Evidence-based practice and clinical reasoning in occupational therapy: A cross-sectional survey in Chile.
Chile
clinical decision-making
clinical reasoning
evidence-based practice
occupational therapy
Journal
Australian occupational therapy journal
ISSN: 1440-1630
Titre abrégé: Aust Occup Ther J
Pays: Australia
ID NLM: 15420200R
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
revised:
01
11
2020
received:
26
03
2020
accepted:
03
11
2020
pubmed:
11
12
2020
medline:
26
10
2021
entrez:
10
12
2020
Statut:
ppublish
Résumé
Evidence-based practice (EBP) is a critical framework for supporting clinical decision-making that has been increasingly promoted in occupational therapy over the last 20 years. Discipline-specific EBP frameworks and resources have emerged, primarily created by scholars from developed countries. However, EBP has received limited attention in literature published in developing and non-English speaking countries. This study aimed to explore Chilean occupational therapists' perceptions of EBP, factors influencing the adoption of EBP and sources of information used to inform clinical decision-making. A cross-sectional online survey of Chilean occupational therapists included socio-demographic information, closed questions using a fivepoint Likert scale and open-ended questions. Numerical data were summarised using frequencies and percentages. Cross-tabulations explored relationships between variables. Narrative data from openended responses were analysed deductively using content analysis. Complete surveys were returned by 192 Chilean respondents. The majority of participants (68.3%) defined EBP as the use of research knowledge only and perceived EBP as useful and important. The most significant barriers to the application of research knowledge included: lack of time (68.2%), an emerging research culture (67.7%) and restricted access to scientific literature (56.8%). Additionally, Chilean occupational therapists did not feel confident finding, appraising and integrating research evidence. Of the four sources of knowledge used in EBP, participants predominantly relied on clinical observations of clients (99.5%), their clinical expertise (89.1%), and discussions with the multidisciplinary team (78.1%) and other occupational therapists (40.1%), to inform clinical decision-making. Language barriers, lack of time, scarcity of locally produced research, and an emergent research culture within Chile impede occupational therapists' ability to implement EBP. The adoption of EBP can facilitate access to contemporary occupational therapy knowledge powerfully guide clinical reasoning, and build local research capacity. Building research partnerships and collaborations with the international scientific community are crucial to the global achievement of EBP.
Identifiants
pubmed: 33300178
doi: 10.1111/1440-1630.12713
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
169-179Informations de copyright
© 2020 Occupational Therapy Australia.
Références
Aravena, J. M. (2015). ¿Qué tanto entendemos el concepto de práctica basada en la evidencia en terapia ocupacional? [How much do we understand about the concept of evidence-based practice in occupational therapy?]. Revista Chilena De Terapia Ocupacional, 15(1), 189-192. https://doi.org/10.5354/0717-5346.2015.37142
Aravena, J. C., Gajardo, J., & Molina, A. (2016). ¿Qué pensamos de la investigación en terapia ocupacional? Percepción de un grupo de estudiantes y docentes en Chile [What do we think of research in occupational therapy? Perceptions of a group of students and teachers in Chile]. Revista Chilena de Terapia Ocupacional, 16(2), 175-183. https://doi.org/10.5354/0719-5346.2016.44761
Ayres, J., Watkeys, F., & Carthy, J. (2014). Quality and effectiveness of clinical supervision: evaluation of an occupational therapy service. The British Journal of Occupational Therapy, 77(9), 447-450. https://doi.org/10.4276/030802214X14098207540992
Bannigan, K. (2011). A global approach to evidence based occupational therapy: What progress has been made since 2006? World Federation of Occupational Therapists Bulletin, 64(1), 4-6. https://doi.org/10.1179/otb.2011.64.1.002
Bannigan, K., & Moores, A. (2009). A model of professional thinking: integrating reflective practice and evidence based practice. Canadian Journal of Occupational Therapy, 76(5), 342-350. https://doi.org/10.1177/000841740907600505
Bennett, S., Allen, S., Caldwell, E., Whitehead, M., Turpin, M., Fleming, J., & Cox, R. (2016). Organisational support for evidence-based practice: Occupational therapists’ perceptions. Australian Occupational Therapy Journal, 63(1), 9-18. https://doi.org/10.1111/1440-1630.12260
Bennett, S., & Bennett, J. (2000). The process of evidence-based practice in occupational therapy: Informing clinical decisions. Australian Occupational Therapy Journal, 47(4), 171-180. https://doi.org/10.1046/j.1440-1630.2000.00237.x
Bennett, S., Tooth, L., McKenna, K., Rodger, S., Strong, J., Ziviani, J., Mickan, S., & Gibson, L. (2003). Perceptions of evidence-based practice: A survey of Australian occupational therapists. Australian Occupational Therapy Journal, 50, 13-22. https://doi.org/10.1046/j.1440-1630.2003.00341.x
Buchanan, H. (2011). The uptake of evidence-based practice by occupational therapists in South Africa. World Federation of Occupational Therapists Bulletin, 64(1), 29-38. https://doi.org/10.1179/otb.2011.64.1.008
Caldwell, E., Whitehead, M., Fleming, J., & Moes, L. (2008). Evidence-based practice in everyday clinical practice: Strategies for change in a tertiary occupational therapy department. Australian Occupational Therapy Journal, 55(2), 79-84. https://doi.org/10.1111/j.1440-1630.2007.00669.x
Chilean Ministry of Education. (2019). Buscador De Carreras [Career Searcher]. https://www.mifuturo.cl/buscador-de-carreras/?tipo=carrera
Chilean Ministry of Health. (2020). Superintendencia de Prestadores de Salud [statistics of graduated occupational therapists in Chile]. http://www.supersalud.gob.cl/documentacion/666/articles-18219_recurso_1.pdf
Eysenbach, G., & Schonlau, M. (2004). Improving the quality of web surveys: The checklist for reporting results of internet E-surveys (CHERRIES). Journal of Medical Internet Research, 6(3), e34. https://doi.org/10.2196/jmir.6.3.e34
Fitzgerald, C., Moores, A., Coleman, A., & Fleming, J. (2015). Supporting new graduate professional development: A clinical learning framework. Australian Occupational Therapy Journal, 62(1), 13-20. https://doi.org/10.1111/1440-1630.12165
Gambrill, E. (2018). Critical thinking and the process of evidence-based practice. Oxford University Press.
