Garcia Jenniffer, Copley Jodie, Turpin Merrill, Bennett Sally, McBryde Catherine, McCosker Josie Louise
Division of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Queensland - St Lucia, Brisbane, Qld., Australia.
Aust Occup Ther J. 2021 Apr;68(2):169-179. doi: 10.1111/1440-1630.12713. Epub 2020 Dec 10.
Evidence-based practice (EBP) is a critical framework for supporting clinical decision-making that has been increasingly promoted in occupational therapy over the last 20 years. Discipline-specific EBP frameworks and resources have emerged, primarily created by scholars from developed countries. However, EBP has received limited attention in literature published in developing and non-English speaking countries. This study aimed to explore Chilean occupational therapists' perceptions of EBP, factors influencing the adoption of EBP and sources of information used to inform clinical decision-making.
A cross-sectional online survey of Chilean occupational therapists included socio-demographic information, closed questions using a fivepoint Likert scale and open-ended questions. Numerical data were summarised using frequencies and percentages. Cross-tabulations explored relationships between variables. Narrative data from openended responses were analysed deductively using content analysis.
Complete surveys were returned by 192 Chilean respondents. The majority of participants (68.3%) defined EBP as the use of research knowledge only and perceived EBP as useful and important. The most significant barriers to the application of research knowledge included: lack of time (68.2%), an emerging research culture (67.7%) and restricted access to scientific literature (56.8%). Additionally, Chilean occupational therapists did not feel confident finding, appraising and integrating research evidence. Of the four sources of knowledge used in EBP, participants predominantly relied on clinical observations of clients (99.5%), their clinical expertise (89.1%), and discussions with the multidisciplinary team (78.1%) and other occupational therapists (40.1%), to inform clinical decision-making.
Language barriers, lack of time, scarcity of locally produced research, and an emergent research culture within Chile impede occupational therapists' ability to implement EBP. The adoption of EBP can facilitate access to contemporary occupational therapy knowledge powerfully guide clinical reasoning, and build local research capacity. Building research partnerships and collaborations with the international scientific community are crucial to the global achievement of EBP.
循证实践（EBP）是支持临床决策的关键框架，在过去20年里，职业治疗领域对其推广力度日益加大。特定学科的循证实践框架和资源不断涌现，主要由发达国家的学者创建。然而，在发展中国家和非英语国家发表的文献中，循证实践受到的关注有限。本研究旨在探讨智利职业治疗师对循证实践的看法、影响循证实践采用的因素以及用于临床决策的信息来源。
对智利职业治疗师进行的横断面在线调查包括社会人口学信息、使用五点李克特量表的封闭式问题和开放式问题。数值数据采用频率和百分比进行汇总。交叉表分析探讨变量之间的关系。对开放式回答的叙述性数据采用内容分析法进行演绎分析。
192名智利受访者返回了完整的调查问卷。大多数参与者（68.3%）将循证实践定义为仅使用研究知识，并认为循证实践有用且重要。应用研究知识的最主要障碍包括：时间不足（68.2%）、新兴的研究文化（67.7%）和获取科学文献受限（56.8%）。此外，智利职业治疗师在查找、评估和整合研究证据方面缺乏信心。在循证实践使用的四种知识来源中，参与者主要依靠对客户的临床观察（99.5%）、自身临床专业知识（89.1%）、与多学科团队的讨论（78.1%）以及与其他职业治疗师的讨论（40.1%）来为临床决策提供依据。
语言障碍、时间不足、本地研究稀缺以及智利国内新兴的研究文化阻碍了职业治疗师实施循证实践的能力。采用循证实践有助于获取当代职业治疗知识，有力地指导临床推理，并建立本地研究能力。与国际科学界建立研究伙伴关系和合作对于在全球实现循证实践至关重要。
