Foundation For Evidence-based Practice Research Articles

Seeing the forest (plot) for the trees-the importance of evidence synthesis in older adult care.

Systematically reviewing all the available evidence and then creating summary analyses of the pooled data is the foundation of evidence-based practice. Indeed, this evidence synthesis approach informs much of the care of older adults in hospital and community. It is perhaps no surprise that the journal Age and Ageing is a frequent platform for publishing research papers based on systematic review and synthesis. This research has evolved substantially from the early days of evidence-based medicine and the Cochrane Collaboration. The traditional approach would be a quantitative summary, calculated using pair-wise meta-analysis of randomised controlled trials of drug versus placebo, or a synthesis of observational studies to create summaries of prevalence, associations and outcomes. Methods have evolved and newer techniques such as scoping reviews, test accuracy meta-analysis and qualitative synthesis are all now available. The sophistication of these methods is driven in part by the increasingly complex decisions that need be made in contemporary older adult care. Age and Ageing continues to champion established and novel evidence synthesis approaches, and in the accompanying Collection exemplars of these differing methods are presented and described. Whilst there is marked heterogeneity in the techniques used, the consistent and defining feature of all these papers is the desire to comprehensively, and critically summarise the evidence in order to answer the most pertinent questions regarding older adult care.

Using Evidence-Based Medicine to Support Clinical Decision-Making in RMS.

The foundations of evidence-based practice are the triad of patient values and preferences, healthcare professional experience, and best available evidence, used together to inform clinical decision-making. Within the field of rhabdomyosarcoma, collaborative groups such as the European Paediatric Soft Tissue Sarcoma Group (EpSSG) have worked to develop evidence to support this process. We have explored many of the key research developments within this review, including patient and public involvement, decision-making research, research into areas other than drug development, core outcome sets, reporting and dissemination of research, evidence synthesis, guideline development and clinical decision rules, research of research methodologies, and supporting research in RMS.

Teaching evidence-based practice: Case study of an integrated assessment task for diagnostic radiography students

IntroductionA core competency for all health care professionals is evidence-based practice (EBP). An understanding of research skills are key to diagnostic radiographers adopting EBP, and should be taught and assessed in curricula leading to eligibility to register and practice. This paper focuses on the design, implementation and initial evaluation of an assessment task in the Diagnostic Radiography (DR) curriculum at an Australian university, which aimed to facilitate students’ skills to identify and interpret research methods and output as a foundation for EBP by combining with EBP and DR theoretical content. MethodsAn integrated assessment task was introduced across two units of study, requiring student groups to produce a single literature review incorporating learning objectives from each distinct unit of study. This approach recognised and incorporated themes of student choice, negotiation of group membership, and scholarly writing as inherent components. ResultsStudent feedback showed that students valued the integration of content knowledge and research principles across two units of study to better reflect their depth and breadth of learning. Students also commented on the value of team or group work in developing their communication and cooperation skills, which are essential skills in the DR workplace. DiscussionA literature review assessment task integrated across two previously separate units of study provided an innovative approach to assessment of EBP in the DR curricula. ConclusionIt is anticipated that DR graduates, who are prepared with knowledge and skills in EBP prior to graduation, will become leaders and drive future innovation in EBP.

A Rasch analysis of the self-administered Foot Health Assessment Instrument (S-FHAI)

BackgroundReliable and valid measurement is the foundation of evidence-based practice. The self-administered Foot Health Assessment Instrument (S-FHAI) was recently developed to measure patients’ evaluations of their own foot health. Evidence regarding the psychometric properties of the S-FHAI is limited. The aim of this study was to investigate those properties by using a Rasch analysis.MethodsThis methodological study analysed secondary data that was collected from nurses (n = 411) in 2015. The psychometric properties of the S-FHAI were evaluated using the Rasch model. Unidimensionality was analysed first, followed by item functioning, person misfit and differential item functioning (DIF).ResultsThe S-FHAI demonstrated evidence of unidimensionality, with an acceptable item fit according to the Rasch model. Person fit and person separation were low, however, indicating restricted separation among different respondents. Item separation was high, demonstrating clear discrimination between the items. No DIF was detected in relation to gender, but significant DIF was demonstrated in relation to age for 6 of the 25 items.ConclusionsThe S-FHAI has potential for use in investigating self-reported foot health. The Rasch analysis revealed that the psychometric properties of the instrument were acceptable, although some issues should be addressed to improve the scale. In future, it may be beneficial to analyse the sensitivity of the items and to test the S-FHAI in more diverse patient populations.

