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Published in: BMC Geriatrics 1/2019

Open Access 01-12-2019 | Research article

Bridging the gap between research-based knowledge and clinical practice: a qualitative examination of patients and physiotherapists’ views on the Otago exercise Programme

Authors: Hilde Worum, Daniela Lillekroken, Birgitte Ahlsen, Kirsti Skavberg Roaldsen, Astrid Bergland

Published in: BMC Geriatrics | Issue 1/2019

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Abstract

Background

Falls and fall-related injuries exacerbate the health problems of older adults, and they are a public health concern. Despite an abundance of research, the implementation of evidence-based fall prevention programs has been slow and limited, additionally and these programs have not reduced the incidence of falling. Therefore, the primary objective of the present study was to examine patients and physiotherapists’ views on the factors that influence the implementation of the community- and evidence-based Otago Exercise Programme for fall prevention.

Methods

We conducted eight in-depth interviews with physiotherapists and patients, and a focus group interview with 12 physiotherapists and authority figures who represented local hospitals and municipalities. The resultant qualitative data were subjected to thematic analysis.

Results

The analysis yielded two main themes: the researcher’s role and position in the implementation process and the tension between research-based knowledge and clinical practice. The participants believed that research-based knowledge can address the challenges of clinical practice. Further, the patients reported that the fall prevention program made them feel safe and enhanced their ability to cope with daily life. The physiotherapists also observed that research findings do not readily translate into clinical practice. Further, they contended that research-based knowledge is not universal and that it cannot be generalized across different contexts; instead, it must be adapted and translated into a user-friendly language. The findings suggest that the application of research-based knowledge does equate to filling up empty jars and that research-based knowledge does not flow from the expert to the non-expert as water through a tube. Indeed, physiotherapists and patients are not tabula rasa. Additionally, the participants believed that researchers and stakeholders must think critically about who has the power and voice to create a common understanding.

Conclusions

Our findings delineate the means by which the gap between research and practice regarding the Otago fall prevention program can bridged. The program can guide clinical work and provide important information that can be used to improve the quality of other fall prevention programs. However, the research-based knowledge that it confers must be adapted for use in clinical contexts.
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Literature
1.
go back to reference Jylhä V, Oikarainen A, Perälä M-L, Holopainen A. Facilitating evidence-based practice in nursing and midwifery in the WHO European region; 2017. Jylhä V, Oikarainen A, Perälä M-L, Holopainen A. Facilitating evidence-based practice in nursing and midwifery in the WHO European region; 2017.
2.
go back to reference Hoffmann T, Bennett S, Del Mar C. Evidence-based practice across the health professions. 3rd ed. ed. Elsevier Australia: Chatswood, NSW; 2017. Hoffmann T, Bennett S, Del Mar C. Evidence-based practice across the health professions. 3rd ed. ed. Elsevier Australia: Chatswood, NSW; 2017.
3.
go back to reference Van Rhyn B, Barwick A. Health practitioners’ perceptions of falls and fall prevention in older people: a Metasynthesis. Qual Health Res. 2018;29(1):69–79.PubMedCrossRef Van Rhyn B, Barwick A. Health practitioners’ perceptions of falls and fall prevention in older people: a Metasynthesis. Qual Health Res. 2018;29(1):69–79.PubMedCrossRef
4.
go back to reference Child S, Goodwin V, Garside R, Jones-Hughes T, Boddy K. Stein K. Factors influencing the implementation of fall-prevention programmes: a systematic review and synthesis of qualitative studies. 2012;7(1):91. Child S, Goodwin V, Garside R, Jones-Hughes T, Boddy K. Stein K. Factors influencing the implementation of fall-prevention programmes: a systematic review and synthesis of qualitative studies. 2012;7(1):91.
5.
go back to reference Knighton AJ, McLaughlin M, Blackburn R, Wolfe D, Andrews S, Hellewell JL, et al. Increasing Adherence to Evidence-Based Clinical Practice. Qual Manag Health Care. 2019;28(1):65–7.PubMedCrossRef Knighton AJ, McLaughlin M, Blackburn R, Wolfe D, Andrews S, Hellewell JL, et al. Increasing Adherence to Evidence-Based Clinical Practice. Qual Manag Health Care. 2019;28(1):65–7.PubMedCrossRef
6.
go back to reference Markle-Reid MF, Dykeman CS, Reimer HD, Boratto LJ, Goodall CE, JL MG. Engaging community organizations in falls prevention for older adults: Moving from research to action. Can J Public Health. 2015;106(4):e189–96.PubMedCrossRefPubMedCentral Markle-Reid MF, Dykeman CS, Reimer HD, Boratto LJ, Goodall CE, JL MG. Engaging community organizations in falls prevention for older adults: Moving from research to action. Can J Public Health. 2015;106(4):e189–96.PubMedCrossRefPubMedCentral
7.
go back to reference Kitson AL, Straus SE. Identifying knowledge to action gaps. In: Straus S, Tetroe J, Graham I, editors. Knowledge translation in health care 2ed. Chichester: WILEY Blackwell; 2013. p. 97–110.CrossRef Kitson AL, Straus SE. Identifying knowledge to action gaps. In: Straus S, Tetroe J, Graham I, editors. Knowledge translation in health care 2ed. Chichester: WILEY Blackwell; 2013. p. 97–110.CrossRef
8.
