Saudi physiotherapists' attitudes, knowledge, behaviors, and barriers towards evidence-based practice: A cross-sectional study
Yıl 2024,
, 143 - 151, 31.05.2024
Amr Abdel-aziem
,
Osama Ragaa
,
Khaled Alqurashi
,
Nashwa Hamed
,
Muhsen Alsufiany
,
Maher Mahdi
,
Sobhy Aly
Öz
Background and objective: At present, there is limited knowledge about the determinants of evidence-based practice (EBP) among Saudi physiotherapists. So, this study investigated the attitudes, knowledge, behaviors and perceived barriers of Saudi physiotherapists regarding EBP.
Methods: A sample of 323 physiotherapists completed an EBP questionnaire, which was designed to cover six domains of EBP; Attitudes and beliefs, interest, attention to literature, information availability, educational background, and its barriers.
Results: The participants concurred that EBP is essential (91%), literature helps practice (75%). EBP enhances patient care (80%), reimbursement rates (82%), and aids in decision-making (75%). They discovered that EBP does not consider patient preferences (37%) or the constraints of the clinical practice (71%). They were interested in enhancing their abilities (80%). They needed to use evidence more frequently in daily work (74%). Seventy-six percent having access to professional publications, and 80% have online access to EBP guidelines. Seventy-one percent disagree that their workplace encouraged the EBP usage. Fifty-one percent had not learned the EBP's fundamentals. Sixty percent had not attended training sessions on finding research, 75% were not confident in their capacity to evaluate professional literature, and locate pertinent research to address clinical concerns (62%).
Conclusion: The Saudi physiotherapists have a generally positive attitude toward EBP and are interested in increasing its usage in their practices. However, their attention to literature was relatively low. They need for training sessions for using data base. The lack of time was the most important barrier to EBP.
Etik Beyan
Ethics committee approval was obtained from the Directorate of Health Affairs-Taif: Research and Studies Department (Date: 26.01.2020, Decision Number: KACST, KSA: HAP-02-T-067).
Teşekkür
The author thanks all physiotherapists for their participation
Kaynakça
- 1. Maher CG, Sherrington C, Elkins M, Herbert RD, Moseley AM. Challenges for evidence-based physical therapy: Accessing and interpreting high-quality evidence on therapy. Phys Ther. 2004;84(7):644-654. doi:10.1093/ptj/84.7.644
- 2. Newhouse RP. Instruments to assess organizational readiness for evidence-based practice. J Nurs Adm. 2010;40:404–407. doi:10.1097/NNA.0b013e3181f2ea08
- 3. Lee C, Hunsley J. Evidence-based practice: Separating science from pseudoscience. Can J Psychiatry. 2015;60:534-540.
- 4. Wilson A, Howitt S, Holloway A, Williams A, Higgins D. Factors affecting paramedicine students’ learning about evidence-based practice: A phenomenographic study. BMC Med Educ. 2021;21:45.
- 5. AlKetbi H, Hegazy F, Alnaqbi A, Shousha T. Evidence-based practice by physiotherapists in UAE: Investigating behavior, attitudes, awareness, knowledge and barriers. PLoS One. 2021;16(6):e0253215. doi:10.1371/journal.pone.0253215
- 6. Schmidt NA, Brown J. Evidenced-Based Practice for Nurses: Appraisal and Application of Research. 4th ed. Jones & Bartlett; 2017.
- 7. Gawlinski A. Evidence-based practice changes: Measuring the outcome. AACN Adv Crit Care. 2007;18(3):320-322. doi:10.1097/01.AACN.0000284433.76028.9d
- 8. Alqahtani N, Oh KM, Kitsantas P, Rodan M. Nurses’ evidence-based practice knowledge, attitudes and implementation: A cross-sectional study. J Clin Nurs. 2020;29(1-2):274–283. doi:10.1111/ jocn.15097
- 9. Alkhatib AH, Ibrahim EA, Ameenuddin M, Ibrahim IA. Nurses’ knowledge, perception, and attitude towards Evidence-Based Practice at King Abdullah Medical City-Saudi Arabia. Am J Nurs Res. 2021;9(1):1-7. doi:10.12691/ajnr-9-1-1
- 10. Alshehri MA, Ahmed Alalawi A, Alhasan H, Stokes E. Physiotherapists’ behaviour, attitudes, awareness, knowledge and barriers in relation to evidence-based practice implementation in Saudi Arabia: a cross-sectional study. Int J Evid Based Healthc. 2017:127-141.
