Do randomised controlled nursing trials have a pragmatic or explanatory attitude? Findings from the Pragmatic-Explanatory Continuum Indicator Summary (PRECIS) tool exercise

Background: Randomized controlled trials (RCTs)may be categorizedas either effectiveness trials or efficacy trials, whichmaybe categorized by the Pragmatic-Explanatory ContinuumIndicatorSummary (PRECIS) tool. However, no data regarding the applicationof the PRECIS tool in a cluster of RCTs belonging to a specificdiscipline such as nursing are available.Purpose: The principal aim of this study was to assess the prevailingnature (pragmatic vs. explanatory) of a cluster of clinical nursingRCTs. Evaluating the suitability of the PRECIS in the analysis ofnursing RCTs was the secondary aim.Methods: All nursing RCTs published in 2010 were identifiedthrough a systematic review and extracted in full-text form. AnexplanatoryYpragmatic (EYP) group consisting of 11 researcherstrained in the use of the PRECIS tool evaluated each RCT in terms of10 domains, respectively scored on a scale ranging from 5 (pragmatic)to 1 (explanatory). The EYP group further scored the feasibility ofthe PRECIS tool using a numerical rating scale (0 = not at all, 10 =entirely feasible).Results: Along the pragmaticYexplanatory continuum, assuming50 as the highest degree of pragmatism and 10 as the highestdegree of explanatory, the evaluation of nursing RCTs returned anaverage of 31.1 (median = 31, SD = 7.18, range = 13Y44). On thepragmaticYexplanatory continuum, theevaluated nursingRCTstendedto be pragmatic, which seems to be consistent with the purposesof the nursing discipline. The feasibility of the PRECIS tool in theevaluation of nursing trials as perceived by the EYP Group was, onaverage, 7.09 (SD = 1.09, 95% CI [6.35, 7.82]).Conclusions/Implications for Practice: Applying the PRECIStool is perceived to be highly feasible in the critical appraisal of acluster of RCTs in a specific discipline such as nursing.