Research Knowledge, Attitudes, Practices and Barriers among Paediatric Occupational Therapists in the United Kingdom

Article excerpt

Introduction

The practice approaches implemented by health professionals are informed by evidence-based knowledge, whereby evidence-based practice and research utilisation enable clinicians to provide high quality care for clients: they remain current with health care trends and improve client care outcomes and health care efficiencies (Law and Baum 1998, Brown and Roger 1999a, Gray 2004, Taylor 2007). However, the use of evidence-based practice and research utilisation is not well developed among therapists who work with children and families, and there continue to be significant knowledge gaps within the occupational therapy profession (Waine et al 1997, Dobbins et al 1998, Brown and Rodger 1999b, Bannigan and Bryar 2002, McCluskey and Cusick 2002). In order to ensure that children and families receive the best and most current care available, an understanding of paediatric occupational therapists' use of evidence-based practice and research utilisation is valuable. This paper outlines the results of a study investigating the knowledge, attitudes, practices and barriers to evidence-based practice and research utilisation of a group of children's occupational therapists in the United Kingdom (UK).

Literature review

Evidence-based practice and research utilisation

The definitions and models of evidence-based practice and research utilisation originated from the field of evidence-based medicine and, although their development has occurred over several decades, the models have not been well evaluated (Brown and Rodger 1999b, Sudsawad 2006). The most widely cited definition of evidence-based (practice) medicine is that of Sackett et al (1996), who described the process as 'the conscientious and judicious use of current best evidence in making decisions about the care of individual patients' (p71). Research utilisation is regarded as a subset of the field of evidence-based practice (Estabrooks 1999a) which, according to Estabrooks (1999b), is 'at its simplest, the use of research to guide practice, and is particularly concerned with the use of research evidence--i.e., the findings of scientific studies' (p54). The process of research utilisation involves critiquing research findings, implementing research findings into clinical practice and evaluating the implementation of research findings (Taylor 2007).

Evidence-based practice and empirically validated therapies are being promoted in the professional literature and practice of the allied health professions (Sheldon 1998, Law and Baum 1998, Gambrill 1999). However, the concept of evidence-based practice is not without controversy in the allied health professions, where a positivist bias towards randomised controlled trials in medicine is regarded as too narrow to encompass the knowledge derived from the alternative sources and research methodologies valued in the allied health fields (Coyler and Kamath 1999, French 1999). Although health professionals demonstrate positive attitudes towards research, evidence indicates that they are less confident in their research knowledge and ability to perform research activities (Van Mullem et al 1999, Eller et al 2003, Witzke et al 2008). Furthermore, there is limited research utilisation amongst the allied health professionals, with the literature replete with examples of research evidence published in professional journals not being adopted, integrated or implemented in clinical practice (Armitage 1990, Rogers 1994, Clarke et al 1996, McCluskey and Cusick 2002, Philibert et al 2003).

Currently, no studies have investigated the evidence-based practice and research utilisation of UK paediatric occupational therapists. As such, research that investigates the knowledge, attitudes, practices and barriers to evidence-based practice and research utilisation amongst paediatric occupational therapists in the UK would be valuable.

Research orientation

'Research orientation' is a term intended as a broad construct, which provides insight into clinicians' overall perception of conducting research and implementing findings into clinical practice, as well as the importance and value placed on providing clients with the most current health care (Pain et al 1996). …