- 11. McEvoy M, Luker J, Fryer C, Lewis L. Changes in physiotherapists’ perceptions of evidence-based practice after a year in the workforce: A mixed-methods study. PLoS One. 2020;15:e0244190.
- 12. Grimmer-Somers K, Lekkas P, Nyland L, Young A, Kumar S. Perspectives on research evidence and clinical practice: A survey of Australian physiotherapists. Physiother Res Int. 2007;12:147-161.
- 13. Bindawas S. Physical therapy entry-level education and post-professional training in Saudi Arabia: a comparison of perceptions of physical therapists from five regions. J Phys Ther Sci. 2014;26:1377–82.
- 14. Amin T, Kaliyadan F, Al Qattan E, Majed M, Al Khanjaf H, Mirza M. Knowledge, attitudes and barriers related to participation of medical students in research in three Arab Universities. Educ Med J. 2012;4:43–56.
- 15. Shousha T, Javed A, Bekhet A, et al. Investigating behavior, attitudes, knowledge, awareness and barriers to the implementation of evidence-based practice by physiotherapists in Egypt: A cross sectional study. Heliyon. 2023;9(12):e22951. doi:10.3390/healthcare8030354
- 16. Bury T. Evidence based practice: an overview. WCPT Keynotes. 2003:1-3.
- 17. Perraton L, Machotka Z, Grimmer K, Gibbs C, Mahar C, Kennedy K. Embedding evidence-based practice education into a post-graduate physiotherapy program: eight years of pre-post course evaluations. Physiother Res Int. 2017;22(2). doi:10.1002/pri.1659
- 18. AlMutair A. Quality of nursing care in Saudi Arabia: needs for improvement. J Nurs Care. 2015;4(6):309. doi:10.4172/2167-1168.1000309
- 19. Alqahtani M, Kashoo F, Ahmad F. Current scenario of evidence-based practice and rationale of preferred approach in stroke rehabilitation among physiotherapists in Saudi Arabia: A cross-sectional survey. Saudi J Heal Sci. 2018;7(1):53-64.
- 20. Hasani F, MacDermid JC, Tang A, Kho M, Alghadir AH, Anwer S. Knowledge, attitude and implementation of evidence-based practice among physiotherapists working in the Kingdom of Saudi Arabia: A cross-sectional survey. Healthc. 2020;8:354.
- 21. Jette DU, Bacon K, Batty C et al. Evidence-based practice: beliefs, attitudes, knowledge, and behaviors of physical therapists. Phys Ther. 2003;(83):786–805.
- 22. Bernhardsson S, Larsson MEH. Measuring evidence-based practice in physical therapy: Translation, adaptation, further development, validation, and reliability test of a questionnaire. Phys Ther. 2013;93(6):819-832. doi:10.2522/ptj.20120270
- 23. Ministry of Health. Health statistical year book, Saudi Arabia. https://www.moh.gov.sa/en/Ministry/Statistics/book/Documents/Statistical-Yearbook-2022.pdf. Published 2022.
- 24. Alsaadi S. Beliefs, attitudes, and behaviors of Saudi physiotherapists toward evidence-based practice: A multicenter, cross-sectional study. Saudi J Med Med Sci. 2022;10(3):227-235. doi:10.4103/sjmms.sjmms_357_21
- 25. Salbach NM, 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;87:1284–1303. doi:10.2522/ptj.20070040
- 26. Akinbo S, Odebiyi D, Okunola T AO. Evidence-based practice: knowledge, attitudes and beliefs of physical therapists in Nigeria. Int J Med Inf. 2009;4:169 –172.
- 27. Iles R, Davidson M. Evidence based practice: a survey of physiotherapists’ current practice. Physiother Res Int. 2006;11:93–103. doi:10.1002/pri.328
- 28. Nilsagrd Y, Lohse G. Evidence-based physiotherapy: A survey of knowledge, behaviour, attitudes and prerequisites. Adv Physiother. 2010;12:179–186. doi:10.3109/14038196.2010.503812
- 29. Ramírez-Vélez R, Correa-Bautista JE, Muñoz-Rodríguez DI, et al. Evidence-based practice: beliefs, attitudes, knowledge, and skills among Colombian physical therapists. Colomb Med. 2015;46(1):33–40.
