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Time as a barrier to evidence uptake -- A qualitative exploration of the concept of time for clinical practice guideline uptake by physiotherapists
  • Jessica Stander,
  • Karen Grimmer,
  • Yolandi Brink
Jessica Stander
Stellenbosch University Faculty of Medicine and Health Sciences
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Karen Grimmer
Stellenbosch University Faculty of Medicine and Health Sciences
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Yolandi Brink
Stellenbosch University Faculty of Medicine and Health Sciences
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Abstract

Background: Lack of time has consistently been reported as a major barrier to effective research evidence-uptake into clinical practice. There has been no research to our knowledge that explores time as a barrier within the Transtheoretical model of Stages of Change (SoC), to better understand the processes of physiotherapists’ uptake of clinical practice guidelines (CPG). This paper explores the concept of lack of time as a barrier for CPG uptake for physiotherapists at different SoC. Methods: A 6-step process is presented to determine the best-fit SoC for 31 physiotherapy interviewees. This process used an amalgamation of interview findings and socio-demographic data, which was layered onto the SoC and previously identified time-barriers to CPG uptake (few staff; high workload; access to CPGs; evidence-based practice as priority in clinical practice; “time is money” attitude; and knowledge on the use of CPGs). Results: The analysis process highlighted the complexities of assigning individuals to a SoC. A model of time management for better CPG uptake is proposed which is a novel approach to assist evidence implementalists and clinicians alike to determine how to progress through the SoC and barriers to improve CPG uptake. Conclusions: To the authors’ knowledge, this is the first attempt at exploring the construct of (lack of) time for CPG-uptake in relation to the physiotherapists’ readiness to behaviour change. This study shows that ‘lack of time’ is a euphemism for quite different barriers, which map to different stages of readiness to embrace current best evidence into physiotherapy practice. By understanding what is meant by ‘lack of time’, it may indicate specific support required by physiotherapists at different stages of changing these behaviours.

Peer review status:ACCEPTED

05 Jan 2020Submitted to Journal of Evaluation in Clinical Practice
06 Jan 2020Submission Checks Completed
06 Jan 2020Assigned to Editor
06 Jan 2020Reviewer(s) Assigned
21 Mar 2020Review(s) Completed, Editorial Evaluation Pending
21 Mar 2020Editorial Decision: Revise Minor
23 Mar 20201st Revision Received
23 Mar 2020Submission Checks Completed
23 Mar 2020Assigned to Editor
23 Mar 2020Review(s) Completed, Editorial Evaluation Pending
23 Mar 2020Editorial Decision: Accept