Physiotherapists’ perceptions of challenges facing evidence-based practice and the importance of environmental empowerment in fall prevention in the municipality – a qualitative study

Abstract Background Falls in older adults are an increasingly important public-health concern. Despite abundant research, fall rates have not been reduced, because implementation of evidence-based fall-prevention measures has been slow and limited. This study aims to explore physiotherapists’ perceptions on external factors, such as public policy, organisation and leadership, regarding the relation between knowledge translation and the three elements of evidence-based practice (EBP) to effectively address barriers and facilitate the uptake of EBP in fall prevention. Methods We conducted semi-structured interviews with 18 physiotherapists (men = 7; women = 11) working with fall prevention in the primary healthcare system. The physiotherapists ranged in age from 27 to 60 years (median 36 years) and had worked as a physiotherapist from 1 to 36 years (median 7 years). Data are analysed using thematic analysis. Results The analysis revealed one main theme and four sub-themes. The main theme was ‘Environmental empowerment enhances physiotherapists’ capabilities for using EBP’. A resourceful work environment facilitates EBP, having access to information about research-based knowledge, supportive leadership, enough human resources and opportunities to learn and grow at work. The four sub-themes were as follows: 1) ‘Tension between attributes of research-based knowledge and organisational routines and practices’; 2) ‘Evidence must be informed by policymakers—What works?’; 3) ‘Empowering culture and work environment—A steppingstone to EBP’ and 4) ‘Organisation readiness for EBP, managerial and clinical relations’. Success in environmental empowerment depends on the leader’s role in creating preconditions at the workplace that may lead to important positive personal and organisational outcomes for EBP. Two-way communication and transfer-of-information are also key factors in the development of positive work engagement when using EBP. Conclusion The findings of this study outline tension between policy, leadership, organisational facilitators and EBP. Leadership is influenced by policy with ripple effects for the organisation and clinicians. Organisational facilitators form structural empowerment, which is the foundation for creating an EBP environment. Trial registration 2018/2227/REC south-east C. Registered 19 December 2018, Norwegian Ethics Committee for Medical and Health Research Ethics.

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Reflections of older people about their experience of fall prevention exercise in the community- a qualitative study exploring evidence-based practice

BMC Public Health ◽

10.1186/s12889-020-09630-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Hilde Worum ◽

Daniela Lillekroken ◽

Kirsti Skavberg Roaldsen ◽

Birgitte Ahlsen ◽

Astrid Bergland

Keyword(s):

Older People ◽

Fall Prevention ◽

Evidence Based Practice ◽

Exercise Program ◽

Community Dwelling ◽

Evidence Based ◽

Structured Interviews ◽

Effective Interventions ◽

Collective Negotiation ◽

Community Dwelling Older People

Abstract Background Evidence-based practice (EBP) ensures that clinicians use effective interventions to achieve desired outcomes, thereby contributing to the best quality of care. The perspective of the participants is fundamental in EBP, as they have their own individual and meaningful rationale for participating in fall prevention. This study aims to explore community-dwelling older people reflections about their reflections about EBP in physiotherapy based on their experiences of a fall prevention exercise program. Methods We conducted semi-structured interviews with 16 community-dwelling older people (men = 7; women = 9). Data were analyzed using thematic analysis. Results The analysis revealed three themes: 1) the tension between knowing and doing, 2) the power of the therapist-participant relationship and the process of putting knowledge into action, and 3) research is interwoven with successful therapy and is an integral component of it. EBP was considered as a collective negotiation and learning process of creating knowledge for clinical practice. The negotiation between different types of knowledge must be performed in a transparent dialogue and through interactive collaboration between the persons involved. The participants appreciated that the research findings indicate that practice gives results. Conclusions EBP was understood and utilized as a seal of approval and a “guarantee of high quality” treatment, and its effects varied based on older people’s preferences, needs, and skills. The therapist’s relational competence appeared to be crucial for the negotiation of various sources of knowledge relative to the older people’s preferences.

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Evidence-Based Practice Work Environment Scale

PsycTESTS Dataset ◽

10.1037/t35939-000 ◽

2014 ◽

Author(s):

Yvette Pryse ◽

Anna McDaniel ◽

John Schafer

Keyword(s):

Work Environment ◽

Evidence Based Practice ◽

Evidence Based ◽

Environment Scale

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Building a foundation for utilizing evidence based practice in conjunction with research in baccalaureate nursing program

Journal of Nursing Education and Practice ◽

10.5430/jnep.v10n10p1 ◽

2020 ◽

Vol 10 (10) ◽

pp. 1

Author(s):

Young-Shin Lee ◽

Carmen Galang ◽

Janet E. Hughen

Keyword(s):