- 30. Silva TM, Costa L, Costa LO. Evidence-Based Practice: a survey regarding behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from Sa˜o Paulo state. Braz J Phys Ther. 2015;19(4):294–303. doi:10.1590/bjpt-rbf.2014.0102
- 31. Castellini G, Corbetta D, Cecchetto S, Gianola S. Twenty-five years after the introduction of Evidence-based Medicine: knowledge, use, attitudes and barriers among physiotherapists in Italy - a cross-sectional study. BMJ Open. 2020;10(6):e037133-e.
- 32. Guyatt GH, Haynes RB, Jaeschke RZ, et al. Users’ guides to the medical literature: XXV. Evidence-based medicine: Principles for applying the users’ guides to patient care. J Am Med Assoc. 2000;284:1290–1296. doi:10.1001/jama.284.10.1290
- 33. Alghadier M, Elnaggar RK, Alasraj MI, Khan N, Almeiman A, Albesher R. Evidence-Based Physiotherapy Practice in Paediatric Subdiscipline: A Cross-Sectional Study in Saudi Arabia. Healthc. 2022;10(11):1-14. doi:10.3390/healthcare10112302
- 34. Turner P, Whitfield TW. Physiotherapists’ use of evidence based practice: a cross-national study. Physiother Res Int. 1997;2:17–29. doi:10.1002/pri.76
- 35. Manspeaker SA, Lunen BL Van, Turocy PS, Pribesh S, Hankemeier D. Student knowledge, attitudes, and use of evidence-based concepts following an educational intervention. Athl Train Educ J. 2011;6(2):88–98.
- 36. Alghamdi AN, Alzahrani SS, Abdel-aziem AA. Students learning and teaching satisfaction. J Contemp Med. 2017;7(1):23-35. doi:10.16899/gopctd.286125
- 37. Stander J, Grimmer K, Brink Y. Training programmes to improve evidence uptake and utilisation by physiotherapists: a systematic scoping review. BMC Med Educ. 2018;18(1):14.
- 38. Alghadir A, Zafar H, Iqbal ZA, Anwer S. Physical therapy education in Saudi Arabia. J Phys Ther Sci. 2015;27(5):1621-1623. doi:1621-3
- 39. Scurlock-Evans L, Upton P, Upton D. Evidence-based practice in physiotherapy: a systematic review of barriers, enablers and interventions. Physiotherapy. 2014;100(3):208–219.
- 40. McKenna HP, Ashton S, Keeney S. Barriers to evidencebased practice in primary care. J Adv Nurs. 2004;45:178–89.
- 41. Ely JW, Osheroff JA, Ebell MH, et al. Obstacles to answering doctors’ questions about patient care with evidence: Qualitative study. Br Med J. 2002;324:710–713. doi:10.1136/bmj.324.7339.710
- 42. Retsas A. Barriers to using research evidence in nursing practice. J Adv Nurs. 2000;21:599–606. doi:10.1046/j.1365-2648.2000.01315.x
- 43. Heiwe S, Kajermo KN T-LR, Guidetti S, Samuelsson M, Andersson I, Wengström Y. Evidence-based practice: attitudes, knowledge and behaviour among allied health care professionals. Int J Qual Heal Care. 2011;23(2):198-209. doi:10.1093/intqhc/mzq083
- 44. Mota da Silva T, da Cunha Menezes Costa L, Garcia AN, Costa LOP. What do physical therapists think about evidence-based practice? A systematic review. Man Ther. 2015;20(3):388-401. doi:10.1016/j.math.2014.10.009
- 45. Lanyon R, Goodstein L. Personality Assessment. 3rd editio. New York: Wiley; 1997.
- 46. Korb K. Self-report questionnaires: can they collect accurate information? J Educ Found. 2011;1:5–12.
- 47. Gonyea R. Self-reported data in institutional research: Review and recommendations. New Dir Inst Res. 2005;127:73-89. doi:10.1002/ir.156
Suudi fizyoterapistlerin kanıta dayalı uygulamaya yönelik tutumları, bilgileri, davranışları ve engelleri: Kesitsel bir çalışma
Yıl 2024,
, 143 - 151, 31.05.2024
Amr Abdel-aziem
,
Osama Ragaa
,
Khaled Alqurashi
,
Nashwa Hamed
,
Muhsen Alsufiany
,
Maher Mahdi
,
Sobhy Aly
Öz
Arka plan ve amaç: Şu anda Suudi fizyoterapistler arasında kanıta dayalı uygulamanın (EBP) belirleyicileri hakkında sınırlı bilgi bulunmaktadır. Dolayısıyla bu çalışma, Suudi fizyoterapistlerin EBP ile ilgili tutumlarını, bilgilerini, davranışlarını ve algılanan engellerini araştırdı.