go back to reference Altin S, Passon A, Kautz-Freimuth S, Berger B, Stock S. A qualitative study on barriers to evidence-based practice in patient counseling and advocacy in Germany. BMC Health Serv Res. 2015;15(1):317.PubMedPubMedCentralCrossRef Altin S, Passon A, Kautz-Freimuth S, Berger B, Stock S. A qualitative study on barriers to evidence-based practice in patient counseling and advocacy in Germany. BMC Health Serv Res. 2015;15(1):317.PubMedPubMedCentralCrossRef
9.
go back to reference Tetroe JM, Graham ID, Scott V. What does it mean to transform knowledge into action in falls prevention research? Perspectives from the Canadian Institutes of Health Research. J Saf Res. 2011;42(6):423–6.CrossRef Tetroe JM, Graham ID, Scott V. What does it mean to transform knowledge into action in falls prevention research? Perspectives from the Canadian Institutes of Health Research. J Saf Res. 2011;42(6):423–6.CrossRef
10.
go back to reference Kitson AL, Harvey G. Methods to succeed in effective knowledge translation in clinical practice. J Nurs Scholarsh. 2016;48(3):294–302.PubMedCrossRef Kitson AL, Harvey G. Methods to succeed in effective knowledge translation in clinical practice. J Nurs Scholarsh. 2016;48(3):294–302.PubMedCrossRef
11.
go back to reference Straus SE, Tetroe J, Graham ID. Introduction: knowledge tranlsatopn: what it is and what it Isn’t. In: Graham ID, Straus SE, Tetroe J, editors. Knowledge translation in health care : moving from evidence to practice. 2nd ed. Chichester: Wiley-Blackwell; 2013. p. 3–13.CrossRef Straus SE, Tetroe J, Graham ID. Introduction: knowledge tranlsatopn: what it is and what it Isn’t. In: Graham ID, Straus SE, Tetroe J, editors. Knowledge translation in health care : moving from evidence to practice. 2nd ed. Chichester: Wiley-Blackwell; 2013. p. 3–13.CrossRef
12.
go back to reference Hauer K, Lamb SE, Jorstad EC, Todd C, Becker C. Systematic review of definitions and methods of measuring falls in randomised controlled fall prevention trials. Age Ageing. 2006;35(1):5–10.PubMedCrossRef Hauer K, Lamb SE, Jorstad EC, Todd C, Becker C. Systematic review of definitions and methods of measuring falls in randomised controlled fall prevention trials. Age Ageing. 2006;35(1):5–10.PubMedCrossRef
13.
go back to reference Bergland A. Falls suffered by the elderly living at home. Doctoral thesis, Oslo: University of Oslo. Oslo: University of Oslo; 2002. Bergland A. Falls suffered by the elderly living at home. Doctoral thesis, Oslo: University of Oslo. Oslo: University of Oslo; 2002.
15.
go back to reference El-Khoury F, Cassou B, Charles M-A, Dargent-Molina P. The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults. Br J Sports Med. 2015;49(20):1348.PubMedCrossRef El-Khoury F, Cassou B, Charles M-A, Dargent-Molina P. The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults. Br J Sports Med. 2015;49(20):1348.PubMedCrossRef
17.
go back to reference Russell K, Taing D, Roy J. Measurement of Fall Prevention Awareness and Behaviours among Older Adults at Home; 2017. p. 1–14. Russell K, Taing D, Roy J. Measurement of Fall Prevention Awareness and Behaviours among Older Adults at Home; 2017. p. 1–14.
18.
go back to reference Grant A, Mackenzie L, Clemson L. How do general practitioners engage with allied health practitioners to prevent falls in older people? An exploratory qualitative study. 2015;34(3):149–54. Grant A, Mackenzie L, Clemson L. How do general practitioners engage with allied health practitioners to prevent falls in older people? An exploratory qualitative study. 2015;34(3):149–54.
19.
go back to reference Vieira ER, Palmer RC, Chaves PHM. Prevention of falls in older people living in the community. BMJ (Clinical research ed). 2016;353:i1419. Vieira ER, Palmer RC, Chaves PHM. Prevention of falls in older people living in the community. BMJ (Clinical research ed). 2016;353:i1419.
20.
go back to reference Goodwin VA, Abbott RA, Whear R, Bethel A, Ukoumunne OC, Thompson-Coon J, et al. Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis. BMC Geriatr. 2014;14:15.PubMedPubMedCentralCrossRef Goodwin VA, Abbott RA, Whear R, Bethel A, Ukoumunne OC, Thompson-Coon J, et al. Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis. BMC Geriatr. 2014;14:15.PubMedPubMedCentralCrossRef
21.
go back to reference Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc. 2008;56(12):2234–43.PubMedCrossRef Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc. 2008;56(12):2234–43.PubMedCrossRef
22.
go back to reference Carande-Kulis V, Stevens JA, Florence CS, Beattie BL, Arias I. A cost-benefit analysis of three older adult fall prevention interventions. J Saf Res. 2015;52:65–70.CrossRef Carande-Kulis V, Stevens JA, Florence CS, Beattie BL, Arias I. A cost-benefit analysis of three older adult fall prevention interventions. J Saf Res. 2015;52:65–70.CrossRef
24.
go back to reference Cheng P, Tan L, Ning P, Li L, Gao Y, Wu Y, et al. Comparative Effectiveness of Published Interventions for Elderly Fall Prevention: A Systematic Review and Network Meta-Analysis. Int J Environ Res Public Health. 2018;15(3):14.PubMedCentralCrossRef Cheng P, Tan L, Ning P, Li L, Gao Y, Wu Y, et al. Comparative Effectiveness of Published Interventions for Elderly Fall Prevention: A Systematic Review and Network Meta-Analysis. Int J Environ Res Public Health. 2018;15(3):14.PubMedCentralCrossRef
25.
