The Impact of Cognitive Factors on Evidence-Based Practice: An Exploration in Occupational Therapy Practitioners
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Authors
Mirecki, Marissa
Issue Date
2026-01-12
Type
Dissertation
Language
en_US
Keywords
Occupational therapy , Adult education , Medical logic , Evidence-based medicine--Practice , Implementation science , Dissertations, Academic
Alternative Title
Abstract
Evidence-based practice (EBP) is a crucial contributor to patient safety and quality outcomes, but it is inconsistently applied by occupational therapy practitioners (OTPs). Much work has identified external factors that impact OTPs’ EBP behavior, such as institutional support or lack thereof. However, despite some theoretical and practical data that suggest a link between internal factors such as cognition and EBP, very little research has been done into the nature of these relationships. The aim of this study is to elucidate the relationship between cognitive factors and OTPs’ EBP behaviors. This study used a cross-sectional survey to measure Floridian OTPs’ reports of EBP behaviors; self-reflective practice (SRP); attitudes, subjective norms, and perceived behavioral control over EBP; and practice demographics. A total of 288 OTPs were included in the final regression analysis to determine predictors of EBP. There was one significant positive predictor of EBP: perceived behavioral control (p = .004). Significant negative predictors of EBP included SRP (p = .001), possession of a bachelor’s degree (p < .001) or master’s degree (p = .002), working in long-term care (p = .01), and 1-5 years of experience (p = .04). Several interaction phrases were included in the model and notable significant interactions included the interaction between SRP and subjective norms (p < .001), and the interaction between subjective norms and perceived behavioral control (p = .001). OTPs without doctoral degrees are less likely to implement EBP. Perceived behavioral control over EBP positively predicts EBP, but self-reflections that are unrelated to this are counterproductive to EBP. Future work in EBP implementation should focus more on perceived behavioral control and less on attitudes and subjective norms.
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This dissertation is protected by the Copyright Laws of the United States (Public Law 94-553, revised in 1976). Consistent with fair use as defined in the Copyright Laws, brief quotations from this material are allowed with proper acknowledgement. Use of the materials for financial gain with the author's expressed written permissions is not allowed.