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Original Research
DOI: 10.1016/j.bjpt.2018.10.002
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Evidence-Based Practice: a survey of Brazilian physical therapists from the dermatology subdiscipline
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Renato Claudinoa, Naudimar de Pietro Simoesb, Tatiane da Silvac,
Corresponding author
tati_911@yahoo.com.br

Corresponding author at: Department of Health Professions, Ground Floor, 75 Talavera Road, Macquarie University, NSW 2109, Australia.
a Centro Universitário Estácio de Santa Catarina, Sao Jose, Santa Catarina, Brazil
b Instituto Brasileiro de Terapias e Ensino (IBRATE), Curitiba, Parana, Brazil
c Department of Health Professions, Macquarie University, Sydney, Australia
Highlights

  • Physical therapists from dermatology report having knowledge to be able to implement EBP.

  • Physical therapists from dermatology believe having skills to be able to implement EBP.

  • There were inconsistencies on some answers about knowledge and skills related to EBP.

This item has received
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Received 26 February 2018, Accepted 03 October 2018
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Figures (1)
Tables (3)
Table 1. Demographic characteristics of respondents (n=101).
Table 2. Self-reported behavior related to EBP (n=101).
Table 3. Self-reported knowledge, skills and resources, and opinion related to EBP.
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Abstract
Background

Dermatology is a relatively new subdiscipline of physical therapy with growth potential. Therefore, it is important to identify whether professionals from this area have the knowledge and skills required to offer the best available service based on evidence-based practice.

Objectives

To describe the self-reported behavior, knowledge, skills, opinion, and barriers related to the evidence-based practice of Brazilian physical therapists from the dermatology subdiscipline.

Methods

An adapted electronic questionnaire was sent by the Brazilian Association of Dermatology Physical Therapy via email to all registered members. The data were analyzed descriptively.

Results

The response rate was 40.4% (101/250). Brazilian physical therapists from the dermatology subdiscipline reported that they update themselves equally through scientific papers and courses, and access preferentially databases that offer scientific papers in the Portuguese language. Respondents believe they have sufficient knowledge to use evidence-based practice, inform patients about treatment options and consider their choices in the decision-making process. However, there were inconsistencies in responses regarding the experience with evidence-based practice during undergraduate or postgraduate degree, as well as having discussions about evidence-based practice in the workplace. The barriers most frequently reported were difficulty to obtain full-text papers, lack of quality of the scientific papers, applicability of the findings into clinical practice, lack of evidence-based practice training and difficulty to understand the statistics.

Conclusion

Brazilian physical therapists from the dermatology subdiscipline have positive perceived behavior, believe that they have sufficient knowledge and skills, and have favorable opinion related to evidence-based practice. However, there are inconsistencies related to some aspects of knowledge and skills set.

Keywords:
Evidence-Based Practice
Physical therapy
Dermatology
Cross-sectional study
Brazil
Full Text
Introduction

The term ‘evidence-based practice’ (EBP) is defined as the use of high quality clinical research to inform decisions in clinical practice with regard to the care of individual patients.1 According to the EBP principles, the decision-making process need also to consider the physical therapist's experience and the patient's preferences.1,2 The EBP can be used according to the following steps: (1) formulation of a clinical question, (2) review of the literature, (3) critical appraisal of the evidence, (4) application of the evidence in clinical practice, and (5) appraisal of the implementation of evidence in clinical practice.3,4 While the definition and process in the use of EBP are very well defined, professionals may face different challenges in effectively use it.

Some of the challenges related to the process of using EBP can be associated with physical therapy practice. For example, the use of the best diagnosis or intervention pointed by the literature may require more time, skills and expertise from the physical therapist; it may be more expensive; or, it may not be available in the physical therapist setting.1 Additionally, cultural influences may affect the expectations of patients and professionals or provide contexts less favorable to the use of EBP.1,5 More importantly, a lack of specific knowledge and skills in EBP may make it difficult to use EBP effectively.

Previous studies have described characteristics related to EBP through the perspectives of physical therapists’. A previous systematic review identified the knowledge, skills, behavior, opinions and barriers faced by physical therapists in relation to EBP.6 The review summarized the results of 12 studies (with a total of 6411 participants) from nine countries. The results showed that from three studies reporting knowledge, between 21 and 82% of respondents had received prior information on EBP. From two studies reporting on skills and behavior, nearly half of the sample had used databases to support clinical decision-making. From six studies reporting opinions, most of the participants considered EBP important. The barriers reported most frequently were lack of time, difficulty to understand statistical analysis, lack of support from the employer, lack of resources, lack of interest and a lack of generalization of the results of studies for clinical practice.6 These difficulties were found by professionals from different specialization areas.