Does Action Planning Create More Harm Than Good? Common Challenges in the Practice of Action Planning After Employee Surveys

Despite the popularity of employee surveys in practice, there has been little research to determine how leaders and managers can effectively take action based on survey results. Without a foundation for evidence-based practice, many organizations rely on action planning processes where individual managers are tasked with developing plans to improve attitudes and perceptions among their subordinates. Although action plans are easy to quantify and monitor, it is unclear whether they are useful for creating change. Action planning is often rated as least favorable among other aspects of employee survey programs. Managers may lack the capability to actively change the causes of dissatisfaction among their subordinates. At worst, managers may grow to perceive action planning as a meaningless, box-checking task. This potentially acts to demotivate and demoralize managers while also increasing pessimism toward future surveys. This article provides several suggestions to avoid these potential pitfalls when designing and implementing employee surveys.

Experimental Psychopathology at the Crossroads: Reflections on Past, Present, and Future Contributions to Cognitive Behavioural Therapy

Experimental psychopathology researchers are devoted to understanding the causes and mechanisms of psychological disorders, with the central goal of developing and improving effective interventions. Indeed, cognitive behavioural therapy (CBT) arose from experiments identifying key mechanisms that clinicians can target to reduce their clients’ symptoms. Despite the well-documented efficacy of CBT for diverse problems, many people continue to live with psychopathology, even after CBT. In this paper, we reflect on ways in which experimental psychopathology has advanced CBT (i.e. Where have we been?), areas that are fruitful for continued progress (i.e. Where are we now?), and crucial areas for improvement (i.e. Where are we going?). In particular, we contend that improving the science of psychopathology via open and transparent practices, prioritising diverse samples, testing the effects of specific CBT techniques, and focusing on problems that our clients identify will enable experimental psychopathology research to serve as the foundation for evidence-based practice.

Self-Efficacy: Changing the Tide of Evidence-Based Practice.

The specific aim for this study was to describe differences in evidence-based practice (EBP) and self-efficacy in frontline RNs. This project utilized a national study with a convenience selection of acute care agencies to examine the relationship between organizational and unit culture, EBP, and self-efficacy in frontline nurses. This national study used descriptive correlational methodology to describe differences in EBP and self-efficacy among RNs. The sample included 245 frontline RNs employed in acute care settings. To measure the study variables, the Nursing Evidence-Based Practice Survey(Titler, Hill, Matthews, & Reed, 1999) and the Evidence-Based Nursing Practice Self-Efficacy Scale were used (Tucker, Olson, & Frusti, 2009).Each instrument was delivered via the Qualtrics online platform. The correlation of bivariate interval level variables was analyzed using Pearson's r. The correlation between EBP and self-efficacy was strongly correlated: r(170)=.537, p=.01. Sections within the Nursing Evidence-Based Practice Survey were calculated and found to be significant (unit culture r=.241, p=.01; organizational culture r=.570, p=.01; knowledge, skills, attitude r=.538, p=.01). Several implications exist for education, staff development, and nursing management. Nursing school programs incorporate EBP into the curriculum so that nurses have a foundation for EBP. However, staff development professionals in clinical settings must continue to build on the nurses' knowledge and skill, thus increasing self-confidence for EBP. Nursing management can provide the resources for staffing models and policies to reinforce the value of EBP and positive patient outcomes. This combination provides frontline staff with EBP participation and increased self-efficacy in its usage.

