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Journal of Occupational Rehabilitation
Erschienen in: Journal of Occupational Rehabilitation 4/2011

01.12.2011

Predicting Intentions to Use Research Evidence for Carpal Tunnel Syndrome Treatment Decisions Among Certified Hand Therapists

verfasst von: Gail N. Groth

Erschienen in: Journal of Occupational Rehabilitation | Ausgabe 4/2011

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Abstract

Introduction: Research evidence is not routinely used for clinical decisions among rehabilitation practitioners. The purpose of this study was to model the predictors of intention to use research evidence for carpal tunnel syndrome (CTS) clinical decisions among certified hand therapists (CHTs). Methods: A total of 308 American CHTs (M age = 46 years, SD = 8.1, M clinical experience = 21 years, SD = 8.2) completed a validated mail survey measuring the variables of intention, attitudes, subjective norms, self-efficacy, workload, and autonomy. Structural equation modeling was used to test the overall model and estimate the direct and indirect relationships of study variables on intention. Results: The model demonstrated excellent overall fit and explained 52% of the variance in intention. The direct significant predictors of intention were attitudes (β = 0.43) and subjective norms (β = 0.34) (Ps = 0.00). Self-efficacy and workload did not directly significantly predict intention (Ps = 0.82/0.09, respectively). Workload and autonomy did not indirectly significantly predict intention (Ps = 0.82/0.07, respectively). Neither did workload significantly predict attitudes (P = 0.06). There were no direct or indirect effects of autonomy, self-efficacy, or workload on the intention to use research evidence. However, autonomy significantly predicted self-efficacy (β = 0.36, P = 0.00). Conclusions: Intention to use research evidence in clinical practice is a complex yet predictable phenomenon. Attitudes and subjective norm were identified as significant predictors of intention. Workload, autonomy and self-efficacy did not directly or indirectly effect intentions for research use. Altering subjective norms and managing attitudes about research are recommended as key factors for increasing the use of research evidence for clinical decisions among CHTs.
Fußnoten
1
1,304 articles identified by searching the PubMed database. “Carpal tunnel syndrome [Mesh]”. Limits 01-01-2005 thru 12-31-2010.
 
Literatur
1.
2.
3.
Atroshi I, Gummesson C, Johnsson R, Sprinchorn A. Symptoms, disability, and quality of life in patients with carpal tunnel syndrome. J Hand Surg. 1999;24(2):398–404.
4.
O’Connor D, Marshall S, Massy-Westropp N. Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database Syst Rev. 2003;(1), Art. No.: CD003219. doi:10.​1002/​14651858.​CD003219.
5.
Huisstede BM, Hoogvliet P, Randsdorp MS, Glerum S, van Middelkoop M, Koes BW. Carpal tunnel syndrome. Part I: effectiveness of nonsurgical treatments–a systematic review. Arch Phys Med Rehabil. 2010;91(7):981–1004.
6.
Piazzini DB, Aprile PE, Ferrara C, Bertolini P, Tonali L, Maggi A. A systematic review of conservative treatment of carpal tunnel syndrome. Clin Rehabil. 2007;21:299–314.PubMedCrossRef
7.
Marshall SC, Tardif G, Ashworth ML. Local corticosteroid injection for carpal tunnel syndrome. Cochrane Database Syst Rev. 2009;1.
8.
9.
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(9):786–805.PubMed
10.
Salls J, Dolhi C, Silverman L, Hansen M. The use of evidence-based practice by occupational therapists. Occup Ther Health Care. 2009;23(02):134–45.CrossRef
11.
Schuster M, McGlynn E, Brook RH. How good is the quality of health care in the United States? Milbank Q. 1998;76(517):563.
12.
Chassin, Galvin RW. The urgent need to improve health care quality. Institute of medicine roundtable on health care quality. JAMA. 1998;280(11):1000–5.PubMedCrossRef
13.
Buchan H. Gaps between best evidence and practice: causes for concern. Med J Aust. 2004;180(6):S48–9.PubMed
14.