Previous studies have investigated perspectives of physical therapists in general, without considering different physical therapy subdisciplines. Dermatology is a recent physical therapy subdiscipline created in 2009 and recognized by the Brazilian physical therapy registration board (Conselho Federal de Fisioterapia e Terapia Ocupacional – COFFITO) in 2010.7 Dermatology assists patients with kinesiological and functional disorders of the skin and related structures, and also preoperative and postoperative conditions.8 Considering it is a subdiscipline that has recently been recognized in physical therapy with significant growth potential, there is a need for a specific investigation into the characteristics of physical therapists in this area with regard to EBP. To date, there has been no study conducted to investigate such characteristics in this subdiscipline. Therefore, this study aims to describe the self-reported behavior, knowledge, opinion and barriers related to EBP experienced by Brazilian physical therapists in the dermatology subdiscipline.

MethodsStudy design

The present study is a cross-sectional descriptive study. The study was approved by the Research Ethics Committee of Instituto Brasileiro de Terapias e Ensino (IBRATE), Curitiba, Parana, Brasil on 12 December 2016 (CAAE: 59741316.9.0000.5229). Participants read and accepted (electronically) the information participant consent form before answering the questionnaire.

Participants

The inclusion criteria were physical therapists, members of the Brazilian Association of Dermatology Physical Therapy up to December 2016, residents in Brazil, with valid certification by the physical therapy registration board of their region. This study received institutional support by the Brazilian Association of Dermatology Physical Therapy that helped in contacting all members and in advertising the study.

Data collection tool

The questionnaire was tested previously in a pilot study9 to guarantee better quality and understanding of the questions. The questionnaire was developed and used in Portuguese language, and divided into the following domains: (1) consent form (1 item); (2) demographic details and educational and professional experience (7 items); (3) area from dermatology (1 item); (4) skills in reading English texts (1 item); and (5) characteristics related to EBP – behavior (5 items), knowledge (9 items), skills and resources (9 items), opinion (5 items), and barriers (15 items). The questionnaire was developed with response options in a five Likert scale between one and five (1=strongly disagree, 2=partially disagree, 3=neutral, 4=partially agree, and 5=strongly agree).9 The full questionnaire is described in Appendix 1.

Data collection procedures

The Brazilian Association of Dermatology Physical Therapy sent an electronic questionnaire to all members via e-mail (professional and/or personal). The association also advertised the study via their website. The advertisement offered a link to the questionnaire page. The data collection was held from January 2017 to June 2017. The electronic questionnaire was created on the Jot Form of Google Chrome that works in Web Navigator. It is a free service tool for the creation of online forms. The participant started to answer the questionnaire after reading and accepting the participant information consent form. The responses were anonymous. The participant could not progress through the survey without answering all the questions of each page. No reminders were sent. However, we extended the data collection time to optimize the response rate.

Data analysis

The data were analyzed using descriptive statistics, and reported through absolute values, percentages and frequencies. We only considered complete questionnaires in the analysis. The analysis was conducted using the IBM SPSS software (version 22.0 for Windows).

Results

The cumulative response rate was 40.4% (101/250). Table 1 describes the demographic characteristics of participants. The majority of participants were women (88.1%), had graduated within the last five years (31.7%) and nine years (26.5%), and held a master of coursework (59.8%). Approximately 77% worked assisting patients, and 50% worked in the esthetic and cosmetic area.

Table 1.

Demographic characteristics of respondents (n=101).

