case study 2 article fall prevention.pdf - Worum et al BMC...

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RESEARCH ARTICLE Open Access Reflections of older people about their experience of fall prevention exercise in the community- a qualitative study exploring evidence-based practice Hilde Worum 1* , Daniela Lillekroken 2 , Kirsti Skavberg Roaldsen 1,3,4 , Birgitte Ahlsen 1 and Astrid Bergland 1 Abstract Background: Evidence-based practice (EBP) ensures that clinicians use effective interventions to achieve desired outcomes, thereby contributing to the best quality of care. The perspective of the participants is fundamental in EBP, as they have their own individual and meaningful rationale for participating in fall prevention. This study aims to explore community-dwelling older people reflections about their reflections about EBP in physiotherapy based on their experiences of a fall prevention exercise program. Methods: We conducted semi-structured interviews with 16 community-dwelling older people (men = 7; women = 9). Data were analyzed using thematic analysis. Results: The analysis revealed three themes: 1) the tension between knowing and doing, 2) the power of the therapist-participant relationship and the process of putting knowledge into action, and 3) research is interwoven with successful therapy and is an integral component of it. EBP was considered as a collective negotiation and learning process of creating knowledge for clinical practice. The negotiation between different types of knowledge must be performed in a transparent dialogue and through interactive collaboration between the persons involved. The participants appreciated that the research findings indicate that practice gives results. Conclusions: EBP was understood and utilized as a seal of approval and a guarantee of high quality treatment, and its effects varied based on older people s preferences, needs, and skills. The therapist s relational competence appeared to be crucial for the negotiation of various sources of knowledge relative to the older people s preferences. Keywords: Collaboration, Engagement, Fall prevention, Impact, Knowledge translation, Patient and public involvement Background Due to the increasing proportion of older people in soci- ety [ 1 ], efficient and effective evidence-based practice (EBP) strategies for managing fall prevention in primary health care are of great importance. Offering customized health services as people become older is a common challenge across Europe [ 2 ]. EBP aims to integrate the best available evidence, clinical expertise, and patient values into clinical practice to ensure positive patient outcomes [ 3 ], as illustrated in Fig. 1 . Applying EBP in primary health care settings ensures that clinicians use effective interventions to achieve desired outcomes, thereby contributing to the best quality of care [ 4 ]. How- ever, there are several barriers for EBP and the compo- nents separately (evidence-based knowledge, clinical expertise, and patient values within a given context) that © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License,

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