go back to reference Campbell AJ, Robertson MC. Rethinking individual and community fall prevention strategies: a meta-regression comparing single and multifactorial interventions. Age Ageing. 2007;36(6):656–62.PubMedCrossRef Campbell AJ, Robertson MC. Rethinking individual and community fall prevention strategies: a meta-regression comparing single and multifactorial interventions. Age Ageing. 2007;36(6):656–62.PubMedCrossRef
26.
go back to reference Naseri C, Haines TP, Etherton-Beer C, McPhail S, Morris ME, Flicker L, et al. Reducing falls in older adults recently discharged from hospital: a systematic review and meta-analysis. Age Ageing. 2018;47(4):512–19.PubMedCrossRefPubMedCentral Naseri C, Haines TP, Etherton-Beer C, McPhail S, Morris ME, Flicker L, et al. Reducing falls in older adults recently discharged from hospital: a systematic review and meta-analysis. Age Ageing. 2018;47(4):512–19.PubMedCrossRefPubMedCentral
27.
go back to reference Stubbs B, Brefka S, Denkinger M. What Works to Prevent Falls in Community-Dwelling Older Adults? An Umbrella Review of Meta-analyses of Randomized Controlled Trials; 2015.CrossRef Stubbs B, Brefka S, Denkinger M. What Works to Prevent Falls in Community-Dwelling Older Adults? An Umbrella Review of Meta-analyses of Randomized Controlled Trials; 2015.CrossRef
28.
go back to reference Gell NM, Patel KV. Rehabilitation services use of older adults according to fall-risk screening guidelines. J Am Geriatr Soc. 2019;67(1):100–7.PubMedCrossRef Gell NM, Patel KV. Rehabilitation services use of older adults according to fall-risk screening guidelines. J Am Geriatr Soc. 2019;67(1):100–7.PubMedCrossRef
29.
go back to reference Elliott S, Leland NE. Occupational Therapy Fall Prevention Interventions for Community-Dwelling Older Adults: A Systematic Review. Am J Occup Ther. 2018;72(4):7204190040p1-7204190040p11.CrossRef Elliott S, Leland NE. Occupational Therapy Fall Prevention Interventions for Community-Dwelling Older Adults: A Systematic Review. Am J Occup Ther. 2018;72(4):7204190040p1-7204190040p11.CrossRef
30.
go back to reference Petridou ET, Manti EG, Ntinapogias AG, Negri E, Szczerbinska K. What works better for community-dwelling older people at risk to fall?: a meta-analysis of multifactorial versus physical exercise-alone interventions. J Aging Health. 2009;21(5):713–29.PubMedCrossRef Petridou ET, Manti EG, Ntinapogias AG, Negri E, Szczerbinska K. What works better for community-dwelling older people at risk to fall?: a meta-analysis of multifactorial versus physical exercise-alone interventions. J Aging Health. 2009;21(5):713–29.PubMedCrossRef
31.
go back to reference Tricco A, Thomas S, Veroniki A, Hamid J, Cogo E, Strifler L, et al Comparisons of Interventions for Preventing Falls in Older Adults: A Systematic Review and Meta-analysis2017. 1687 p. Tricco A, Thomas S, Veroniki A, Hamid J, Cogo E, Strifler L, et al Comparisons of Interventions for Preventing Falls in Older Adults: A Systematic Review and Meta-analysis2017. 1687 p.
32.
go back to reference Sherrington C, Tiedemann A. Physiotherapy in the prevention of falls in older people. J Phys. 2015;61(2):54–60. Sherrington C, Tiedemann A. Physiotherapy in the prevention of falls in older people. J Phys. 2015;61(2):54–60.
33.
go back to reference Campbell AJ, Robertson MC, Gardner MM, Norton RN, Tilyard MW. Buchner DM. Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. 1997;315(7115):1065–9. Campbell AJ, Robertson MC, Gardner MM, Norton RN, Tilyard MW. Buchner DM. Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. 1997;315(7115):1065–9.
34.
go back to reference Campbell AJ, Robertson MC. Otago Exercise programme to prevent falls in older adults; 2003. Campbell AJ, Robertson MC. Otago Exercise programme to prevent falls in older adults; 2003.
35.
go back to reference Simek EM, McPhate L, Haines TP. Adherence to and efficacy of home exercise programs to prevent falls: a systematic review and meta-analysis of the impact of exercise program characteristics. Prev Med. 2012;55(4):262–75.PubMedCrossRef Simek EM, McPhate L, Haines TP. Adherence to and efficacy of home exercise programs to prevent falls: a systematic review and meta-analysis of the impact of exercise program characteristics. Prev Med. 2012;55(4):262–75.PubMedCrossRef
36.
go back to reference Li F, Harmer P. Protocol for disseminating an evidence-based fall prevention program in community senior centers: evaluation of translatability and public health impact via a single group pre-post study. Implementation science : IS. 2014;9:63.CrossRefPubMedCentral Li F, Harmer P. Protocol for disseminating an evidence-based fall prevention program in community senior centers: evaluation of translatability and public health impact via a single group pre-post study. Implementation science : IS. 2014;9:63.CrossRefPubMedCentral
37.
go back to reference Luk JK, Chan TY, Chan DK. Falls prevention in the elderly: translating evidence into practice. Hong Kong medical journal = Xianggang yi xue za zhi. 2015;21(2):165–71.PubMed Luk JK, Chan TY, Chan DK. Falls prevention in the elderly: translating evidence into practice. Hong Kong medical journal = Xianggang yi xue za zhi. 2015;21(2):165–71.PubMed
38.