Characteristics  n (%) 
Gender
Female  89 (88.1) 
Time from graduation
Less than 5 years  32 (31.7) 
5–9 years  25 (26.5) 
10–14 years  28 (27.6) 
15–19 years  9 (10.4) 
20–24 years  4 (2.5) 
More than 24 years  3 (1.3) 
Highest level of education
Bachelor degree  11 (10.9) 
Master degree of coursework  60 (59.8) 
Master degree of research  23 (22.3) 
Doctorate degree  4 (4.0) 
Post-Doctoral degree  3 (3.0) 
Type of university (during graduate course)
Private  89 (88.1) 
Current practice
Assisting patients  78 (77.2) 
Teaching  20 (19.8) 
Research  3 (3.0) 
Employment sector
Public  11 (10.9) 
Private  34 (36.7) 
Both  10 (9.9) 
Self-employed  46 (42.5) 
Teaching experience
Yes  61 (60.4) 
Dermatology working area
Plastic surgery (pre and post)  23 (22.8) 
Angiology and lymphedema  4 (4.0) 
Dermatology  18 (17.8) 
Esthetic and cosmetic  51 (50.4) 
Burns  5 (5.0) 
Skills in reading English texts
Poor  22 (21.8) 
Moderate  58 (57.5) 
Good  21 (20.7) 
Behavior in EBP

Table 2 describes the behavior of the physical therapists in relation to EBP. Approximately 38% of the respondents update themselves through scientific papers, and the same percentage through courses. According to the use of databases, most of the respondents access databases in the Portuguese language (80.3% use the Lilacs database frequently and 78.3% use the SciELO database frequently); however, 72.1% report using PubMed frequently.

Table 2.

Self-reported behavior related to EBP (n=101).

Characteristic  n (%) 
Updating knowledge methodsa
Courses  38 (37.6) 
Meetings, lectures and conferences  20 (19.8) 
Study groups  3 (3.0) 
Books  1 (1.0) 
Scientific papers  38 (37.6) 
Frequency of databases use
Everyday  5 (5.0) 
1–3 times a week  30 (29.7) 
1–3 times a month  33 (32.7) 
Once every 2 months  16 (15.8) 
Very rarely  17 (16.8) 
Place of using databases
Home  64 (63.4) 
Work  29 (28.7) 
University  8 (7.9) 
Databases useda
PubMed  91 (89.1) 
Cochrane  44 (22.8) 
SciELO  100 (99.0) 
Lilacs  85 (81.1) 
PEDro  37 (42.1) 
Google scholar  82 (76.8) 
Databased used frequentlya
PubMed  79 (72.1) 
Cochrane  23 (29.4) 
SciELO  83 (78.3) 
Lilacs  56 (80.3) 
PEDro  20 (24.0) 
Google scholar  67 (50.7) 
a

Respondents could choose more than one option in this question.

Knowledge about EBP

Table 3 describes the self-reported knowledge, skills and resources, and opinions about EBP. The majority of respondents reported that they know the meaning of the term ‘evidence-based practice’ (72.3% strongly agree), clearly understand the use of research findings into clinical practice (67.3% strongly or partially agree), understand different study designs (62.4% strongly or partially agree), and believe they have sufficient knowledge to use EBP (58.4% strongly or partially agree). However, there was inconsistency in the responses regarding experience in EBP during undergraduate or postgraduate degree, and about the information about EBP during the undergraduate or postgraduate degree being sufficient.

Table 3.

Self-reported knowledge, skills and resources, and opinion related to EBP.

  Strongly disagree  Partially disagree  Neutral  Partially agree  Strongly agree 
Knowledge
I know the meaning of the term evidence-based practice.  0.0  5.0  7.9  14.8  72.3 
I had no experience with evidence-based practice during my undergraduate or postgraduate course(s).  27.7  19.8  11.0  25.7  15.8 
The information about evidence-based practice during my undergraduate or postgraduate degree was sufficient.  20.8  23.8  16.8  26.7  11.9 
I do not understand the core elements of evidence-based practice.  30.7  28.7  14.9  17.8  7.9 
I know clearly how to apply the research findings into clinical practice.  5.0  15.8  11.9  25.7  41.6 
I understand different types of studies (study designs).  7.9  17.8  11.9  32.7  29.7 
I do not understand statistical data.  30.7  27.7  13.9  16.8  10.9 
I believe I have sufficient knowledge to use evidence-based practice.  5.9  19.8  15.8  32.7  25.8 
I am not interested in learning more about evidence-based practice.  74.3  9.9  9.8  1.0  5.0 
Skills and resources
I am not able to conduct searches in online databases.  38.6  29.7  9.9  13.9  7.9 
I am able to critically assess scientific papers.  5.9  12.9  10.9  37.6  32.7 
I often access online databases.  3.0  9.9  8.9  28.7  49.5 
I am not motivated to use evidence-based practice in my daily practice.  31.7  16.9  17.8  15.8  17.8 
I have computer resources and Internet access at my workplace that facilitates the use of evidence-based practice.  8.9  4.0  6.9  15.8  64.4 
I do not have discussions about evidence-based practice in my workplace.  30.7  9.9  19.8  12.9  26.7 
I ask my patients about their preferences and I consider them in my decision-making.  12.9  9.9  9.8  32.7  34.7 
I inform my patients of their treatment options and consider their choices in the decision-making process.  7.9  7.9  8.9  25.8  49.5 
I do not use the best scientific evidence in my clinical practice.  67.3  12.9  8.9  6.9  4.0 
Opinion
Evidence-based practice is important to my clinical practice.  0.0  3.0  3.0  21.7  72.3 
I do not believe that evidence-based practice improves patient care in physical therapy.  80.2  9.8  4.0  2.0  4.0 
Much of my decision-making regarding the treatment of my patients incorporates evidence-based practice.  1.0  9.9  15.8  30.7  42.6 
An expert's opinion in my field is the most important factor in my decision-making process.  8.9  12.9  18.8  40.6  18.8 
The use of the best scientific evidence does not improve the quality of health services.  51.5  26.7  5.0  6.9  9.9 

