Australian Physiotherapists Research Articles

Current practice in management of pelvic girdle pain amongst physiotherapists in Norway and Australia

Pelvic girdle pain (PGP) is frequently managed by physiotherapists. Little is known about current physiotherapy practice and beliefs in the management of PGP disorders. The primary aim of this study was to investigate current practice and beliefs in management of PGP among physiotherapists working in Norway and Australia. A secondary aim was to compare current practice with clinical guidelines. A questionnaire was developed and electronically distributed to physiotherapists in Norway (n = 65) and Australia (n = 77). Treatment and management were determined via responses to 2 case vignettes (during pregnancy, not related to pregnancy), with participants selecting their four primary preferences for treatment and management from a list of 33 possibilities. During pregnancy, ‘education around instability’ and ‘soft tissue treatment’ were selected amongst the most common interventions by physiotherapists in both countries. Norwegian physiotherapists selected ‘pelvic floor exercises’ more frequently, while Australian physiotherapists more commonly selected ‘correcting functional impairments’. In the other case, common responses from both countries were ‘hip strengthening in weight bearing’ and ‘correction of functional impairments’. Norwegian physiotherapists selected ‘general physical exercise’ and ‘general education’ more frequently, while Australian physiotherapists more commonly selected ‘hip strengthening in non-weight bearing’ and ‘muscular relaxation of the abdominal wall/pelvic floor’. Beliefs about PGP were generally positive in both groups while knowledge of and adherence to clinical guidelines were limited. The findings provide direction for future research related to the management and treatment of PGP, and targets for education of physiotherapists working in this area.

Australian physiotherapists and their engagement with people with chronic pain: do their emotional responses affect practice?

This study explores the experiences of Australian physiotherapists who see people with chronic pain as part of their daily practice. It has been established in the literature that Australian physiotherapists do not manage people with chronic pain well; however, the reasons for this are not well understood. This study aimed to explore this phenomenon through a qualitative approach that generated data about the perceptions of physiotherapists in regard to caring for people with chronic pain. Fourteen physiotherapists were interviewed using a semi-structured interview approach. The results indicate that the therapists experience emotional responses to people with chronic pain, which lead to difficulties in being able to successfully provide effective care. These findings also provide the beginnings of a framework that may support physiotherapists in engaging more successfully with people with chronic pain.

Australian physiotherapists’ priorities for the development of clinical prediction rules for low back pain: A qualitative study

ObjectiveTo identify the types of clinical prediction rules (CPRs) for low back pain (LBP) that Australian physiotherapists wish to see developed and the characteristics of LBP CPRs that physiotherapists believe are important. DesignQualitative study using semi-structured focus groups. SettingMetropolitan and regional areas of New South Wales, Australia. ParticipantsTwenty-six physiotherapists who manage patients with LBP (77% male, 81% private practice). ResultsParticipants welcomed the development of prognostic forms of LBP CPRs. Tools that assist in identifying serious spinal pathology, likely responders to interventions, patients who are likely to experience an adverse outcome, and patients not requiring physiotherapy management were also considered useful. Participants thought that LBP CPRs should be uncomplicated, easy to remember, easy to apply, accurate and precise, and well-supported by research evidence. They should not contain an excessive number of variables, use complicated statistics, or contain variables that have no clear logical relationship to the dependent outcome. It was considered by participants that LBP CPRs need to be compatible with traditional clinical reasoning and decision-making processes, and sufficiently inclusive of a broad range of management approaches and common clinical assessment techniques. ConclusionThere were several identified areas of perceived need for LBP CPR development and a range of characteristics such tools need to encompass to be considered clinically meaningful and useful by physiotherapists in this study. Targeting and incorporating the needs and preferences of physiotherapists is likely to result in the development of tools for LBP with the greatest potential to positively impact clinical practice.