Yöntemler: 323 fizyoterapistten oluşan bir örnek, KBP'nin altı alanını kapsayacak şekilde tasarlanmış bir KBP anketini doldurdu; Tutumlar ve inançlar, ilgi, literatüre olan ilgi, bilgi bulunabilirliği, eğitim geçmişi ve bunun engelleri.
Bulgular: Katılımcılar KBP'nin gerekli olduğu (%91), edebiyatın uygulamaya yardımcı olduğu (%75) konusunda hemfikirdir. EBP hasta bakımını (%80), geri ödeme oranlarını (%82) artırır ve karar verme sürecine yardımcı olur (%75). EBP'nin hasta tercihlerini (%37) veya klinik uygulamanın kısıtlamalarını (%71) dikkate almadığını keşfettiler. Yeteneklerini geliştirmekle ilgileniyorlardı (%80). Günlük işlerinde kanıtları daha sık kullanma ihtiyacı duydular (%74). Yüzde yetmiş altısının profesyonel yayınlara erişimi var ve %80'inin EBP kılavuzlarına çevrimiçi erişimi var. Yüzde yetmiş bir kişi işyerlerinin EBP kullanımını teşvik ettiğine katılmıyor. Yüzde elli bir EBP'nin temellerini öğrenmemişti. Yüzde altmışı araştırma bulma konusunda eğitim oturumlarına katılmamıştı, %75'i mesleki literatürü değerlendirme ve klinik kaygıları ele alacak uygun araştırmaları bulma kapasitelerine güvenmiyordu (%62).
Sonuç: Suudi fizyoterapistler EBP'ye karşı genel olarak olumlu bir tutuma sahipler ve uygulamalarında kullanımını arttırmakla ilgileniyorlar. Ancak edebiyata olan ilgileri nispeten düşüktü. Veri tabanını kullanmak için eğitim oturumlarına ihtiyaçları var. Zaman eksikliği EBP'nin önündeki en önemli engeldi.
Kaynakça
- 1. Maher CG, Sherrington C, Elkins M, Herbert RD, Moseley AM. Challenges for evidence-based physical therapy: Accessing and interpreting high-quality evidence on therapy. Phys Ther. 2004;84(7):644-654. doi:10.1093/ptj/84.7.644
- 2. Newhouse RP. Instruments to assess organizational readiness for evidence-based practice. J Nurs Adm. 2010;40:404–407. doi:10.1097/NNA.0b013e3181f2ea08
- 3. Lee C, Hunsley J. Evidence-based practice: Separating science from pseudoscience. Can J Psychiatry. 2015;60:534-540.
- 4. Wilson A, Howitt S, Holloway A, Williams A, Higgins D. Factors affecting paramedicine students’ learning about evidence-based practice: A phenomenographic study. BMC Med Educ. 2021;21:45.
- 5. AlKetbi H, Hegazy F, Alnaqbi A, Shousha T. Evidence-based practice by physiotherapists in UAE: Investigating behavior, attitudes, awareness, knowledge and barriers. PLoS One. 2021;16(6):e0253215. doi:10.1371/journal.pone.0253215
- 6. Schmidt NA, Brown J. Evidenced-Based Practice for Nurses: Appraisal and Application of Research. 4th ed. Jones & Bartlett; 2017.
- 7. Gawlinski A. Evidence-based practice changes: Measuring the outcome. AACN Adv Crit Care. 2007;18(3):320-322. doi:10.1097/01.AACN.0000284433.76028.9d
- 8. Alqahtani N, Oh KM, Kitsantas P, Rodan M. Nurses’ evidence-based practice knowledge, attitudes and implementation: A cross-sectional study. J Clin Nurs. 2020;29(1-2):274–283. doi:10.1111/ jocn.15097
- 9. Alkhatib AH, Ibrahim EA, Ameenuddin M, Ibrahim IA. Nurses’ knowledge, perception, and attitude towards Evidence-Based Practice at King Abdullah Medical City-Saudi Arabia. Am J Nurs Res. 2021;9(1):1-7. doi:10.12691/ajnr-9-1-1
- 10. Alshehri MA, Ahmed Alalawi A, Alhasan H, Stokes E. Physiotherapists’ behaviour, attitudes, awareness, knowledge and barriers in relation to evidence-based practice implementation in Saudi Arabia: a cross-sectional study. Int J Evid Based Healthc. 2017:127-141.