Older Adults ◽

Nursing Students ◽

Community Health ◽

Fall Prevention ◽

Evidence Based Practice ◽

Assessment Tools ◽

Evidence Based ◽

Timed Up And Go ◽

Screening Process ◽

Health Fair

Less is known about the undergraduate nursing students’ ability to conduct beginning research. This study aims to explore and describe nursing students' experiences in planning and implementation of community health fairs; and utilizing evidence based practice integrated with research as a learning outcome. The study using a quantitative and descriptive design was conducted by senior nursing students during diverse community health events as a part of Gerontological nursing clinical. The students utilized three fall assessment tools: Balance and Gait test, Timed Up and Go test, and 10-year Fracture Risk Calculation. A total of 74 students participated in seven community health fair events focused on Fall Prevention. This health fair event was in conjunction with the National Fall Prevention Awareness week. A total of 201 older adults were served during the event by nursing students who provided screening process and related health education. Data were gathered and a group of students volunteered to complete the research process. The students participated in oral presentation in the Annual University Research Student Symposium and had poster presentation in the professional academic conference. Early systematic organized planning of the clinical experience gives students opportunity to integrate evidence based practice into research. Application of varied evidence based assessment tools focused on older adults enables students to understand the health issue in depth and the need for additional services. Health fair experiences improve students’ communication and education skills, reality of health issues of the target population in a community, and evidence based research.

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Nurses’ knowledge, attitudes and practices regarding evidence-based practice in the prevention of mother-to-child transmission of HIV programme in Malawi

Curationis ◽

10.4102/curationis.v40i1.1656 ◽

2017 ◽

Vol 40 (1) ◽

Cited By ~ 4

Author(s):

Chisomo Mulenga ◽

Joanne R. Naidoo

Keyword(s):

Evidence Based Practice ◽

Predictive Analytics ◽

Health Concern ◽

Evidence Based ◽

Global Public Health ◽

Mother To Child Transmission ◽

Child Transmission ◽

Attitudes And Practices ◽

Mother To Child ◽

Knowledge Attitudes And Practices

Background: HIV continues to be a global public health concern with Malawi being among the worst affected countries. The prevalence of HIV among pregnant women is also very high, thereby raising concerns of mother-to-child transmission of the virus. Prevention of mother-to-child transmission (PMTCT) of HIV is therefore a priority in the efforts to curb the HIV pandemic. Keeping in mind that the area of HIV management is rapidly evolving, underpinning nursing care with evidence-based practice is essential and has been reported to reduce mother-to-child transmission.Objectives: The aim of the study was to explore and describe the knowledge, attitudes and practices of nurses regarding evidence-based practice in PMTCT at a selected hospital in Malawi.Methods: An exploratory descriptive quantitative design was used, and 81 nurses working in paediatric, obstetrics and gynaecology departments completed a self-administered questionnaire. Data were analysed using Predictive Analytics Software.Results: The results showed that nurses had average knowledge of evidence-based practice and although their attitudes were favourable, their practice was very low. Certain sociodemographic variables had an influence on the respondent’s knowledge, attitudes and practices. Furthermore, the results have indicated that evidence-based practice was mainly hampered by insufficient resources and difficulties in accessing research articles. It emerged from the study that mentoring, training and access to literature could facilitate evidence-based practice in PMTCT among nurses.Conclusion: Nurses need to be provided with the necessary support including education and resources if evidence-based practice in PMTCT is to be promoted.

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Evidence-based practice self-efficacy of speech-language pathologists across settings

10.32469/10355/79493 ◽

2020 ◽

Author(s):

◽

Misty Tilmon

Keyword(s):

Clinical Judgment ◽

Self Efficacy ◽

Graduate Program ◽

Evidence Based Practice ◽

Evidence Based ◽

Master's Level ◽

Years Of Experience ◽

Structured Interviews ◽

Speech Language Pathologists ◽

Significant Difference

The purpose of this mixed-methods sequential explanatory study was to explore self-efficacy of speech-language pathologists (SLPs) employed in various settings. Self-efficacy of master's level SLPs was compared across settings to determine if differences existed in each of four experience groups. Self-efficacy ratings were also compared based on degree held, area of practice, and years of experience. Participants (n = 342) completed a survey containing 10 demographic questions, 11 items from Salbach and Jaglal's (2010) Evidence-Based Practice Confidence (EPIC) scale, and 2 open-ended questions regarding factors impacting self-efficacy. Participants (n=34) completed semi structured interviews to further explore factors influencing self-efficacy. No significant difference was noted in self-efficacy of master's level SLPs among settings. There was a significant difference between self-efficacy ratings based on degree held and years of experience. A significant difference in self-efficacy was found based on practice category (i.e., identification of knowledge gap, critical appraisal of research, development of treatment plans based on evidence, clinical judgment, and client preferences). Qualitative analysis revealed graduate program and post-graduate factors which impacted self efficacy ratings both positively and negatively.

