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

PeerJ ◽  
2022 ◽  
Vol 9 ◽  
pp. e12666
Author(s):  
Ricardo M. Ferreira ◽  
Pedro N. Martins ◽  
Nuno Pimenta ◽  
Rui S. Gonçalves

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.

Author(s):  
Stephanie Hovick ◽  
Ingrid Provident

Evidence-based practice enables rehabilitation therapists to provide the best quality of care and outcomes for patients. However, rehabilitation therapists are often not confident in using evidence in many settings. Purpose. The objective of this evidence-based practice project was to determine if educational small group sessions enhanced occupational therapists, occupational therapy assistants, physical therapists, physical therapy assistants, and a speech and language pathologist’s confidence in utilizing and applying evidence. Method. Eleven rehabilitation therapists of multiple disciplines (occupational therapists, occupational therapy assistants, physical therapists, physical therapy assistants, and a speech and language pathologist) from a skilled nursing facility participated in six educational sessions designed to increase evidence-based practice. A pre- and post-test utilizing the Evidence-Based Practice Profile Questionnaire (EBPPQ), measured change in therapists’confidence regarding evidence-based practice. Results. Results on the Evidence-Based Practice Profile Questionnaire concluded that 7 of 11 rehabilitation therapists reported an increase in confidence levels. Conclusion. Educational small group sessions can be an effective method to assist rehabilitation therapists in developing this confidence. KEYWORDS: Evidence-based practice, confidence levels, rehabilitation therapists, educational sessions, skilled nursing facility


2004 ◽  
Vol 84 (7) ◽  
pp. 644-654 ◽  
Author(s):  
Christopher G Maher ◽  
Catherine Sherrington ◽  
Mark Elkins ◽  
Robert D Herbert ◽  
Anne M Moseley

Although there is a growing awareness of evidence-based practice among physical therapists, implementation of evidence-based practice has proved difficult. This article discusses barriers to access and interpretation of evidence. Some solutions are offered, including facilitating the publication of all research, use of an optimum format for reporting research, maximizing the efficient use of electronic databases, improving physical therapists' skills in critical appraisal of published research, and fostering consumer access to evidence. These strategies and others discussed in the article might facilitate implementation of evidence-based physical therapy.


Author(s):  
Joe Schreiber ◽  
Perri Stern

The term “evidence-based practice” (EBP) has become ubiquitous in physical therapy practice. Since the mid 1990s, over 70 articles have been published in the physical therapy literature relating to EBP. Many physical therapists agree with the notion that scientific evidence should be utilized to guide practice decisions. However, for physical therapy clinicians, there are numerous barriers to EBP. Also, there appears to be a disconnect between academia and clinical practice in terms of the utilization of research evidence to inform clinical decision making. The purpose of this review of the literature is to begin to elucidate and address some of the many issues that the physical therapy profession faces with respect to evidence-based practice by providing a comprehensive synthesis and analysis of the EBP literature in Physical Therapy (PT).


Author(s):  
Debra Bierwas ◽  
Joan Leafman ◽  
Lisa Wallace ◽  
Donald Shaw ◽  
Steven Fehrer

Introduction: Evidence-based practice is a required component of student physical therapist education. Practice applying the five steps of evidence-based practice to patient care (formulate question, retrieve evidence, appraise evidence, integrate evidence, evaluate outcomes), most effectively performed during clinical education, must occur for students to become proficient. Clinical instructor use of evidence-based practice is essential to assure that student physical therapist practice occurs during clinical education. Purpose: The purpose of this study was to assess self-reported evidence-based practice use by physical therapy clinical instructors and examine whether an association exists between professional characteristics and evidence-based practice use. Methods: This study was a cross-sectional, descriptive study using an electronic survey to collect data on clinical instructor professional characteristics and evidence-based practice use. Results: Respondents included 376 physical therapists who were clinical instructors in the United States. Participant responses for frequency evidence-based practice steps use ranged from never to frequently. Specifically, respondents reported integrating evidence into clinical instruction: never 2.1% (n = 8); rarely 6.4% (n = 24); occasionally 13.3% (n = 50); sometimes 28.7% (n = 108); and frequently 49.5% (n = 186). There was no difference in evidence-based practice use as the result of age or highest degree. Respondents who were American Physical Therapy Association members or held an American Board of Physical Therapy Specialties certification reported using some of the evidence-based practice steps more frequently than those who were not. Discussion and Conclusion: Although the majority of respondents in this study reported using evidence-based practice to some extent, there was great variability. Student physical therapists may be exposed to evidence-based practice during clinical education since the majority of respondents, considering their role as clinical instructors, reported evidence-based practice use. However, exposure cannot be guaranteed for every student because some respondents reported never using evidence-based practice. Educational program use of supplemental learning activities during clinical experiences may facilitate student practice of all five steps of evidence-based practice during clinical education.


