Utilisation of research evidence in clinical practice to improve health care delivery- practices, attitudes and challenges faced by physiotherapists in Zimbabwe: a descriptive cross sectional study

Abstract

Background: Decision-making in health care delivery should be based on the best available current, valid and relevant evidence. Healthcare professionals should therefore be well versed with the skills required to make evidence based clinical decisions in patient care. The aims of this study were to investigate the attitudes of physiotherapists towards utilisation of evidence-based practice (EBP) during patient care, identify barriers to the use of EBP and strategies to improve utilisation of EBP. Method: A descriptive cross sectional study was conducted using a survey questionnaire. Fifty five questionnaires were administered to randomly selected physiotherapists, working in either private or public hospitals in Zimbabwe. The questionnaire collected information on demographics, utilisation of EBP, factors affecting use of EBP and recommendations. Results: The response rate was 91 % (n = 50). Majority of respondents (n = 30; 60.0 %) were female, mean age of respondents was 36.4 years (SD = 9.8) and median years of experience was 8.5 (IQR = 5-15). A positive attitude towards EBP was displayed by 18 of 31 respondents (58.1 %) from private hospitals and 14 of 19 respondents (73.4 %) from public hospitals. All participants indicated that the knowledge obtained through undergraduate training was their major source of evidence-based information whilst a combined 19 respondents (38.0 %) indicated reading of journals and carrying out research as their main source of evidence. Lack of time was indicated as the major factor influencing utilisation of EBP by respondents. Limited access to online information was reported by 15 of 19 respondents from public hospitals (78.9 %) to be a major factor affecting their EBP. Respondents recommended training for physiotherapists to improve their skills in critical evaluation of research as a way to promote EBP and highlighted the need for organisational support to facilitate access to online sources of EBP in the clinical environment. Conclusion: Physiotherapists in Zimbabwe seem to rely on knowledge obtained from undergraduate training to guide them in patient care with a few highlighting the importance of research activities to guide clinical practice and their involvement in them. There is need to for physiotherapists to make time to acquire information on evidence based treatment methods in order to improve the quality of clinical practice and ultimately the standard of health care delivery.

Attitudes, perceptions and barriers around evidence-based practice in sports physiotherapy in Kenya

“…This implies that, with the removal of the barriers or with some type of facilitation process, they would be willing to employ EBP at a higher level. This finding is also supported by systematic reviews which found insufficient time to be the most important barrier (Scurlock-Evans et al 2014 ; Tadyanemhandu et al 2016 ). Other studies also established that the respondents believed that insufficient time was the most important barrier: Salbach et al ( 2007 ) at 52%; Akinbo et al ( 2008 ) at 64%; Nilsagård and Lohse ( 2010 ) at 86%; Heiwe et al ( 2011 ) at 43.5% and Ramírez-Vélez et al ( 2015a ) at 84%.…”

“…Positive attitudes were also identified by Scurlock-Evans et al (2014) in a systematic review, as well as in other studies which found physiotherapists with positive attitudes and perceptions regarding EBP (Frantz & Diener 2009;Hannes et al 2009;Heiwe et al 2011;Iles & Davidson 2006;Jette et al 2003;Ramírez-Vélez et al 2015b;Schreiber et al 2009;Silva et al 2015;Tadyanemhandu et al 2016;Yahui & Swaminathan 2017). Specifically, the respondents were found to have a positive attitude to the fact that 'evidence-based practice is important for offering patients the best possible treatment'; and that 'it is important that evidence-based guidelines related to their work exist'.…”

“…This implies that, with the removal of the barriers or with some type of facilitation process, they would be willing to employ EBP at a higher level. This finding is also supported by systematic reviews which found insufficient time to be the most important barrier (Scurlock-Evans et al 2014;Tadyanemhandu et al 2016). Other studies also established that the respondents believed that insufficient time was the most In the context of time being a barrier, the authors consider it important for healthcare institutions to create EBP-friendly incentives, such as the provision of internet-connected computers with access to the necessary search engines and databases.…”

“…In addition, some countries in the Asia-Pacific region, such as Malaysia (Yahui & Swaminathan 2017 ), Australia (Iles & Davidson 2006 ) and India (Panhale & Bellare 2015 ), have also reported positive attitudes among their respondents. Literature from African countries such as Zimbabwe (Tadyanemhandu et al 2016 ) and South Africa (Frantz & Diener 2009 ) have also reported positive attitudes towards EBP. However, a study in Belgium reported negative attitudes towards the concept, purely as a result of concerns around reduced therapeutic autonomy, with a resultant lack of motivation to implement it (Hannes et al 2009 ).…”

Health system challenges affecting falls prevention in persons living with HIV: perspectives from physiotherapists in four sub-Saharan regions

“…An understanding of professional roles within teams can be acquired through interprofessional collaboration during undergraduate education (Berman, 2013). Practicing clinicians may be educated by means of courses, workshops, team meetings, grand rounds and research publications (Tadyanemhandu et al, 2016). In collaboration with other rehabilitation professions, physiotherapists should imprint their hallmark in primary HIV care (Cobbing et al, 2013).…”