A national cross-sectional survey of the attitudes, skills and use of evidence-based practice amongst Spanish osteopaths
Tóm tắt
Although evidence-based practice (EBP) is largely supported across healthcare professions, its implementation in manual therapy professions such as osteopathy remains limited and debated. There is currently little knowledge of how Spanish osteopaths relate to EBP. The main aim of this study was to investigate the attitudes, skills and use of EBP among Spanish osteopaths. A secondary aim was to identify barriers and facilitators for the adoption of EBP in the Spanish osteopathic context. National cross-sectional survey of Spanish osteopaths registered and non-registered to an osteopathic association in Spain. Eligible participants were invited by a range of recruitment strategies including email and social media campaigns to complete the Spanish-translated Evidence-Based practice Attitude and utilization Survey (EBASE) anonymously online. A total of 567 osteopaths completed the survey which represents an approximate response rate of 9%. Participant’s attitudes toward EBP were largely positive. Most respondents agreed or strongly agreed that EBP was necessary in the practice of osteopathy (89.6%) and that professional literature and research findings were useful to their day-to-day practice (88.9%). Levels of perceived skill in EBP were reported as low to moderate with lowest levels for items related to ‘research conduct’. Except reading/reviewing professional literature and using online search engines to find practice-related literature, participant engagement in all other EBP-related activities was generally infrequent. The perceived proportion of clinical practice that was based on clinical research evidence was reported to be very small. Main barriers to EBP uptake included a lack of clinical evidence in osteopathy and insufficient skills for applying research findings. Main facilitators of EBP uptake included access to full-text articles, internet at the workplace and online databases. Spanish osteopaths were largely supportive of evidence-based practice, had low to moderate skills in EBP and engaged in EBP activities infrequently. Formal regulation of the profession in Spain and the inclusion of osteopathic programs into the university sector would potentially improve EBP skills and use.
Tài liệu tham khảo
Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ. 1996;312:71–2. https://doi.org/10.1136/bmj.312.7023.71.
Innes SI, Leboeuf-Yde C, Walker BF. How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years. Chiropr Man Therap. 2018;26:8.
Rabey M, Hall T, Hebron C, Palsson TS, Christensen SW, Moloney N. Reconceptualising manual therapy skills in contemporary practice. Musculoskelet Sci Pract. 2017;29:28–32.
Ladeira CE, Cheng MS, da Silva RA. Clinical Specialization and Adherence to Evidence-Based Practice Guidelines for Low Back Pain Management: A Survey of US Physical Therapists. J Orthop Sports Phys Ther. 2017;47:347–58.
Kume J, Tandel R, Indelicato J. Application of the Evidence-Based Practice Model by Physical Therapy Clinical Practitioners. J Allied Health. 2019;48:e79–85.
Zadro J, O’Keeffe M, Maher C. Do physical therapists follow evidence-based guidelines when managing musculoskeletal conditions? Systematic review. BMJ Open. 2019;9:e032329.
Greenhalgh T, Howick J, Maskrey N, Evidence Based Medicine Renaissance Group. Evidence based medicine: a movement in crisis? BMJ. 2014;348:g3725.
Veziari Y, Leach MJ, Kumar S. Barriers to the conduct and application of research in complementary and alternative medicine: a systematic review. BMC Complement Altern Med. 2017;17:166.
Bussières AE, Terhorst L, Leach M, Stuber K, Evans R, Schneider MJ. Self-reported attitudes, skills and use of evidence-based practice among Canadian doctors of chiropractic: a national survey. J Can Chiropr Assoc. 2015;59:332–48.
Leach MJ, Gillham D. Are complementary medicine practitioners implementing evidence based practice? Complement Ther Med. 2011;19:128–36.
da Silva TM, Costa L da CM, Garcia AN, Costa LOP. What do physical therapists think about evidence-based practice? A systematic review. Man Ther. 2015;20:388–401.
Schneider MJ, Evans R, Haas M, Leach M, Hawk C, Long C, et al. US chiropractors’ attitudes, skills and use of evidence-based practice: A cross-sectional national survey. Chiropr Man Therap. 2015;23:16.
Snow JE, Leach MJ, Clare BA. Attitudes, skill and use of evidence-based practice among US Western herbal medicine providers: a national survey. J Complement Integr Med. 2017;14. https://doi.org/10.1515/jcim-2015-0101.
Upton D, Upton P. Knowledge and use of evidence-based practice of GPs and hospital doctors. J Eval Clin Pract. 2006;12:376–84.
Fryer G. Teaching critical thinking in osteopathy – Integrating craft knowledge and evidence-informed approaches. Int J Osteopath Med. 2008;11:56–61.
Thomson OP, Petty NJ, Moore AP. Clinical reasoning in osteopathy – More than just principles? Int J Osteopath Med. 2011;14:71–6.
van Dun PLS, Wagner C. Die Identität der Osteopathie in Europa. Osteopathische Medizin. 2012;13:22–6.