Variables expressed in percentages (%).

Skills and resources related to EBP

The majority of the respondents reported being able to critically assess scientific papers (70.3% strongly or partially agree), often access online databases (78.2% strongly or partially agree), have computer resources and Internet access at the workplace that facilitates the use of EBP (80.2% strongly or partially agree), ask patients about their preferences and consider them in the decision-making (67.4% strongly or partially agree), and inform patients of their treatment options and consider their choices in the decision-making process (75.3% strongly or partially agree). Although there were reports of being encouraged at work to use EBP, there was inconsistency with regard to having discussions about EBP in the workplace.

Opinion related to EBP

The respondents believed that EBP is important in clinical practice (94% strongly or partially agree), and agree that much of the decision-making regarding the treatment of the patients incorporates EBP. However, controversially, respondents reported that experts opinion in the field is the most important factor for their clinical decision-making (59.4% strongly or partially agree).

Barriers faced in EBP

Fig. 1 shows the self-reported barriers related to EBP. The barriers that were reported by respondents most frequently were the difficulty to obtain full-text papers (76.2% strongly or partially agree), lack of quality of the scientific papers (67.4% strongly or partially agree), applicability of the findings into clinical practice (61.4% strongly or partially agree), lack of EBP training (57.5% strongly or partially agree), and difficulty to understand statistics (54.5% strongly or partially agree).

Figure 1.
(0.26MB).

Self-reported barriers related to EBP.

DiscussionSummary of main findings

Brazilian physical therapists from the dermatology subdiscipline reported that they update themselves equally through scientific papers and courses, most of the respondents access databases in the Portuguese language; however, around 70% report using PubMed frequently. Respondents reported that they believe they have sufficient knowledge to use EBP, inform patients of their treatment options and consider their choices in the decision-making process, and are encouraged at work to use EBP. However, there were inconsistencies in the answers regarding experience with EBP during undergraduate or postgraduate degree, and having discussions about EBP in the workplace. Although respondents have favorable opinion related to EBP, they report that expert opinions are the most important factor for their clinical decision-making process. The barriers reported most frequently were the difficulty to obtain full-text papers, lack of quality of the scientific papers, applicability of the findings into clinical practice, lack of EBP training, and difficulty to understand the statistics.

Strengths and weaknesses of the study

We had a satisfactory response rate (101/250: 40%) when compared to previous studies (20%,10 26%,11 51%,12 and 54%13). We have used different resources to improve data collection by sending questionnaires to both personal and professional e-mail addresses, and by using electronic advertising on the association website (with direct access to the questionnaire). We also extended the data collection time to optimize the response rate. The study also has some limitations. We did not send reminders to participants as an attempt to improve the response rate. And we did not control for participants that could answer the questionnaire more than one time. Unfortunately, many physical therapists in Brazil are not members of physical therapy associations, and therefore we believe we may not have reached all professionals from the dermatology subdiscipline within the nation.