Weight management including dietary and physical activity advice provided by Australian physiotherapists: a pilot cross-sectional survey

Physiotherapists may have an impact on obesity prevention and treatment by providing nutrition and physical activity advice to overweight or obese clients; yet little is known about physiotherapists’ beliefs and practices related to client weight management. The aim of this pilot study was to determine the practices, beliefs, attitudes and knowledge of physiotherapists regarding the provision of weight management advice to overweight or obese clients. Physiotherapists (n = 65) working in multiple practice settings completed a self-administered questionnaire. Logistic regression determined factors associated with the provision of dietary and physical activity advice for weight management. The majority of physiotherapists (n = 53 [81.5%]) believed providing weight management advice was within their scope of practice, yet only a minority had received training during their professional entry level education (n = 13 [20%]) or through professional development (n = 7 [11%]). Most physiotherapists (n = 55 [84.6%]) provided physical activity advice for weight management, but a minority (n = 27 [41.5%]) provided dietary advice. Having received training in weight management during their professional entry level education was associated with providing dietary advice (Odds ratio 8.8, 95% confidence interval 2.0–38.9, p = 0.004). Training in weight management may increase the likelihood of physiotherapists providing dietary advice, improving physiotherapists’ management of obesity.

Exploring how Australian occupational therapists and physiotherapists understand each other’s professional values: implications for interprofessional education and practice

This article provides insight into the values Australian occupational therapists and physiotherapists consider essential for their practice and the values that they perceive as important for each other. Findings from a study that employed the Delphi technique to identify the values occupational therapists and physiotherapists consider essential for their practice were compared with interview results that provide insight into how these professionals perceive one another’s values. The results from this comparison indicate that occupational therapy and physiotherapy participants have limited knowledge of each other’s values. This is evidenced by participants only identifying a minority of the values considered essential within the other profession and not identifying many of the values that guide daily practice within the other profession. The results hold implications for interprofessional education and practice, where knowledge of the values of other professions in the team is essential. To enable interprofessional collaboration, professions need to make their values explicit and provide their students, practitioners and educators with opportunities to learn about their own values and the values of other professions.

Non-medical prescribing by physiotherapists: Issues reported in the current evidence

Physiotherapists should be proactive in preparing themselves to participate in innovative models of health care, which are emerging from the healthcare workforce reforms in Australia. One challenging outcome of workforce change is physiotherapy (non-medical) prescribing (NMP), which is part of the extension of scope of physiotherapy practice. This paper summarises the current evidence base for Australian physiotherapists seeking to obtain prescribing rights. A targeted literature review was undertaken through EBSCO Host, Cochrane, Medline, SportsDiscus, Cinahl, Healthsource and Google.com using broad search terms to identify peer-reviewed and grey literature pertaining to NMP by physiotherapists, nationally and internationally. No critical appraisal was undertaken however literature was structured into the NHMRC hierarchy of evidence. Themes raised in the included literature were reported descriptively. There were six relevant peer-reviewed articles, of hierarchy levels III_3 and IV. There was however, comprehensive and recent grey literature to inform Australian physiotherapy NMP initiatives. Themes included the need for standard National action in relation to legislative and regulatory/registration issues, appropriate education, credentialing and supervisory requirements for physiotherapy prescribing.Many lessons can be learnt from the literature, including the importance of planned, uniform National action (rather than piecemeal state-by-state initiatives). Essential elements include appropriate training and skills-based recognition within the discipline and the broader health team, and the need to overtly demonstrate effectiveness and safety. Regularly-evaluated service-delivery models which support NMP by physiotherapists are further required, to demonstrate efficiency, timeliness, patient centredness and equity.

Professional issues in the use of diagnostic ultrasound biofeedback in physiotherapy of the female pelvic floor

The usage of diagnostic ultrasound equipment has expanded into physiotherapy. The aim of this paper is to deliver to both the ultrasound and physiotherapy professions an understanding of the use of diagnostic ultrasound for biofeedback in physiotherapy of the female pelvic floor and the issues related to competent and safe practice, including accessing suitable training. This has been evaluated using a qualitative research paradigm with data gathered via focus groups of Australian physiotherapists. The target group were pelvic floor physiotherapists as this is one of the main uses of diagnostic ultrasound within physiotherapy and the main area physiotherapists would like to be trained in. Two focus groups were run with a total of sixteen physiotherapists. Focus group participants reported their training in diagnostic ultrasound to be largely self directed. They also reported they were learning on their patients. Despite very limited training, participants demonstrated some familiarity with images and equipment settings. Participants felt the modality had a role within physiotherapy as an adjunct to their current practices. The main need raised by participants during the focus groups was related to patient expectations and the fact that the physiotherapist may miss evidence of pathology.

