A qualitative application of the diffusion of innovations theory to examine determinants of guideline adherence among physical therapists.
BACKGROUND: Evidence-based practice has become a major issue in physical therapy. Many evidence-based guidelines, however, are not used extensively after dissemination, and interventions aimed at increasing guideline adherence often have limited effects. OBJECTIVE: As a prerequisite for changing thi...
| Publicado en: | Physical Therapy Vol. 89; no. 3; pp. 221 - 233 |
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| Autores principales: | , , , |
| Formato: | practice guidelines research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Mar2009
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105470527&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105470527 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00319023 PTH jtl: Physical Therapy issn: 00319023 maglogo: N pubinfo: dt: Mar2009 vid: 89 iid: 3 pid: 10398 pub: Oxford University Press / USA artinfo: ui: 105470527 2010214195 10.2522/ptj.20080185 NLM19168713 105470527 ppf: 221 ppct: 12 formats: fmt: @attributes: type: P tig: atl: A qualitative application of the diffusion of innovations theory to examine determinants of guideline adherence among physical therapists. aug: au: Harting J Rutten GMJ Rutten STJ Kremers SP affil: IQ Healthcare, University Medical Centre St Radboud, PO Box 9101, 6500 HB Nijmegen, the Netherlands. j.harting@iq.umcn.nl sug: subj: Decision Making, Clinical Diffusion of Innovation Physical Therapists Practice Guidelines Utilization Professional Compliance Attitude Measures Audiorecording Content Analysis Data Analysis Software Focus Groups Interviews Low Back Pain Rehabilitation Netherlands Nonexperimental Studies Physical Therapist Attitudes Psychological Theory Qualitative Studies Human ab: BACKGROUND: Evidence-based practice has become a major issue in physical therapy. Many evidence-based guidelines, however, are not used extensively after dissemination, and interventions aimed at increasing guideline adherence often have limited effects. OBJECTIVE: As a prerequisite for changing this situation, the aims of this study were to gain an in-depth understanding of the determinants of guideline adherence among physical therapists in the Netherlands and to evaluate the opportunities of a theoretical framework in this respect. Design and METHODS: This observational study consisted of 3 focus group interviews (n=12, 10, and 8) between November 2002 and January 2003. Physical therapists were asked to discuss their opinions about and experiences with the Dutch guidelines for low back pain. Data were analyzed qualitatively using a directed approach to content analysis. Both the interview route and the analysis of the interviews were informed by Rogers' Diffusion of Innovations Theory. RESULTS: Our study yielded in-depth insights into the various determinants of guideline adherence. Overall, the participants had rather unfavorable opinions about issues related to the dissemination of the guidelines (first phase of the diffusion process) and provided relatively little information on the subsequent adoption process (second phase of the diffusion process). The theoretical framework appeared to be a useful tool to properly structure the focus group interviews, to systematically analyze the data collected, and to determine that supplementary interviews would be necessary to cover the entire diffusion process. CONCLUSIONS: Our findings indicated that the diffusion process of guidelines among physical therapists was not yet completed. The use of theory can provide added value to guideline implementation studies. pubtype: Academic Journal doctype: practice guidelines research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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