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The BARRIERS scale -- the barriers to research utilization scale: A systematic review

Kerstin Nilsson Kajermo1, Anne-Marie Boström23*, David S Thompson4, Alison M Hutchinson5, Carole A Estabrooks2 and Lars Wallin13

Author Affiliations

1 Clinical Research Utilization (CRU), Karolinska University Hospital, Eugeniahemmet T4:02, SE-171 76 Stockholm, Sweden

2 Knowledge Utilization Studies Program (KUSP), Faculty of Nursing, University of Alberta, 5-104 Clinical Science Building, Edmonton, Alberta T6G 2G3, Canada

3 Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, 23 300, SE-141 83 Huddinge, Sweden

4 Northern Ontario School of Medicine, 955 Oliver Road, Thunder Bay, Ontario P7B 5E1, Canada

5 School of Nursing, Deakin University and Cabrini-Deakin Centre for Nursing Research, Cabrini Institute, 183 Wattletree Road Malvern 3144, Victoria, Australia

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Implementation Science 2010, 5:32  doi:10.1186/1748-5908-5-32

Published: 26 April 2010



A commonly recommended strategy for increasing research use in clinical practice is to identify barriers to change and then tailor interventions to overcome the identified barriers. In nursing, the BARRIERS scale has been used extensively to identify barriers to research utilization.

Aim and objectives

The aim of this systematic review was to examine the state of knowledge resulting from use of the BARRIERS scale and to make recommendations about future use of the scale. The following objectives were addressed: To examine how the scale has been modified, to examine its psychometric properties, to determine the main barriers (and whether they varied over time and geographic locations), and to identify associations between nurses' reported barriers and reported research use.


Medline (1991 to September 2009) and CINHAL (1991 to September 2009) were searched for published research, and ProQuest® digital dissertations were searched for unpublished dissertations using the BARRIERS scale. Inclusion criteria were: studies using the BARRIERS scale in its entirety and where the sample was nurses. Two authors independently assessed the study quality and extracted the data. Descriptive and inferential statistics were used.


Sixty-three studies were included, with most using a cross-sectional design. Not one study used the scale for tailoring interventions to overcome identified barriers. The main barriers reported were related to the setting, and the presentation of research findings. Overall, identified barriers were consistent over time and across geographic locations, despite varying sample size, response rate, study setting, and assessment of study quality. Few studies reported associations between reported research use and perceptions of barriers to research utilization.


The BARRIERS scale is a nonspecific tool for identifying general barriers to research utilization. The scale is reliable as reflected in assessments of internal consistency. The validity of the scale, however, is doubtful. There is no evidence that it is a useful tool for planning implementation interventions. We recommend that no further descriptive studies using the BARRIERS scale be undertaken. Barriers need to be measured specific to the particular context of implementation and the intended evidence to be implemented.