Time as a barrier to evidence uptake -- A qualitative exploration of the
concept of time for clinical practice guideline uptake by
Background: Lack of time has consistently been reported as a major
barrier to effective research evidence-uptake into clinical practice.
There has been no research to our knowledge that explores time as a
barrier within the Transtheoretical model of Stages of Change (SoC), to
better understand the processes of physiotherapists’ uptake of clinical
practice guidelines (CPG). This paper explores the concept of lack of
time as a barrier for CPG uptake for physiotherapists at different SoC.
Methods: A 6-step process is presented to determine the best-fit SoC for
31 physiotherapy interviewees. This process used an amalgamation of
interview findings and socio-demographic data, which was layered onto
the SoC and previously identified time-barriers to CPG uptake (few
staff; high workload; access to CPGs; evidence-based practice as
priority in clinical practice; “time is money” attitude; and knowledge
on the use of CPGs). Results: The analysis process highlighted the
complexities of assigning individuals to a SoC. A model of time
management for better CPG uptake is proposed which is a novel approach
to assist evidence implementalists and clinicians alike to determine how
to progress through the SoC and barriers to improve CPG uptake.
Conclusions: To the authors’ knowledge, this is the first attempt at
exploring the construct of (lack of) time for CPG-uptake in relation to
the physiotherapists’ readiness to behaviour change. This study shows
that ‘lack of time’ is a euphemism for quite different barriers, which
map to different stages of readiness to embrace current best evidence
into physiotherapy practice. By understanding what is meant by ‘lack of
time’, it may indicate specific support required by physiotherapists at
different stages of changing these behaviours.