Investigating attitudes, skills, and use of evidence-based practice among Norwegian chiropractors; a national cross-sectional study

Birgitte Lawaetz Myhrvold; Iben Axén; Matthew J Leach; Tobias Sundberg; Anne Marie Gausel

doi:10.1186/s12913-023-09354-2

Investigating attitudes, skills, and use of evidence-based practice among Norwegian chiropractors; a national cross-sectional study

BMC Health Serv Res. 2023 Apr 20;23(1):385. doi: 10.1186/s12913-023-09354-2.

Authors

Birgitte Lawaetz Myhrvold^{1

2}, Iben Axén^{3

4}, Matthew J Leach⁵, Tobias Sundberg⁶, Anne Marie Gausel^{3

7

8}

Affiliations

¹ Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, P.O. Box 1089, Blindern, Oslo, 0317, Norway. b.l.myhrvold@medisin.uio.no.
² Et Liv I Bevegelse (ELiB), The Norwegian Chiropractic Research Foundation, Oslo, Norway. b.l.myhrvold@medisin.uio.no.
³ Et Liv I Bevegelse (ELiB), The Norwegian Chiropractic Research Foundation, Oslo, Norway.
⁴ Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 171 77, Stockholm, Sweden.
⁵ National Centre for Naturopathic Medicine, Southern Cross University, Military Road, East Lismore, NSW, Sydney, 2480, Australia.
⁶ Musculoskeletal & Sports Injury Epidemiology Center, Department of Health Promotion Science, Sophiahemmet University, Box 5605, Stockholm, 114 86, SE, Sweden.
⁷ Department for Caring and Ethics, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
⁸ Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway.

Abstract

Background: Evidence-based practice (EBP) is essential in improving the quality of healthcare and of importance for all health care personnel. No study in Norway has investigated attitudes, skills and use related to EBP among chiropractors. The aim of this study was to describe Norwegian chiropractors' attitudes, skills, and use of EBP, as well as the barriers and facilitators to their use of EBP.

Methods: A national cross-sectional survey, the online version of the Evidence Based practice Attitudes & Utilisation SurvEy (EBASE), was sent by email to 770 Norwegian practicing chiropractors, all members of the Norwegian Chiropractic Association. Three EBASE sub-scores were generated (Attitudes, Skills and Use), and the demographic characteristics of the sample were reported. Linear regression analyses were conducted to examine the association between responses of the three sub-scores and demographic characteristics. Information on main barriers and facilitators of EBP was collected and described.

Results: A total of 312 (41%) chiropractors responded to the survey, and 95% agreed that EBP is necessary for chiropractic practice. While overall use of EBP activities was low participants were interested in learning and improving their skills to incorporate EBP into practice. Chiropractors' attitudes, skills, and use of EBP were positively associated with being female and having spent more than one hour per week on research, but negatively associated with having practiced more than 10 years. Main barriers of EBP were lack of skills to critically evaluate, interpret, and apply research findings to practice. Main facilitators of EBP included access to the internet and free online databases in the workplace.

Conclusion: Although chiropractors in Norway reported positive attitudes and moderate skills in EBP, their use of EBP activities was limited. The main barriers and facilitators to EBP were primarily related to perceived skills deficits, whilst enablers of EBP were mostly related to infrastructure requirements.

Keywords: Attitudes; Barriers; Chiropractors; Evidence-based practice; Facilitators; Norwegian; Skills; Use.

MeSH terms

Attitude of Health Personnel
Chiropractic*
Cross-Sectional Studies
Evidence-Based Practice
Female
Health Knowledge, Attitudes, Practice
Health Personnel
Humans
Male
Surveys and Questionnaires