Knowledge, attitude and barrier to evidence – based practice among physiotherapists in selected districts of NEPAL

Abstract

Introduction Evidence based Practice is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients (conscientious: based on principles, explicit: clear, judicious: sensible) (Sackett et al., 1996). Evidence based practice was started from 1990 in Physiotherapy and in Nepal from 2010 (Hoffman et al., 2010). Objective: The objective of the study was to determine the level of Knowledge, Attitude and Barriers towards Evidence Based practice among physiotherapists Methods: A cross-sectional study was carried out. Sample size consisted of 164 Physiotherapists. Data were collected from the Physiotherapists working in different hospitals and rehabilitation centers of Nepal. The questionnaire was adapted from the standard questionnaire by Jette et al and Yahui & Swaminathan. Self-reported questionnaires were distributed and collected later. Data were analyzed using SPSS .Mainly descriptive and inferential statistics were used and Chi-square tests and multiple logistic regression analysis were carried out. Results It was found that the Physiotherapists had positive attitude towards EBP with 95.2% agreeing or strongly agreeing that EBP is necessary in practice of Physical Therapy and also overall total mean score of 34.73(72.35%) out of 48 and overall mean 2.8 out of 4.It was also found that Physiotherapists had moderate knowledge towards Evidence Based Practice with overall total mean score of 19.18(68.5%) out of 28 and overall mean of 2.74 out of 4.Only 68.3% of the respondents agreed the fact that they were confident in their ability to critically review professional literature. It was found that those having specialization degree had five times greater knowledge than without specialization. They tend to be more familiar with the research terms. The respondents seemed to have good understanding of research terms with maximum of the respondents not understanding the term odds ratio. Availability of search engines at home and away from home were similar. Significant associations were seen between knowledge, attitude and specialization level, gender, facility at which Physiotherapist work and number of patients seen in a day. It was found that only 32.3% of the Physiotherapists read less than 2 articles in a month. Major ix

barrier to Evidence based practice were obtained insufficient time and traditional methods of treatment. Conclusion & Discussion Physical Therapists of Nepal stated they had positive attitude towards Evidence-Based Practice with majority of the Physiotherapists interested in learning more about the topic. They were of the opinion that they needed to increase the use of evidence in practice. They thought major barrier as insufficient time hence continuous professional development trainings that incorporate EBP were of greater importance. Key words: Knowledge, Attitude, Barrier, Evidence-Based Practice