Olson KL, Bungard TJ, Tsuyuki RT. Cholesterol risk management: a systematic examination of the gap from evidence to practice. Pharmacotherapy. 2001;21(7):807–17.PubMedCrossRef
15.
Villar J, Carroll G, Gulmezoglu AM. The gap between evidence and practice in maternal healthcare. Int J Gynaecol Obstetrics. 2001;75:S47–54.CrossRef
16.
Horsley JA, Crane J. Using research to improve nursing practice: a guide. New York: Grune & Stratton; 1983.
17.
Cader R, Campbell S, Watson D. Cognitive continuum theory in nursing decision-making. J Adv Nurs. 2005;49(4):397–405.PubMedCrossRef
18.
Litchfield R, MacDougall C. Professional issues for physiotherapists in family-centred and community-based settings. Aust J Physiother. 2002;48:105–12.PubMed
19.
Stevenson K, Lewis M, Hay E. Does physiotherapy management of low back pain change as a result of an evidence-based educational programme? J Eval Clin Pract. 2006;12(3):365–75.PubMedCrossRef
20.
Bekkering GE, Engers AJ, Wensing M, Hendriks HJM, van Tulder MW, Oostendorp RAB, et al. Development of an implementation strategy for physiotherapy guidelines on low back pain. Aust J Physiother. 2003;49:208–14.PubMed
21.
Sudsawad P. Barriers and facilitators of research utilization for evidence-based practice. Arch Phys Med Rehabil. 2004;95:E10.
22.
Sweetland J, Craik C. The use of evidence-based practice by occupational therapists who treat adult stroke patients. Br J Occup Ther. 2001;64(5):256–60.
23.
Salbach N, Jaglal SB, Korner-Bitensky N, Rappolt S, Davis D. Practitioner and organizational barriers to evidence-based practice of physical therapists for people with stroke. Phys Ther. 2007;87(10):1284–303.
24.
Mount J, Kern J, Delicana B, Levitsky E, Michlik E. Environmental supports and barriers to physical and occupational therapists using evidence-based practice in a neurological rehabilitation setting. J Neurol Phys Therapy. 2006;30(4):210.
25.
Bennett S, Tooth L, McKenna K, Rodger S, Strong J, Ziviani J, et al. Perceptions of evidence-based practice: a survey of Australian occupational therapists. Aust Occup Ther J. 2003;50(1):13–22.CrossRef
26.
Kamwendo K. What do Swedish physiotherapists feel about research? A survey of perceptions, attitudes, intentions and engagement. Physiother Res Int. 2002;7(1):23–34.PubMedCrossRef
27.
Metcalfe C, Lewin R, Wisher S, Perry S, Bannigan K, Moffett JK. Barriers to implementing the evidence base in four NHS therapies: dietitians, occupational therapists, physiotherapists, speech and language therapists. Physiotherapy. 2001;87(8):433–41.CrossRef
28.
Curtin M, Jaramazovic E. Occupational therapists’ views and perceptions of evidence-based practice. Br J Occup Ther. 2001;64(5):214–22.
29.
Iles R, Davidson M. Evidence based practice: a survey of physiotherapists’ current practice. Physiother Res Int. 2006;11(2):93–103.PubMedCrossRef
30.
Meline T, Paradiso T. Evidence-based practice in schools: evaluating research and reducing barriers. Lang Speech Hear Serv Sch. 2003;34:273–83.CrossRef
31.
Pollock AS, Legg L, Langhorne P, Sellars C. Barriers to achieving evidence-based stroke rehabilitation. Clinical Rehabil. 2000;14(6):611–7.CrossRef
32.
Schreiber J, Stern P. A review of the literature on evidence-based practice in physical therapy. Internet J Allied Health Sci Pract. 2005;3(4).
33.
Zipoli RP, Kennedy M. Evidence-based practice among speech-language pathologists: attitudes, utilization, and barriers. Am J Speech Lang Pathol. 2005;14:208–20.PubMedCrossRef
34.
