Gronwald M1, Wieduwild E2,3, Elsner B1,4
1Technische Universität Dresden, Department of Public Health, Dresden, Germany, 2Friedrich Schiller University, Jena, Germany, 3Moritz Klinik, Klosterlausnitz, Germany, 4SRH University of Applied Health Sciences Gera, Gera, Germany
Background: EBP is defined as the integration of clinical expertise and the best available external expertise based on the individual patient. In contrast to other countries, physical therapy in Germany has almost no academic or scientific history. Previous research on EBP has been investigated in many countries by validated questionnaires. Until now, there has been no adapted and validly tested questionnaire for the German context. However, this is necessary to develop effective strategies for the implementation of EBP, adapted to the specific requirements in the different fields of work and activity of physical therapists in Germany.
Purpose: The purpose of the study was to provide reliability and validity of the adapted questionnaire for measuring the construct EBP in physical therapy.
Methods: Content validity was assessed by experts (n=7) using a validated questionnaire. Structure validity was quantified using a principal component factor analysis (PCA). In a reliability analysis, the internal consistency (Cronbach´s α) and the interrater reliability (Spearman´s Rho) were calculated. For this purpose, an online-questionnaire was conducted with physical therapists working in Germany (n=1000). When responding for missing values, data for PCA and reliability analysis were excluded if more than 25% of the non-demographic data were not answered.
Results: The adapted questionnaire was accepted by experts. The final sample size for the cross-sectional study was 103 (response rate: 10.3%). The dataset met the admission criteria for the PCA with an adequacy value of 0.86 for the Kaiser-Meyer-Olkin Index. The Bartlett's test of Sphericity was significant (χ2 = 1332,31; df = 253; p . 00). Examination of Kaiser's criteria and the scree-plot yielded empirical justification for retaining five factors with eigenvalues exceeding 1 which accounted for 65,02% of the total variance. Among the factor solutions, the varimax-rotated five-factor solution yielded the most interpretable solution, and most items loaded highly on only four of the five factors. The internal consistency was high with Cronbach´s α=.93. For the Interrater reliability, the items correlated strongly (r=.841, p=.000) to moderately.
Conclusion(s): The final translated and adapted questionnaire contained 31 items and measured 4 domains of EBP: attitudes, knowledge, behaviour, and prerequisites and barriers. The content validity, structural validity and reliability analysis confirmed an adequate operationalization of the EBP construct through the questionnaire.
Implications: In the German health care system, cost bearers and professional associations have increasingly appealed in recent years to demonstrate the effectiveness of therapeutic interventions. However, the attitude, knowledge, behaviour and barriers toward EBP in physical therapy is unknown. The survey tool could be useful for assessing the impact of specific measures to improve EBP in Germany.
Keywords: physical therapy, evidence-based practice, psychometrics
Funding acknowledgements: The authors declare that they have no competing interests.
Purpose: The purpose of the study was to provide reliability and validity of the adapted questionnaire for measuring the construct EBP in physical therapy.
Methods: Content validity was assessed by experts (n=7) using a validated questionnaire. Structure validity was quantified using a principal component factor analysis (PCA). In a reliability analysis, the internal consistency (Cronbach´s α) and the interrater reliability (Spearman´s Rho) were calculated. For this purpose, an online-questionnaire was conducted with physical therapists working in Germany (n=1000). When responding for missing values, data for PCA and reliability analysis were excluded if more than 25% of the non-demographic data were not answered.
Results: The adapted questionnaire was accepted by experts. The final sample size for the cross-sectional study was 103 (response rate: 10.3%). The dataset met the admission criteria for the PCA with an adequacy value of 0.86 for the Kaiser-Meyer-Olkin Index. The Bartlett's test of Sphericity was significant (χ2 = 1332,31; df = 253; p . 00). Examination of Kaiser's criteria and the scree-plot yielded empirical justification for retaining five factors with eigenvalues exceeding 1 which accounted for 65,02% of the total variance. Among the factor solutions, the varimax-rotated five-factor solution yielded the most interpretable solution, and most items loaded highly on only four of the five factors. The internal consistency was high with Cronbach´s α=.93. For the Interrater reliability, the items correlated strongly (r=.841, p=.000) to moderately.
Conclusion(s): The final translated and adapted questionnaire contained 31 items and measured 4 domains of EBP: attitudes, knowledge, behaviour, and prerequisites and barriers. The content validity, structural validity and reliability analysis confirmed an adequate operationalization of the EBP construct through the questionnaire.
Implications: In the German health care system, cost bearers and professional associations have increasingly appealed in recent years to demonstrate the effectiveness of therapeutic interventions. However, the attitude, knowledge, behaviour and barriers toward EBP in physical therapy is unknown. The survey tool could be useful for assessing the impact of specific measures to improve EBP in Germany.
Keywords: physical therapy, evidence-based practice, psychometrics
Funding acknowledgements: The authors declare that they have no competing interests.
Topic: Research methodology & knowledge translation; Research methodology & knowledge translation; Outcome measurement
Ethics approval required: No
Institution: n/a
Ethics committee: n/a
Reason not required: The cross-sectional study was approved by the ethic commission of Technical University Dresden, but I don´t have the ethics approval number at the moment. The participants responded to the cross-sectional study free of charge and voluntarily. There were no negative effects due to non-participation and data were pseudonymised.
All authors, affiliations and abstracts have been published as submitted.
