Predicting intentions to use research evidence for carpal tunnel syndrome treatment decisions among certified hand therapists.

Introduction: Research evidence is not routinely used for clinical decisions among rehabilitation practitioners. The purpose of this study was to model the predictors of intention to use research evidence for carpal tunnel syndrome (CTS) clinical decisions among certified hand therapists (CHTs).

Methods: A total of 308 American CHTs (M age = 46 years, SD = 8.1, M clinical experience = 21 years, SD = 8.2) completed a validated mail survey measuring the variables of intention, attitudes, subjective norms, self-efficacy, workload, and autonomy. Structural equation modeling was used to test the overall model and estimate the direct and indirect relationships of study variables on intention.

Results: The model demonstrated excellent overall fit and explained 52% of the variance in intention. The direct significant predictors of intention were attitudes (β = 0.43) and subjective norms (β = 0.34) (Ps = 0.00). Self-efficacy and workload did not directly significantly predict intention (Ps = 0.82/0.09, respectively). Workload and autonomy did not indirectly significantly predict intention (Ps = 0.82/0.07, respectively). Neither did workload significantly predict attitudes (P = 0.06). There were no direct or indirect effects of autonomy, self-efficacy, or workload on the intention to use research evidence. However, autonomy significantly predicted self-efficacy (β = 0.36, P = 0.00).

Conclusions: Intention to use research evidence in clinical practice is a complex yet predictable phenomenon. Attitudes and subjective norm were identified as significant predictors of intention. Workload, autonomy and self-efficacy did not directly or indirectly effect intentions for research use. Altering subjective norms and managing attitudes about research are recommended as key factors for increasing the use of research evidence for clinical decisions among CHTs.