Exploring the Professional Values of Australian Physiotherapists

A profession's values guide daily practice and professional behaviours. They clarify what professionalism means to a profession, by providing insight into the values that members of the profession aim to uphold and profess. There has been limited research into the values of the Australian physiotherapy profession, and as such, the values that guide practice and constitute professionalism are not explicit. This study aimed to make a preliminary identification of the values of the profession, by exploring the shared professional values of 14 Australian physiotherapists. This study was guided by a qualitative approach and constructivist paradigm. Purposive sampling was employed to identify physiotherapists who could contribute rich information to the study. Semi-structured interviews were conducted and analysed using an inductive data analysis method. The emerging professional values formed three main themes. The first theme, 'the patient and the patient-therapist partnership', incorporated values such as having patient trust and working collaboratively with patients. The theme labelled 'physiotherapy knowledge, skills and practice' included the values of having an evidence base and respecting professional boundaries. The last theme, 'altruistic values', was inclusive of values such as honesty, empathy and caring. The values that emerged went beyond philanthropic values, to values that guided every day practice, professional relationships and the responsibilities of being a professional. The results contribute to research orientated towards identifying the values of the profession and in doing so, clarifying what professionalism means to the Australian physiotherapy profession. Differences between the values identified by the American Physical Therapy Association and the study reported in this paper highlight the importance of identifying the values of the profession within the Australian context. In terms of practice implications, physiotherapists may be prompted to reflect on their values and how these values align with those of their patients.

Physiotherapy in Critical Care in Australia

A physiotherapist is part of the multidisciplinary team in most intensive care units in Australia. Physiotherapists are primary contact practitioners and use a comprehensive multisystem assessment that includes the respiratory, cardiovascular, neurological, and musculoskeletal systems to formulate individualized treatment plans. The traditional focus of treatment has been the respiratory management of both intubated and spontaneously breathing patients. However, the emerging evidence of the longstanding physical impairment suffered by survivors of intensive care has resulted in physiotherapists re-evaluating treatment priorities to include exercise rehabilitation as a part of standard clinical practice. The goals of respiratory physiotherapy management are to promote secretion clearance, maintain or recruit lung volume, optimize oxygenation, and prevent respiratory complications in both the intubated and spontaneously breathing patient. In the intubated patient, physiotherapists commonly employ manual and ventilator hyperinflation and positioning as treatment techniques whilst in the spontaneously breathing patients there is an emphasis on mobilization. Physiotherapists predominantly use functional activities for the rehabilitation of the critically ill patient in intensive care. While variability exists between states and centers, Australian physiotherapists actively treat critically ill patients targeting interventions based upon research evidence and individualized assessment. A trend toward more emphasis on exercise rehabilitation over respiratory management is evident.

Evidence-Based Practice (EBP) in Rehabilitative Physiotherapy

Evidence-Based Practice (EBP) is considered to be an essential component of clinical service delivery in healthcare. Australian physiotherapists have access to a wide range of resources to support the implementation of EBP. However, research indicates variability in how physiotherapists apply EBP with a range of factors affecting the successful implementation of EBP into everyday clinical practice. Using survey methodology, this study examined whether participation in an EBP professional development workshop is an effective strategy to enhance knowledge, attitudes and behaviours associated with EBP of physiotherapists working in a rehabilitation setting. Results revealed that nearly one third of participants rated their EBP knowledge and skills at a higher level following attendance at the workshop. An increase in the frequency in EBP related activities by physiotherapists including conducting searches and reading or reviewing research literature to support clinical decision-making was observed following attendance at the EBP workshop. Participants’ opinions of the value of EBP in improving the quality of patient care were noted to be more positive following the workshop. This small-scale study provides some promising results regarding the positive effects that designated EBP professional development can have on knowledge, attitudes, and behaviours of physiotherapists in their application of EBP. The elements that are required to further support and sustain a strong EBP culture amongst physiotherapists working in rehabilitation are also discussed.

