title: Aspects affecting occupational therapists' reasoning when implementing research-based evidence in stroke rehabilitation.
abstract: BACKGROUND
  When implementing evidence-based practice in occupational therapy the investigation of clinical reasoning provides important information on research utilization.
  
  
  OBJECTIVE
  This study investigates aspects affecting occupational therapists' reasoning when implementing research-based evidence within stroke rehabilitation.
  
  
  METHODS
  The study was based on a phenomenological hermeneutical and an action research approach in collaboration with three occupational therapy settings including 25 occupational therapists. Data collection consisted of 41 field observations, 14 individual interviews, and six focus-group interviews.
  
  
  RESULTS
  New knowledge concerning the substantial influence of professional values in the occupational therapists' local cultures was indicated. It was of importance that the therapists as a group are given the opportunity to explicit and critically appraise values and knowledge use in order to develop their practice knowledge and new skills. Moreover personal values and clinical experiences influenced clinical reasoning. Current knowledge of the importance of local cultures and leadership was reinforced.
  
  
  CONCLUSIONS
  The influence of professional values in the occupational therapists' local cultures was a substantial factor in the implementation processes. In addition personal values and clinical experiences influenced professional decision-making. Furthermore, the study reinforced current knowledge of the importance of culture and leadership in implementation of research-based clinical guidelines.
authors.affiliation: Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Denmark. hanne.kaae@ouh.regionsyddanmark.dk
authors.forename: Hanne Kaae
authors.initials: HK
authors.lastname: Kristensen
authors.forename: Tove
authors.initials: T
authors.lastname: Borg
authors.forename: L
authors.initials: L
authors.lastname: Hounsgaard
mesh_terms: D000328:Adult; D000488:Allied Health Personnel / Q000523:psychology*; D001291:Attitude of Health Personnel; D003657:Decision Making; D019317:Evidence-Based Medicine; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D007857:Leadership; D008875:Middle Aged; D009788:Occupational Therapy / Q000523:psychology*; D015279:Organizational Culture; D012945:Social Values; D000071939:Stroke Rehabilitation; D013850:Thinking