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应用自主决定理论增进对物理治疗师将研究应用于临床实践之理由的理解:瑞典的一项定性研究。

Applying self-determination theory for improved understanding of physiotherapists' rationale for using research in clinical practice: a qualitative study in Sweden.

机构信息

Department of Medical and Health Sciences, Linköping University , Linköping , Sweden.

出版信息

Physiother Theory Pract. 2014 Jan;30(1):20-8. doi: 10.3109/09593985.2013.814185. Epub 2013 Jul 30.

Abstract

Physiotherapists are generally positive to evidence-based practice (EBP) and the use of research in clinical practice, yet many still base clinical decisions on knowledge obtained during their initial education and/or personal experience. Our aim was to explore motivations behind physiotherapists' use of research in clinical practice. Self-Determination Theory was applied to identify the different types of motivation for use of research. This theory posits that all behaviours lie along a continuum of relative autonomy, reflecting the extent to which a person endorses their actions. Eleven focus group interviews were conducted, involving 45 physiotherapists in various settings in Sweden. Data were analysed using qualitative content analysis and the findings compared with Self-Determination Theory using a deductive approach. Motivations underlying physiotherapists use of research in clinical practice were identified. Most physiotherapists expressed autonomous forms of motivation for research use, but some exhibited more controlled motivation. Several implications about how more evidence-based physiotherapy can be achieved are discussed, including the potential to tailor educational programs on EBP to better account for differences in motivation among participants, using autonomously motivated physiotherapists as change agents and creating favourable conditions to encourage autonomous motivation by way of feelings of competence, autonomy and a sense of relatedness.

摘要

物理治疗师通常对循证实践(EBP)和在临床实践中使用研究持积极态度,但许多人仍然根据他们在初始教育和/或个人经验中获得的知识做出临床决策。我们的目的是探讨物理治疗师在临床实践中使用研究的动机。应用自我决定理论来确定使用研究的不同类型的动机。该理论假设所有行为都沿着相对自主性的连续体排列,反映了一个人对自己行为的认可程度。在瑞典的各种环境中,进行了 11 次焦点小组访谈,涉及 45 名物理治疗师。使用定性内容分析对数据进行分析,并使用演绎方法将研究结果与自我决定理论进行比较。确定了物理治疗师在临床实践中使用研究的动机。大多数物理治疗师对研究使用表现出自主的动机形式,但也有一些表现出更受控制的动机。讨论了如何实现更基于证据的物理治疗的一些含义,包括通过以下方式实现更基于证据的物理治疗的潜力:根据参与者的动机差异,调整循证实践教育计划;利用自主动机的物理治疗师作为变革推动者;并创造有利条件,通过增强能力感、自主性和归属感来鼓励自主动机。

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