Larson EA, Zemke R. Shaping the temporal patterns of our lives: the social coordination of occupation. J Occup Sci. 2003;10(2):80–9.CrossRef
35.
Humphris D, Littlejohns P, Victor C, O’Halloran P, Peacock J. Implementing evidence-based practice: factors that influence the use of research evidence by occupational therapists. Br J Occup Ther. 2000;63(11):516–22.
36.
McCluskey A. Occupational therapists report on low level of knowledge, skill and involvement in evidence-based practice. Aust Occup Ther J. 2003;50(1):3–12.CrossRef
37.
Rappolt S, Tassone M. How rehabilitation therapists gather, evaluate, and implement new knowledge. J Contin Educ Health Prof. 2002;22:170–80.PubMedCrossRef
38.
Dwyer DJ, Ganster DC. The effects of job demands and control on employee attendance and satisfaction. J Organ Behav. 1991;12(7):595–608.CrossRef
39.
Thompson D, O’Leary KA, Jensen E, Scott-Findlay S, O’Brien-Pallas L, Estabrooks CA. The relationship between busyness and research utilization: it is about time. J Clin Nurs. 2008;17(4):539–48.PubMedCrossRef
40.
Bandura A. Self-efficacy: the exercise of control. New York: Freeman; 1997.
41.
Dysart AM, Tomlin GS. Factors related to evidence-based practice among US occupational therapy clinicians. Am J Occup Ther. 2002;56(3):275–84.PubMedCrossRef
42.
Philibert DB, Snyder P, Judd D, Windsor MM. Practitioners’ reading patterns, attitudes, and use of research reported in occupational therapy journals. Am J Occup Ther. 2003;57:450–8.PubMedCrossRef
43.
Egan M, Dubouloz CJ, Zweck CV, Vallerand J. The client-centred evidence-based practice of occupational therapy. Can J Occup Ther. 1998;65(3):136–43.
44.
45.
McColl A, Smith H, White P, Field J. General practitioners’ perceptions of the route to evidence based medicine: a questionnaire survey. Br Med J. 1998;316:361–5.CrossRef
46.
Ajzen I. The theory of planned behavior. Organ Behav Human Decis Processes. 1991;50:179–211.CrossRef
47.
Estabrooks CA. Modeling the individual determinants of research utilization. West J Nurs Res. 1999;21(6):758–72.PubMedCrossRef
48.
Estabrooks CA, Midodzi W, Cummings G, Wallin L. Predicting research use in nursing organizations: a multilevel analysis. Nurs Res. 2007;56(4 Suppl):S7–23.PubMedCrossRef
49.
Cummings GG, Estabrooks CA, Midodzi WK, Wallin L, Hayduk L. Influence of organizational characteristics and context on research utilization. Nurs Res. 2007;56(4 Suppl):S24–39.PubMedCrossRef
50.
Milner FM, Estabrooks CA, Humphrey C. Clinical nurse educators as agents for change: increasing research utilization. Int J Nurs Stud. 2005;42:899–914.PubMedCrossRef
51.
Godin G, Belanger-Gravel A, Eccles M, Grimshaw J. Healthcare professionals’ intentions and behaviours: A systematic review of studies based on social cognitive theories. Implement Sci. 2008;3:36.
52.
Eccles M, Hrisos S, Francis J, Kaner EF, Dickinson HO, Beyer F, et al. Do self- reported intentions predict clinicians’ behaviour: a systematic review. Implement Sci. 2006;1:28.PubMedCrossRef
53.
Ajzen I. From intentions to actions: a theory of planned behavior. In: Kulh J, Beckman J, editors. Action-control: from cognition to behavior. Heidelberg: Springer; 1985. p. 11–39.
54.
Hackman JR. Motivation through the design of work: test of a theory. Organ Behav Human Perform. 1976;16:250–79.CrossRef
55.
