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Practitioner and organizational barriers to evidence-based practice of physical therapists for people with stroke.

Salbach NM, Jaglal SB, Korner-Bitensky N, Rappolt S, Davis D

Department of Physical Therapy, Faculty of Medicine, University of Toronto, 160-500 University Ave, Toronto, Ontario, Canada M5G 1V7. nancy.salbach@utoronto.ca

BACKGROUND AND PURPOSE: The purpose of this study was to identify practitioner barriers (education, attitudes and beliefs, interest and perceived role, and self-efficacy) and organizational barriers (perceived support and resources) to physical therapists' implementation of evidence-based practice (EBP) for people with stroke. SUBJECTS: The participants were 270 physical therapists providing services to people with stroke in Ontario, Canada. METHODS: A cross-sectional mail survey was conducted. RESULTS: Only half of respondents had learned the foundations of EBP in their academic preparation or received training in searching or appraising research literature. Although 78% agreed that research findings are useful, 55% agreed that a divide exists between research and practice. Almost all respondents were interested in learning EBP skills; however, 50% indicated that physical therapists should not be responsible for conducting literature reviews. Average self-efficacy ratings were between 50% and 80% for searching and appraising the literature and below 50% for critically appraising psychometric properties and understanding statistical analyses. Despite Internet access at work for 80% of respondents, only 8% were given protected work time to search and appraise the literature. DISCUSSION AND CONCLUSION: Lack of education, negative perceptions about research and physical therapists' role in EBP, and low self-efficacy to perform EBP activities represent barriers to implementing EBP for people with stroke that can be addressed through continuing education. Organizational provision of access to Web-based resources is likely insufficient to enhance research use by clinicians.

Published 2 October 2007 in Phys Ther, 87(10): 1284-303; discussion 1304-6.
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Stroke Books

Stroke: Brain-Assault : Suggestions, Encourgement, and Exercises to Help You or Your Loved One Overcome the Effects of a Stroke

Stroke: Brain-Assault : Suggestions, Encourgement, and Exercises to Help You or Your Loved One Overcome the Effects of a Stroke