms of market share. The market leaders are Best Mushroom Limited and Mushroom India Limited. Protrich is almost at par with the market leaders in terms of the brand value. In the UAE market all the three brands are very popular. The advantage of current expansion move of Protrich is that it will be a ble to gain market share over the other two. Neither Best Mushroom nor Mushroom India has a market presence in Europe and USA. At this point, if Protrich is able to provide the market with quality products, it will be advantageous for the company in terms of brand value and market share. Host Country The potential host markets of Protrich are China, Europe and USA. Among these, foreign direct investment will be made by Protrich in China where it intends to setup the manufacturing units. The analysis will be based on the

Internet Marketing Case Study Example | Topics and Well Written Essays - 3000 words

Internet Marketing - Case Study Example With the series of eCommerce, which is the buying and selling of products and services via the internet, e-business has broken off into quite a few components, two of which are Business-to-Consumer (B2C) in addition to Business-to-Business (B2B). Furthermore, Business-to-Consumer or B2C commerce refers to the buying and selling of products and services online from the seller to the purchaser. It engages the "consumers shopping for and buying individual and household products. It also needs businesses to use online marketing and products techniques to draw and retain customers as well as to endorse products and services to them (eCommerce Program, 2005)." An instance of a victorious Business-to-Consumer website would be Target.com. Just like the usual brick and mortar store, customers can log onto the site and shop for personal and family items. There are no mediators to go during, the shopper just adds items to his or her shopping cart and when ended, checks out with a credit card or online check. In a Business-to-Consumer environment, mainly functions of the company are handling or are obtainable to the consumer via the internet from sales to purchaser support. One of the advantages to online B2C method is the unlimited ava ilability of the site; as long as you can log in, you are free to browse and purchase. Background of Organization Established in 1982, Futureshop had turn into today Canada's main electronics retailer. Throughout these 20 years, Future Shop has full-grown from a "one store operation" situated in Burnaby, British Columbia, to Canada's main, fastest-growing nationwide retailer of customer electronic products for the digital age with more than 100 stores from coast to shore and still rising. (Their annual sales in year 2001 had surpassed 2 $ billion) Future Shop stores are now a separation of Burnaby-based Best Buy Canada Ltd., which is a wholly-owned supplementary of Best Buy Co. In order to achieve our objective the consulting team first looked at the company background and analyzed Futureshop's current value chain activities and the revenue model being used. An examination of the various methods they use in order to market and promote their website was conducted. This was achieved by looking into aspects of market segmentation, web presence, and specific advertising used at Futureshop's webpage. Our team also studied the legal, ethical and cultural issues pertaining to Futureshop. Now for each of these sections of analysis we performed a SWOT analysis in order to characterize our most important findings. By using our SWOT analysis we were able to propose recommendations which are suggested to improve the business. Service/Product Offering This project investigates the web based business of a well known Canadian based retailer, Futureshop.com. The main objective of the Futureshop e-commerce website is to be at an international level of business and to enhance its marketing capabilities. Our team analyzed the website of Futureshop. This company's presence on the web was established in 1995 and represents a reflection of all goods and services delivered by Futureshop to its customers. Futureshop. By the end of the project we have given our conclusions

Market entry strategy of retailer in China - The case of Walmart Dissertation

Market entry strategy of retailer in China - The case of Walmart - Dissertation Example This area of research was of immense interest because global chain had achieved success and failures in different markets. To evaluate the entry mode choice Wal-Mart was selected for this study, being the largest global retailer. China was selected as the location because of the phenomenal economic growth in recent decades and the high consumer base, both of which have been attracting foreign retailers. Thus, three objectives were set at the beginning of the study. All the three objectives have been achieved based on a study with qualitative data and qualitative analysis. The study finds that both push and pull factors motivated Wal-Mart to entre China. Its home market was saturated and Wal-Mart was driven by the sheer size of China’s consumer base. Since the outcome of any foreign venture depends upon the initial entry mode, Wal-Mart’s entry mode has been evaluated. The study finds that during the time that Wal-Mart entered China it had no alternative but to enter into joint venture but it appears that Wal-Mart did not assess several factors before entering the market. For instance, it did not conduct a proper research on the partner characteristics and the expected synergies; it did not take into account the local business environment, the consumer characteristics and the government regulations. ... While the timing of the entry was perfect (weak retail sector and high potential in China), Wal-Mart tried to impose its home market strategies which did not work in the Chinese business environment. Wal-Mart attempted standardizing operations across countries but this is not feasible in a retail environment. The entry choice of Wal-Mart into China does not conform to the theories governing entry mode choice. This suggests that no single entry mode can be generalized to be the right entry mode. Literature on the subject amply suggests that different factors influence the entry mode choice. This study confirms that different factors have to be taken into account when evaluating the entry mode, without which the expected synergies may not be achieved. The outcome of this study is expected to benefit the retailers that plan expansion into emerging economies. Based on the limitations, the study recommends other areas of research on the subject. Contents Chapter I Introduction 1 1.1 Backg round – Globalization and Retail Sector 1 1.2 China’s Retail Sector 2 1.3 International Retailers’ Presence in China 3 1.4 Wal-Mart in China 4 1.5 International Market Entry Strategy 5 1.6 Rationale for Research 5 1.7 Research Aims and Objectives 7 1.8 Structure of the Study 8 Chapter II Literature Review 10 2.1 Chapter Overview 10 2.2 Motives for Internationalization 10 2.3 Policy Framework in China 12 2.4 Internationalization Theories 13 2.4.1 International Market Selection 13 2.4.2 Market Challenges faced by International Retailers 14 2.4.3 Foreign Market Entry Modes 16 2.4.4 Theories Governing Market Entry Mode Decision 19 2.4.5 The Uppsala Stage Theory of Internationalization 21

