Physiotherapy: How to work with evidence in daily practice

Abstract

Rationale, aims, and objectives: The concept of evidence-based health care has gained increasing currency over the past decades; however, questions persist regarding how to overcome the gap between research and health care practice. The question arises whether this gap derives from a true knowledge deficit or from physiotherapists' perception of working with evidence. The aim of the current study was to illuminate changes to the meaning of working with evidence experienced by a cohort of physiotherapists following an education program. Methods: A phenomenological hermeneutic design with open-ended group inter-views was carried out with physiotherapists who had participated in an education program about evidence and how to implement evidence-based practice (EBP) in day-to-day practice.Findings: The interviews provided descriptions of working with evidence according to three major themes: "Confidence with the concept of evidence in relation to a way of working"; "Experience of EBP as a duty to seek evidence for individual patients";and "EBP experienced as an integrated and patient-oriented activity". Conclusions:The physiotherapists' lived experiences demonstrated that the participants' perception of the concept of evidence mainly concerned a broadening of the definition of evidence, and this altered perception of evidence could interpreted as the physiotherapists viewing EBP as a more integrated and patient-oriented activity than before. KEYWORDS education, elder care, evidence-based practice, physiotherapy, primary care, professional development 1 | INTRODUCTION Health systems worldwide are concerned with the quality and safety of patient care and endeavour to ensure that they deliver care based on the best current research evidence, known as evidence-based practice (EBP) and is defined by Sackett et al as "The integration of the best research evidence with clinical expertise and patient values". 1 EBP can be theorized in five steps as followed: (1) ask an answerable clinical question; (2) acquire the best available evidence; (3) appraise the evidence; (4) apply the evidence; and (5) assess the process. 1,2Furthermore, health care professionals need to understand the principles of EBP, recognize EBP in action, implement evidence-based policies, and have a critical attitude to their own practice and to evidence to be able to provide "best practice." 3 Previous studies demonstrate that most physiotherapists have a positive attitude towards EBP and are interested in learning how to improve their skills in EBP, but its implementation is still deficient. [4][5][6][7] There are some barriers that will impact the physiotherapists ability to implement EBP in the workplace as, eg, lack of time, lack of expertise, difficulty obtaining full-text articles, inability to understand statistics, lack of support from employers,

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“…The informants stated that a barrier towards putting research-based knowledge into practice was that they needed more resources. Our findings support the proposal of Snöljung and Gustafsson [40], who note that the barriers encountered by PTs in their implementation of EBP may be related to a lack of expertise and a limited understanding of scientific research. Further, in accordance with our findings, previous studies have also shown that most PTs are interested in improving their EBP skills and that they have a positive attitude towards EBP [41,42].…”

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

“…1 . Applying EBP in primary health care settings ensures that clinicians use effective interventions to achieve desired outcomes, thereby contributing to the best quality of care [ 4 ]. However, there are several barriers for EBP and the components separately (evidence-based knowledge, clinical expertise, and patient values within a given context) that must be overcome in order to succeed with increased quality of care.…”

“…The perspective of older people is fundamental in EBP [ 25 , 28 , 29 ], as they have their own individual and meaningful rationale for participating in interventions [ 30 ]. Considering the views of older people is important for identifying their needs, which in turn helps providers to develop appropriate and responsive services [ 31 ].…”