What counts as evidence in evidence‐based practice?

Rycroft‐Malone, Jo; Seers, Kate; Titchen, Angie; Harvey, Gill; Kitson, Alison; McCormack, Brendan

doi:10.1111/j.1365-2648.2004.03068.x

Cited by 740 publications

(728 citation statements)

References 48 publications

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“…Rycroft-Malone et al [42][43][44] suggest that patient experiences should be regarded as an important source for evidence in quality improvement. In Sweden the organisation for reporting complaints to the Patients' Advisory Committee is well known by the patients, and the complaints could be a complement to patient questionnaires about the quality of care.…”

Section: Discussionmentioning

confidence: 99%

Patients’ and relatives’ complaints about encounters and communication in health care: Evidence for quality improvement

Jangland

Gunningberg

Carlsson

2009

Patient Education and Counseling

131

141

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Results Three categories were identified: "Not receiving information or being given the option to participate", "Not being encountered in a professional manner" and "Not receiving nursing or practical support". Insufficient information, insufficient respect and insufficient empathy were described as the most common reasons for a negative professional encounter. ConclusionPatients and relatives experienced unnecessary anxiety and reduced confidence in health care after negative professional encounters. Practice implicationsThe complaints reported to the Patients' Advisory Committee could be used more effectively in health care and be regarded as important evidence when working with quality improvement. To systematically use patient stories, such as those obtained in this report, as a reflective tool in education and supervision could be one way to improve communication and bring new understanding about the patient's perspective in health care. KeywordsComplaints, communication, professional encounter and content analysis. Much research has been done on communication between patients and health professionals. For example, the power of the information communicated by the voice was studied among surgeons, and it was suggested that "how" a message is conveyed may be as important as "what" is said [8]. The physician-patient communication was studied among primary care physicians and surgeons. Physicians with no-claim seemed to conduct longer visits, educate patients more, check understanding more and use more humour during the visit than physicians with claims [9]. A study by Kuzel [10] showed that negative outcomes in the clinician-patient relationship, dominated by stories of disrespect or insensitivity, were reported as more common than technical errors in diagnosis and treatment.The Institute for Healthcare Improvement (IHI) emphasizes that the health care system needs to be more patient-centred and to involve the patients and families in the design of care. Patient-centred care requires respect for patients' values and expressed needs, information and communication, coordination of care, involvement of family, 4 and concordance between the patient and health professionals [11]. Eldh [12] concludes that health care professionals should support patient participation by recognizing the patient as an individual and as a resourceful partner. The benefits of patient-centred care could be that patients are more motivated to follow treatment advice [13] and are more satisfied with health care [14].Patient satisfaction is used as a common quality indicator in health care [15][16]. A problem using patient satisfaction as a quality indicator depends on the complexities where different factors could affect the outcome, and the reliability and validity questioned [17]. Factors such as gratitude, faith and loyalty to health care providers, could influence patient satisfaction [18] as well as background factors such as age, health status and expectations of care [19][20]. A patient's evaluation could be positive, even when care...

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Section: Discussionmentioning

confidence: 99%

Patients’ and relatives’ complaints about encounters and communication in health care: Evidence for quality improvement

Jangland

Gunningberg

Carlsson

2009

Patient Education and Counseling

131

141

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“…[10][11][12][13][14] In this case the various tenets from philosophy of science determine what is evidence and can be summarized as knowledge that is:…”

Section: Conceptualizing and Combining Evidence For Health System Guimentioning

confidence: 99%

“…8 The research community's view of evidence, although not uniform, is narrower and generally restricted to information generated through a prescribed set of processes and procedures recognized as scientific. [10][11][12][13][14] In this case the various tenets from philosophy of science determine what is evidence and can be summarized as knowledge that is:…”

Section: Section 1: What Counts As Evidence? Two Views Of Evidence -Cmentioning

confidence: 99%

“…34 Indeed, some authors appear to implicitly assume that experiential and context evidence are too elusive to be captured by means of research: "this paper outlines … four types of evidence … research, clinical experience, patient experience and information from the local context." 10 Many others, however, see a broad range of factors that can be illuminated with research methods, beyond the health effects of clinical programs or interventions: "For … improvements in public health decision-making to occur, the systematic evaluation of research on potential interventions and the contextual factors, such as acceptability to stakeholders and implementation constraints, need to be considered together." 7 The variety of evidence dimensions or categories proposed in the articles of this review are summarized in Box 2.…”

Section: Dimensions Of Context and Scientific Evidencementioning

confidence: 99%

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Wildlife Health 2.0: Bridging the Knowledge-to-Action Gap