Cotton A. Osteopathic principles in the modern world. Int J Osteopath Med. 2013;16:17–24.
Paulus S. The core principles of osteopathic philosophy. Int J Osteopath Med. 2013;16:11–6.
Hartman SE. Cranial osteopathy: its fate seems clear. Chiropr Osteopat. 2006;14:10.
McGrath MC. A global view of osteopathic practice – mirror or echo chamber? Int J Osteopath Med. 2015;18:130–40.
Vogel S. Evidence, theory and variability in osteopathic practice. Int J Osteopath Med. 2015;18:1–4.
Esteves JE, Zegarra-Parodi R, van Dun P, Cerritelli F, Vaucher P. Models and theoretical frameworks for osteopathic care – A critical view and call for updates and research. Int J Osteopath Med. 2020;35:1–4.
Thomson OP, Petty NJ, Moore AP. Osteopaths’ professional views, identities and conceptions – A qualitative grounded theory study. Int J Osteopath Med. 2014;17:146–59. https://doi.org/10.1016/j.ijosm.2013.12.002.
Humpage C. Opinions on research and evidence based medicine within the UK osteopathic profession: A thematic analysis of public documents 2003–2009. Int J Osteopath Med. 2011;14:48–56. https://doi.org/10.1016/j.ijosm.2010.11.005.
Sundberg T, Leach MJ, Thomson OP, Austin P, Fryer G, Adams J. Attitudes, skills and use of evidence-based practice among UK osteopaths: a national cross-sectional survey. BMC Musculoskelet Disord. 2018;19:439.
Weber V, Rajendran D. UK trained osteopaths’ relationship to evidence based practice - An analysis of influencing factors. Int J Osteopath Med. 2018;29:15–25. https://doi.org/10.1016/j.ijosm.2018.07.007.
World Health Organization (Hs). Benchmarks for training in traditional/complementary and alternative medicine: Benchmarks for Training in Osteopathy. Geneva: World Health Organization; 2010. p. 1–23. http://www.who.int/medicines/areas/traditional/BenchmarksforTraininginOsteopathy.pdf.
Leach J. Towards an osteopathic understanding of evidence. Int J Osteopath Med. 2008;11:3–6.
Leach MJ, Sundberg T, Fryer G, Austin P, Thomson OP, Adams J. An investigation of Australian osteopaths’ attitudes, skills and utilisation of evidence-based practice: a national cross-sectional survey. BMC Health Serv Res. 2019;19:498.
Bustins GA, Plaza P-VL, Carvajal SR. Profile of osteopathic practice in Spain: results from a standardized data collection study. BMC Complement Altern Med. 2018;18. https://doi.org/10.1186/s12906-018-2190-0.
Alvarez G, Roura S, Cerritelli F, Esteves JE, Verbeeck J, van Dun PLS. The Spanish Osteopathic Practitioners Estimates and RAtes (OPERA) study: A cross-sectional survey. PLoS One. 2020;15:e0234713. https://doi.org/10.1371/journal.pone.0234713.
CEN’s Project Committee on “Services for Osteopaths”. The European Standard on Osteopathic Healthcare Provision. Brussels: CEN-CENELEC Management Center; 2015. https://www.cencenelec.eu/aboutus/MgtCentre/VisitUs/Pages/default.aspx. Accessed 20 Mar 2020.
Fernández-Domínguez JC, Escobio-Prieto I, Sesé-Abad A, Jiménez-López R, Romero-Franco N, Oliva-Pascual-Vaca Á. Health Sciences-Evidence Based Practice Questionnaire (HS-EBP): Normative Data and Differential Profiles in Spanish Osteopathic Professionals. Int J Environ Res Public Health. 2020;17. https://doi.org/10.3390/ijerph17228454.
Leach MJ, Shaw R, Austin P, Fryer G, Thomson OP, Adams J, et al. Attitudes, skills, and use of evidence-based practice: a cross-sectional survey of Swedish osteopaths. Int J Osteopath Med. 2020. https://doi.org/10.1016/j.ijosm.2020.10.006.
Leach MJ, Palmgren PJ, Thomson OP, Fryer G, Eklund A, Lilje S, et al. Skills, attitudes and uptake of evidence-based practice: a cross-sectional study of chiropractors in the Swedish Chiropractic Association. Chiropr Man Therap. 2021;29:2.
Leach MJ, Gillham D. Evaluation of the Evidence-Based practice Attitude and utilization SurvEy for complementary and alternative medicine practitioners. J Eval Clin Pract. 2008;14:792–8.
Terhorst L, Leach M, Bussières A, Evans R, Schneider MJ. Evaluating the Psychometric Properties of the Evidence-Based Practice Attitude and Utilization Survey. J Altern Complement Med. 2016;22:328–35.