go back to reference Jansen S, Schoe J, van Rijn M, Abu-Hanna A. Moll van Charante EP, van der Velde N, et al. Factors associated with recognition and prioritization for falling, and the effect on fall incidence in community dwelling older adults. BMC Geriatr. 2015;15:169.PubMedPubMedCentralCrossRef Jansen S, Schoe J, van Rijn M, Abu-Hanna A. Moll van Charante EP, van der Velde N, et al. Factors associated with recognition and prioritization for falling, and the effect on fall incidence in community dwelling older adults. BMC Geriatr. 2015;15:169.PubMedPubMedCentralCrossRef
39.
go back to reference Carpenter CR, Lo AX. Falling behind? Understanding implementation science in future emergency department management strategies for geriatric fall prevention. Acad Emerg Med Off J Soc Acad Emerg Med. 2015;22(4):478–80.CrossRef Carpenter CR, Lo AX. Falling behind? Understanding implementation science in future emergency department management strategies for geriatric fall prevention. Acad Emerg Med Off J Soc Acad Emerg Med. 2015;22(4):478–80.CrossRef
40.
go back to reference Li F, Eckstrom E, Harmer P, Fitzgerald K, Voit J, Cameron KA. Exercise and fall prevention: narrowing the research-to-practice gap and enhancing integration of clinical and community practice. J Am Geriatr Soc. 2016;64(2):425–31.PubMedPubMedCentralCrossRef Li F, Eckstrom E, Harmer P, Fitzgerald K, Voit J, Cameron KA. Exercise and fall prevention: narrowing the research-to-practice gap and enhancing integration of clinical and community practice. J Am Geriatr Soc. 2016;64(2):425–31.PubMedPubMedCentralCrossRef
41.
go back to reference Guse CE, Peterson DJ, Christiansen AL, Mahoney J, Laud P, Layde PM. Translating a fall prevention intervention into practice: a randomized community trial. Am J Public Health. 2015;105(7):1475–81.PubMedPubMedCentralCrossRef Guse CE, Peterson DJ, Christiansen AL, Mahoney J, Laud P, Layde PM. Translating a fall prevention intervention into practice: a randomized community trial. Am J Public Health. 2015;105(7):1475–81.PubMedPubMedCentralCrossRef
42.
go back to reference Radecki B, Reynolds S, Kara A. Inpatient fall prevention from the patient's perspective: a qualitative study. Appl Nurs Res. 2018;43:114–9.PubMedCrossRef Radecki B, Reynolds S, Kara A. Inpatient fall prevention from the patient's perspective: a qualitative study. Appl Nurs Res. 2018;43:114–9.PubMedCrossRef
43.
go back to reference Snöljung Å, Gustafsson L-K. Physiotherapy: How to work with evidence in daily practice. J Eval Clin Pract. 2019;25(2):216–23. Snöljung Å, Gustafsson L-K. Physiotherapy: How to work with evidence in daily practice. J Eval Clin Pract. 2019;25(2):216–23.
44.
go back to reference Porter RB, Cullen L, Farrington M, Matthews G, Tucker S. CE: original research: exploring clinicians’ perceptions about sustaining an evidence-based fall prevention program. AJN The American Journal of Nursing. 2018;118(5):24–33.PubMedCrossRef Porter RB, Cullen L, Farrington M, Matthews G, Tucker S. CE: original research: exploring clinicians’ perceptions about sustaining an evidence-based fall prevention program. AJN The American Journal of Nursing. 2018;118(5):24–33.PubMedCrossRef
45.
go back to reference Malterud K. The art and science of clinical knowledge: evidence beyond measures and numbers. Lancet. 2001;358(9279):397–400.CrossRefPubMed Malterud K. The art and science of clinical knowledge: evidence beyond measures and numbers. Lancet. 2001;358(9279):397–400.CrossRefPubMed
46.
go back to reference Bottorff JL. Knowledge translation: where are the qualitative health researchers? Qual Health Res. 2015;25(11):1461–2.PubMedCrossRef Bottorff JL. Knowledge translation: where are the qualitative health researchers? Qual Health Res. 2015;25(11):1461–2.PubMedCrossRef
47.
go back to reference Forde C, Slater G. The nature and experience of agency working in Britain: what are the challenges for human resource management? Pers Rev. 2006;35(2):141–57.CrossRef Forde C, Slater G. The nature and experience of agency working in Britain: what are the challenges for human resource management? Pers Rev. 2006;35(2):141–57.CrossRef
48.
go back to reference Patton MQ, Herman JL, University of California LACftSoE, the Origin of L. How to use qualitative methods in evaluation. 2nd ed. ed. Newbury Park: Sage; 1987. Patton MQ, Herman JL, University of California LACftSoE, the Origin of L. How to use qualitative methods in evaluation. 2nd ed. ed. Newbury Park: Sage; 1987.
49.
go back to reference Creswell JW, Poth CN. Qualitative inquiry & research design : choosing among five approaches. 4th ed. ed. Los Angeles: SAGE Publications; 2018. Creswell JW, Poth CN. Qualitative inquiry & research design : choosing among five approaches. 4th ed. ed. Los Angeles: SAGE Publications; 2018.
50.
go back to reference Grbich C. Qualitative data analysis : an introduction. 2nd ed. ed. London: Sage; 2013. Grbich C. Qualitative data analysis : an introduction. 2nd ed. ed. London: Sage; 2013.
