Barriers to evidence-based physiotherapy practice for stroke survivors in Ghana

BACKGROUND: Physiotherapy has evolved over the years, and this has led to an increasing demand in using evidence as a basis for making clinical decisions because evidence-based interventions for stroke have been shown to be effective. However, the inability to carry out any of the evidence-based practice (EBP) processes may constitute a barrier to its application in practice. AIM: To determine the barriers to EBP of physiotherapy services for stroke survivors in Ghana. METHODS: A cross-sectional study that involved 121 physiotherapists of the Ghana Physiotherapy Association providing services to stroke survivors. Physiotherapists completed a self-administered questionnaire. Logistic regressions were used to examine relationships between socio-demographic and practice characteristics of respondents and each practitioner factor. A logistic regression was used to identify the association between organisational characteristics and each organisational factor that facilitates EBP. RESULTS: Self-efficacy ratings for performing EBP were below 50% for critical appraisal of the literature and interpretation of statistics. All the participants stated that they had organisational challenges, which tend to affect the implementation of evidence-based physiotherapy practice for stroke. The five most reported barriers to updating knowledge on EBP included lack of organisational mandate (56.2%), insufficient time (46.3%), lack of information resources (43%), lack of understanding of statistics (35.5%) and lack of interest (33.1%). CONCLUSION: Lack of adequate resources, lack of organisational support and low self-efficacy to perform EBP activities constitute barriers to implementing EBP for stroke survivors. CLINICAL IMPLICATIONS: Findings of the study reinforce the need to develop a supportive organisational infrastructure to increase research integration in physiotherapy practice.