Democracy in America Essay Example | Topics and Well Written Essays - 1750 words

Democracy in America - Essay Example If the headlines and pundits are to be believed, the American government is a wreck. The reality of the situation is the American government is alive, well and working much the way it was designed by the gentlemen that crafted it over two hundred years ago. The system of checks and balances keeps any one branch of the government from bullying the other, personal liberties are vigorously defended each day and an amazing amount of services, from safe food to national defense, are provided ceaselessly to the American people. Considering the often touted inefficiencies of our democratic government and the wonderful things that are actually accomplished and achieved each day, it is clear that there are certain aspects of the constitution that could be changed or updated. This is clear when one looks at many of the social issues that face the nation at this time. The changes do not need to be profound, but as in any system, when you make a change to one part of the system, you may see nega tive effects in other parts. As we examine the parts of the out governmental structure, it becomes apparent that our modern society requires some changes to how people are elected to government, how the departments of government works, the relationship of the executive to the other branches of government and even some of the personal liberties enjoyed in the Bill of rights. ... I would increase the length of term for a member of the House of Representatives to four years. As it stands now, most of the House of Representatives spend their time running for re-election and not running the country. Elections every two years are a huge distraction to these members of congress. Running an election is more complicated and expensive than it was when the constitution was established. For this reason, members of the house should have longer terms. The House of Representatives should have 25% of its members being elected each year. This means that some of the members will always be running for office, but it also ensures that there will be constant turnover if people are not pleased with the way the House of Representatives is running the nation. These changes will result in more focused legislators and a more responsive House. The second change that should be made concerns the role of money in the electoral process. The entire process of getting elected now focuses o n having enough money to get your message out, hire staff and run negative advertisements against your opponents. The only donors that can give enough money to really influence a national campaign are the ultra-wealthy and large corporations. The Supreme Court has recently ruled that corporations can make unlimited, anonymous contributions to political parties and individuals though Political Action Committees (Liptak, 2010). This ruling is very dangerous for our democratic process. The Court reasoned that money is the same as speech, as protected in the Bill of Rights. The justices ruled that if the government curtailed the spending of money in the political process, then it would be the same a curtailing

In the United States, many states Essay Example for Free

In the United States, many states Essay The rescue game, a joint social responsibility, must be approached with a lot of tact and undying resilience. With mortality rates on the high and visible evidences of the cause stirring us in the face, we are left with but one question, just one: who is the real killer? The very undeniable frequent recurrence of death through heart disease has been on the high for long stretches of time, which earlier was solely traceable to tobacco. The earlier discovery though incomplete has led the Government of the United States to impose heavy taxes on the tobacco manufacturing companies. Much of the funds realized from such taxes have helped to project billboards and campaigns against tobacco use. However, of late a more devastating killer of mankind was sighted. This, which had stayed so closely to the bosom of humans and even lured many until it became a delight, suddenly brings out its silent pistol carting the lives of many away. Who may have realized how potentially harmful a seeming sumptuous high-fat diet would have turned out? The facts are however showing by the day in alarming numbers of the heart disease even in non-smokers. I hereby use this medium to vigorously alert the Government to the incumbent dangers and threat to life these die hard life stealer have been and therewith request urgently that a bill be passed to levy high-fat fast food producers with heavy tax duties as was with the tobacco, seeing now this high fat foods even kills more and faster than other possible causes of heart failure. Such funds can then be re-channeled to educate the still ignorant many through the use of advance multimedia projections on lighted digital boards, billboard, newspaper and television.

