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Psychometric properties of questionnaires to assess evidence-based practice among occupational, physical and speech therapists: A systematic review

Published:January 24, 2023DOI:https://doi.org/10.1016/j.zefq.2022.11.003

      Abstract

      Introduction

      Evidence-based practice (EBP) is an important aspect of healthcare work, but the clinical implementation is complex. To be able to facilitate EBP implementation, valid measurement of the “EBP status quo” is essential. Therefore, we aimed to identify valid tools for EBP status assessment among occupational, physical and speech therapists in Germany.

      Methods

      The databases PubMed, Cochrane Library, PsycINFO, and CINAHL were systematically searched from August 2011 until July 2022. Methodological quality and evidence level were scored by two independent raters via: i) the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist, ii) updated criteria for good measurement properties, and iii) modified GRADE criteria.

      Results

      Overall, 57 reports describing the development or validation of 31 EBP questionnaires were included. Six questionnaires showed “sufficient” evidence for content validity, three questionnaires showed “sufficient” evidence for reliability, two questionnaires showed “sufficient” evidence for structural validity as well as internal consistency, and nine questionnaires showed “sufficient” evidence for construct validity. Most questionnaires demonstrated moderate or low-quality evidence for the psychometric properties tested.

      Discussion

      Overall, the present review found a lack of sufficient evidence on the psychometric properties of most questionnaires. The Evidence-Based Practice Inventory (EBPI), the Evidence-based Practice Confidence (EPIC) scale and the Health Sciences-Evidence-Based Practice (HS-EBP) questionnaire were the only questionnaires with “sufficient” content validity and, in addition, “sufficient” reliability or “sufficient” internal consistency.

      Conclusion

      Although a lack of high-quality psychometric properties of EBP tools became apparent, the EBPI, the EPIC scale and the HS-EBP questionnaire currently appear to be the best validated tools to assess EBP behavior/attitude and implementation in occupational, physical and speech therapists.

      Zusammenfassung

      Hintergrund

      Evidenzbasierte Praxis (EBP) ist ein wichtiger Aspekt der Arbeit im Gesundheitswesen. Die Umsetzung im Bereich der Gesundheitsfachberufe unterliegt allerdings komplexen Bedingungen. Um eine effiziente Implementierung in der Praxis zu erreichen, bedarf es einer zuverlässigen Evaluation des „EBP-Status quo“. Eine Identifizierung valider Instrumente zur Erfassung des EBP-Status für Ergo-, Physio- und Sprachtherapeut*innen in Deutschland soll hierzu beitragen.

      Methode

      Die Datenbanken PubMed, Cochrane Library, PsycINFO und CINAHL wurden von August 2011 bis Juli 2022 systematisch durchsucht. Die methodologische Qualität sowie die Evidenzklasse wurden von zwei unabhängigen Gutachtenden mittels der COSMIN-Checkliste (COnsensus-based Standards for the selection of health Measurement Instruments), ii) den zugehörigen aktualisierten Kriterien zur Bewertung von Messeigenschaften und iii) adaptierten GRADE-Kriterien bewertet.

      Ergebnisse

      Es wurden insgesamt 57 Publikationen eingeschlossen, in denen die Entwicklung oder Validierung von 31 EBP-Fragebögen beschrieben wurde. Sechs Fragebögen wiesen eine „ausreichende“ Evidenz für die Inhaltsvalidität auf, drei Fragebögen wiesen eine „ausreichende“ Evidenz für die Reliabilität auf, zwei Fragebögen wiesen eine „ausreichende“ Evidenz für die strukturelle Validität sowie die interne Konsistenz auf, und neun Fragebögen wiesen eine „ausreichende“ Evidenz für die Konstruktvalidität auf. Die meisten Fragebögen zeigten eine moderate bis geringe Qualität der Evidenz in Bezug auf die getesteten psychometrischen Eigenschaften.

      Diskussion

      Insgesamt wurde in dem vorliegenden Review festgestellt, dass für die psychometrischen Eigenschaften der meisten Fragebögen keine ausreichende Evidenz vorliegt. Das Evidence-Based Practice Inventory (EBPI), die Evidence-Based Practice Confidence (EPIC)-Skala und der Health-Sciences Evidence-Based Practice (HS-EBP) Questionnaire waren die einzigen Fragebögen, die eine „ausreichende“ Inhaltsvalidität und darüber hinaus eine „ausreichende“ Reliabilität oder eine „ausreichende“ interne Konsistenz aufwiesen.

      Schlussfolgerung

      Obwohl ein Mangel an qualitativ hochwertigen psychometrischen Eigenschaften von EBP-Fragebögen deutlich wurde, scheinen das EBPI, die EPIC-Skala und der HS-EBP derzeit die am besten validierten Instrumente zur Bewertung von EBP-Verhalten/Einstellung und -Umsetzung bei Ergo-, Physio- und Sprachtherapeut*innen zu sein.

      Keywords

      Schlüsselwörter

      Abbreviations:

      AFT (Adapted Fresno Test), COSMIN (COnsensus-based Standards for the selection of health Measurement Instruments), EBP (Evidence-based Practice), EBPAS (Evidence-based Practice Attitude Scale), EBPCBS (Evidence-based Practice Capabilities Beliefs Scale), EBPI (Evidence-based Practice Inventory), EBPIS (EBP Implementation Scale), EPIC (Evidence-based practice confidence scale), EROS (Edmonton Research Orientation Survey), GRADE (Grading of Recommendations Assessment Development and Evaluation), HS-EBP (Health-Sciences Evidence-Based Practice Questionnaire), OSF (Open Science Framework), PROMs (Patient-Reported Outcome Measures), RoB (Risk of Bias)
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