Comparison with other studies

To date, only two previous studies have identified characteristics related to EBP of Brazilian physical therapists. The first study14 identified whether the physical therapists had skills to review the scientific literature and to use EBP in clinical practice. The study reported that physical therapists have positive behavior related to EBP and are interested in improving their skills.14 This study was a pilot with only 67 physical therapists from one state in Brazil. The second study9 identified the perceived knowledge, skills, resources, opinions and barriers related to EBP of 316 Brazilian physical therapists. Respondents also believed they have the knowledge and skills necessary to apply EBP and also had favorable opinion about it.9 The study also pointed out some inconsistencies in the answers, such as understanding the core elements of EBP and understanding statistical data.9 This study had a large sample; however, it considered only one state in Brazil and only 12.1% of the sample was from the dermatology subdiscipline. The results of our study also agree with existing studies from other countries.

In comparison to studies around the world, differently to our study, 82% of physical therapists of a study from USA,15 more than 50% of a study from Philippines,16 and 44.5% of a study from Canada17 reported that they received information about EBP during their undergraduate or postgraduate degrees. Controversially, 89% of physical therapists of a study from Japan,18 70.2% of a study from Saudi Arabia, and 30.8 of a study from Germany11 had no formal EBP training. Physical therapists from Canada,17 USA,15 Sweden,19 Japan,18 France,12 Sweden,20 Colombia,21 and Germany11 also agree that EBP is necessary to clinical practice. The main barrier reported by previous studies was lack of time.12,13,15,17,19,20 The study from France also reported no access to full articles as an important barrier. The studies from USA,15 Canada,17 Sweden,19 and Colombia21 also reported applicability of the findings into clinical practice as an important barrier. And the studies from USA,15 Canada,17 Philippines,16 and Colombia21 also reported inability to understand statistics as an important barrier.

Meaning of the study

Although respondents reported that they have sufficient knowledge to use EBP, there were inconsistencies in the answers regarding experience with EBP during their degrees, and regarding having discussions about EBP in the workplace. The most important barrier was difficulty to obtain full-text papers. These findings demonstrate implications in three possible levels. First, the need of educational strategies related to EBP – as part of the undergraduate degree, master of coursework of dermatology degree, and continuing education or short courses. Second, workplaces may encourage the use of high-quality research to guide clinical practice. This can be done by organizing times for discussions about patients focused on EBP principles, or discussions about specific issues such as methodology or statistics, and by offering facilities such as computer resources and Internet access at the workplace. And finally, there are some possible options to get full-text papers for free. Bireme22 grants free access to many databases. Capes e-journal web portal23 grants access to public universities and few private universities, along with other web portals that provide access to scientific journals. However, the physical therapists need proper training and good English language reading skills to be able to use these databases.

Conclusion

Brazilian physical therapists from the dermatology subdiscipline have positive perceived behaviors related to EBP, believe they have sufficient knowledge and skills to use EBP, and have favorable opinion related to it. However, there are current inconsistencies related to some aspects of their knowledge and skill set. The barriers reported most frequently were the difficulty to obtain full-text papers, lack of quality of the scientific papers, applicability of the findings into clinical practice, lack of EBP training, and difficulty to understand statistics.

Conflicts of interest

The authors declare no conflicts of interest.

Acknowledgements

CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), Ministry of Education of Brazil. This study was supported by the Brazilian Association of Dermatology Physical Therapy (ABRAFIDEF), who helped in the selection and recruitment of participants. We thank all the participants who participated in the study.

