Date of Award

5-1-2014

Degree Name

Doctor of Philosophy

Department

Health Education

First Advisor

Brown, Stephen

Abstract

AN ABSTRACT OF THE DISSERTATION OF MICHAEL A. STROUD, for Doctor of Philosophy degree in HEALTH EDUCATION, presented on MARCH 20, 2014, at Southern Illinois University Carbondale. TITLE: PHYSICAL THERAPISTS' CLINICAL PRACTICES REAGARDING INTRINSIC AND EXTRINSIC FALL RISK FACTORS AND THEIR ATTITUDES TOWARD THE USE OF EVIDENCE-BASED PRACTICE MAJOR PROFESSOR: Dr. Stephen Brown The phenomenon of falls among community-dwelling adults--coupled with an aging baby boomer generation and an increasing life expectancy--presents a significant concern for an increased number of unintentional deaths and injuries and their associated costs. The risk factors associated with falling are often categorized as intrinsic and extrinsic. Physical therapists have a unique opportunity to positively impact issues involving physical dysfunction and to educate their community-dwelling adult patients about the environmental risk factors and interventions that lessen their risk of falling. Abundant evidence-based research exists regarding interventions for the treatment and prevention of falls; however, this research indicates that physical therapists fail to consistently utilize evidence-based practice (EBP) in their daily clinical practices. The diffusion of innovations theory examines how innovations are adopted (Rogers, 2012). However, the innovation of EBP is not always adopted by physical therapists. Lack of time to conduct literature searches was the most common barrier noted by physical therapists for not adopting EBP (Jette et al., 2003; Fruth et al., 2010; Salbach, Jagial, Korner-Bitensky, Rappolt, & Davis, 2007). This study, which utilized a cross-sectional descriptive research design, provided insight into physical therapists' clinical practices regarding intrinsic and extrinsic fall risks in the treatment of community-dwelling adults aged 65 years and older. It examined physical therapists' attitudes and beliefs toward the use of EBP and identified the barriers to their adoption of it. The demographic data provided a descriptive overview of the study respondents. There were 3,523 potential physical therapist respondents, and the study's return rate was 9% (316 respondents. The majority of the respondents held doctoral degrees (49.4%), more than half (55.4%) worked in an outpatient physical therapy clinical setting, and approximately half indicated that they were American Physical Therapy Association (APTA)-certified instructors. The results of the study indicated that physical therapists who had more experience displayed a higher level of attention to clinical practices than those with less experience. The physical therapists who were APTA-certified clinical instructors demonstrated a higher level of attention to the intrinsic and extrinsic risks of falling than those who were not APTA-certified instructors. The physical therapists whose highest level of education was a doctorate placed greater importance on the utilization of EBP than respondents with a baccalaureate or master's degree. Although most physical therapists believe that the utilization of EBP holds significant value, they do not always access or apply it. Insufficient time for using EBP was the major barrier noted by most physical therapists. The results of this study concurred with those of previous studies regarding common barriers to physical therapists' adoption of EBP. Rehabilitation organizations may want to examine methods to promote the use of the most current physical therapy practices based on the evidence revealed in the literature and to explore options for improving staff access to and utilization of EBP research.

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