Investigating attitudes, skills, and use of evidence-based practice among Norwegian chiropractors; a national cross-sectional study

Abstract

Background Evidence-based practice (EBP) is essential in improving the quality of healthcare and of importance for all health care personnel. No study in Norway has investigated attitudes, skills and use related to EBP among chiropractors. The aim of this study was to describe Norwegian chiropractors’ attitudes, skills, and use of EBP, as well as the barriers and facilitators to their use of EBP. Methods A national cross-sectional survey, the online version of the Evidence Based practice Attitudes & Utilisation SurvEy (EBASE), was sent by email to 770 Norwegian practicing chiropractors, all members of the Norwegian Chiropractic Association. Three EBASE sub-scores were generated (Attitudes, Skills and Use), and the demographic characteristics of the sample were reported. Linear regression analyses were conducted to examine the association between responses of the three sub-scores and demographic characteristics. Information on main barriers and facilitators of EBP was collected and described. Results A total of 312 (41%) chiropractors responded to the survey, and 95% agreed that EBP is necessary for chiropractic practice. While overall use of EBP activities was low participants were interested in learning and improving their skills to incorporate EBP into practice. Chiropractors’ attitudes, skills, and use of EBP were positively associated with being female and having spent more than one hour per week on research, but negatively associated with having practiced more than 10 years. Main barriers of EBP were lack of skills to critically evaluate, interpret, and apply research findings to practice. Main facilitators of EBP included access to the internet and free online databases in the workplace. Conclusion Although chiropractors in Norway reported positive attitudes and moderate skills in EBP, their use of EBP activities was limited. The main barriers and facilitators to EBP were primarily related to perceived skills deficits, whilst enablers of EBP were mostly related to infrastructure requirements.

Chiropractic attitude and utilisation of evidence-based practice in South Africa: a secondary analysis

“…Almost 60% of the respondents in our study were female, which was not the case for the Australian and American studies, as males appeared to be more willing to respond (73.4% and 91%, respectively) [ 10 , 17 ]. Males and females were almost evenly distributed in the research conducted on Norwegian chiropractors [ 18 ]. Our study, therefore, reflects similar trends to Yelverton et al, indicating the findings are representative of the sex demographic in South Africa as female chiropractors within the country are increasing [ 19 ].…”

“…Many doctors prefer solo practice because it develops more professional autonomy, which is a key principle of the medical profession [ 21 ]. However, Norwegian chiropractors preferred to work in a multidisciplinary setting with conventional healthcare providers [ 18 ]. In Australia, chiropractors were mainly situated in a suburban setting [ 17 ], similar to South Africa.…”

“…In Australia, chiropractors were mainly situated in a suburban setting [ 17 ], similar to South Africa. The preference to practice in the city and suburban areas were demonstrated in Norway [ 18 ]. Practitioners choose to practice in urban areas because they have more time and are able to operate in a multidisciplinary environment to handle the workload [ 22 ].…”

“…In a comparable study, Americans chiropractors exhibited stronger confidence in their EBP skills except for research evidence synthesis [ 10 ]. Norwegian chiropractors displayed inadequate skills in conducting clinical research or systematic review skills [ 18 ]. These findings can be attributed to chiropractic programs that focus on locating and analysing current data rather than actively performing their own research projects, which are mostly influenced by academics in their respective fields.…”

“…The use of clinical research, publications and CPGs was not the first line of information used to assist patients, nor were patient preferences taken into account when treating, which are practices that did not align with the EBP model. Engagement with EBP activities was also moderately low among Norwegian chiropractors, who consulted published research studies about 1–5 times per month on average [ 18 ]. All types of research sources were deemed valuable, however they were not used as frequently as chiropractors wanted owing to a variety of barriers.…”