Abate, Roza (2014) Assessment of Knowledge, Attitude and Practice and Barriers on Evidence Based Medicine among Physicians Practicing in Tikur Anbessa Hospital, Addis Ababa, Ethiopia. Masters thesis, Addis Ababa University.
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Abstract
Background Evidence based medicine plays a crucial role as a tool that helps integrate research evidence into clinical practice. However, few reports have yet to examine its application in daily practice among resident physicians in Japan. The aim of this study was to assess the attitudes towards and knowledge of EBM among resident physicians in Japanese and determine perceived barriers to its use. Objectives: The main objective of this study is to assess and determine the knowledge, attitude and practice towards EBM among physicians and their perceived barriers impeding the application of EBM practice. Methods: A conventional study was conducted in TASH from March, 1-May 30, 2014 on 400 physicians (residents and interns) working at Tikur Anbessa Hospital to assess their knowledge, attitude and practice towards EBM. Data were collected using a structured pre tested questionnaire. Results A total of (422) physicians were interviewed. Out of which 20 declined to participate, which makes giving a response rate of 95.3 % and the nonresponsive rate 4.7 % and two questionnaires were rejected because of their incompleteness. Among the 400 participants (293)73.3% were males and (107)26.7% were females. The (374) 93.5% of the study participants were between the age of 21 - 30 years and the remaining (26)6.5% of them belonging to the age group 31-40 years. Among the total respondents (173) 43.3% were interns and (227) 56.7% were residents. From the total study subjects 75.5 % have heard about EBM and among all of the widely known and used during clinical decision making EBM resources indicated in this survey are Uptodate (85%), Google(57.3%) followed by PUBMED(39.5%). Familiarity and use of electronic EBM resources did not differ between male and female residents. Residents with internet access at work compared to those without internet access, had no effect on familiarity and use of electronic EBM resources. There was significant correlation between years of residency and familiarity and use of electronic EBM resources. Comparing the interns and the residents, 53.2% of the interns were familiar to electronic EBM resources whereas 92.5% for the residents.There was no significant mean difference in familiarity of electronic EBM sources between male and female respondents (Mann Whitney U test P = 0.226), and those with and without Internet facilities at work (Independent sample T test P = 0.228). Similarly, no significant correlation is seen between the residents graduated university and the familiarity and use of electronic EBM. The Positive responses toward EBM reflected the positive attitude and welcoming situation in the medical school. 96% of physicians agree that EBM practices improves patient care ; 94.6% EBM improves patient outcomes; 94.8%EBM helps clinical decision making; 67.1%EBM practice reduce healthcare cost; 93.1%EBM brings about quick knowledge update; 74.6%EBM focused on patients value; 94.8%EBM should be taught in medical school ; 79.5%EBM importance to apply in Ethiopia; 82.8%lack of knowledge on EBM has negative impact on quality of medical care. On the other side negative response to EBM practice were also noticeable in that 31.6 % respondent agree that EBM is difficult to be applied in daily practices. Of the total 400 respondents only 30.8% respondents had educational exposure about EBM during their stay in medical school, while the remaining 69.2% didn‘t have any. This indicated that either the effort spent to expand the access to EBM is minimal or little has been done to increase the awareness about EBM among physicians. Among the total respondents 66% of the physicians apply practicing EBM for any of the following reasons; when the patient does not improve while getting appropriate treatment, whenever they get new patient, when they encounter uncommon case, for grand rounds or similar case discussions. The four most common barriers identified in this study to EBM application were: EBM being a new concept 72.2%, lack of time 56%, lack of skill 60.7%, and scepticism 33.2%. Other barriers that are identified by the respondents also include lack of access to EBM sources and internet access. Conclusions In general, attitudes towards EBM are positive. Respondents moderately understood and knew basic EBM skill; however, barriers in its application were shown to exist. Based on these finding we would like to suggest to AA University TASH to conduct more workshops on EBM, and facilitate residents' physician and interns to improve their comprehensions and skills to EBM. In general, respondents positively welcomed EBM, and moderately understood and knew basic EBM skill; however, barriers in its application were shown to exist.
| Item Type: | Thesis (Masters) |
|---|---|
| Subjects: | R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
| Divisions: | Africana |
| Depositing User: | Emmanuel Ndorimana |
| Date Deposited: | 28 Nov 2018 10:44 |
| Last Modified: | 28 Nov 2018 10:44 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/7890 |
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