Universität zu Köln

Altin, Sibel, Passon, Anna, Kautz-Freimuth, Sibylle, Berger, Bettina ORCID: 0000-0003-4999-8898 and Stock, Stephanie (2015). A qualitative study on barriers to evidence-based practice in patient counseling and advocacy in Germany. BMC Health Serv. Res., 15. LONDON: BMC. ISSN 1472-6963

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Abstract

Background: Despite the attempt to integrate evidence-based practice (EBP) in patient counseling and advocacy, there is limited knowledge on the status quo of this process in the German health care system. Our objective was to identify important determinants influencing the application of EBP in the counseling and advocacy setting in Germany. Methods: We carried out a qualitative study performing semi-structured expert interviews and one group discussion among n = 9 patient counselors (PCs) and patient advocates (PAs) identified via expert recommendations and by contacting relevant institutions. The interview manual was developed on the basis of a literature review on barriers/facilitators of EBP in health care delivery and a preamble oriented pyramid discussion with a multidisciplinary team. Interviews were analyzed using the Grounded Theory method. A paradigm was developed to present the interrelations between hindering and facilitating factors for EBP and the attitude towards the utilization of EBP among PAs and PCs. Results: Findings from nine face-to-face interviews and one group discussion demonstrate that by now PCs and PAs do not recognize EBP as a tool to facilitate the professionalization of patient counselors and advocates. This result is due to individual and institutional barriers such as cognitive-behavioral, professional, attitude related as well as resource and system barriers. PCs and PAs have predominantly critical attitudes towards EBP caused by a lack of trust in its reliability and by concerns regarding unfavorable effects EBP may have on the relationship with the patient and on the cooperation with physicians. A missing infrastructure of needs-based EBP training programs also discourages PCs and PAs from engaging in EBP. Despite the numerous hindering factors, there is also a growing awareness that EBP could help to improve patient counseling and advocacy. To facilitate EBP in future, needs-based training programs and health policy interventions that support interdisciplinary collaboration are required. Conclusion: Although EBP among PCs and PAs is gaining importance, it is still less likely to be recognized as helpful and its application faces various barriers. More needs-based EBP training programs and health policy interventions to decrease barriers and foster interdisciplinary collaboration are necessary.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Altin, Sibel UNSPECIFIED UNSPECIFIED UNSPECIFIED Passon, Anna UNSPECIFIED UNSPECIFIED UNSPECIFIED Kautz-Freimuth, Sibylle UNSPECIFIED UNSPECIFIED UNSPECIFIED Berger, Bettina UNSPECIFIED orcid.org/0000-0003-4999-8898 UNSPECIFIED Stock, Stephanie UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-396526
DOI:	10.1186/s12913-015-0979-9
Journal or Publication Title:	BMC Health Serv. Res.
Volume:	15
Date:	2015
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1472-6963
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EVIDENCE-BASED MEDICINE; KNOWLEDGE TRANSLATION; DECISION-MAKING; PROFESSIONALS; FACILITATORS Multiple languages Health Care Sciences & Services Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/39652