Challenges and Opportunities in Conducting International Research Study: Family-Witnessed Resuscitation in Two European Countries

Background: Conducting international nursing research has been recognized to be crucial in advancing professional healthcare practice (Opollo et al. 2014). Besides providing opportunities for building cultural competences and enhancing effective multi-cultural collaboration, international research projects have been found to have significant implications for research, education, policy and practice (Opollo et al. 2014, Fronda & Alhusen 2016). Its importance for the ethical aspects in critical care has been emphasized after the European Resuscitation Council recognized a need for unification of national legislations and improved application of ethical principles in CPR across Europe (Bossaert et al. 2015, Mentzelopoulos et al. 2016). It is therefore important to conduct research which include samples from different countries, what will contribute to the enhanced understanding of barriers preventing from implementing evidence-based nursing practices globally.

Purpose: The purpose of this presentation is to describe practical experiences in conducting international multisite study aiming to understand the barriers to family-witnessed cardiopulmonary resuscitation practice implementation in two European countries, Poland and Finland.

Methods: A multisite international study using a mixed-method descriptive-explanatory research design was conducted (Author citation 2015, Author citation 2016). Challenges, opportunities, and solutions to the encountered barrier were discussed.

Results: The international study we conducted was divided into two main phases: (1) a quantitative part in which we used a survey questionnaire to explore critical care and emergency nurses and physicians’ experiences and attitudes related to in-hospital family-witnessed CPR, and (2) a qualitative part in which we interviewed critical patients’ family members to explore and understand their views regarding family-witnessed CPR option. Despite many opportunities such as more diverse and larger sample, enhanced intercultural collaboration, presence of different cultural contexts and thus better understanding of the studied phenomenon, we faced multiple challenges related to in-between country differences which resulted in study protocol changes and adjustments. Translating the data collection instrument, different policies regarding ethical approval application, availability of the sample and culturally-determined willingness to participate in a research study were the main challenges we experienced during the design, empirical and analytic phases of the research process. Strategies such as adjusting the recruitment and data collection strategies, extending data collection time frames, unification of study variables, and analysis of the context and organization of care were used in order to address the encountered barriers.

Conclusion:  Despite the generally recognized importance of international nursing studies, their planning, conducting, and implementing can be challenging especially when exploring an ethically sensitive phenomena. Critical issues related to the philosophical, methodological, practical, ethical and financial aspects need to be addressed during every phase of the international research process. Available strategies can help the researchers to overcome encountered challenges. Sometimes study protocol adjustments need to be made, to successfully conduct and meet the research aims of a multinational nursing research.