Refurbishment vs redevelopment

Refurbishment vs redevelopment Chapter 1 Refurbishment vs redevelopment Malaysia property market has experienced a drastic change in 2008. The property market moved from a boom at the end of 2007 to uncertainties due to increasing construction cost. Finally, the property market moved into a relatively quiet market towards the end of 2008. With all the banks trying to tighten their loan terms, obtaining loans for development of all types of commercial building have been difficult in the last three years. Yet, study shows that there is still a high demand for space in office building in area like Kuala Lumpur. From time to time, there are several developments of new office buildings in Klang Valley area. From the study done by JPPH, there is an increase of approximately 10 million square metres of new office space throughout Kuala Lumpur. Yet, the average vacancy rate in office space decreased to 18.6%. This proved that the demand for office building is still able to cater the increase in new office space. Study also showed that there is a new supply of approximately 280,000 square metres of new office space and additional 92,000 square metres of office being refurbished and repositioned in the year of 2009. So, building owners have to struggle to maintain the popularity and the competitiveness of their building. The current lack of new-build development raises the likelihood of grade-A supply shortages when the occupier market returns, creating investment opportunities for carefully targeted refurbishment. But, usually owner is in great dilemma when they are in such situation. As everyone know, the refurbishment of office space offers advantages over new-build which can facilitate the achievement of economic, social and environmental sustainability. But, redevelopment is the ultimate solution for eliminating all problems regarding the maintenance, changing tenants requirement and other probems. Making comparisons between refurbishment and redevelopment is also problematic because the term refurbishment can be used to encompass a wide spectrum of building works, from minor cosmetic improvements through to extensive reconstruction. But, in the majority of cases, refurbishment will be a quicker and cheaper means of restoring second-hand office space to grade-A specification. As a low-cost option, the refurbishment of office space should be intuitively attractive in an economic climate marked by a lack of development finance. But in many cases refurbishment is as costly as redevelopment and likely to carry with it greater risks and physical constraints. Problem statement Malaysian has been accused as a clever builder but poor manager. For example, certain office buildings in Golden Triangle are often looked deteriorated and relatively matured compared to other purposed-built office building. Example of such older office buildings are those office building located on the fringe of Central Business District, like Jalan Ampang. These older office buildings have a higher tendency to be left vacant due to its poor office building images. This will leads to lower rental rate to be paid by the tenants to remain its competitiveness. Other important characteristic of such office building also includes by low occupancy rate, lower quality of the building and services provided. Besides, recent office developments are very likely to adopt green features such as energy saving, reduction of wastage and water usage, as well as the use of environmentally friendly materials. This new trend in development had forced many owners evaluate the condition of their building and try to make several changes to the buildings to attracts more tenants. These efforts are important to attract corporations who fascinate energy-saving and environmental-friendly building. But making such decision is not easy. The owners have to evaluate the cost and benefit of each choice, and determine the solution he desires to improve the condition of his buildings. But other factors also have to take into consideration. For example, the rate of interest the bank would charge for development of different risk, the time of completion and others also greatly affect the decision-making of owner Objectives of study This study has three main objectives. There are: To determine factors influencing the decision-making in deriving a solution to the method chosen. To identify the benefits of building refurbishment or redevelopment to the building users. To determine whether tenant likes refurbished secondary office building or newly redeveloped building. Scope of study The scope of this study will focus on selected office buildings, both building which had undergo refurbishment and those which had undergone redevelopment. To ensure a more complete study, the newly constructed building is also considered as building undergone redevelopment. The respondents of the questionnaire are limited to tenants in Golden Triangle area only. As for the property manager, all property managers can be chosen as the interviewee. Building manager who are hired by owners and acted on behalf of them, will gives their opinions in owner perspectives (maximise profit) and current tenants will voice out their preferences in choosing a building space. Methodology All the relevant data are collected through primary data and secondary data. Primary data includes questionnaire, samplings, interviews and case study. In this study, respondents identified in questionnaire study are selected property manager who represents building owners point of view and some tenants within Golden Triangle area through sampling. As for interview session, interviewees targeted are property manager who are the representatives of building owners. Through this interview sessions, benefit of building refurbishment and redevelopment will be ascertained. Finally, case study of three similar office buildings will also be done as the quantitative analysis. All three building will be compared according to the cost incurred for construction and the benefit obtained. Then the differences in term of occupancy rates, rental and others will be calculated to represent the increment in term of market value. On the other hand, collection of data in this study will also includes references such as reference book, journal, articles, conference paper, property market reports, internet/ website searching and other sources. In addition, data will also be collected from books, magazines or newspaper article to obtain general information on building refurbishment and the effects of building refurbishment. Further details of methodology will be discussed in Chapter 3. Structure of Study This study consisted of five chapters. The brief discussion of each chapter is discussed as follows: Chapter 1 Chapter 1 is the introduction of the study. This chapter starts with an introduction of this study with a brief background. Besides, other things like problem statement, scope of study, methodology and others are also discussed in this chapter. Chapter 2 Chapter 2 is about the literature review. In this chapter, definition of building refurbishment and redevelopment, benefit of building refurbishment and redevelopment and others will be discussed in this chapter. Besides, factor influencing decision making of building refurbishment and the tenant preferences will also be discussed. Chapter 3 Chapter 3 is the methodology. In this chapter, methodology used to survey and interview in order to gather information needed. The structure of questionnaire is also discussed in this chapter. Furthermore, a brief discussion on the opinion of respondents of questionnaire and interviews will also be carried out in the last part of this chapter. Chapter 4 Chapter 4 is the chapter regarding research findings analysis. In this chapter, data gather will be analysed and presented in this chapter. An analysis on the benefit of building refurbishment and its value-enhancing ability will also be carried out by studying the information gathered through interviews, questionnaire survey, and secondary data. Chapter 5 Chapter 5 discuss about the conclusion and recommendation. In this chapter, conclusion from the findings and analysis of data in the previous chapter will be discussed and summarized. Besides, it also illustrate on the confirmation of the objectives and overall summary for the whole study. Other information included in this chapter is the suggestions for further study.