KNOWLEDGE, ATTITUDE AND BARRIER TO EVIDENCE BASED PRACTICE AMONG PHYSIOTHERAPISTS IN SELECTED DISTRICTS OF NEPAL

S. Bajracharya¹, S. Suwal¹, G. Lippolis², G. Mareshal¹, N. Tharu³, D. Bokalial⁴

Background: Evidence Based Practice (EBP) is considered one of the most accepted practices all over the world. It is sensible, clear and principle based use of current best evidence, in making decisions about care of individual patients. Physiotherapists in Nepal have started using EBP, but physiotherapist's knowledge and attitude towards EBP and the barriers for implementation of EBP has not yet been studied in Nepal.

Purpose: To identify the level of knowledge, attitude and barriers towards EBP among physiotherapists working in selected districts of Nepal.

Methods: Cross sectional study was carried out on a sample size of 196 Physiotherapists. Districts were selected based on purposive sampling method, depending on the maximum number of physiotherapists working in the particular districts. Information regarding the physiotherapist's distribution was obtained from Physiotherapy Association of Nepal (NEPTA). A self-reported questionnaire was provided to the Physiotherapists working in various hospitals, rehabilitation centers as well as those working in the community. The questionnaires were distributed and responses were collected with the help of NEPTA. Data were analyzed using SPSS. Descriptive and inferential statistics (Chi-square, Multiple logistic regression analysis) were carried out.

Results: Out of the 196 questionnaires distributed, a total of 164 physiotherapists participated in the study. It was found that the physiotherapists had positive attitude towards EBP with 95.2% agreeing or strongly agreeing that EBP is necessary. In the questions related to attitude, overall total mean score of 34.73 was obtained out of 48. It was also found that Physiotherapists had moderate knowledge towards EBP with total mean score obtained 19.18 out of 28. 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 thought they had 2.6 times greater knowledge than those without specialization. They tend to be more familiar with the research terms. Significant associations were seen between knowledge and variables (age,  gender, number of years working as a physiotherapist and specialization degree). Major barriers to the use of EBP were insufficient time and trust in traditional methods of treatment.

Conclusion(s): Physiotherapists in the sample stated they had positive attitude towards EBP with majority of them interested in learning more about the topic. They also recognized the need to increase the use of evidence in their practice. They thought major barrier for EBP was insufficient time, hence continuous professional development trainings could be of greater importance.

Implications: There's only handful of research conducted in the field of Physiotherapy in Nepal and even lesser number of research regarding EBP has been carried out. Health professionals need be updated regarding EBP, as it has been seen that whatever taught as important at one aspect of time may no longer be important in 15 years of time later on. This research will help us to know about the current status of EBP among physiotherapists, to work towards improvement  of EBP in Nepal and to further work on the professional development of  physiotherapists in providing best care for the patients.

Funding, acknowledgements: NA

Keywords: Knowledge, Attitude, Evidence-based practice

Topic: Education: continuing professional development

Did this work require ethics approval? Yes

Institution: Nepal Health Research Council (NHRC)

Committee: Ethical Review Board of NHRC

Ethics number: (Reg. no. 517/2017)