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Kwakye S.K.1, Quartey J.1, Asante J.H.1, Sarpong B.1, Yanney H.1, Amara A.1, Aborchie B.M.1, Binfoah A.1, Quansah M.E.1
1University of Ghana, Physiotherapy, Accra, Ghana
Background: Evidence-based practice (EBP) is a 5-step process whereby clinicians integrate research evidence with clinical expertise and patient preferences, producing the most appropriate and effective service. The inability to carry out any of these processes may constitute a barrier to the application of EBP in practice. Physiotherapy has evolved over the years and this has led to an increasing demand in using evidence as basis for making diagnostic care decisions since evidence-based interventions has been proven to be effective. However, even when an intervention has good evidence of benefit, the application of EBP for stroke patients can still raise challenges and thus the need to evaluate the barriers physiotherapists encounter in the implementation of EBP for stroke survivors in Ghana.
Purpose: To determine the barriers to evidence-based physiotherapy practice for stroke survivors.
Methods: One hundred and twenty one physiotherapists (PTs) of Ghana Physiotherapy Association (GPA) who were providing or have provided services to stroke survivors were involved in this cross sectional study. The PTs completed the practitioner and organizational barriers to evidence-based stroke rehabilitation questionnaire provided either in person or by e-mail following ethics approval. Copies of the questionnaire were delivered physically or by e-mail and retrieved within a period of four weeks. Data obtained was analysed using SPSS, version 23. Logistic regression was used to determine relationships between variables.
Results: Although 112 (98%) agreed that research findings are useful, 56 (46%) claimed there was insufficient time in its implementation for stroke survivors. More than 80% of the participants stated that they do not have access in their facility to current research through professional journals in paper form and the ability to access relevant databases at their facility. The five most frequently reported barriers for updating knowledge on EBP were lack of organizational mandate (56.2%), insufficient time provided by management (46.3%), lack of information resources (43%), lack of understanding of statistical analyses (35.5%) and lack of interest (33.1%). Self-efficacy ratings for performing EBP were below 50% for critical appraisal of literature and the interpretation of t-test, chi square, logistic and linear regression.
Conclusion(s): Lack of adequate resources, lack of organizational support and low self-efficacy to perform EBP activities represent barriers to implementing EBP for stroke survivors. The study found a positive relationship between educational qualification and knowledge and skills of EBP. In addition, the study showed that most physiotherapy facilities or organizations in Ghana were not supportive in the implementation of EBP for stroke survivors. Future research could focus on evaluating the effectiveness of EBP training programmes in physiotherapy.
Implications: These findings reinforce the need for continuing education to enhance skills and self-efficacy to search and critically evaluate the research literature among Ghanaian PTs. Overall, there is a need to develop a supportive organizational infrastructure to increase research integration in physiotherapy practice for stroke survivors.
Funding acknowledgements: None
Topic: Neurology: stroke
Ethics approval: Ethics and Protocol Review Committee of School of Biomedical and Allied Health Sciences, University of Ghana.
All authors, affiliations and abstracts have been published as submitted.