Thoracic Hyperkyphosis: A Survey of Australian Physiotherapists

Age-related thoracic hyperkyphosis can lead to poor health outcomes including pain and dysfunction. Physiotherapists are fundamentally involved in the assessment and treatment of this problem but there is no published data that details assessment and treatment strategies or the attitudes of practitioners with respect to hyperkyphosis. The purpose of the study is to ascertain current physiotherapy practice for, and attitudes to, the assessment and treatment of thoracic hyperkyphosis in Australia. A stratified random sample (N = 468) of Australian physiotherapists in all states and territories working in hospitals, outpatient clinics and community clinics were sent an anonymous cross-sectional postal survey. The survey had six sections identifying clinical profile, prevalence, measurement strategy, treatment frequency, treatment strategy and evidence source. A response rate of 47% with anonymity preserved was achieved. The majority of respondents had a musculoskeletal practice profile (75%). Seventy-eight per cent encountered hyperkyphosis at least weekly, and three treatment sessions were most commonly given (35%). Visual inspection was almost universally used to assess the degree of hyperkyphosis (98%), and for 64% it was their only measurement tool. Postural re-education was the most common treatment strategy (90%) but the range of treatments reported was diverse. The primary source of evidence used by the majority of respondents was their undergraduate education, and there was concern expressed that physiotherapists lack good evidence upon which to make therapeutic decisions about hyperkyphosis. Thoracic hyperkyphosis is commonly encountered by physiotherapists. Measurement of treatment efficacy is highly subjective, and the treatment modalities employed are diverse. Many physiotherapists based their management of hyperkyphosis on their undergraduate education alone.

Core components of communication of clinical reasoning: a qualitative study with experienced Australian physiotherapists

Communication is an important area in health professional education curricula, however it has been dealt with as discrete skills that can be learned and taught separate to the underlying thinking. Communication of clinical reasoning is a phenomenon that has largely been ignored in the literature. This research sought to examine how experienced physiotherapists communicate their clinical reasoning and to identify the core processes of this communication. A hermeneutic phenomenological research study was conducted using multiple methods of text construction including repeated semi-structured interviews, observation and written exercises. Hermeneutic analysis of texts involved iterative reading and interpretation of texts with the development of themes and sub-themes. Communication of clinical reasoning was perceived to be complex, dynamic and largely automatic. A key finding was that articulating reasoning (particularly during research) does not completely represent actual reasoning processes but represents a (re)construction of the more complex, rapid and multi-layered processes that operate in practice. These communications are constructed in ways that are perceived as being most relevant to the audience, context and purpose of the communication. Five core components of communicating clinical reasoning were identified: active listening, framing and presenting the message, matching the co-communicator, metacognitive aspects of communication and clinical reasoning abilities. We propose that communication of clinical reasoning is both an inherent part of reasoning as well as an essential and complementary skill based on the contextual demands of the task and situation. In this way clinical reasoning and its communication are intertwined, providing evidence for the argument that they should be learned (and explicitly taught) in synergy and in context.

Knowledge and use of craniovertebral instability testing by Australian physiotherapists

Internationally, manual therapy has moved towards formalised guidelines for pre-manipulative screening of the cervical spine. A controversial aspect to emerge from this involves craniovertebral instability (CVI) testing. This study examined current practice, knowledge and attitudes of Australian physiotherapists regarding pre-manipulative testing for CVI. Members of Musculoskeletal Physiotherapy Australia were surveyed by formally validated questionnaire. Sub-group analysis was performed by post-graduate musculoskeletal qualification. The response rate was 37.8%. Respondents provided differing definitions of CVI; 46.5% describing loss of anatomical integrity and 24.9% a biomechanical problem. Over half indicated they rarely or never used stress tests for CVI screening. Of 42 published signs and symptoms associated with CVI, seven were identified by more than 50% of respondents. Of published disorders associated with CVI, four were considered worthy of testing by more than 30% of respondents. Support for inclusion of information on CVI in pre-manipulative guidelines was given by 87% of respondents. Recommendations for screening tests received less support, particularly among physiotherapists holding post-graduate musculoskeletal qualifications ( p = 0.0002). These results indicate disagreement regarding the nature and presentation of CVI. Clinical testing is inconsistent, reflecting underlying confusion about CVI. Currently, there is not an appropriate level of knowledge or willingness to recommend guidelines for CVI screening.

Current Australian physiotherapy management of hip osteoarthritis

Objectives Symptomatic osteoarthritis can be a painful, costly and debilitating condition. Whilst there is a substantial body of literature surrounding osteoarthritis of the knee, there is less reported research on the hip joint, especially pertaining to physiotherapy intervention. This descriptive study aimed to describe current physiotherapy management of osteoarthritis of the hip by Australian physiotherapists in private practice and acute hospital settings. Design Cross-sectional survey. Participants A questionnaire was administered to 364 public and private practitioners in the state of Victoria. Results A response rate of 66% was achieved. Physiotherapists working in the private and public sectors reported frequent use of manual therapy (78% and 87%, respectively), aquatic therapy (82% and 58%, respectively) and home exercise programmes (88% and 80%, respectively). Class-based physiotherapy is employed less frequently (44% and 28%, respectively). Strengthening exercises are the most common treatment technique. Conclusions The widespread use of exercise and manual therapy in the management of osteoarthritis of the hip is highlighted. There was little difference in overall physiotherapy management between the public and private settings. The results identify interventions commonly used in clinical practice. The need for further research to evaluate the effectiveness of frequently used interventions is also highlighted.