References
[1]
R. Herbert,G. Jamtvedt,K.B. Hagen,J. Mead
Practical Evidence-based Physiotherapy
2nd ed., Elsevier, (2011)
[2]
D.L. Sackett,W.M. Rosenberg,J.A. Gray,R.B. Haynes,W.S. Richardson
Evidence based medicine: what it is and what it isn’t
BMJ, 312 (1996), pp. 71-72
[3]
T. Mota da Silva,A. Narciso Garcia,L. Oliveira Pena Costa
Pratica baseada em evidencia: como efetivamente utilizar na prática clínica
[4]
D.L. Sackett,S.E. Straus,W.S. Richardson,W. Rosenberg,R.B. Haynes
Evidence-Based Medicine. How to Practice and Teach EBM
2nd ed., Churchill Livingstone, (2000)
[5]
S. Sharma,J.H. Abbott,M.P. Jensen
Why clinicians should consider the role of culture in chronic pain
Braz J Phys Ther, 22 (2018), pp. 345-346
[6]
T.M. da Silva,L.d.C.M. Costa,A.N. Garcia,L.O.P. Costa
What do physical therapists think about evidence-based practice? A systematic review
Man Ther, 20 (2015), pp. 388-401
[7]
COFFITO. Conselho Federal de Fisioterapia e Terapia Ocupacional. Parana; 2018. Available from: https://www.coffito.gov.br/nsite/?p=3125.
[8]
G.B. Milani,S.M.A. João,E.A. Farah
Fundamentos da Fisioterapia dermato-funcional: revisão de literatura
Fisioterapia e pesquisa, 13 (2006), pp. 37-43
[9]
T. Mota da Silva,L. da Cunha Menezes Costa,L. Oliveira Pena Costa
Evidence-Based Practice: a survey regarding behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from Sao Paulo state
Braz J Phys Ther, 19 (2015), pp. 294-303
[10]
G.G.M. Scholten-Peeters,M.S. Beekman-Evers,A.C.J.W. van Boxel
Attitude, knowledge and behaviour towards evidence-based medicine of physical therapists, students, teachers and supervisors in the Netherlands: a survey
J Eval Clin Pract, 19 (2013), pp. 598-606
[11]
I. Bauer,S. Lechner,S. Walt,J. Wojciech
Evidence-based practice in physiotherapy: the current situation in Germany as compared to England (part 2)
Z Physiother, 59 (2007), pp. 122e37
[in German]
[12]
P. Buchard
La pratique fondée sur les résultats probants en physiothérapie Position des physiothérapeutes valaisans francophones
Kinésithérapie, 9 (2009), pp. 50-57
[13]
R. Iles,M. Davidson
Evidence based practice: a survey of physiotherapists’ current practice
Physiother Res Int, 11 (2006), pp. 93-103
[14]
P.S. Queiroz,M.J.d. Santos
Facilidades e habilidades do fisioterapeuta na procura, interpretação e aplicação do conhecimento científico na prática clínica: um estudo piloto easiness and skillfulness of physical therapists in searching, interpreting and applying scientific knowledge in clinical practice: a pilot study
Fisioter Mov, 26 (2013), pp. 13-23
[15]
D.U. Jette,K. Bacon,C. Batty
Evidence-based practice: beliefs, attitudes, knowledge, and behaviors of physical therapists
Phys Ther, 83 (2003), pp. 786-805
[16]
E.J.R. Gorgon,H.G.T. Barrozo,L.G. Mariano,E.F. Rivera
Research evidence uptake in a developing country: a survey of attitudes, education and self-efficacy, engagement, and barriers among physical therapists in the Philippines
J Eval Clin Pract, 19 (2013), pp. 782-790
[17]
N.M. Salbach,S.B. Jaglal,N. Korner-Bitensky,S. Rappolt,D. Davis
Practitioner and organizational barriers to evidence-based practice of physical therapists for people with stroke
Phys Ther, 87 (2007), pp. 1284-1303
[18]
S. Fujimoto,N. Kon,J. Takasugi,T. Nakayama
Attitudes, knowledge and behavior of Japanese physical therapists with regard to evidence-based practice and clinical practice guidelines: a cross-sectional mail survey
J Phys Ther Sci, 29 (2017), pp. 198-208
[19]
S. Bernhardsson,K. Johansson,P. Nilsen,B. Oberg,M.E. Larsson
Determinants of guideline use in primary care physical therapy: a cross-sectional survey of attitudes, knowledge, and behavior
Phys Ther, 94 (2014), pp. 343-354
[20]
Y. Nilsagård,G. Lohse
Evidence-based physiotherapy: a survey of knowledge, behaviour, attitudes and prerequisites
Adv Physiother, 12 (2010), pp. 179-186
[21]
R. Ramirez-Velez,J.E. Correa-Bautista,D.I. Munoz-Rodriguez
Evidence-based practice: beliefs, attitudes, knowledge, and skills among Colombian physical therapists
Colomb Med (Cali), 46 (2015), pp. 33-40
[22]
BIREME. Biblioteca Virtual em Saúde. São Paulo; 2018. Available from: http://www.bireme.br.
[23]
CAPES. Portal de Periódicos CAPES. Brasília; 2018. Available from: http://www.periodicos.capes.gov.br.
Copyright © 2018. Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
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