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Enhanced implementation of low back pain guidelines in general practice: study protocol of a cluster randomised controlled trial |
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| Authors: | Riis Allan Jensen Cathrine Elgaard Bro Flemming Maindal Helle Terkildsen Petersen Karin Dam Jensen Martin Bach |
| Affiliation: | 1. Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom 2. Manchester Business School, University of Manchester, Booth Street West, Manchester, M15 6PB, United Kingdom 3. Research Department of Primary Care & Population Health, University College London, Royal Free Campus, London, NW3 2PF, United Kingdom 4. Division of Health & Social Care Research, School of Medicine, King’s College London, Capital House 7th Floor, 42 Weston Street, London, SE1 3QD, United Kingdom 5. King’s College London Stroke Research Patients and Family Group, Division of Health & Social Care Research, School of Medicine, King’s College London, Capital House 7th Floor, 42 Weston Street, London, SE1 3QD, United Kingdom 6. Guy’s and St Thomas’ NHS Foundation Trust, St Thomas’ Hospital, London, SE1 7EH, United Kingdom 7. The University of Manchester Stroke & Vascular Centre, Manchester Academic Health Science Centre, Salford Royal Hospitals NHS Foundation Trust, Eccles Old Road, Stott Lane, Salford, M6 8HD, United Kingdom |
| Abstract: | Implementation of evidence-based practice (EBP) is regarded as core competence to improve healthcare quality. In the current study, we investigated the EBP of six groups of professionals: physicians, nurses, pharmacists, physical therapists, technicians, and other allied healthcare personnel. A structured questionnaire survey of regional hospitals throughout Taiwan was conducted by post in 2011. Questionnaires were mailed to all healthcare workers of 11 randomly selected hospitals. Linear and logistic regression models were used to examine predictors for implementing EBP. In total, 6,160 returned questionnaires, including 645 from physicians, 4,206 from nurses, 430 from pharmacists, 179 from physical therapists, 537 from technicians, and 163 from other allied healthcare professionals, were valid for the analysis. Physicians and pharmacists were more aware of EBP than were the other professional groups (p < 0.001). Positive attitudes toward and beliefs in EBP were significantly lower among nurses than in the other groups (p < 0.001). Physicians had more sufficient knowledge and skills of EBP than did the other professionals (p < 0.001); in addition, they implemented EBP for clinical decision-making more often and perceived fewer personal barriers to EBP (p < 0.001). Multivariate logistic regression analyses showed that EBP implementation was associated with the following characteristics of participants: EBP training, having a faculty position, academic degree, one's profession, and perceptions (beliefs, attitudes, knowledge, skills and barriers). This study depicts various levels of EBP implementation among medical, nursing, pharmacological, and allied healthcare personnel. There were significant differences in their implementation of EBP. We observed that certain factors were associated with EBP implementation, including personal backgrounds and perceptions toward EBP. The data suggest that strategies for enhancing EBP implementation should differ for various groups of professionals. |
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