Karaseck RA. Job demands, job decision latitude, and mental strain: implications for job re-design. Adm Sci Q. 1979;24:285–307.CrossRef
56.
Perkins MB, Jensen PS, Jaccard J, Gollwitzer P, Oettingen G, Pappadopulos E, et al. Applying theory-driven approaches to understanding, modifying clinicians’ behavior: what do we know? Psychiatr Serv. 2007;58(3):342–8.PubMedCrossRef
57.
58.
Mattingly C, Fleming MH. Clinical reasoning: forms of inquiry in a therapeutic practice. Philadelphia: F.A. Davis; 1994.
59.
Higgs J, Jones M. Clinical reasoning in the health professions. In: Higgs J, Jones M, editors. Clinical reasoning in the health professions. Oxford: Butterworth-Heinemann; 2000. p. 3–14.
60.
Gibson D, Velde B, Hoff T, Kvashay D, Manross PL, Moreau V. Clinical reasoning of a novice versus an experienced occupational therapist: a qualitative study. Occup Ther Health Care. 2000;12(4):15–31.CrossRef
61.
Mitchell R, Unsworth CA. Clinical reasoning during community health home visits: expert and novice differences. Br J Occup Ther. 2005;68(5):215–23.
62.
Unsworth CA. The clinical reasoning of novice and expert occupational therapists. Scand J Occup Ther. 2001;8:163–73.CrossRef
63.
Strong J, Gilbert J, Cassidy S, Bennett S. Expert clinicians’ and students’ views on clinical reasoning in occupational therapy. Br J Occup Ther. 1995;58(3):119–23.
64.
Estabrooks CA. The conceptual structure of research utilization. Res Nurs Health. 1999;22:203–16.PubMedCrossRef
65.
Hackman JR, Oldman GR. The job diagnostic survey: an instrument for the diagnosis of jobs and the evaluation of job redesign projects. New Haven, Conn: Yale University; 1974.
66.
Caplan RD, Cobb S, French JRP, Van Harrison R, Pinneau SR. Job demands and worker health. Ann Arbor: University of Michigan, Institute for Social Research; 1980.
67.
Fields DL. Taking the measure of work. Thousand Oak: Sage; 2002.
68.
Francis JJ, Eccles MP, Johnston M, Walker AE, Grimshaw JM, Foy R, et al. Constructing questionnaires based on the theory of planned behaviour. A manual for health services researchers. http://​www.​rebeqi.​org/​ViewFile.​aspx?​itemID=​212. Downloaded 2-1-08.: Centre for Health Services Research, University of Newcastle upon Tyne, UK; 2004.
69.
Willis G. Cognitive interviewing: a tool for improving questionnaire design. Thousand Oaks, CA: Sage Publications; 2005.
70.
Pelz DC, Horsley JA. Measuring utilization of nursing research. In: Ciarlo JA, editor. Utilizing evaluation: concepts and measurement techniques. Beverly Hills, CA: Sage Publications; 1981.
71.
Groves RM, Fowler FJ, Couper MP, Lepkowski JM, Singer E, Tourangeau R. Survey methodology. Hoboken: John Wiley & Sons, Inc.; 2004.
72.
Dillman DA. Mail and internet surveys: the tailored design method. 2 ed. 2007 update with new internet v, and mixed mode guide, editor. Hoboken: John Wiley & Sons, Inc.; 2007.
73.
Kaplan D. Structural equation modeling: foundations and extensions. 2cd ed. Thousand Oaks, CA: Sage Publications; 2009.
74.
Kline RB. Principles and practice of structural equation modeling. 2nd ed. New York: Guilford Publications, Inc.; 2005.
75.
Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate data analysis. 7 ed. Upper Saddle River, NJ: Prentice Hall; 2009.
76.
Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Modeling. 1999;6:1–55.CrossRef
77.
Yu CY. Evaluating cutoff criteria of model fit indices for latent variable models with binary and continuous outcomes. Los Angeles, CA: University of California; 2002.
78.
Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol. 1997;50(10):1129–36.PubMedCrossRef
79.
