Chinese medicine (2) Evidence-based medicine in China

10 July, 2018

Dear HIFA colleagues,

(with thanks to Irina Ibraghimova and LRC Network)

I was interested to see this open-access paper that identifies 'fear that patients will be angry about receiving care that is perceived as non-traditional' as a barrier to evidence-based healthcare.

CITATION: When east meets west: a qualitative study of barriers and facilitators to evidence-based practice in Hunan China.

Gifford W(1)(2), Zhang Q(3), Chen S(3), Davies B(1)(2), Xie R(4)(5), Wen SW(6)(7), Harvey G(8)(9).

BMC Nurs. 2018 Jun 20;17:26. doi: 10.1186/s12912-018-0295-x. eCollection 2018.


Background: Research into evidence-based practice has been extensively explored in nursing and there is strong recognition that the organizational context influences implementation. A range of barriers has been identified; however, the research has predominantly taken place in Western cultures, and there is little information about factors that influence evidence-based practice in China. The purpose of this study was to explore barriers and facilitators to evidence-based practice in Hunan province, a less developed region in China.

Methods: A descriptive qualitative methodology was employed. Semi-structured interviews were conducted with staff nurses, head nurses and directors (n?=?13). Interviews were translated into English and verified for accuracy by two bilingual researchers. Both Chinese and English data were simultaneously analyzed for themes related to factors related to the evidence to be implemented (Innovation), nurses’ attitudes and beliefs (Potential Adopters), and the organizational setting (Practice Environment).

Results: Barriers included lack of available evidence in Chinese, nurses’ lack of understanding of what evidence-based practice means, and fear that patients will be angry about receiving care that is perceived as non-traditional. Nurses believed evidence-based practice was to be used when clinical problems arose, and not as a routine way to practice. Facilitators included leadership support and the pervasiveness of web based social network services such as Baidu (??) for easy access to information.

Conclusion: While several parallels to previous research were found, our study adds to the knowledge base about factors related to evidence-based practice in different contextual settings. Findings are important for international comparisons to develop strategies for nurses to provide evidence-based care.


Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - ), a global community with more than 18,000 members in 177 countries, interacting on five global forums in three languages. He also currently chairs the Dgroups Foundation (, which supports 800 communities of practice on international development, health and social justice. Twitter: @hifa_org FB: