Theses and dissertations (Health Sciences)
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Item Student radiographers’ knowledge and practices of ethical responsibilities for the radiography profession at a selected university in Gauteng province(2024) Mosathupa, Jane Granny; Nkosi, Pauline BusisiweAbstract Background Student radiographers’ knowledge and practices with regard to the ethical responsibilities for the Radiography profession at Sefako Makgatho Health Sciences University is described in the study. The study explored their knowledge, practices and suggestions for improvement of ethical responsibilities. Knowledge differed widely because of the differential practical experiences that participants were exposed to in the clinical environment. All the students acknowledged that they received theory lectures about ethics, although they are not entirely convinced that it is practiced at selected clinical training institutions. Aim of the study The study explored student radiographers’ knowledge and practices of ethical responsibilities for the Radiography profession and ultimately provided recommendations to improve their knowledge and practices at the workplace. The study was conducted at a selected university in Gauteng province. Methodology A qualitative, exploratory study was undertaken in order to comprehend student radiographers’ knowledge and practices of their ethical responsibilities in the Radiography profession. Although there have been a few studies on ethics with reference to qualified radiographers, qualitative studies on the subject of ethics regarding students is limited. Recommendations for qualitative research on the subject are elaborated in a number of existing studies as a way of acquiring more information from the respondents and gaining more insight on the subject. Findings The code of conduct was clearly outlined to students on each level of the programme during their theory lectures, but was not well articulated in practice. The first and second levels of the programme offer limited knowledge on ethics, which is only incorporated into one of the core modules. Effective patient care is the primary focus of healthcare services; hence it needs more thoughtful attention in the Radiology department. Quality healthcare should be patient-centred to give patients a say in the service they receive. The findings of the study suggested that the revised scope of practice, which is currently under review, will add to their responsibilities and will require specific focus on ethical matters, patients’ rights and medical law. The General Medical Council has stated that medical ethics and law should constitute core components of the medical curriculum. When the students were questioned about their knowledge of ethical issues, they were reasonably confident of their knowledge of professional duties, such as confidentiality and scope of duties. Conclusion Teaching ethics to students in the clinical environment is complex and cannot be compared to teaching the knowledge of ethics in Radiography. Role-modelling and integration of ethics into the clinical education curriculum needs to be critically re visited. The scope of radiographic practice should be broad enough to include additional ethics and medical law. Ethical practice means that a radiographer must be competent to be able to demonstrate professional judgments and practice by upholding professional and ethical behaviours.Item The knowledge, attitudes and practices of health care workers regarding the occupational exposure to blood and bodily fluids in a public hospital, KwaZulu-Natal(2023-05) Govender, Nakita; Ghuman, Shanaz; Niranjan, IvanThe risk of exposure to BBF amongst health care professionals may be considered a consequential yet vastly unexplored field of study in the medical setting, particularly in the developing world. In South Africa, knowledge and practices to safeguard health care workers (HCWs) from blood borne infections (BBI) proved substandard in necessitous health care facilities. Ideally, hospital management should be provided with data to guide and inform procedures for prevention and control for potential infections arising in the work environment. An extensive review of South African literature showcased finite research data published on blood and bodily fluid (BBF) exposures and factors affecting infection prevention and control (IPC). In the KwaZulu Natal province, knowledge, attitude and practices (KAP) of HCWs, regarding occupational exposure to BBF, as well as the HCWs perceptions on the barriers to IPC, in a public hospital, has yet to be studied, with no recently published research encountered thus far, in South Africa. This study aimed to evaluate the KAP of HCWs regarding occupational exposure to BBF in a public hospital of KwaZulu-Natal. An institutional based, observational-descriptive cross-sectional study with a quantitative approach was conducted, in order to determine the association between the knowledge and attitudes of HCWs and behavioral risks for occupational exposure, as well as the perceptions of HCWs, on the barriers to IPC in a public hospital of KwaZulu Natal. This study utilised a simple-random sampling technique from a total number of 199 HCWs. The minimum sample size was calculated at 166, by a statistician, in which the margin of error is set at 5%. This study found a correlation between profession as well as work department and risk of exposure to BBF. Level of education was found to play a significant role in HCW knowledge of PEP. Work practices were found to greatly influence the likelihood of an NSI. Post exposure prophylaxis amongst a substantial amount of HCWs who did experience an accidental exposure, was distressingly low. Underreporting seemed to have been associated with profession. The age of the respondents did play a significant role in terms of the needle recapping practices of HCWs, with the middle age category between 36 to 40 years most often engaged in needle recapping behaviour. As per the active belief of the HCWs themselves, lack of knowledge, feedback on monitoring and training on IPC, as well as lack of availability of infection prevention and control guidelines were considered to be barriers to IPC in the hospital. Respondnets in this study also displayed a potential lack of awareness on the infrequent or absence of regular infection prevention and control committee meetings. Additionally, more than half of the total sample exhibited complete ignorance in terms of cost requirements for IPC interventions as a likely impedance of IPC. A disquieting amount of HCWs were found to have received training more than 24 months ago which deviated from the recommended annual refresher training as per the Occupational Health and Safety Act (No. 85 of 1993).Item The knowledge, attitudes and perceptions of qualified chiropractors and physiotherapists in South Africa regarding the other professional practice(2022) Ravidutt, Micaela; Maharaj, Sonill Sooknunan; Prince, CleoChiropractors and physiotherapists treat patients that present with similar conditions. Arising from this, a sense of competition is perceived between these professionals, as both professions use similar methods of treatment when providing care to their patients. However, chiropractors and physiotherapists may belong to different health paradigms which influences how each profession approaches patient management. There is also an overlap between the roles of each profession in providing healthcare, as the methods of managing patients seem to be similar. This requires an investigation into the knowledge, attitudes and perceptions of qualified chiropractors and physiotherapists in South Africa regarding the other professional practice. This could potentially determine possible misconceptions and myths that the two professions have of each other’s practice. If identified and corrected, this could influence awareness within a multidisciplinary setting to enhance and promote holistic patient-centred care. Aim The aim of this study was to determine the knowledge, attitudes and perceptions of qualified chiropractors and physiotherapists in South Africa regarding the other professional practice. Methodology The research conducted was a quantitative study with a descriptive design which targeted qualified chiropractors and physiotherapists in South Africa. The research tool was an online questionnaire administered through an online platform named the QuestionPro Survey, which included questions and statements relating to the knowledge, attitudes and perceptions of the two professions regarding the other professional practice to meet the objectives of the study. The minimum sample size required for this study comprised of 116 chiropractors and 128 physiotherapists. The data obtained from each group were analysed separately and then a comparative analysis was done. An alpha value of 0.05 and a margin of error of 0.085 were assumed. Results Chiropractors and physiotherapists in South Africa generally demonstrated good knowledge, positive attitudes, and positive perceptions toward the other profession. Both professions were familiar with the other profession’s scope of practice. Chiropractors achieved a mean knowledge score of 75.7%, whereas physiotherapists obtained 59.7% on their knowledge of the examinations performed by the other profession. Chiropractors obtained an average score of 85.3% and physiotherapists achieved 72.0% on their knowledge of the treatment modalities that the other profession may perform for a patient. Both professions had good knowledge about the conditions that the other profession may treat, with chiropractors having achieved a mean knowledge score of 82.4% and physiotherapists having obtained a score of 77.3%. A total of 75.0% of chiropractors and 72.1% of physiotherapists considered the other profession to be competent in examining neuromusculoskeletal conditions. More chiropractors (82.8%) than physiotherapists (70.0%) believed the other profession to be competent in treating neuromusculoskeletal conditions. Each profession acknowledged the role of the other profession within the South African healthcare system. Of the sampled professions, 81.9% of chiropractors and 55.3% of physiotherapists had referred patients to the other profession. It was found that 69.8% of chiropractors, compared to 32.1% of physiotherapists, had patients referred to them by the other profession. A total of 69.0% of chiropractors and 55.3% of physiotherapists were in agreement that they would like to work closely with the other profession. Conclusion In South Africa, chiropractors and physiotherapists had good knowledge and positive attitudes and perceptions of each other’s practices. There also appeared to be a referral relationship between these professions. However, the challenges between the professions were limited and there was insufficient inter-professional awareness and exposure when practicing within the different health paradigms. Therefore, inter-professional education between chiropractors and physiotherapists of their practices as part of the university curriculum within a multidisciplinary team should be enhanced and encouraged. This would enhance and encourage inter-professional relationships between the two professions, thus promoting the delivery of holistic patient-centred care.Item Knowledge, clinical competencies and medico legal responsibilities required by diagnostic radiographers for the interpretation of radiographs(2022-09-29) Budhu, Reshel; Nkosi, Pauline Busisiwe; Khoza, Thandokuhle EmmanuelIn SA, image interpretation and reporting by diagnostic radiographers have yet to be validated. Currently, the only training exposure and formalized education that diagnostic radiography students get in the four-year undergraduate degree relates to pattern recognition and pathological conditions However, a review of the regulations on the scope of practice of radiographers is currently being undertaken by the Health Professions Council of South Africa (HPCSA) to include formal reporting in South Africa. Aim The aim of the study was to explore the knowledge, clinical competencies and medico-legal responsibilities required by diagnostic radiographers for the interpretation of radiographs and ultimately, to recommend training guidelines for radiographers in the interpretation of radiographic images. Methodology A qualitative descriptive study employing criterion sampling of qualified radiologists practicing within the eThekwini district of KZN province was conducted. Ethics approval to perform this study was obtained from the Durban University of Technology’s (DUT’s) Institutional Research Ethics Committee (IREC). All the participants were contacted in their personal capacity. The research tool used for this study was face-to-face, one-on-one, semi-structured and in-depth interviews, which included various questions related to radiographic image interpretation. The data from the interviews were analysed by the researcher using Tesch’s eight steps for analysing qualitative data. Moreover, all the data obtained from this research study was kept confidential and under password protection by the researcher. Findings Findings reveal that Radiologists support the interpretation of radiographic images by radiographers in rural settings, and for the radiographer’s scope of practice to be restructured to include the chest and the musculoskeletal system. Extension in the scope of practice would result in increased job satisfaction, as the overall costs, rates and turnaround time will be affected if radiographers interpret images. Moreover, image interpretation training should begin 3-5 years post degree. An in-depth knowledge of anatomy, radiological anatomy and pathophysiology is required to understand pattern recognition during image interpretation. The training would be between 6 months and 5 years. Findings also indicated that there should be continuous monitoring and accreditation for image interpretation courses, with accreditation being in the form of a diploma for each system, a degree or a certificate of competence. Assessments for image interpretation should be carried out by radiologists. The participants of this study found that clinical competency for radiographers who are performing image interpretation has to do with the assessment of the patient, with assessment determining the history, the background, the past medical history of relevance and the current presenting symptoms. The study also suggested that apart from having stringent criteria for radiographers entering the image interpretation course, radiographers must be able to triage patients and all assessments should be done by a radiologist. The findings also indicated that no harm is to be done to the patient; patient information must not be disclosed to others; radiographers should be covered in the event of adverse outcomes when interpreting images; there should be decision-making regarding the radiologic/radiographic report; and the rights of a healthcare provider are to be protected.Item Knowledge, attitudes and perceptions of Genomic Medicine among medical students, private medical practitioners and the general public in eThekwini, KwaZulu-Natal(2019) Naidoo, Levani; Reddy, PoovendhreeThe use of genomics in public health has the potential to contribute towards the diagnoses of diseases, ensuring the efficiency of health promotion interventions and assist in developing more effective pharmaceuticals. Research conducted abroad has documented the discourse of public and medical perceptions towards genetic testing, however, there is a lack of information to inform the health sector within South Africa with respect to the knowledge and attitudes of the general public and medical sector towards genetic testing. Therefore, the aim of this study was to document and evaluate the knowledge, attitudes and perceptions surrounding the use of public health genomic (PHG) medicine. This was a quantitative cross sectional study and our convenient sample included representatives from the general public, medical students and medical practitioners within the eThekwini region in KwaZulu-Natal (n=170). Participants were required to fill out administered questionnaires which included likert scale questions. Medical practitioners from both private and public health sector in the KZN region were sampled (n=45). Medical students comprised of second year students from the UKZN Nelson R Mandela medical school who had not yet been exposed to the genetic module in their medical curriculum (n=79). Representatives of the general public included educators from private and public primary schools in Durban and surrounding areas (n=46). Descriptive and frequency analysis using mean, standard deviation and range was used for quantitative variables. Knowledge and attitude responses were stratified by gender, race and for medical practitioners by practice type. Bivariate correlations using Spearman’s rho test and principle component analysis was conducted. Scoring scales were used to determine the level of knowledge and type of attitude among participants towards predictive genetic testing. Results revealed that the knowledge of the general public, medical practitioners and medical students towards the use of public health genomics were adequate. Medical students displayed a negative attitude towards the uptake of predictive genetic testing which was contrary to the positive attitudes of the general public and medical practitioners. Stratification by gender indicated that women from the general public were more accepting of PHG despite the increased costs associated with genetic testing. We found that females were knowledgeable on the primary use of predictive genetic testing, and more Africans (77%) than Indians (46.2%) and Whites (50%) were aware that genetic testing is being offered in South Africa. Results of bivariate correlations revealed that current medical practitioners would still use predictive genetic testing despite the possible ethical, legal, and social implications for the end user. PCA (Principle Component Analysis) confirmed a strong factor loading for a willingness to use predictive genetic testing among the general public. PCA yielded a high factor loading on an awareness for the need for a proper legislative framework for PHG among medical students. Medical students articulated a need for additional training in public health genomics. In order to improve knowledge among the medical fraternity, institutions should adapt undergraduate and post-graduate curriculum to make provision for relevant PHG training that would be extended not only to medical and health care students but offered to qualified practitioners for continuous professional development training. In addition, awareness should be created on various media platforms to inform the public about the availability and costs associated with predictive genetic testing services in South Africa. Relevant stakeholders from both the public and private health sector in South Africa should be aware of the challenges that could impact on the uptake of public health genomics in South Africa, given its potential for use in the NHI (National Health Insurance) structure.Item Knowledge, attitudes and practices of Black African males towards the use of sun protection : a case study of a University of Technology in KwaZulu-Natal(2021-12-01) Mayeza, Zamani Effort; Sibiya, Maureen Nokuthula; Makgobole, Mokgadi UrsulaBackground Although there may be some Black African males who are informed about sun protection and may be practicing it, there is still a lack of information amongst many Black African males on sun protection. It is generally recognised that some still think that it only applies to females. Aim of the study The aim of the study was to assess the knowledge, attitudes and practices of Black African males towards the use of sun protection at a University of Technology in the province of KwaZulu-Natal. Methodology This study was guided by a quantitative research design. A quantitative research approach is methodical and unbiased research that utilises numerical information from a selected sample from a universe or population to generalise the findings only to the population that is being studied. The quantitative research design was selected for this study as it the most suitable, scientific, more controllable, less biased and deals with larger samples to provide more accurate information/results. The study was conducted at a University of Technology. The participants comprised of Black African male students. The sample size of the study was 409 participants. Descriptive statistics, in the form of tables and graphs, were used to describe the data graphically. In order to test for significant trends in the data, inferential statistics were applied. These included Pearson’s correlation, t-tests, Analysis of variance and chi-square tests. Where the conditions were not met for the application of these tests, non-parametric equivalent tests or exact tests were used. Throughout, a p-value of 0.05 was used to indicate significance. The analysis was carried out using SPSS, version 26. Results Results revealed that black communities, especially males need to be taught about sun protection. A certain percentage of the participants displayed that they have knowledge about sun protection, but they do not practice it. The study showed that there is still a lot to do in terms of educating the South Africans, especially those that are dark-skinned, about the vitality of sun protection. Conclusion In conclusion, skincare sun protection is vitally important for everyone to practice. It is not made for a specific gender; therefore, it is advised to be practiced by everybody, regardless of gender and/or race. Even though black skin has its natural shield (melanin) to protect against harsh sun’s ultraviolet(UV) rays, it is still important for Black people to protect themselves from UV radiation. This will help in reducing the chances of developing skin cancer in the long run.Item Knowledge, attitudes and perceptions of biopuncture and its use in clinical practice by registered homoeopaths(2021-05-27) Mbokazi, Nonhlakanipho Sinenhlanhla; Hall, Cornelia MariaIntroduction Biopuncture is an injectable therapy which employs ultra-diluted biotherapeutic regulators. The proposed means by which biopuncture induces healing is by stimulating the immune system to heal the body. Biopuncture is currently used worldwide in the health sector for treating a variety of diseases, the most common being musculoskeletal complaints. Biopuncture has recently become a popular adjunctive therapeutic method which has been integrated into many homoeopathic healthcare practices in South Africa. There is currently limited literature on biopuncture in a South African context. Most of the existing literature needs to be translated into English. This study allowed homoeopaths to provide useful information about their level of awareness and practical uses of biopuncture. This study also identified existing misconceptions about biopuncture amongst homoeopaths in South Africa. Aim of the study The study aimed to investigate the knowledge, attitudes, and perceptions of registered homoeopathic practitioners regarding biopuncture treatment, and their management of clinical cases with biopuncture as a treatment modality. Methods Data was collected using a self-administered questionnaire. Self-report techniques are the most effective way to gather factual information about participants’ perceptions, knowledge levels, and experiences. This quantitative study employed a convenience sampling method. The participants were homoeopaths who were registered with the Allied Health Professions Council of South Africa (AHPCSA) and were practising in South Africa. There were about 500 homoeopaths who were registered with the Council at the time of the study. The study's desired sample size was n = 225. The questionnaires were distributed electronically with the assistance of AHPCSA. The participants were expected to fill in the forms within two weeks but there was a time extension. The researcher received and collected the responses of the questionnaire forms by email. The data was coded and captured into a Microsoft Excel spreadsheet and the results were analysed using SPSS version 25®. Results The response rate was 35% (n = 77) of the initial sample size. The results showed 72% of the participants understood and had a knowledge of biopuncture. The overall attitude was positive that biopuncture is an appropriate complimentary adjunctive therapy in a homoeopathic practice. The majority (62%) of the participants were using biopuncture in their practice. Chi-squared analysis found that the number of years practised and the use of biopuncture are dependent. The finding was that all of the practitioners who were in practice for less than two years were using biopuncture. Biopuncture has been effectively used as a treatment and to manage clinical cases. A minority of participants (4%) perceived biopuncture to be unhomoeopathic and responded that it should be eliminated from homoeopathic practice. The importance and need for biopuncture technique training before applying it in practice came through as a strong finding, and, therefore, recommendation.Item Knowledge, attitude and practices of sharps waste disposal by diabetic patients at home settings in uMzinyathi District Municipality(2020-11-30) Ziqubu, Lihle Nomfundo; Sokhela, Dudu G.; Gabela, Sibusiso DerrickBackground Sharps waste is one of the categories of hazardous waste which must be properly managed. Sharps waste is hazardous and it should be disposed of in a proper manner. This waste has an ability to transmit diseases, as well as create a negative impact on the environment. The disposal of sharps waste generated in the community has been recognised as an area of public concern. There is a gap in proper disposal of sharps waste among diabetic patients in the home setting. Diabetic patients dispose of their sharps waste in different ways, but mainly in general waste. Umzinyathi District Municipality has semi-urban and rural areas with four sub-districts, namely, Nquthu, Endumeni, Umsinga and Umvoti. Umzinyathi District Mucipality has a substantial number of diabetic patients who are on insulin and who inject themselves at home. This study aims to describe the knowledge, attitude and practices on sharps waste disposal by diabetic patients at home. Methodology A quantitative, descriptive cross sectional study was used to investigate knowledge, attitude and practices on sharps waste disposal by diabetic patients at UMzinyathi District Municipality. A selfadministered questionnaire was used to collect data. A convenience consecutive sampling was used to sample respondents. A total number of 308 insulin-dependent diabetic patients from selected health facilities of UMzinyathi District Municipality, filled in the questionnaires. Results A majority of respondents n=149 (48.4%) disposed of their sharps waste in a toilet, while n=92 (29.8%) disposed of their sharps waste in general waste. Amongst those who responded, the majority n=193 (62.3%) were not educated on disposal of sharps waste; they had moderate knowledge of proper disposal of sharps waste. Most of the respondents practiced improper disposal of sharps waste. Conclusion Generally, the majority of the respondents n=193 (62.3%) lacked knowledge of safe and effective disposal of sharps waste. They were not educated in this regard, which had a negative influence on how they disposed of sharps waste. There are serious concerns regarding current practices of sharps waste disposal by diabetic patients at home.Item Knowledge, attitudes and perceptions of registered Master’s Degree homoeopathy students of the role of nutrition in Homoeopathic management(2019-09-05) Sotondoshe, Olwethu; Maharaj, MadhueshwareeBackground: Nutrition is a vital component of health promotion and disease prevention. Homoeopathic practitioners are in a good position to offer nutritional advice to patients. However, M. Tech: Hom students at DUT find their nutrition education to be inadequate. Therefore, this research is aimed at understanding knowledge, attitudes and perceptions of students registered at the master‘s level of their M. Tech: Hom degrees, regarding the role of nutrition in homoeopathic management of patients. Method: Following a qualitative exploratory descriptive design, semi-structured interviews were conducted with 13 M. Tech: Hom students to determine their levels of knowledge, attitudes and perceptions of nutrition education at the Homoeopathic Day Clinic (HDC) at the Durban University of Technology (DUT), in a quiet, private and comfortable consultation room. The interview data was transcribed into Microsoft word document. Transcripts were analysed using Tesch‘s thematic eight-step procedure of data analysis. Subsequently, categories, codes and themes were formed. Results: From 13 semi-structured interviews with M. Tech: Hom students, three themes emerged. Those three themes were knowledge of nutrition, perception of nutrition and attitude towards nutrition. All participants considered nutrition applicable to homoeopathic management. However, the majority of participants were dissatisfied with the amount of time allocated for nutrition education in the homoeopathic curriculum. Furthermore, they felt unprepared to provide nutrition care to patients. Conclusion: Participants in this study recognised the importance of nutrition training in homoeopathic management. However, they felt dissatisfied with the quality and quantity of the nutrition training offered in the current homoeopathy syllabus and inadequately equipped to offer nutrition care.Item The knowledge, attitudes, perceptions and perceived barriers of chiropractors within the eThekwini Municipality towards evidence-based practice(2018) Naidoo, Divashni; O'Connor, Laura; Mshunqane, NombekoBackground ABSTRACT In the chiropractic profession, it has been an established goal to utilise evidence-based practice (EBP) in clinical practice in order to empower chiropractors to develop effective treatment protocols. However, the extent to which chiropractors are utilising EBP, and the factors associated with its implementation in practice is unknown. The lack of research in this regard suggests that further studies need to be undertaken within the chiropractic profession in South Africa in order to fully understand the relationship of factors which contribute to the adoption and application of EBP by chiropractors in clinical practice. Therefore, the aim of this study was to investigate the knowledge of, attitudes towards, perceptions of and perceived barriers towards EBP by chiropractors within the eThekwini municipality. Method A pre-validated cross sectional descriptive survey was administered to chiropractors practicing within the eThekwini municipality (n = 101) by hand delivery. The questionnaire was validated by means of a focus group and pilot testing. Participants gave informed consent prior to participation. Data were analysed using using SPSS Statistics 24.0 and Statgraphics Centurion 15.1 (2006) to determine the descriptive and inferential statistics while the open- ended questions were analysed qualitatively using manifest coding. Results A response rate of 51% (n=51) was obtained. The majority of respondents were male (51%), mean age of 37.8 years, practicing for less than 19 years, working in full time practice (76.5%) between 40 and 49 hours per week (45.1%). The majority of the respondents had a positive attitude and perception towards EBP with respondents showing a willingness to improve skills (72.6%) and utilisation (52.9%) of EBP. Respondent 15 explained that “it is very important to have the skills in order to utilise EBP. Once you have the skills, utilising EBP becomes easy”. Responses highlighted that respondents are engaging with scientific literature when necessary and possess the skills necessary to utilise EBP. The majority of respondents believe that they had a strong academic foundation in their knowledge and skills related to accessing and interpreting information, yet 47.1% reported not having received formal training in search strategies to access literature. However, most felt confident about their knowledge and skills to utilise EBP. Insufficient time (66.7%), lack of generalisability of the literature findings to their patient population (49.0%) and the inability to apply research findings to individual patients with unique characteristics (45.1%) were the three top barriers identified. Respondent 12 described: “most articles are vague or time consuming and searching for relevant, up to date and reliable articles is a difficult process that can take a lot of time” as a possible barrier to utilising EBP. Conclusion The respondents in this study had a favourable attitude towards, and perception of, EBP and its usefulness to chiropractic practice. However, like other healthcare professionals they felt that they had insufficient time to utilise EBP. This study also highlighted the importance of academic institutions providing the necessary skills required to utilise EBP. It is recommended that workshops focusing on EBP principles and training are arranged to assist practitioners in integrating EBP into practice