Godin G, Kok G. The theory of planned behavior: a review of its applications to health-related behaviors. Am J Health Promot. 1996;11(2):87–98.PubMed
80.
Armitage CJ, Conner M. Efficacy of the theory of planned behaviour: a meta-analytic review. Br J Soc Psychol. 2001;40(Pt 4):471–99.PubMedCrossRef
81.
Conner M, Sparks P. Theory of planned behaviour and health behaviour. In: Conner M, Norman P, editors. Predicting health behaviour: research and practice with social cognition models. 2cd edition ed. Berkshire: Open University Press; 2005. p. 170–222.
82.
Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q. 1989;13:319–39.CrossRef
83.
Davis FD, Bagozzi RP, Warshaw PR. User acceptance of computer technology: a comparison of two theoretical models. Manage Sci. 1989;35:982–1003.CrossRef
84.
Venkatesh V, Davis FD. A theoretical extension of the technology acceptance mode: four longitudinal field studies. Manage Sci. 2000;46:186–204.CrossRef
85.
Holden RJ, Karsh BT. The technology acceptance model: its past and its future in health care. J Biomed Inform. [serial on the Internet]. 2010;43(1)
86.
MacDermid JC, Graham I. Knowledge translation: putting the “Practice” in evidence-based practice. Hand Clin. 2009;25:125–43.PubMedCrossRef
87.
Funk SG, Champagne MT, Wiese RA, Tornquist ME. Barriers: the barriers to research utilization scale. Appl Nurs Res. 1991;4(1):39–45.PubMedCrossRef
88.
Lacey EA. Research utilization in nursing practice–a pilot study. J Adv Nurs. 1994;19:987–95.PubMedCrossRef
89.
Walczak JR, McGuire DB, Haisfield ME, Beezley A. A survey of research-related activities and perceived barriers to research utilization among professional oncology nurses. Oncol Nurs Forum. 1994;21:710–5.PubMed
90.
Estabrooks CA, Scott S, Squires JE, Stevens B, O-Brien-Pallas L, Watt-Watson J, et al. Patterns of research utilization on patient care units. Implement Sci [serial on the Internet]. 2008;3.
91.
Lockyer J, Gondocz ST, Thivierge RL. Knowledge translation: the role and place of practice reflection. J Contin Educ Health Prof. 2004;24(1):50–6.PubMedCrossRef
92.
Higgs J, Burn A, Jones M. Integrating clinical reasoning and evidence-based practice. AACN Clin Issues. 2001;12(4):482–90.PubMedCrossRef
93.
94.
Rubenstein LV, Pugh J. Strategies for promoting organizational and practice change by advancing implementation research. J Gen Intern Med. 2006;21(Suppl 2):S58–64.PubMedCrossRef
95.
Jacobson N, Butterill D, Goering P. Development of a framework for knowledge translation: understanding user context. J Health Serv Res Policy. 2003;8(2):94–9.PubMedCrossRef
96.
Harvey G, Loftus-Hill A, Rycroft-Malone J, Titchen A, Kitson A, McCormack B, et al. Getting evidence into practice: the role and function of facilitation. J Adv Nurs. 2002;37(6):S77–88.CrossRef
97.
98.
Hamm RM. Clinical intuition and clinical analysis: expertise and the cognitive continuum. In: Dowie J, Elstein A, editors. Professional judgement: a reader in clinical decision making. Cambridge: Cambridge University Press; 1988. p. 78–105.
Metadaten
Titel
Predicting Intentions to Use Research Evidence for Carpal Tunnel Syndrome Treatment Decisions Among Certified Hand Therapists
verfasst von
Gail N. Groth
Publikationsdatum
01.12.2011
Verlag
Springer US
Erschienen in
Journal of Occupational Rehabilitation / Ausgabe 4/2011
Print ISSN: 1053-0487
Elektronische ISSN: 1573-3688
DOI
https://doi.org/10.1007/s10926-011-9305-5

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