2013 ◽  
Vol 93 (6) ◽  
pp. 819-832 ◽  
Author(s):  
Susanne Bernhardsson ◽  
Maria E.H. Larsson

BackgroundEvidence-based practice (EBP) and evidence-based clinical practice guidelines are becoming increasingly important in physical therapy. For the purpose of meeting the goals of designing, implementing, and evaluating strategies to facilitate the development of more EBP in primary care physical therapy, a valid and reliable questionnaire for measuring attitudes, knowledge, behavior, prerequisites, and barriers related to EBP and guidelines is needed.ObjectiveThe 3 objectives of this study were: (1) to translate and cross-culturally adapt a questionnaire to a Swedish primary care context for the purpose of measuring various aspects of EBP and guidelines in physical therapy, (2) to further develop the questionnaire to examine more aspects of guidelines, and (3) to test the validity and reliability of the adapted Swedish questionnaire.DesignThis was an instrument development study with validity and reliability testing.MethodsA previously used questionnaire about EBP was translated and cross-culturally adapted to a Swedish primary care physical therapy context. Additional items were constructed. A draft version was pilot tested for content validity (n=10), and a revised version was tested for test-retest reliability (n=42). The percentage of agreement between the 2 tests was analyzed.ResultsThe development process resulted in a first questionnaire draft containing 48 items. The validation process resulted in a second draft with acceptable content validity and consisting of 38 items. The test-retest analysis showed that the median percentage of agreement was 67% (range=41%–81%). After removal or revision of items with poor agreement, the final questionnaire included 31 items.LimitationsOnly face validity and content validity were tested.ConclusionsThe final translated and adapted questionnaire was determined to have good face and content validity and acceptable reliability for measuring self-reported attitudes, knowledge, behavior, prerequisites, and barriers related to EBP and guidelines among physical therapists in primary care settings.


2003 ◽  
Vol 83 (9) ◽  
pp. 786-805 ◽  
Author(s):  
Diane U Jette ◽  
Kimberly Bacon ◽  
Cheryl Batty ◽  
Melissa Carlson ◽  
Amanda Ferland ◽  
...  

Background and Purpose. Little research has been done regarding the attitudes and behaviors of physical therapists relative to the use of evidence in practice. The purposes of this study were to describe the beliefs, attitudes, knowledge, and behaviors of physical therapist members of the American Physical Therapy Association (APTA) as they relate to evidence-based practice (EBP) and to generate hypotheses about the relationship between these attributes and personal and practice characteristics of the respondents. Methods. A survey of a random sample of physical therapist members of APTA resulted in a 48.8% return rate and a sample of 488 that was fairly representative of the national membership. Participants completed a questionnaire designed to determine beliefs, attitudes, knowledge, and behaviors regarding EBP, as well as demographic information about themselves and their practice settings. Responses were summarized for each item, and logistic regression analyses were used to examine relationships among variables. Results. Respondents agreed that the use of evidence in practice was necessary, that the literature was helpful in their practices, and that quality of patient care was better when evidence was used. Training, familiarity with and confidence in search strategies, use of databases, and critical appraisal tended to be associated with younger therapists with fewer years since they were licensed. Seventeen percent of the respondents stated they read fewer than 2 articles in a typical month, and one quarter of the respondents stated they used literature in their clinical decision making less than twice per month. The majority of the respondents had access to online information, although more had access at home than at work. According to the respondents, the primary barrier to implementing EBP was lack of time. Discussion and Conclusion. Physical therapists stated they had a positive attitude about EBP and were interested in learning or improving the skills necessary to implement EBP. They noted that they needed to increase the use of evidence in their daily practice.