51.
go back to reference Hand DJ. Qualitative inquiry in clinical and educational settings by Danica G. hays, Anneliese a. Singh. Int Stat Rev. 2013;81(1):167–8.CrossRef Hand DJ. Qualitative inquiry in clinical and educational settings by Danica G. hays, Anneliese a. Singh. Int Stat Rev. 2013;81(1):167–8.CrossRef
52.
go back to reference Malterud K. Qualitative research: standards, challenges, and guidelines. Lancet. 2001;358(9280):483–8.PubMedCrossRef Malterud K. Qualitative research: standards, challenges, and guidelines. Lancet. 2001;358(9280):483–8.PubMedCrossRef
53.
go back to reference Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. 3rd ed. ed. Los Angeles: Sage; 2018. Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. 3rd ed. ed. Los Angeles: Sage; 2018.
54.
go back to reference Kvale S, Brinkmann S. Interviews : learning the craft of qualitative research interviewing. 2nd ed. ed. Los Angeles, Calif: Sage; 2009. Kvale S, Brinkmann S. Interviews : learning the craft of qualitative research interviewing. 2nd ed. ed. Los Angeles, Calif: Sage; 2009.
55.
go back to reference Malterud K, Siersma VD, Guassora AD. Sample size in qualitative interview studies: guided by information power. Qual Health Res. 2016;26(13):1753–60.PubMedCrossRef Malterud K, Siersma VD, Guassora AD. Sample size in qualitative interview studies: guided by information power. Qual Health Res. 2016;26(13):1753–60.PubMedCrossRef
56.
go back to reference Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000;55(4):M221–31.PubMedCrossRef Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000;55(4):M221–31.PubMedCrossRef
57.
go back to reference Halsaa KE, Brovold T, Graver V, Sandvik L, Bergland A. Assessments of interrater reliability and internal consistency of the Norwegian version of the Berg balance scale. Arch Phys Med Rehabil. 2007;88(1):94.PubMedCrossRef Halsaa KE, Brovold T, Graver V, Sandvik L, Bergland A. Assessments of interrater reliability and internal consistency of the Norwegian version of the Berg balance scale. Arch Phys Med Rehabil. 2007;88(1):94.PubMedCrossRef
58.
go back to reference Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Canadian journal of public health = Revue canadienne de sante publique. 1992;83(Suppl 2):S7–11.PubMed Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Canadian journal of public health = Revue canadienne de sante publique. 1992;83(Suppl 2):S7–11.PubMed
59.
go back to reference Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc. 1992;40(9):922–35.PubMedCrossRef Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc. 1992;40(9):922–35.PubMedCrossRef
60.
go back to reference Ware J. SF-36 Health Survey update; 2001. p. 3130–9. Ware J. SF-36 Health Survey update; 2001. p. 3130–9.
61.
go back to reference Morgan DL. Focus Groups as Qualitative Research, 2nd Ed. (Book Review) (Brief Review). 2003. p. 281. Morgan DL. Focus Groups as Qualitative Research, 2nd Ed. (Book Review) (Brief Review). 2003. p. 281.
63.
go back to reference Baztán JJ, Suárez-García FM, López-Arrieta J, Rodríguez-Mañas L, Rodríguez-Artalejo F. Effectiveness of acute geriatric units on functional decline, living at home, and case fatality among older patients admitted to Hospital for Acute Medical Disorders: meta-analysis. BMJ: British Medical Journal. 2009;338(7690):334–6. Baztán JJ, Suárez-García FM, López-Arrieta J, Rodríguez-Mañas L, Rodríguez-Artalejo F. Effectiveness of acute geriatric units on functional decline, living at home, and case fatality among older patients admitted to Hospital for Acute Medical Disorders: meta-analysis. BMJ: British Medical Journal. 2009;338(7690):334–6.
64.
go back to reference Beard JR, Officer A, De Carvalho IA, Sadana R, Pot AM, Michel JP, et al. The world report on ageing and health: a policy framework for healthy ageing. Lancet. 2016;387(10033):2145–54.PubMedCrossRef Beard JR, Officer A, De Carvalho IA, Sadana R, Pot AM, Michel JP, et al. The world report on ageing and health: a policy framework for healthy ageing. Lancet. 2016;387(10033):2145–54.PubMedCrossRef
65.
go back to reference Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
66.
go back to reference Lincoln YS, Guba EG. Naturalistic inquiry. Newbury Park: Sage Publications; 1985.CrossRef Lincoln YS, Guba EG. Naturalistic inquiry. Newbury Park: Sage Publications; 1985.CrossRef
67.
go back to reference Berger R. Now I see it, now I don’t: researcher’s position and reflexivity in qualitative research. Qual Res. 2015;15(2):219–34.CrossRef Berger R. Now I see it, now I don’t: researcher’s position and reflexivity in qualitative research. Qual Res. 2015;15(2):219–34.CrossRef
68.
go back to reference Enosh G, Ben-Ari A. Reflexivity: the creation of liminal spaces—researchers, participants, and research encounters. Qual Health Res. 2016;26(4):578–84.PubMedCrossRef Enosh G, Ben-Ari A. Reflexivity: the creation of liminal spaces—researchers, participants, and research encounters. Qual Health Res. 2016;26(4):578–84.PubMedCrossRef
69.
go back to reference Haynes RB, Devereaux PJ, Guyatt GH. Physicians' And Patients' Choices In Evidence Based Practice: Evidence Does Not Make Decisions, People Do. BMJ: British Medical Journal. 2002;324(7350):1350.PubMedCrossRefPubMedCentral Haynes RB, Devereaux PJ, Guyatt GH. Physicians' And Patients' Choices In Evidence Based Practice: Evidence Does Not Make Decisions, People Do. BMJ: British Medical Journal. 2002;324(7350):1350.PubMedCrossRefPubMedCentral
70.
go back to reference Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ (Clinical research ed). 1996;312(7023):71–2.CrossRef Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ (Clinical research ed). 1996;312(7023):71–2.CrossRef
71.
go back to reference Levant RF, Hasan NT, Roberts MC, Barnett JE. Evidence-based practice in psychology. Prof Psychol Res Pract. 2008;39(6):658–62.CrossRef Levant RF, Hasan NT, Roberts MC, Barnett JE. Evidence-based practice in psychology. Prof Psychol Res Pract. 2008;39(6):658–62.CrossRef
72.
go back to reference Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: The National Academies Press; 2001. 360 p. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: The National Academies Press; 2001. 360 p.
