Barriers to evidence-based physiotherapy practice for stroke survivors in Ghana.

Jonathan Quartey,Samuel Kwakye

doi:10.4102/sajp.v74i1.423

Jonathan Quartey, Samuel Kwakye

Open Access

https://doi.org/10.4102/sajp.v74i1.423

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Abstract

BackgroundPhysiotherapy has evolved over the years, and this has led to an increasing demand in using evidence as a basis for making clinical decisions because evidence-based interventions for stroke have been shown to be effective. However, the inability to carry out any of the evidence-based practice (EBP) processes may constitute a barrier to its application in practice.AimTo determine the barriers to EBP of physiotherapy services for stroke survivors in Ghana.MethodsA cross-sectional study that involved 121 physiotherapists of the Ghana Physiotherapy Association providing services to stroke survivors. Physiotherapists completed a self-administered questionnaire. Logistic regressions were used to examine relationships between socio-demographic and practice characteristics of respondents and each practitioner factor. A logistic regression was used to identify the association between organisational characteristics and each organisational factor that facilitates EBP.ResultsSelf-efficacy ratings for performing EBP were below 50% for critical appraisal of the literature and interpretation of statistics. All the participants stated that they had organisational challenges, which tend to affect the implementation of evidence-based physiotherapy practice for stroke. The five most reported barriers to updating knowledge on EBP included lack of organisational mandate (56.2%), insufficient time (46.3%), lack of information resources (43%), lack of understanding of statistics (35.5%) and lack of interest (33.1%).ConclusionLack of adequate resources, lack of organisational support and low self-efficacy to perform EBP activities constitute barriers to implementing EBP for stroke survivors.Clinical implicationsFindings of the study reinforce the need to develop a supportive organisational infrastructure to increase research integration in physiotherapy practice.

Highlights

Evidence-based practice (EBP) is a five-step process through which clinicians integrate research evidence with clinical expertise and patient preferences, producing the most appropriate and effective service (Bello 2011)
A systematic review of studies conducted over the world, describing current evidence of EBP by physiotherapists (PTs), showed that the most frequent barriers reported were lack of time, inability to understand statistics, lack of support from employer, lack of resources, lack of interest and lack of generalisation of results (Mota da Silva, Costa & Garcia 2015)
Contrary to the findings made by Jette et al (2003), participants (PTs) of this study rated their confidence in research as very low, likewise critical appraisal of psychometrics and statistics

Summary

Introduction

Evidence-based practice (EBP) is a five-step process through which clinicians integrate research evidence with clinical expertise and patient preferences, producing the most appropriate and effective service (Bello 2011). It includes expressing questions that arise from clinical practice in a searchable format; effectively finding the best evidence to address the question, a step that may require an online literature search; and critically appraising the evidence for validity, impact and applicability to the clinical question (Silva, Costa and Costa 2015). The inability to carry out any of these functions may constitute a barrier to the application of EBP in practice. The inability to carry out any of the evidence-based practice (EBP) processes may constitute a barrier to its application in practice

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