Barriers to evidence-based physiotherapy practice for stroke survivors in Ghana.
Jonathan Quartey, Samuel Kwakye
PMID 30135919WHAT IT FOUND
Ghanaian physiotherapists treating stroke survivors reported organisational barriers as the biggest problem: no protected time, no current research access, and no mandate to use evidence.
They still valued evidence-based practice but felt less confident interpreting research results.
Key findings
01All participants reported organisational challenges affecting implementation, and most said their facilities did not provide protected time for literature review and appraisal or access to current research.
02The most frequently reported barrier to updating practice was lack of organisational mandate (68 participants, 56.2%).
03Participants generally held positive attitudes about using evidence, while average confidence in interpreting statistical procedures was below 50%.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was a cross-sectional self-report survey, so it describes perceived barriers at one time and cannot show whether those barriers led to less evidence-based care or worse patient outcomes. The sample was convenience-based and limited to registered Ghana Physiotherapy Association members with at least 2 years' experience who had treated stroke, so it may not represent all physiotherapists in Ghana. Data collection was limited in time, and participants may have completed the questionnaire in haste because of busy schedules. Some participants were reluctant to take part because of work and personal schedules, so responses may still miss the busiest clinicians. The questionnaire was adapted from a previous tool and included added items, and response categories were collapsed for analysis, which may affect how precisely each barrier was measured. Some reported associations had very wide or inconsistent uncertainty ranges, so they should not be treated as firm.
Declared interests
No funding or conflict-of-interest declaration is reported.
The easy way to misread this
Do not conclude that physiotherapists do not want to use evidence or that fixing access and protected time will improve stroke outcomes. Most participants valued evidence-based practice, and the study measured self-reported barriers only; it did not test an intervention or patient outcomes.