World Health Organitation: Process of translation and adaptation of instruments. https://www.who.int/substance_abuse/research_tools/translation/en/.
Konstan JA, Simon Rosser BR, Ross MW, Stanton J, Edwards WM. The Story of Subject Naught: A Cautionary but Optimistic Tale of Internet Survey Research. J Comput-Mediat Commun. 2006;10:00.
Cohen J. Statistical power analyses for the social sciences. Hillsdale: Lawrence Erlbauni Associates; 1988.
Li S, Cao M, Zhu X. Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses-systematic review. Medicine. 2019;98:e17209.
Farokhzadian J, Khajouei R, Ahmadian L. Evaluating factors associated with implementing evidence-based practice in nursing. J Eval Clin Pract. 2015;21:1107–13.
Scurlock-Evans L, Upton P, Upton D. Evidence-based practice in physiotherapy: a systematic review of barriers, enablers and interventions. Physiotherapy. 2014;100:208–19.
Jette DU, Bacon K, Batty C, Carlson M, Ferland A, Hemingway RD, et al. Evidence-based practice: beliefs, attitudes, knowledge, and behaviors of physical therapists. Phys Ther. 2003;83:786–805.
Iqbal A, Glenny A-M. General dental practitioners’ knowledge of and attitudes towards evidence based practice. Br Dent J. 2002;193:587–91 discussion 583.
Bridges PH, Bierema LL, Valentine T. The propensity to adopt evidence-based practice among physical therapists. BMC Health Serv Res. 2007;7:103.
Thorsteinsson HS, Sveinsdóttir H. Readiness for and predictors of evidence-based practice of acute-care nurses: A cross-sectional postal survey. Scand J Caring Sci. 2014;28:572–81.
Alvarez G, Van Biesen T, Roura S. Professional identity in the evolution of osteopathic models: Response to Esteves et al. Int J Osteopath Med. 2020;36:58–9.
Kristensen N, Nymann C, Konradsen H. Implementing research results in clinical practice- the experiences of healthcare professionals. BMC Health Serv Res. 2016;16:48.
Bialocerkowski AE, Grimmer KA, Milanese SF, Kumar VSS. Application of current research evidence to clinical physiotherapy practice. J Allied Health. 2004;33:230–7.
Rangachari P, Rissing P, Rethemeyer K. Awareness of evidence-based practices alone does not translate to implementation: insights from implementation research. Qual Manag Health Care. 2013;22:117–25.
Alcantara J, Leach MJ. Chiropractic Attitudes and Utilization of Evidence-Based Practice: The Use of the EBASE Questionnaire. Explore. 2015;11:367–76.
Fell DW, Burnham JF, Dockery JM. Determining where physical therapists get information to support clinical practice decisions. Health Inf Libr J. 2013;30:35–48.
Girabent-Farrés M, Bagur-Calafat C, Serra-Llobet P, Sánchez-Puccini MB, Domínguez-Sánchez MA, Correa-Bautista JE, et al. Barriers to implementation of Evidence-Based Practice (EBP): a survey of Colombian and Spanish physiotherapists. Physiotherapy. 2015;101:e1256–7.
Stevenson K, Lewis M, Hay E. Do physiotherapists’ attitudes towards evidence-based practice change as a result of an evidence-based educational programme? J Eval Clin Pract. 2004;10:207–17. https://doi.org/10.1111/j.1365-2753.2003.00479.x.
Stander J, Grimmer K, Brink Y. Training programmes to improve evidence uptake and utilisation by physiotherapists: a systematic scoping review. BMC Med Educ. 2018;18:14.
Larsen CM, Terkelsen AS, Carlsen A-MF, Kristensen HK. Methods for teaching evidence-based practice: a scoping review. BMC Med Educ. 2019;19. https://doi.org/10.1186/s12909-019-1681-0.
Albarqouni L, Hoffmann T, Straus S, Olsen NR, Young T, Ilic D, et al. Core Competencies in Evidence-Based Practice for Health Professionals: Consensus Statement Based on a Systematic Review and Delphi Survey. JAMA Netw Open. 2018;1:e180281.
Lehane E, Leahy-Warren P, O’Riordan C, Savage E, Drennan J, O’Tuathaigh C, et al. Evidence-based practice education for healthcare professions: an expert view. BMJ Evid Based Med. 2019;24:103–8.
Diery A, Vogel F, Knogler M, Seidel T. Evidence-Based Practice in Higher Education: Teacher Educators’ Attitudes, Challenges, and Uses. Front Educ. 2020;5:62.
Glasziou P, Burls A, Gilbert R. Evidence based medicine and the medical curriculum. BMJ. 2008;337:a1253.
Asokan GV. Evidence-based practice curriculum in allied health professions for teaching-research-practice nexus: Evidence-based practice curriculum in allied health. J Evid Based Med. 2012;5:226–31.