The ‘lone ranger’: a descriptive study of physiotherapy practice in Australian emergency departments

Objectives Physiotherapy services have recently been introduced to Australian emergency departments in an attempt to address service delivery issues such as access block. This study aimed to determine the roles, including those relating to extended scope practice, currently undertaken by physiotherapists in Australian emergency departments. Design Descriptive cross-sectional design. An Internet-based survey, containing 37 items to access demographic and perceptual data, was distributed to Australian emergency department physiotherapists between 8 February and 30 April 2009. Twenty-eight of these questions generated categorical data, which were analysed using frequency distributions. Thematic analysis was undertaken for the nine questions that generated text responses. Participants Participants were included if they were registered Australian physiotherapists working in an emergency department as part of the multidisciplinary team, and did not provide on-call service to the emergency department. Twenty-eight Australian emergency department physiotherapists met the inclusion criteria and completed the survey. Results The respondents were predominantly females working on a full-time basis in the emergency department. Responses indicated that the role is subject to time pressures with an emphasis on diagnosis and discharge planning. One respondent described emergency department physiotherapists as ‘lone rangers’ due to their autonomous work. Australian emergency department physiotherapists are not currently performing extended scope tasks, as many are prohibited under Australian legislation, but it is also unclear which tasks might be classified as extended scope. Conclusion Australian emergency department physiotherapists currently perform traditional physiotherapy roles in a non-traditional work environment. The role is aligned with musculoskeletal physiotherapy; however, there is a degree of holistic care involved, particularly for elderly patients. The effect that an emergency department physiotherapy service has on health outcomes is not known, but the study participants indicated that they believe their service has system-wide benefits.

A national study of the availability and use of electrophysical agents by Australian physiotherapists

Electrophysical agents (EPAs) are a core part of physiotherapy practice and entry level education. With the increase in the number of EPAs over time, their availability and use in contemporary physiotherapy practice is an important consideration when determining entry level curricula. Thus, the aim of the study was to ascertain the current availability and usage of EPAs in Australian physiotherapy practice. A purpose-designed questionnaire was mailed to all registered physiotherapists in Australia. A response rate of 27% was obtained (n=3,538). Nonresponder analyses indicated that the results were representative of the total population of Australian physiotherapists. Over 70% of respondents had access to ultrasound, cold packs/ice, heat packs, electrical stimulation for sensory stimulation, and interferential therapy. Two main groups of EPAs were used relatively frequently. The first group was used daily or monthly by 60% of respondents (ultrasound, hot packs, and cold packs/ice), and a second group (electromyographic and pressure biofeedback, interferential therapy, and electrical stimulation for sensory stimulation) was used on a daily or monthly basis by between 30% and 45% of the sample. A group of EPAs, including ultraviolet light, microwave, and shortwave diathermy, was not used by over 90% of the sample. The study has provided contemporary national data on EPA availability and use in Australia.

Preparedness of new graduate Australian physiotherapists in the use of electrophysical agents

Objective To determine the perceptions of physiotherapists concerning the preparedness of new graduates to use electrophysical agents (EPAs) in clinical practice. Design An observational cross-sectional questionnaire was developed and demonstrated to be reliable and valid. Participants The questionnaire was mailed to all registered physiotherapists in Australia in 2005 ( n = 12,893). Results In total, 3538 questionnaires were returned complete. Two forms of non-responder analysis indicated that the sample and their associated responses were representative of the Australian physiotherapy population. Eight out of 10 new graduates felt prepared to use EPAs that are common in Australian clinical practice. However, 80% felt underprepared to use a range of other EPAs. Similar trends were found when new graduate preparedness was examined from the perspective of physiotherapists who were working with or mentoring new graduates. However, experienced physiotherapists rated preparedness lower than the new graduates themselves ( χ 2 = 525.7, P < 0.01). Conclusions These findings raise questions about the adequacy of entry-level education and the level of competence expected of new graduates for the safe and effective application of a range of EPAs upon entry to the workforce. The findings indicate the need for clearer guidelines on the levels of competency expected of new graduate physiotherapists in Australia.