73.
go back to reference Perraton L, Machotka Z, Gibbs C, Mahar C, Kennedy K, Grimmer K. Evidence-based practice intentions and long-term Behaviours of physiotherapy graduates following an intensive education Programme. Physiother Res Int. 2017;22(3):e1666.CrossRef Perraton L, Machotka Z, Gibbs C, Mahar C, Kennedy K, Grimmer K. Evidence-based practice intentions and long-term Behaviours of physiotherapy graduates following an intensive education Programme. Physiother Res Int. 2017;22(3):e1666.CrossRef
74.
go back to reference Ritchie JA, Tips on implementation. Knowledge translation is the use of knowledge in health care decision making: WILEY Blackwell; 2011. p. 263–76. Ritchie JA, Tips on implementation. Knowledge translation is the use of knowledge in health care decision making: WILEY Blackwell; 2011. p. 263–76.
75.
go back to reference Nilsen P, Eilström P-E. Fostering Practice-Based Innovation Through Reflection at Work; 2012. p. 155–72. Nilsen P, Eilström P-E. Fostering Practice-Based Innovation Through Reflection at Work; 2012. p. 155–72.
76.
go back to reference Shaw J, Connelly D. Phenomenology and physiotherapy: Meaning in research and practice2012. p. 398–408.CrossRef Shaw J, Connelly D. Phenomenology and physiotherapy: Meaning in research and practice2012. p. 398–408.CrossRef
77.
go back to reference Andreassen TA, Når pasienter blir brukere. En utfordring for ekspertisens posisjon i helsetjenesten/ When patients become users. A challenge for the position of expertise in the health service. In: Moser I, Asdal K, editors. Ekspertise og brukermakt/ Expertise and user-power. Oslo: Universitetet i Oslo Senter for teknologi, innovasjon og kultur; 2008. p. 93–117. Andreassen TA, Når pasienter blir brukere. En utfordring for ekspertisens posisjon i helsetjenesten/ When patients become users. A challenge for the position of expertise in the health service. In: Moser I, Asdal K, editors. Ekspertise og brukermakt/ Expertise and user-power. Oslo: Universitetet i Oslo Senter for teknologi, innovasjon og kultur; 2008. p. 93–117.
79.
go back to reference Batalden P. Getting more health from healthcare: quality improvement must acknowledge patient coproduction—an essay by Paul Batalden. BMJ. 2018;362:k3617. Batalden P. Getting more health from healthcare: quality improvement must acknowledge patient coproduction—an essay by Paul Batalden. BMJ. 2018;362:k3617.
80.
go back to reference Nadi A, Shojaee J, Abedi G, Siamian H, Abedini E, Rostami F. Patients' Expectations and Perceptions of Service Quality in the Selected Hospitals. Medical archives (Sarajevo, Bosnia and Herzegovina). 2016;70(2):135. Nadi A, Shojaee J, Abedi G, Siamian H, Abedini E, Rostami F. Patients' Expectations and Perceptions of Service Quality in the Selected Hospitals. Medical archives (Sarajevo, Bosnia and Herzegovina). 2016;70(2):135.
81.
go back to reference Green LW, Ottoson JM, Garcia C, Hiatt RA. Diffusion theory and knowledge dissemination, utilization, and integration in public health. Annu Rev Public Health. 2009;30:151–74.PubMedCrossRef Green LW, Ottoson JM, Garcia C, Hiatt RA. Diffusion theory and knowledge dissemination, utilization, and integration in public health. Annu Rev Public Health. 2009;30:151–74.PubMedCrossRef
82.
go back to reference Jones M, Grimmer K, Edwards I, Higgs J, Trede F. Challenges in Applying Best Evidence to Physiotherapy. 2006;4. Jones M, Grimmer K, Edwards I, Higgs J, Trede F. Challenges in Applying Best Evidence to Physiotherapy. 2006;4.
83.
go back to reference Haas R, Maloney S, Pausenberger E, Keating JL, Sims J, Molloy E, et al. Clinical decision making in exercise prescription for fall prevention. Phys Ther. 2012;92(5):666–79.PubMedCrossRef Haas R, Maloney S, Pausenberger E, Keating JL, Sims J, Molloy E, et al. Clinical decision making in exercise prescription for fall prevention. Phys Ther. 2012;92(5):666–79.PubMedCrossRef
84.
go back to reference Martins AC, Santos C, Silva C, Baltazar D, Moreira J, Tavares N. Does modified Otago exercise program improves balance in older people? A systematic review. Prev Med Rep. 2018;11:231–9.PubMedPubMedCentralCrossRef Martins AC, Santos C, Silva C, Baltazar D, Moreira J, Tavares N. Does modified Otago exercise program improves balance in older people? A systematic review. Prev Med Rep. 2018;11:231–9.PubMedPubMedCentralCrossRef
85.