Revisões da literatura científica: tipos, métodos e aplicações em enfermagem

Introdução: O interesse da Enfermagem pela metodologia de revisões da literatura tem vindo a aumentar, constituindo-se métodos que permitem uma prática baseada na evidência científica. Objetivo: Caracterizar os diferentes tipos de revisões da literatura e descrever etapas principais de uma revisão sistemática da literatura. Material e métodos: Revisão narrativa da literatura. Pesquisa em bases de dados nas seguintes plataformas Google Académico, Scientific Electronic Library Online (SciELO), EBSCO Host, e Biblioteca Virtual em Saúde (BVS). As palavras-chave: metanálise; medicina baseada em evidências; literatura de revisão como assunto; metodologia, nos idiomas inglês e português. Resultados: Foram descritas 14 tipos de revisões e analisadas de acordo com o tipo de pesquisa, avaliação da qualidade metodológica dos artigos incluídos, síntese da informação colhida e análise global dos dados. Foram apresentadas as vantagens e desvantagens de cada tipo e descritos os principais passos de uma revisão sistemática da literatura. Conclusões: A revisão sistemática da literatura é um dos alicerces para prática baseada em evidência, uma vez que agrega uma grande quantidade de informações num único estudo. Palavras-chave: metanálise; medicina baseada em evidências; literatura de revisão como assunto; metodologia; enfermagem de reabilitação.

Social Work Research and Evaluation: Foundations of Evidence-Based Practice, 11th edition

Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation David Beimers; Social Work Research and Evaluation: Foundations of Evidence-Based Practice, 11th edition. Journal of Baccalaureate Social Work 1 January 2018; 23 (1): 327–329. doi: https://doi.org/10.18084/1084-7219.23.1.BR327 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest Search

Formulating Clinical Trials in Prosthetics and Orthotics and Allied Health Fields

ABSTRACT Introduction Clinical trials (CTs) are an essential component of modern health care, and a prerequisite to policy making. Clinical trials are the foundation of evidence-based practice and are the final legitimizer of any clinical discipline. Today, the allied health fields in general, and prosthetics and orthotics (P&O) in particular, are at an especially opportune position to launch CT initiatives: There are many “big questions” needing answers and a critical mass of field professionals capable of executing a CT operation. Materials and Methods None. Results None. Conclusion Here, we formalize the call for active engagement in CTs within P&O and provide a framework for CT design, with guidance that generalizes across the allied health fields.

Review of the International Council of Nurses (ICN) Framework of Disaster Nursing Competencies.

The International Council of Nurses (ICN; Geneva, Switzerland) and the World Association for Disaster and Emergency Medicine (WADEM; Madison, Wisconsin USA) joined together in 2014 to review the use of the ICN Framework of Disaster Nursing Competencies. The existing ICN Framework (version 1.10; dated 2009) formed the starting point for this review. The key target audiences for this process were members of the disaster nursing community concerned with pre-service education for professional nursing and the continuing education of practicing professional nurses. To minimize risk in the disaster nursing practice, competencies have been identified as the foundation of evidence-based practice and standard development. A Steering Committee was established by the WADEM Nursing Section to discuss how to initiate a review of the ICN Framework of Disaster Nursing Competencies. The Steering Committee then worked via email to develop a survey to send out to disaster/emergency groups that may have nurse members who work/respond in disasters. Thirty-five invitations were sent out with 20 responses (57%) received. Ninety-five percent of respondents knew of the ICN Framework of Disaster Nursing Competencies, with the majority accessing these competencies via the Internet. The majority of those who responded said that they make use of the ICN Framework of Disaster Nursing Competencies with the most common use being for educational purposes. Education was done at a local, national, and international level. The competencies were held in high esteem and valued by these organizations as the cornerstone of their disaster education, and also were used for the continued professional development of disaster nursing. However, respondents stated that five years on from their development, the competencies also should include the psychosocial elements of nurses caring for themselves and their colleagues. Additionally, further studies should explore if there are other areas related to the disaster nursing practice (in addition to psychosocial concerns) that may be missing or not fully developed. Finally, the authors of this report recommend that future research explore how the ICN Framework of Disaster Nursing Competencies do or do not assist in maintaining best practices in this field and improve outcomes for victims of disaster. Hutton A , Veenema TG , Gebbie K . Review of the International Council of Nurses (ICN) Framework of Disaster Nursing Competencies. Prehosp Disaster Med. 2016;31(6):680-683.