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Measuring evidence-based practice in physical therapy: a mix-methods study

PeerJ ◽

10.7717/peerj.12666 ◽

2022 ◽

Vol 9 ◽

pp. e12666

Author(s):

Ricardo M. Ferreira ◽

Pedro N. Martins ◽

Nuno Pimenta ◽

Rui S. Gonçalves

Keyword(s):

Logistic Regression ◽

Physical Therapy ◽

Evidence Based Practice ◽

Physical Therapists ◽

Population Sample ◽

Individual Characteristics ◽

Evidence Based ◽

Structured Interviews ◽

Academic Degree ◽

And Behaviors

Background Evidence-based practice (EBP) is considered the “holy grail” to manage patients by health practitioners (such as physical therapists). However, sometimes, patients are not treated with the best interventions for their condition. Although studies already explored the facilitators and barriers for this issue, they increase in the level of importance if the information gathered are context appropriated. As the profession is relatively new in Portugal, currently little is known about the implementation of EBP in Portuguese physical therapists context. So, the aim of this study is to know if the Portuguese physical therapists use an EBP, and collect and deeper understand the factors, barriers and facilitators associated with EBP. Methods This study incorporated a mixed-methods design (quantitative and qualitative). In an attempt to ensure the correct population sample, a national professional association e-mail database and the e-mails of past students from national schools were requested. For the quantitative data it was choose an e-survey, adapted from the EBP: Beliefs, Attitudes, Knowledge, and Behaviors of Physical Therapists Portuguese version questionnaire, consisted of 55 close-ended questions. It was analyzed response frequencies and associations between variables with logistic regression analyses. For the qualitative data, it was choose to perform semi-structured interviews in purposefully selected physical therapists to include different sociodemographic factors (especially those found to be statistically significant in the logistic regression) and survey responses regarding the physical therapists’ beliefs, attitudes, knowledge, and behaviors. The interviews were performed in an online software, where only audio contact was performed. The audios were anonymized and verbatim transcribed, and the texts explored by the thematic approach. Results From the 277 physical therapists that shown interest in participating in the study, 193 fully completed the questionnaire and, from those, 10 participated in the interviews. The Portuguese physical therapists reported positive beliefs, attitudes, knowledge, and behaviors regarding EBP. Among the physical therapists characteristics it seems that age (younger therapists), education (participating in continuing education courses; belonging to practice-orientated organizations; having a doctorate degree; pursuing a higher academic degree; and being a clinical instructor), and workplace (working for someone else account; and academic sector) are the main factors in the Portuguese EBP implementation. The Portuguese physical therapists, beyond the physical therapists individual characteristics and workplace, also stated that evidence, patients, clinical experience, schools, country and physical therapy characteristics, may behave as facilitators or barriers when performing an EBP.

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Barriers of Implementing Evidence-Based Practice Perceived by Iranian Speech and Language Pathologists: A Qualitative Study

Middle East Journal of Rehabilitation and Health ◽

10.5812/mejrh.117262 ◽

2021 ◽

Vol 8 (4) ◽

Author(s):

Seyed Abolfazl Tohidast ◽

Leila Ghelichi ◽

Mohammad Kamali ◽

Abbas Ebadi ◽

Narges Shafaroodi ◽

...

Keyword(s):

Data Analysis ◽

Evidence Based Practice ◽

Qualitative Content Analysis ◽

Sampling Technique ◽

Organizational Factors ◽

Evidence Based ◽

Speech And Language ◽

Structured Interviews ◽

Rehabilitation Team ◽

Speech And Language Pathologists

Background: Identifying and removing the barriers faced by speech and language pathologists (SLPs) for implementing evidence-based practice (EBP) can facilitate its administration among Iranian SLPs. Objectives: The present study was conducted to explore the barriers to implementing EBP among Iranian SLPs. Methods: A total of 14 SLPs were recruited using a purposive sampling technique. Semi-structured interviews were conducted for data collection. The interviews continued until data saturation was reached. Data were recorded and transcribed verbatim, and qualitative content analysis was used for data analysis. Results: Data analysis yielded three themes, including individual factors, organizational (workplace) factors, and extra organizational factors, and 13 subthemes. Conclusions: This study demonstrated that Iranian SLPs are faced with several barriers to using EBP in clinical practice, which may be related to both the SLPs themselves and their surroundings. These barriers should be considered by policymakers, administrators, teachers, and rehabilitation team members to facilitate the implementation of EBP by SLPs.

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