go back to reference Shayan SJ, Kiwanuka F, Nakaye Z. Barriers associated with evidence-based practice among nurses in low- and middle-income countries: a systematic review. Worldviews Evid-Based Nurs. 2019;16(1):12–20.PubMedCrossRef Shayan SJ, Kiwanuka F, Nakaye Z. Barriers associated with evidence-based practice among nurses in low- and middle-income countries: a systematic review. Worldviews Evid-Based Nurs. 2019;16(1):12–20.PubMedCrossRef
86.
go back to reference Mackenzie L. Perceptions of health professionals about effective practice in falls prevention. Disabil Rehabil. 2009;31(24):2005–12.PubMedCrossRef Mackenzie L. Perceptions of health professionals about effective practice in falls prevention. Disabil Rehabil. 2009;31(24):2005–12.PubMedCrossRef
87.
go back to reference Foucault M, Gordon C. Power/knowledge : selected interviews and other writings 1972–1977. Brighton: Harvester Press; 1980. Foucault M, Gordon C. Power/knowledge : selected interviews and other writings 1972–1977. Brighton: Harvester Press; 1980.
88.
go back to reference Foucault M. Discipline and punish : the birth of the prison. London: Allen Lane; 1977. Foucault M. Discipline and punish : the birth of the prison. London: Allen Lane; 1977.
91.
go back to reference Russell K, Taing D, Roy J. Measurement of Fall Prevention Awareness and Behaviours among Older Adults at Home. Canadian journal on aging = La revue canadienne du vieillissement. 2017;36(4):522–35. Russell K, Taing D, Roy J. Measurement of Fall Prevention Awareness and Behaviours among Older Adults at Home. Canadian journal on aging = La revue canadienne du vieillissement. 2017;36(4):522–35.
92.
go back to reference Joseph-Williams N, Edwards A. Elwyn G. Power imbalance prevents shared decision making: British Medical Journal Publishing Group; 2014. Joseph-Williams N, Edwards A. Elwyn G. Power imbalance prevents shared decision making: British Medical Journal Publishing Group; 2014.
93.
go back to reference Ballinger C, Payne S. Falling from grace or into expert hands? Alternative Accounts about Falling in Older People. 2000;63(12):573–9. Ballinger C, Payne S. Falling from grace or into expert hands? Alternative Accounts about Falling in Older People. 2000;63(12):573–9.
94.
go back to reference Contu A. On boundaries and difference: communities of practice and power relations in creative work. Manag Learn. 2014;45(3):289–316.CrossRef Contu A. On boundaries and difference: communities of practice and power relations in creative work. Manag Learn. 2014;45(3):289–316.CrossRef
95.
go back to reference Lukes S, British SA. Power : a radical view. 2nd ed. ed. Basingstoke: Palgrave Macmillan; 2005.CrossRef Lukes S, British SA. Power : a radical view. 2nd ed. ed. Basingstoke: Palgrave Macmillan; 2005.CrossRef
96.
go back to reference McCluskey A, Middleton S. Delivering an evidence-based outdoor journey intervention to people with stroke: barriers and enablers experienced by community rehabilitation teams. BMC Health Serv Res. 2010;10(1):18.PubMedPubMedCentralCrossRef McCluskey A, Middleton S. Delivering an evidence-based outdoor journey intervention to people with stroke: barriers and enablers experienced by community rehabilitation teams. BMC Health Serv Res. 2010;10(1):18.PubMedPubMedCentralCrossRef
97.
go back to reference Law M, Baptiste S, Mills J. Client-Centred practice: what does it mean and does it make a difference? Can J Occup Ther. 1995;62(5):250–7.PubMedCrossRef Law M, Baptiste S, Mills J. Client-Centred practice: what does it mean and does it make a difference? Can J Occup Ther. 1995;62(5):250–7.PubMedCrossRef
98.
go back to reference Clemson L, Cusick A, Fozzard C. Managing risk and exerting control: determining follow through with falls prevention. Disabil Rehabil. 1999;21(12):531–41.PubMedCrossRef Clemson L, Cusick A, Fozzard C. Managing risk and exerting control: determining follow through with falls prevention. Disabil Rehabil. 1999;21(12):531–41.PubMedCrossRef
99.
go back to reference Ahlsen B, Mengshoel AM, Bondevik H, Engebretsen E. Physiotherapists as detectives: investigating clues and plots in the clinical encounter; 2017. Ahlsen B, Mengshoel AM, Bondevik H, Engebretsen E. Physiotherapists as detectives: investigating clues and plots in the clinical encounter; 2017.
100.
go back to reference Baker C, Heitkamp K. NURSING HOME AMERICA—F-TAG REVISIONS AND GUIDELINES—ARE WE DEMONSTRATING BEST PRACTICE?: 1349. J Wound Ostomy Cont Nurs. 2007;34(3S):S52.CrossRef Baker C, Heitkamp K. NURSING HOME AMERICA—F-TAG REVISIONS AND GUIDELINES—ARE WE DEMONSTRATING BEST PRACTICE?: 1349. J Wound Ostomy Cont Nurs. 2007;34(3S):S52.CrossRef
101.
go back to reference Timmins E. Record-keeping. Nursing standard Royal College of Nursing Great Britain: 1987. 2007;21(44):59.CrossRef Timmins E. Record-keeping. Nursing standard Royal College of Nursing Great Britain: 1987. 2007;21(44):59.CrossRef
103.
go back to reference Schreiber J, F Marchetti G, Racicot B, Kaminski E. The Use of a Knowledge Translation Program to Increase Use of Standardized Outcome Measures in an Outpatient Pediatric Physical Therapy Clinic: An Administrative Case Report2014. Schreiber J, F Marchetti G, Racicot B, Kaminski E. The Use of a Knowledge Translation Program to Increase Use of Standardized Outcome Measures in an Outpatient Pediatric Physical Therapy Clinic: An Administrative Case Report2014.