Stephen

2017

Journal of Wildlife Diseases

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OUR PURPOSE VisionOur vision is a strong Canadian healthcare system that is guided by solid, research-based management and policy decisions. MissionTo support evidence-based decision-making in the organization, management, and delivery of health services through funding research, building capacity, and transferring knowledge. StrategyTo establish and foster linkages between decision makers (managers and policy makers) and researchers in the governance of the foundation and in the design and implementation of programs to support research, develop researchers, and transfer knowledge. Main Messages• At a basic level, the notion of evidence concerns facts (actual or asserted) intended for use in support of a conclusion.• Most decision makers view evidence colloquially -"anything that establishes a fact or gives reason for believing something" -and define it by its relevance. Most researchers view evidence scientifically -the use of systematic, replicable methods for production -and define it by its methodology.• Scientists' views on the role of evidence divide into those who emphasize more context-free universal truths (identified closely with "evidence-based medicine") and those who emphasize a context-sensitive role for evidence in a particular decision (identified closely with the applied social sciences).• The appropriate methods for obtaining scientific evidence on context factors are not the same as those for obtaining scientific evidence on program or intervention effectiveness -but this makes such evidence no less "scientific."• Scientific evidence on context can usefully be divided into evidence about attitudes, implementation, organizational capacity, forecasting, economics/finance, and ethics.• Colloquial evidence can usefully be divided into evidence about resources, expert and professional opinion, political judgment, values, habits and traditions, lobbyists and pressure groups, and the particular pragmatics and contingencies of the situation.• These three different forms of evidence -colloquial evidence, scientific evidence on effectiveness, and scientific evidence on context -will not combine of themselves to produce health system guidance; combining and interpreting them requires a deliberative process.• A deliberative process is participative and often follows a period of consultation with relevant stakeholders; it entails both the eliciting and the combining of various types of evidence in order to reach an evidence-based judgment.• There is little evidence on the effectiveness of deliberative processes, though there is much to be said in favour of them on grounds of principle.• The design of a deliberative process is not neutral and may well influence the relative weights assigned to each of the three forms of evidence, thus influencing the extent to which guidance is "evidence-based."• Characteristics of a deliberative process likely to ensure evidence-based guidance include consultation with all parties affected by the outcome, fair representation of scientists and stakeholders, high-quality s...

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“…EBP aims to enhance the quality of clinical services and assists in justifying the impact of health care provided by practitioners (Lin et al, 2010;Rycroft-Malone, 2010;Rycroft-Malone et al, 2004). Practicing based on evidence is a ubiquitous need today, given that research knowledge related to health care is constantly being created and growing exponentially within the globalized world.…”

Section: Introductionmentioning

confidence: 99%

Sources of information used by paediatric occupational therapists in Chile to make clinical decisions

Rojas¹

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IntroductionEvidence-based practice (EBP) is a global movement that fosters the use of research evidence, clinical expertise, the patient's values and circumstances, and information from the practice context. It aims to support high quality practice through providing and using sound evidence for decision making, thereby enhancing the client's outcomes. Occupational therapists have been challenged to advance the profession and adopt EBP as a global approach. Although EBP has been increasingly promoted and applied in occupational therapy over the last twenty years, there is a scarcity of research conducted in developing countries, and evidence-based occupational therapy is not yet a worldwide reality. Chile, a developing country graduating an increasing number of occupational therapists, provides a useful case for exploring EBP. The aim of this study was to investigate which sources of information are accessed by occupational therapists in Chile, and how knowledge is built and integrated in paediatric practice. MethodsInterpretive description served as the methodological framework for this study. Ten Chilean occupational therapists, who had diverse demographic profiles and worked in a variety of paediatric settings, were recruited. Participants completed in-depth interviews regarding their decision-making in daily practice. Interviews were conducted in Spanish, transcribed verbatim in Spanish, and then translated into English. Data were rigorously coded and analyzed thematically. To enhance credibility of the data analysis, preliminary conceptualizations and interpretations were returned to the participants for their critical DiscussionScarce access to research knowledge, precarious development of a research culture and lack of connection with the global scientific community can lead occupational therapists to rely on information that has not undergone quality evaluation. In Chile, the absence of regulatory bodies represent an additional risk to the profession , as there are no formal procedures to oversee the quality of professional practice, the standards of continuing professional development nor educational programs. Practitioners may benefit from developing a clinical reasoning framework based on evidence to guide their decision-making, in order to improve quality of practice and client outcomes. The establishment of a clinical reasoning framework based on evidence might be particularly relevant at this time, due to the increasing number of educational programs offering occupational therapy training in Chile.

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What counts as evidence in evidence‐based practice?

Cited by 740 publications

References 48 publications

Patients’ and relatives’ complaints about encounters and communication in health care: Evidence for quality improvement

Patients’ and relatives’ complaints about encounters and communication in health care: Evidence for quality improvement

Wildlife Health 2.0: Bridging the Knowledge-to-Action Gap

Sources of information used by paediatric occupational therapists in Chile to make clinical decisions

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