Advancing the Scientific Foundation for Evidence-Based Practice in Clinical Child and Adolescent Psychology

Evidence-based practice (EBP) has become a central focus in clinical child and adolescent psychology. As originally defined, EBP in psychology is the integration of the best available research evidence, patient characteristics, and clinical expertise. Although evidence-based perspectives have garnered widespread acceptance in recent years, there has also been some confusion and disagreement about the 3-part definition of EBP, particularly the role of research. In this article, we first provide a brief review of the development of EBP in clinical child and adolescent psychology. Next, we outline the following 4 points to help clarify the understanding of EBP: (a) knowledge should not be confused with epistemic processes, (b) research on clinician and client factors is needed for EBP, (c) research on assessment is needed for EBP, and (d) the 3-part conceptualization of EBP can serve as a useful framework to guide research. Based on these principles, we put forth a slightly revised conceptualization of EBP, in which the role of research is expanded and more clearly operationalized. Finally, based on our review of the literature, we offer illustrative examples of specific directions for future research to advance the evidence base for EBP in clinical child and adolescent psychology.

Williams, L., Patterson, J., & Edwards, T. M. (2014). Clinician's guide to research methods in family therapy: Foundations of evidence-based practice. New York, NY: Guilford, 298 pp., $40.00.

Williams, L., Patterson, J., & Edwards, T. M. (2014). Clinician's guide to research methods in family therapy: Foundations of evidence-based practice. New York, NY: Guilford, 298 pp., $40.00.

Book Review: Clinician’s guide to research methods in family therapy: Foundations for evidence-based practice

Book Review: Clinician’s guide to research methods in family therapy: Foundations for evidence-based practice

Meaningfulness of mean group results for determining the optimal motor rehabilitation program for an individual child with cerebral palsy.

As research on the efficacy or effectiveness of interventions to improve motor functioning in cerebral palsy (CP) has accumulated and been incorporated into systematic reviews, the foundation for evidence-based practice in CP is growing. To determine whether an intervention is effective, clinical trials report mean group differences. However, even if a statistically significant mean group effect is found, this does not imply that this intervention was effective for each study participant or ensure positive outcomes for all with CP. A personalized approach to medical care is currently being advocated based primarily on increasingly recognized genetic variations in individual responses to medications and other therapies. A similar approach is also warranted, and perhaps more justifiable, in CP which includes a heterogeneous group of disorders. Even interventions deemed highly effective in CP demonstrate a range of individual responses along a continuum from a negative or negligible response to a strong positive effect, the bases for which remain incompletely understood. This narrative review recommends that the next critical step in advancing evidence-based practice is to implement research strategies to identify patient factors that predict treatment responses so we can not only answer the question 'what works', but also 'what works best, for whom'.

My Crash Course in Publication Ethics

My Crash Course in Publication Ethics

Description of Physical Therapist Student Use of Manipulation During Clinical Internships

Background and Purpose. While evidence shows that therapist students are introduced to manipulation within academic curriculum, little is known about its use during their final clinical internships. The purpose of this study was to identify student perceptions of clinical barriers and support for manipulation, student frequency and type of manipulation use, and factors guiding student decision-making in the selection of manipulation. Subjects. Two consecutive classes of Doctor of Physical Therapy program students represented an overall sample of 48 clinical survey responses. Methods. The survey was completed by students completing clinical internships in outpatient orthopedic clinical sites during their final clinical internships. The survey documented the students' perspective of their academic preparation, experience with manipulation in the clinical setting, and student reasoning regarding the use of manipulation as an intervention option. Results. Of 48 returned survey responses out of 70 surveys (69%), 24 (50%) indicated some use of manipulation. Spinal manipulation was used at a minimum level, and peripheral manipulation essentially was not used. When students were supervised by clinical instructors (CIs) who practiced manipulation, 74% indicated that the CIs used manipulation. Of the students who were supervised by a CI who did not practice manipulation, only 28% reported using manipulation during their internship; suggesting that students model the CIs' clinical practices. A variety of clinical factors influenced students' decision- making and frequency of manipulation use. Overall, 87% of participants agreed that they were academically prepared to perform manipulation in a clinical setting. Discussion and Conclusion. Results indicate minimal student use of manipulation during clinical internships. Students perceived that CI training and CI practice were factors involved in the student practice of manipulation. Patient diagnosis and population type also were influential. Future research should focus on manipulation opportunities during clinical internships for students from multiple programs and from the CI perspective. Key Words: Physical therapist education, Clinical internship, Manipulation, Decision-making. BACKGROUND AND PURPOSE In recent years, therapist education has progressed to a doctorate degree, preparing graduates for primary contact in neuromusculoskeletal health care. The transition to the doctoral level has allowed expanded curriculum in differential diagnosis and manual therapy, including manipulation. Manipulation is one part of a continuum of manual therapy techniques that has been associated with the therapy profession since its inception.1'3 Manipulation is defined as a high velocity, low-amplitude therapeutic movement within or at end range of motion (thrust joint manipulation). Ii4(p2) Doctorallevel education advocates for the use of interventions that are supported by evidence, including manipulation. In fact, the Manipulation Education Manual4 (MEM) from the American Physical Therapy Association (APTA) suggests that physical therapist students must be prepared with the knowledge and skills to practice manipulation if they are expected to practice in an evidence-based manner.4'p4' In the past, the foundation for evidencebased practice and increasing use of manipulation within the profession has mostly occurred in postprofessional education.4 Over time, the realm of manipulation education has shifted from the postprofessional sphere to the professional therapist education curricula. Almost 2 decades ago, only 17.5% of programs covered manipulation within professional education.5 Currently, nearly 75% of therapist professional education programs either include manipulation in their curriculum or have plans to do so.6 These numbers are expected to rise as nearly all professional therapist education programs have converted to doctorallevel education. …