Garcia, J. (2017). Sources of information used by paediatric occupational therapists in Chile to make clinical decisions. (Masters dissertation, University of Queensland, Brisbane, Australia).
García Rojas, J., Copley, J., Turpin, M., & Peña Jeldes, N. (2017). Práctica basada en evidencia en el área pediátrica en Chile, un desafío pendiente. [Evidence-based practice in paediatrics in Chile, an imminent challenge]. Revista Chilena de Terapia Ocupacional, 17(2), 57-68. https://doi.org/10.5354/0719-5346.2018.48086
Hoffmann, T., Bennett, S., & Del Mar, C. (2017). Evidence-based practice across the health professions (3rd. ed.). Elsevier Australia a division of Reed International Books Australia Pty Ltd..
Illott, I., Taylor, M., & Bolanos, C. (2006). Evidence-based occupational therapy: It’s time to take a global approach. British Journal of Occupational Therapy, 69(1), 38-41. https://doi.org/10.1177/030802260606900107
Karanja, E., Zaveri, J., & Ahmed, A. (2013). How do MIS researchers handle missing data in survey-based research: A content analysis approach. International Journal of Information Management, 33(5), 734-751. https://doi.org/10.1016/j.ijinfomgt.2013.05.002
Lindström, A. C., & Bernhardsson, S. (2018). Evidence-based practice in primary care occupational therapy: A cross-sectional survey in Sweden. Occupational Therapy International, 2018(2), 1-9. https://doi.org/10.1155/2018/5376764
McCluskey, A., Bennett, S., Hoffmann, T., & Tooth, L. (2010). OTseeker helps library and allied health professionals to find quality evidence efficiently. Health Information & Libraries Journal, 27(2), 106-113. https://doi.org/10.1111/j.1471-1842.2010.00877.x
Organisation for Economic Cooperation and Development (OECD). (2019). Income inequality. https://data.oecd.org/inequality/income-inequality.htm
Patton, M. Q. (2002). Qualitative research & evaluation methods (3rd. ed.). Sage Publications.
Pigott, T. D. (2001). A review of methods for missing data. Educational Research and Evaluation, 7(4), 353-383. https://doi.org/10.1076/edre.7.4.353.8937
Remedios, L., & Webb, G. (2005). Chapter 12 - Clinical educators as cultural guides. In M. L. Rose, & D. L. Best (Eds.), Transforming practice through clinical education, professional supervision and mentoring (pp. 207-218). https://doi.org/10.1016/B978-0-443-07454-7.50029-0
Rose, M. L., & Best, D. L. (2005). Transforming practice through clinical education, professional supervision, and mentoring. Elsevier Churchill Livingstone.
Schell, B. (2019). Professional reasoning in practice. In B. A. B. Schell, & G. Gillen (Eds.), Willard and Spackman's occupational therapy (13th ed.). Wolters Kluwer.
Thomas, A., & Law, M. (2014). Evidence-based practice supports among Canadian occupational therapists: Enquête sur les mécanismes de soutien de la pratique fondée sur les données probantes offerts aux ergothérapeutes canadiens. Canadian Journal of Occupational Therapy, 81(2), 79-92. https://doi.org/10.1177/0008417414526972
Tomlin, G., & Borgetto, B. (2011). Research pyramid: A new evidence-based practice model for occupational therapy. The American Journal of Occupational Therapy, 65(2), 189-196. https://doi.org/10.5014/ajot.2011.000828
Upton, D., Stephens, D., Williams, B., & Scurlock-Evans, L. (2014). Occupational therapists' attitudes, knowledge, and implementation of evidence-based practice: A systematic review of published research. British Journal of Occupational Therapy, 77(1), 24-38. https://doi.org/10.4276/030802214X13887685335544
World Federation of Occupational Therapists (WFOT). (2018). Occupational therapy human resources project 2018. https://www.wfot.org/resources/2018-occupational-therapy-human-resources-project-full-alphabetical
World Federation of Occupational Therapists (WFOT). (2020). Entry-level education programs WFOT approved. https://www.wfot.org/programmes/education/wfot-approved-education-programmes