104.
go back to reference Jette DU, Bacon K, Batty C, Carlson M, Ferland A, Hemingway RD, et al. Evidence-based practice: beliefs, attitudes, knowledge, and behaviors of physical therapists. Phys Ther. 2003;83(9):786–805. Jette DU, Bacon K, Batty C, Carlson M, Ferland A, Hemingway RD, et al. Evidence-based practice: beliefs, attitudes, knowledge, and behaviors of physical therapists. Phys Ther. 2003;83(9):786–805.
105.
go back to reference Ramírez-Vélez R, Correa-Bautista JE, Muñoz-Rodríguez DI, Ramírez L, González-Ruíz K, Domínguez-Sánchez MA, et al. Evidence-based practice: beliefs, attitudes, knowledge, and skills among Colombian physical therapists. Colombia medica (Cali, Colombia). 2015;46(1):33–40. Ramírez-Vélez R, Correa-Bautista JE, Muñoz-Rodríguez DI, Ramírez L, González-Ruíz K, Domínguez-Sánchez MA, et al. Evidence-based practice: beliefs, attitudes, knowledge, and skills among Colombian physical therapists. Colombia medica (Cali, Colombia). 2015;46(1):33–40.
106.
go back to reference Ubbink DT, Guyatt GH, Vermeulen H. Framework of policy recommendations for implementation of evidence-based practice: a systematic scoping review. BMJ Open. 2013;3(1):e001881.PubMedPubMedCentralCrossRef Ubbink DT, Guyatt GH, Vermeulen H. Framework of policy recommendations for implementation of evidence-based practice: a systematic scoping review. BMJ Open. 2013;3(1):e001881.PubMedPubMedCentralCrossRef
107.
go back to reference Patelarou AE, Patelarou E, Brokalaki H, Dafermos V, Thiel L, Melas CD, et al. Current evidence on the attitudes, knowledge and perceptions ofnurses regarding evidence-based practice implementation in European community settings: a systematic review. J Community Health Nurs. 2013;30(4):230–44.PubMedCrossRef Patelarou AE, Patelarou E, Brokalaki H, Dafermos V, Thiel L, Melas CD, et al. Current evidence on the attitudes, knowledge and perceptions ofnurses regarding evidence-based practice implementation in European community settings: a systematic review. J Community Health Nurs. 2013;30(4):230–44.PubMedCrossRef
108.
go back to reference Snöljung Å1, Mattsson K, Gustafsson LK. The diverging perception among physiotherapists of how to work with the concept of evidence: a phenomenographic analysis. J Eval Clin Pract. 2014;20(6):759–66.PubMedCrossRef Snöljung Å1, Mattsson K, Gustafsson LK. The diverging perception among physiotherapists of how to work with the concept of evidence: a phenomenographic analysis. J Eval Clin Pract. 2014;20(6):759–66.PubMedCrossRef
109.
go back to reference Morse JM. Designing funded qualitative research. In: Denzin NK, Lincoln YS, editors. Handbook of qualitative research. Thousand Oaks: Sage Publications; 1994. Morse JM. Designing funded qualitative research. In: Denzin NK, Lincoln YS, editors. Handbook of qualitative research. Thousand Oaks: Sage Publications; 1994.
110.
go back to reference Geertz C, Darnton R. The interpretation of cultures : selected essays. 3rd ed. ed. New York: Basic Books; 2017. Geertz C, Darnton R. The interpretation of cultures : selected essays. 3rd ed. ed. New York: Basic Books; 2017.
111.
go back to reference Van Manen M. Phenomenology of practice : meaning-giving methods in phenomenological research and writing. Walnut Creek: Left Coast Press; 2014. Van Manen M. Phenomenology of practice : meaning-giving methods in phenomenological research and writing. Walnut Creek: Left Coast Press; 2014.
112.
go back to reference Åkerlind G. Phenomenographic methods. A case illustration. In: Bowden JA, Green P, editors. Doing Developmental Phenomenography. 6. Melbourne: RMIT University Press. 2005. p. 103–27. Åkerlind G. Phenomenographic methods. A case illustration. In: Bowden JA, Green P, editors. Doing Developmental Phenomenography. 6. Melbourne: RMIT University Press. 2005. p. 103–27.
113.
go back to reference Schaefer JD, Welton JM. Evidence based practice readiness: a concept analysis. J Nurs Manag. 2018;26(6):621–9.PubMedCrossRef Schaefer JD, Welton JM. Evidence based practice readiness: a concept analysis. J Nurs Manag. 2018;26(6):621–9.PubMedCrossRef
114.
go back to reference Ward ME, De Brún A, Beirne D, Conway C, Cunningham U, English A, et al. Using co-design to develop a collective leadership intervention for healthcare teams to improve safety culture. Int J Environ Res Public Health. 2018;15(6):1182.PubMedCentralCrossRef Ward ME, De Brún A, Beirne D, Conway C, Cunningham U, English A, et al. Using co-design to develop a collective leadership intervention for healthcare teams to improve safety culture. Int J Environ Res Public Health. 2018;15(6):1182.PubMedCentralCrossRef
Metadata
Title
Bridging the gap between research-based knowledge and clinical practice: a qualitative examination of patients and physiotherapists’ views on the Otago exercise Programme
Authors
Hilde Worum
Daniela Lillekroken
Birgitte Ahlsen
Kirsti Skavberg Roaldsen
Astrid Bergland
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2019
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-019-1309-6

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