Attitudes, Skills and Implementation of Evidence-based Practice: a National Cross-sectional Survey of Licensed Naprapaths in Sweden

Overview

Journal Chiropr Man Therap

Publisher Biomed Central

Date 2023 Jan 20

PMID 36670483

Authors

Tobias Sundberg

Matthew J Leach

Stina Lilje

Oliver P Thomson

Gary Fryer

Per J Palmgren

Jon Adams

Eva Skillgate

Affiliations

Soon will be listed here.

Abstract

Background: Evidence-based practice (EBP) is fundamental to the delivery of high-quality, safe and effective health care. Naprapaths, manual therapy providers that specialize in the treatment of musculoskeletal pain and dysfunction, became a Swedish licensed health profession in 1994. This study investigated the attitudes, skills and implementation of EBP among licensed naprapaths in Sweden.

Methods: Licensed naprapaths (n = 950) of Svenska Naprapatförbundet (the Swedish Naprapathy Association) were invited by email to take part in this cross-sectional anonymous online study using the Evidence-Based Practice Attitude and Utilisation Survey in February 2019.

Results: Fourteen percent (137/950) of invited naprapaths completed the survey. There was an approximately equal gender divide among responders; most were in the mid-career age range, practiced in city areas, and had a university or college certificate/diploma as their highest qualification. The majority of naprapaths agreed or strongly agreed that EBP was necessary in the practice of naprapathy, assisted them in making care decisions, and improved the quality of patient care. Naprapaths' self-reported skills in EBP were mostly in the moderate to moderate-high range. The majority of participating naprapaths reported infrequent implementation of EBP. Perceived minor or moderate barriers to EBP uptake included a lack of colleague support for EBP and a lack of relevant resources. Access to the internet and free online databases were reported as very useful enablers to improving EBP uptake.

Conclusions: The licensed naprapaths participating in this survey reported positive attitudes toward EBP, moderate levels of EBP skills, and infrequent implementation of EBP.

References

Greenhalgh T . Of lamp posts, keys, and fabled drunkards: A perspectival tale of 4 guidelines. J Eval Clin Pract. 2018; 24(5):1132-1138. PMC: 6175189. DOI: 10.1111/jep.12925. View

Sullivan M, Leach M, Snow J, Moonaz S . Understanding North American yoga therapists' attitudes, skills and use of evidence-based practice: A cross-national survey. Complement Ther Med. 2017; 32:11-18. DOI: 10.1016/j.ctim.2017.03.005. View

Leach M, Sundberg T, Fryer G, Austin P, Thomson O, 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(1):498. PMC: 6637614. DOI: 10.1186/s12913-019-4329-1. View

Slawson D, Shaughnessy A . Teaching evidence-based medicine: should we be teaching information management instead?. Acad Med. 2005; 80(7):685-9. DOI: 10.1097/00001888-200507000-00014. View

Sundberg T, Leach M, Thomson O, 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(1):439. PMC: 6286591. DOI: 10.1186/s12891-018-2354-6. View

Leach M, Palmgren P, Thomson O, Fryer G, Eklund A, Lilje S . Skills, attitudes and uptake of evidence-based practice: a cross-sectional study of chiropractors in the Swedish Chiropractic Association. Chiropr Man Therap. 2021; 29(1):2. PMC: 7798252. DOI: 10.1186/s12998-020-00359-w. View

Terhorst L, Leach M, Bussieres A, Evans R, Schneider M . Evaluating the Psychometric Properties of the Evidence-Based Practice Attitude and Utilization Survey. J Altern Complement Med. 2016; 22(4):328-35. PMC: 4827288. DOI: 10.1089/acm.2015.0221. View

Alcantara J, Leach M . Chiropractic Attitudes and Utilization of Evidence-Based Practice: The Use of the EBASE Questionnaire. Explore (NY). 2015; 11(5):367-76. DOI: 10.1016/j.explore.2015.06.002. View

Bussieres A, Terhorst L, Leach M, Stuber K, Evans R, Schneider M . Self-reported attitudes, skills and use of evidence-based practice among Canadian doctors of chiropractic: a national survey. J Can Chiropr Assoc. 2016; 59(4):332-48. PMC: 4711333. View

10.

Schneider M, Evans R, Haas M, Leach M, Hawk C, Long C . US chiropractors' attitudes, skills and use of evidence-based practice: A cross-sectional national survey. Chiropr Man Therap. 2015; 23:16. PMC: 4422535. DOI: 10.1186/s12998-015-0060-0. View

11.

Greenhalgh T, Howick J, Maskrey N . Evidence based medicine: a movement in crisis?. BMJ. 2014; 348:g3725. PMC: 4056639. DOI: 10.1136/bmj.g3725. View

12.

Snow J, Leach M, Clare B . Attitudes, skill and use of evidence-based practice among US Western herbal medicine providers: a national survey. J Complement Integr Med. 2017; 14(1). DOI: 10.1515/jcim-2015-0101. View

13.

Adams J . General practitioners, complementary therapies and evidence-based medicine: the defence of clinical autonomy. Complement Ther Med. 2000; 8(4):248-52. DOI: 10.1054/ctim.2000.0396. View

14.

Cerritelli F, Iacopini A, Galli M, Thomson O, Sundberg T, Leach M . Evidence-based practice among Italian osteopaths: a national cross-sectional survey. BMC Complement Med Ther. 2021; 21(1):252. PMC: 8496002. DOI: 10.1186/s12906-021-03430-y. View

15.

Sackett D, Rosenberg W, Gray J, Haynes R, Richardson W . Evidence based medicine: what it is and what it isn't. BMJ. 1996; 312(7023):71-2. PMC: 2349778. DOI: 10.1136/bmj.312.7023.71. View

16.

Tonelli M . Integrating evidence into clinical practice: an alternative to evidence-based approaches. J Eval Clin Pract. 2006; 12(3):248-56. DOI: 10.1111/j.1365-2753.2004.00551.x. View

17.

Scurlock-Evans L, Upton P, Upton D . Evidence-based practice in physiotherapy: a systematic review of barriers, enablers and interventions. Physiotherapy. 2014; 100(3):208-19. DOI: 10.1016/j.physio.2014.03.001. View

18.

Hurwitz S, Slawson D . Should we be teaching information management instead of evidence-based medicine?. Clin Orthop Relat Res. 2010; 468(10):2633-9. PMC: 3049623. DOI: 10.1007/s11999-010-1381-x. View

19.

Sharma A, Duc N, Luu Lam Thang T, Nam N, Ng S, Abbas K . A Consensus-Based Checklist for Reporting of Survey Studies (CROSS). J Gen Intern Med. 2021; 36(10):3179-3187. PMC: 8481359. DOI: 10.1007/s11606-021-06737-1. View

20.

Alvarez G, Justribo C, Sundberg T, Thomson O, Leach M . A national cross-sectional survey of the attitudes, skills and use of evidence-based practice amongst Spanish osteopaths. BMC Health Serv Res. 2021; 21(1):130. PMC: 7874623. DOI: 10.1186/s12913-021-06128-6. View