2020 ◽  
Vol 11 (4) ◽  
pp. 7056-7063
Author(s):  
Vineel P ◽  
Gopala Krishna Alaparthi ◽  
Kalyana Chakravarthy Bairapareddy ◽  
Sampath Kumar Amaravadi

  Evidence-based Practice is defined as usage of current best evidence which is conscientious, explicit and judicious in deciding on the care of the individual. It is one of the vital decision-making processes in the medical profession. Though India is renowned as a center for medical education, there is scarcity regarding the literature on evidence-based practice. The survey aims to identify the prevalence of evidence-based practice among the physical therapists of Mangalore. The study protocol submitted to scientific research committee and Ethical institutional committee, K.M.C. Mangalore Manipal University. On approval, the questionnaire had been distributed among the physical therapists of Mangalore through mails and in the written form. The questionnaire consists of questions divided into eight sections: 1) consent form 2) current practice status; 3) demographic data; 4) behavior; 5) previous knowledge of E.B.P. resources; 6) skills and available resources; 7) Opinions regarding E.B.P.; 8)Perceived barriers regarding E.B.P. The emails were sent through Google forms to all the physical therapists, and hard copies were distributed among the selected physical therapists. The response rate for the emails was 13.1%. The response collected through hard copies was 178, whereas total hard copies distributed was 320, the participants rejected some due to lack of interest. In total, including emails and hard copy questionnaire 205 was the response rate in which all were practicing physical therapy as their primary profession. The findings of the study will pave the way to identify the status of evidence-based practice as well as help in designing promotional programmers for evidence-based practice.


1998 ◽  
Vol 65 (3) ◽  
pp. 136-143 ◽  
Author(s):  
Mary Egan ◽  
Claire-Jehanne Dubouloz ◽  
Claudia Von Zweck ◽  
Josée Vallerand

Evidence-based practice has its roots in evidence-based medicine. This term refers to the formulation of treatment decision using the best available research evidence. While the concept has gained increased attention among health care workers in the recent past, practice based on scientific evidence has been recommended for over 300 years. However, all health-related professions continue to report difficulties adopting evidence-based practice. Notably, practitioners are often concerned that results of population-based research may not be relevant for their specific patients. This may be of particular concern for occupational therapists who aim to provide client-centred intervention, taking into consideration individual characteristics of the client, the environment and the occupation. As well, those wishing to practice evidence-based occupational therapy must determine which decisions are made during the course of therapy and what evidence may impact on these decisions. The Occupational Performance Process Model (Fearing, Law & Clark, 1997) outlines the occupational therapy problem solving process and assists therapists to integrate knowledge from both client and therapist. A framework for evidence-based occupational therapy is presented, based on this model.


2019 ◽  
Vol 1 (2) ◽  
pp. 83
Author(s):  
Ricardo Maia Ferreira ◽  
Pedro Lopes Ferreira ◽  
Luis Cavalheiro ◽  
José Alberto Duarte ◽  
Rui Soles Gonçalves

BACKGROUND: Evidence-Based Practice (EBP) is becoming increasingly important in Physical Therapy (PT). For proper designing, implementing, disseminating and evaluating EBP in PT, a valid and reliable questionnaire measuring attitudes, knowledge, behavior, prerequisites, and barriers related to EBP and guidelines is needed. One questionnaire that could be used to collect this information is the “EBP Questionnaire”, developed by Jette et al. 2003. However, to our knowledge, no Portuguese version or published study with the Portuguese PT population was performed using this questionnaire. OBJECTIVE: The aim of this study was to translate, cross-culturally adapt and validate the “EBP Questionnaire” to European Portuguese and for the PT population. Material and Methods: A draft version was pilot tested for content validity (n=17), and a revised version was tested for test-retest reliability (n=72). The percentage of agreement and the Kappa coefficients between the 2 tests were analyzed. Additionally, the internal consistency was calculated. RESULTS: The preliminary final version of the European Portuguese EBP questionnaire was well accepted (only the items 22, 23, 45-51 needed to be reviewed). The mean average percentage of agreement was 82% (ranged 58–97%), and the Kappa coefficients were 0.658 (ranged 0.336–0.844). In the internal consistency, the mean average Cronbach’s α coefficients were 0.665 (ranged 0.365–0.879). CONCLUSION: The results suggested that this questionnaire can be a useful instrument for measuring self-reported beliefs, attitudes, knowledge, and behaviors related to EBP in the Portuguese PTs context.


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