Abstract
BACKROUND: It has always been a goal of the chiropractic profession to employ evidence-based practice (EBP) to ensure effective development of treatment protocols when making clinical decisions. However, the extent of the use of EBP as well as the attitudes towards EBP amongst chiropractors in South Africa is unknown. There has only been one similar survey completed in South Africa which was used to ascertain the knowledge of, attitudes towards, perceptions of and perceived barriers towards EBP by chiropractors within the eThekwini municipality (Naidoo, 2018). The lack of research in EBP amongst chiropractors in South Africa suggests that further research needs to take place to ascertain the relationship between the attitudes and use of EBP and its adoption into practice.
AIM: The aim of the study to investigate the extent of the utilization and attitudes towards EBP amongst chiropractors of the Western Cape.
METHOD: A cross-sectional, descriptive, quantitative study with the use of the EBASE questionnaire was used. The Evidence-Based practice Attitude and utilization Survey (EBASE) was originally developed to evaluate the attitudes, skills, and use of Evidence-based practice amongst clinicians (Leach and Gilham, 2008). This was an online self-administered questionnaire by which chiropractors of the Western Cape accessed via email through a link. Membership databases of the Allied Health Professionals Council (AHPCSA) as well as the Chiropractic Association of South Africa (CASA) were utilised for the distribution of the survey.
PROCEDURE: An email including an information letter was sent to all registered chiropractors of the Western Cape via the AHPCSA and CASA membership databases. If the chiropractor was interested in taking part in the study, the chiropractor would agree click ‘agree’ and continue to a google forms platform where the questionnaire would be answered anonymously.
RESULTS: Data was collected through this study to determine the attitudes and utilization of chiropractors in the Western Cape. The response rate of this study was 11.54%, the overall attitudes to EBP amongst the chiropractors of the Western Cape which participated in the study were generally favourable, 66.7% respondents strongly agreeing that EBP is necessary in the practice of chiropractic. 53.3% respondents agreed that professional literature such as journal articles and textbooks were useful in their day-to- day practice while 33.3% strongly agreed with this statement. 53.3% of respondents agreed that EBP improves their patient care, while 46.7% of respondents strongly favoured learning the necessary skills to incorporate EBP into their practices. 60% respondents strongly agreed with the statement that EBP assists them in making clinical decisions about patient care. 46.7% of respondents strongly agreed with the statement that EBP considers their clinical experience when making clinical decisions, 46.7% of respondents also strongly agreed with the statement that EBP considers patient preference for treatment. 40% respondents also strongly disagreed with the statement that the adoption of EBP places and unreasonable demand on their practices. With regards to the utilization of EBP 66.7% of respondents rated that they read/ reviewed professional literature related to their practices. There was a majority split in the responses asking what percentage of their practice relies on clinical research which showed that 33.3% of responses said that a moderate proportion (51-75%) was based on clinical research evidence and 33.3% of responses said that a large proportion (76-99%) was based on clinical research this contrasted to 13.3% (n=2) of responses that felt that only a small proportion (25-60%) was based on clinical research evidence.
Participants of this study were also asked to rank (scale of 1-5) their skills with regards to the use of EBP 53.3% of respondents ranked themselves as a ‘4’ for the statement of identifying knowledge in practice with 33.3% ranking themselves as a ‘3’ on the scale. For the statement of identifying answerable clinical questions 73.3% ranked themselves as a ‘4’ on the scale. For locating professional literature 33.3% rated themselves as a ‘4’ with the balance of respondents rating themselves between a ‘3’ at 26.7% and a ‘2’ at 20%. For the statement regarding online database searching there were equal responses of 26.7% ranking themselves as a ‘2’ and a ‘3’. Majority of participants ranking themselves as a ‘3’ for evidence retrieval at 40%, while 46.7% of respondents ranked themselves as a ‘3’ for critical appraisal of evidence-based data. 40% ranked themselves as a ‘4’ for the synthesis of research evidence, while 60% ranked themselves as a ‘4’ regarding the integration of research evidence to patient cases. 46.7% of participants ranked themselves as a ‘4’ regarding the sharing of evidence with colleagues. However, 40% of participants ranked themselves as ‘poor’ regarding conducting clinical research. 40% of participants ranked themselves as a ‘1’ on the scale regarding conducting of systematic reviews...