Knowledge, Attitudes, Perceptions, Adherence and Barriers to Evidence Basedsports Physiotherapy Standards among the Physiotherapists in Kenya

Abstract

Evidence-based practice (EBP) and evidence-based physiotherapy (EBPT) has been investigated in different physiotherapy clinical settings including sports physiotherapy practice. However, no research has been done regarding the knowledge, attitudes & perceptions of, adherence and barriers towards evidence-based sports physiotherapy standards among the physiotherapists in Kenya. The Objective of this study was to establish the current knowledge, attitudes & perceptions of, adherence and barriers towards evidence-based sports physiotherapy standards among the physiotherapists in Kenya. A cross-sectional study utilizing quantitative methods was conducted among the entire total population of 700 licensed physiotherapists in the republic of kenya who completed a self-administered questionnaire. Data collection was through personal face-to-face visits, e mails and follow up through telephone calls and e- mails. Data was analysed using the SPSS Statistics version 25, summarized into descriptive statistics and displayed in tables and figures. Association between the demographic characteristics and other information (independent variables) and knowledge, attitudes & perceptions of, adherence and barriers (dependent variables) were determined using Chi-square test. The level of significance was set up at (p ≤ 0.05). A 55.9% (n=391) response rate was recorded. Those involved in structured sports physiotherapy practice accounted for 32.9% (n=129). High levels of knowledge of EBP (67.8%; n=265) were reported. More males (73.4%; n=185) than females (57.5%; n=80) presented with high levels of knowledge of EBP. Those with specialization (83.3%; n=65) demonstrated high levels of knowledge of EBP than those without (63.9%; n=200). A positive attitude towards EBP was reported by 94.6% (n=370) of the respondents. The most evident areas of agreement with attitude and perception related statements were that “EBP is important in that patients can receive the best possible treatment” (95.9%; n=375), that “evidence-based guidelines related to work exists” (84.6%; n=331). However, the respondents strongly disagreed that there is no “value in conducting EBP” (74.9%; n=293). Adherence to the step wise process of EBP accounted for 36.6% (n=143). More males (41.3%; n=104) than females (28.1%; n=39) adhered to the step wise process of EBP. Those with specialization (61.5%; n=48) and those without (30.4%; n=95) adhered to the step wise process of EBP. Insufficient time was highlighted by (57.8%; n=226) of the respondents as one of the “most important barriers”. Gender (p=0.006), training (p=0.000) and specialization (p=0.003) were found to have statistically- significant associations with knowledge and adherence (p ≤ 0.05). Lower levels of adherence to the step wise process of EBP was established among reportedly knowledgeable physiotherapists. This was statistically attributed to training and specialization whose enhancement may improve adherence. Strong positive attitudes towards EB sports physiotherapy were reported though barred mainly by lack of time, lack of generalizability of literature findings to Kenya’s sporting population and inability to apply research findings. Physiotherapists in Kenya have an idea of what EB sports physiotherapy entails. They however require support with regards to exposure time for stepwise execution of the EBP process and in training on application strategies which will improve adherence. Physiotherapists in Kenya present with high levels of knowledge in EB sports physiotherapy but with lower levels of adherence to thestep wise process of EBP. The understanding ofthe researchterms were equally found to be lower. Although strong positive attitudes towards EBsports physiotherapy practice was depicted, barriers were identified which could hinder the implementation of EB in sports physiotherapy practice. Continuous professional development to enhance competencies in data analysis is important. That health care institution that attends to clients with sports injuries provide electronic access to databases and physical infrastructure to support EBP. Future studies should seek to establish the actual impact of the current mode of practice on athletes with sports injuries in Kenya and also explore the in-depth realities related to the barriers highlighted.