- 11. McEvoy M, Luker J, Fryer C, Lewis L. Changes in physiotherapists’ perceptions of evidence-based practice after a year in the workforce: A mixed-methods study. PLoS One. 2020;15:e0244190.
- 12. Grimmer-Somers K, Lekkas P, Nyland L, Young A, Kumar S. Perspectives on research evidence and clinical practice: A survey of Australian physiotherapists. Physiother Res Int. 2007;12:147-161.
- 13. Bindawas S. Physical therapy entry-level education and post-professional training in Saudi Arabia: a comparison of perceptions of physical therapists from five regions. J Phys Ther Sci. 2014;26:1377–82.
- 14. Amin T, Kaliyadan F, Al Qattan E, Majed M, Al Khanjaf H, Mirza M. Knowledge, attitudes and barriers related to participation of medical students in research in three Arab Universities. Educ Med J. 2012;4:43–56.
- 15. Shousha T, Javed A, Bekhet A, et al. Investigating behavior, attitudes, knowledge, awareness and barriers to the implementation of evidence-based practice by physiotherapists in Egypt: A cross sectional study. Heliyon. 2023;9(12):e22951. doi:10.3390/healthcare8030354
- 16. Bury T. Evidence based practice: an overview. WCPT Keynotes. 2003:1-3.
- 17. Perraton L, Machotka Z, Grimmer K, Gibbs C, Mahar C, Kennedy K. Embedding evidence-based practice education into a post-graduate physiotherapy program: eight years of pre-post course evaluations. Physiother Res Int. 2017;22(2). doi:10.1002/pri.1659
- 18. AlMutair A. Quality of nursing care in Saudi Arabia: needs for improvement. J Nurs Care. 2015;4(6):309. doi:10.4172/2167-1168.1000309
- 19. Alqahtani M, Kashoo F, Ahmad F. Current scenario of evidence-based practice and rationale of preferred approach in stroke rehabilitation among physiotherapists in Saudi Arabia: A cross-sectional survey. Saudi J Heal Sci. 2018;7(1):53-64.
- 20. Hasani F, MacDermid JC, Tang A, Kho M, Alghadir AH, Anwer S. Knowledge, attitude and implementation of evidence-based practice among physiotherapists working in the Kingdom of Saudi Arabia: A cross-sectional survey. Healthc. 2020;8:354.
- 21. Jette DU, Bacon K, Batty C et al. Evidence-based practice: beliefs, attitudes, knowledge, and behaviors of physical therapists. Phys Ther. 2003;(83):786–805.
- 22. Bernhardsson S, Larsson MEH. Measuring evidence-based practice in physical therapy: Translation, adaptation, further development, validation, and reliability test of a questionnaire. Phys Ther. 2013;93(6):819-832. doi:10.2522/ptj.20120270
- 23. Ministry of Health. Health statistical year book, Saudi Arabia. https://www.moh.gov.sa/en/Ministry/Statistics/book/Documents/Statistical-Yearbook-2022.pdf. Published 2022.
- 24. Alsaadi S. Beliefs, attitudes, and behaviors of Saudi physiotherapists toward evidence-based practice: A multicenter, cross-sectional study. Saudi J Med Med Sci. 2022;10(3):227-235. doi:10.4103/sjmms.sjmms_357_21
- 25. Salbach NM, 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;87:1284–1303. doi:10.2522/ptj.20070040
- 26. Akinbo S, Odebiyi D, Okunola T AO. Evidence-based practice: knowledge, attitudes and beliefs of physical therapists in Nigeria. Int J Med Inf. 2009;4:169 –172.