Ethical Deliberation: A Foundation for Evidence-Based Practice

Infusing evidence-based practice (EBP) into the clinical setting implies that professionals use evidence that is relevant and credible, maintain their pursuit of best current knowledge, respect their clients' preferences and values, and keep these clients and their families appropriately informed about their treatment options. Thus, rational and judicious EBP must be guided by speech-language pathologists' or audiologists' ethical principles of beneficence, non-maleficence, justice, and autonomy. In this article, we will affirm the centrality of ethical reasoning in EBP by describing what it means to be a professional as reflected in our Code of Ethics, reviewing the principles of ethics that underlie clinical decision making, and demonstrating how an ethical framework can and should provide the context in which EBP is conducted.

Evaluating a cardiac rehabilitation service

Cardiac rehabilitation programmes reduce cardiac-related morbidity. However, evidence suggests that cardiac rehabilitation services nationally are not equitable, with regional variation in the scope of service provision and patient outcome. With new commissioning groups being established, service providers have an opportunity to highlight gaps in the quality of their service. Commissioning groups now require evidence to demonstrate efficacy and cost effectiveness of services. Data collected during cardiac rehabilitation can be reviewed to provide such evidence. This article discusses the value of performing service evaluation for cardiac rehabilitation services as a means of improving service efficiency, patient care and to provide a foundation for evidence-based practice.

Irritability: an underappreciated side effect of interferon treatment for chronic hepatitis C?

The research literature was reviewed with the aim of answering the question 'is irritability an underappreciated side effect of interferon and ribavirin treatment for hepatitis C'. The majority of information regarding interferon treatment identifies depression as the main psychological side effect. However, clinical observation and patient reports suggest that irritability, not depression, is the predominant side effect. The literature review included research and discussion papers. Data bases were searched using the keywords interferon and hepatitis C in combination with one of the following: side effects, depression, mood alteration/change, irritability, anger, impulse control, psychiatric side effects or neuropsychiatric side effects. The review revealed a gap in the literature regarding interferon-related irritability. Whereas depression was well researched and described, irritability was afforded little research time. However, where irritability was assessed, it was found to occur to a significant degree. Issues identified were difficulty defining and categorising irritability; lack of irritability-specific assessment tools and failure of depression rating scales to adequately discern irritable mood; and the confounding effect of physiological side effects on mood alteration. Relevance to clinical practice. Underappreciation and underrecognition of irritability have implications for clinical practice. Good research is the foundation for evidence-based practice; therefore, the possibility exists that, based on current research evidence, patients may not be receiving a standard care that adequately addresses the entirety of the side effect spectrum. Irritability is an underappreciated psychological side effect of interferon therapy. Although irritability is recognised as a side effect of interferon, there is considerable discordance between clinical observation, patient reports and research evidence as reported in the literature.