Rehabilitation and exercise prescription in Australian intensive care units

Objectives To identify methods of exercise prescription by physiotherapists across Australian intensive care units (ICUs), including the most commonly used activities for both mechanically ventilated and spontaneously breathing patients; and to determine the outcome measures used for the evaluation of exercise intervention. Design Postal questionnaire. Setting One hundred and sixty-seven adult ICUs across all Australian states and territories. Participants Australian intensive care physiotherapists. Results In total, 126 questionnaires were returned from all states and territories of Australia except the Northern Territory. Almost half of the ICUs (49%, 20/41) that did not return a questionnaire lacked a permanent physiotherapy service. Seventy-eight percent (87/111) of respondents were senior staff, and 49% (54/111) of respondents had worked in ICUs for longer than 5 years. Almost all (94%, 104/111) physiotherapists prescribed exercise routinely for ICU patients, with active and active-assisted exercise techniques along with mobilisation being the most common activities utilised. Heart rate, oxygen saturation and respiratory rate were the most important factors used in modification of exercise prescription. Seventy-one percent (79/111) of respondents prescribed exercise routinely for mechanically ventilated patients, but altered the type of exercise prescription for these patients compared with spontaneously breathing patients. Only one-third (34%, 38/111) of physiotherapists used outcome measures routinely in ICU exercise prescription. Conclusions Although a large majority of ICU physiotherapists prescribed exercise routinely in ICU patients (including those on mechanical ventilation), practice varies widely throughout Australia. No validated, functional exercise outcome measures were used, highlighting that further research is required to enable adequate evaluation of exercise prescription and rehabilitation in ICUs.

Physiotherapy education in Australia

Physiotherapy university education commenced in Australia more than 100 years ago. In 2007, baccalaureate and graduate entry programmes are available in 14 universities. Rigorous educational standards set by the universities must also meet the Australian Physiotherapy Council requirements before programmes are accredited and their graduates are eligible for registration to practice. Academic and clinical physiotherapists have contributed to the development of these national standards and continue to work collaboratively in the delivery of educational programmes where clinical education is an integral component of all degrees. Physiotherapy graduates are broadly representative of Australia's multicultural community although with a higher percentage of women. There are about 1100 graduates annually joining a workforce of about 16,000 physiotherapists. Australian physiotherapists have enjoyed autonomous primary care practice for more than 30 years. A wide range of specialist areas is open to them, supported by extensive continuing education and formal university programmes leading to postgraduate doctoral and masters degrees in clinical practice and research.

Perspectives on research evidence and clinical practice: a survey of Australian physiotherapists

Physiotherapists' use of research evidence with clinical decision-making has interested researchers world-wide since 1980; however, little is known about such practices in Australia. The present survey sought information on Australian physiotherapists' perceptions of the importance of research, and barriers to uptake of evidence in clinical practice, when compared with an international cohort from 2001. An Australian-relevant version of an English (UK) National Health Service (NHS) survey instrument was used to canvass 453 physiotherapists, randomly selected from the South Australian Physiotherapy Registration Board 2004-2005 records. The first survey was mailed in August 2005, a reminder was sent two weeks later to non-responders and a follow-up survey was sent in April 2006 to non-responders whose addresses had changed since 2005. There was a 51% response rate. Of the non-responders, 12% were not contactable at their listed address, highlighting the mobility of Australian physiotherapists. Most respondents had undertaken research as students (59.5%) or as students and clinicians (11.5%). Of these, 37.1% were encouraged to embark on more research, and 20.5% were discouraged. The significant predictors of positive perceived importance of research were: previous research experience; being positive about undertaking further research; working in hospitals and holding a postgraduate degree. Clinicians working privately were significantly less likely than managers to be positive about research importance. The only significant predictor for not perceiving barriers to uptake of evidence was being positive about undertaking future research. The study identified constraints on uptake of evidence into practice that were related to accessing, reading and interpreting published research, and implementing findings. Found consistently across employment categories were barriers relating to lack of time, uncertainty about what the research reported, scepticism about the value of research and being isolated from peer support and literature sources. The responses indicated a positive shift towards evidence uptake since the 2001 NHS survey, suggesting an influence of increased exposure to information on evidence-based practice. A greater focus on research whilst training, the application of educational strategies for empowerment, better knowledge transfer and upskilling within the workplace, and ensuring dedicated time and organizational support for research activities are indicated.