- 27. Iles R, Davidson M. Evidence based practice: a survey of physiotherapists’ current practice. Physiother Res Int. 2006;11:93–103. doi:10.1002/pri.328
- 28. Nilsagrd Y, Lohse G. Evidence-based physiotherapy: A survey of knowledge, behaviour, attitudes and prerequisites. Adv Physiother. 2010;12:179–186. doi:10.3109/14038196.2010.503812
- 29. Ramírez-Vélez R, Correa-Bautista JE, Muñoz-Rodríguez DI, et al. Evidence-based practice: beliefs, attitudes, knowledge, and skills among Colombian physical therapists. Colomb Med. 2015;46(1):33–40.
- 30. Silva TM, Costa L, Costa LO. Evidence-Based Practice: a survey regarding behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from Sa˜o Paulo state. Braz J Phys Ther. 2015;19(4):294–303. doi:10.1590/bjpt-rbf.2014.0102
- 31. Castellini G, Corbetta D, Cecchetto S, Gianola S. Twenty-five years after the introduction of Evidence-based Medicine: knowledge, use, attitudes and barriers among physiotherapists in Italy - a cross-sectional study. BMJ Open. 2020;10(6):e037133-e.
- 32. Guyatt GH, Haynes RB, Jaeschke RZ, et al. Users’ guides to the medical literature: XXV. Evidence-based medicine: Principles for applying the users’ guides to patient care. J Am Med Assoc. 2000;284:1290–1296. doi:10.1001/jama.284.10.1290
- 33. Alghadier M, Elnaggar RK, Alasraj MI, Khan N, Almeiman A, Albesher R. Evidence-Based Physiotherapy Practice in Paediatric Subdiscipline: A Cross-Sectional Study in Saudi Arabia. Healthc. 2022;10(11):1-14. doi:10.3390/healthcare10112302
- 34. Turner P, Whitfield TW. Physiotherapists’ use of evidence based practice: a cross-national study. Physiother Res Int. 1997;2:17–29. doi:10.1002/pri.76
- 35. Manspeaker SA, Lunen BL Van, Turocy PS, Pribesh S, Hankemeier D. Student knowledge, attitudes, and use of evidence-based concepts following an educational intervention. Athl Train Educ J. 2011;6(2):88–98.
- 36. Alghamdi AN, Alzahrani SS, Abdel-aziem AA. Students learning and teaching satisfaction. J Contemp Med. 2017;7(1):23-35. doi:10.16899/gopctd.286125
- 37. Stander J, Grimmer K, Brink Y. Training programmes to improve evidence uptake and utilisation by physiotherapists: a systematic scoping review. BMC Med Educ. 2018;18(1):14.
- 38. Alghadir A, Zafar H, Iqbal ZA, Anwer S. Physical therapy education in Saudi Arabia. J Phys Ther Sci. 2015;27(5):1621-1623. doi:1621-3
- 39. Scurlock-Evans L, Upton P, Upton D. Evidence-based practice in physiotherapy: a systematic review of barriers, enablers and interventions. Physiotherapy. 2014;100(3):208–219.
- 40. McKenna HP, Ashton S, Keeney S. Barriers to evidencebased practice in primary care. J Adv Nurs. 2004;45:178–89.
- 41. Ely JW, Osheroff JA, Ebell MH, et al. Obstacles to answering doctors’ questions about patient care with evidence: Qualitative study. Br Med J. 2002;324:710–713. doi:10.1136/bmj.324.7339.710
- 42. Retsas A. Barriers to using research evidence in nursing practice. J Adv Nurs. 2000;21:599–606. doi:10.1046/j.1365-2648.2000.01315.x
- 43. Heiwe S, Kajermo KN T-LR, Guidetti S, Samuelsson M, Andersson I, Wengström Y. Evidence-based practice: attitudes, knowledge and behaviour among allied health care professionals. Int J Qual Heal Care. 2011;23(2):198-209. doi:10.1093/intqhc/mzq083
- 44. Mota da Silva T, da Cunha Menezes Costa L, Garcia AN, Costa LOP. What do physical therapists think about evidence-based practice? A systematic review. Man Ther. 2015;20(3):388-401. doi:10.1016/j.math.2014.10.009
- 45. Lanyon R, Goodstein L. Personality Assessment. 3rd editio. New York: Wiley; 1997.
- 46. Korb K. Self-report questionnaires: can they collect accurate information? J Educ Found. 2011;1:5–12.
- 47. Gonyea R. Self-reported data in institutional research: Review and recommendations. New Dir Inst Res. 2005;127:73-89. doi:10.1002/ir.156