scholarly journals Provider–Patient Communication and Involvement in Physical Activity Programs Among Patients Receiving Physical Therapy Services: A Qualitative Study

2019 ◽  
Vol 39 (9) ◽  
pp. 1000-1007 ◽  
Author(s):  
Christine M. Kava ◽  
Sarah Fishleder ◽  
Lesley Steinman ◽  
Miruna Petrescu-Prahova ◽  
Lori Schrodt ◽  
...  

Objectives: To describe how physical therapy providers and their patients interact and communicate about physical activity (PA), and explore the barriers and facilitators to patient involvement in PA programs. Method: We conducted 39 direct observations of patient visits with physical therapy providers and 30 telephone interviews with physical therapists (PTs). We conducted a thematic analysis of observation field notes and interview transcripts. Results: PTs and patients engaged in several behaviors to build rapport, discussed PA type and frequency, and exchanged advice and information about PA. Barriers to patient participation in PA programs included low instrumental support, physical limitations, lack of motivation and confidence, and lack of knowledge about available programs. Facilitators included emotional support from friends, peers, and family, and encouragement and information-sharing from providers. Discussion: PTs play an important role in improving older adult PA and could be instrumental in reducing barriers to PA participation.

2015 ◽  
Vol 95 (11) ◽  
pp. 1507-1517 ◽  
Author(s):  
Kira M. Pattison ◽  
Dina Brooks ◽  
Jill I. Cameron ◽  
Nancy M. Salbach

Background The use of standardized assessment tools is an element of evidence-informed rehabilitation, but physical therapists report administering these tools inconsistently poststroke. An in-depth understanding of physical therapists' approaches to walking assessment is needed to develop strategies to advance assessment practice. Objectives The objective of this study was to explore the methods physical therapists use to evaluate walking poststroke, reasons for selecting these methods, and the use of assessment results in clinical practice. Design A qualitative descriptive study involving semistructured telephone interviews was conducted. Methods Registered physical therapists assessing a minimum of 10 people with stroke per year in Ontario, Canada, were purposively recruited from acute care, rehabilitation, and outpatient settings. Interviews were audiotaped and transcribed verbatim. Transcripts were coded line by line by the interviewer. Credibility was optimized through triangulation of analysts, audit trail, and collection of field notes. Results Study participants worked in acute care (n=8), rehabilitation (n=11), or outpatient (n=9) settings and reported using movement observation and standardized assessment tools to evaluate walking. When selecting methods to evaluate walking, physical therapists described being influenced by a hierarchy of factors. Factors included characteristics of the assessment tool, the therapist, the workplace, and patients, as well as influential individuals or organizations. Familiarity exerted the primary influence on adoption of a tool into a therapist's assessment repertoire, whereas patient factors commonly determined daily use. Participants reported using the results from walking assessments to communicate progress to the patient and health care professionals. Conclusions Multilevel factors influence physical therapists' adoption and daily administration of standardized tools to assess walking. Findings will inform knowledge translation efforts aimed at increasing the standardized assessment of walking poststroke.


1992 ◽  
Vol 8 (1) ◽  
pp. 102-108 ◽  
Author(s):  
Steven L. Wolf

AbstractBiofeedback instrumentation has been a growing part of physical therapy practice for 20 years, and physical therapists have contributed to researching its efficacy in treating varying conditions. The application of biofeedback to the treatment of stroke was marked by some early difficulties with the quality of the electronics, but sophisticated contemporary equipment can do much more than was originally envisioned. The importance of relating quantified movement-based data to functional measures is projected as a high priority if appropriate reimbursement for physical therapy services with biofeedback is to continue in the future.


2013 ◽  
Vol 93 (10) ◽  
pp. 1321-1330 ◽  
Author(s):  
Katreine Dierckx ◽  
Myriam Deveugele ◽  
Philip Roosen ◽  
Ignaas Devisch

BackgroundShared decision making (SDM) reduces the asymmetrical power between the therapist and the patient. Patient involvement improves patient satisfaction, adherence, and health outcomes and is a prerequisite for good clinical practice. The opportunities for using SDM in physical therapy have been previously considered.ObjectiveThe objective of this study was to examine the status of SDM in physical therapy, patients’ preferred levels of involvement, and the agreement between therapist perception and patient preferred level of involvement.DesignThis was an observational study of real consultations in physical therapy.MethodsIn total, 237 consultations, undertaken by 13 physical therapists, were audiorecorded, and 210 records were analyzed using the Observing Patient Involvement (OPTION) instrument. Before the consultation, the patient and therapist completed the Control Preference Scale (CPS). Multilevel analysis was used to study the association between individual variables and the level of SDM. Agreement on preferences was calculated using kappa coefficients.ResultsThe mean OPTION score was 5.2 (SD=6.8), out of a total score of 100. Female therapists achieved a higher OPTION score (b=−0.86, P=0.01). In total, 36.7% of the patients wanted to share decisions, and 36.2% preferred to give their opinion before delegating the decisions. In the majority of cases, therapists believed that they had to decide. The kappa coefficient for agreement was poor at .062 (95% confidence interval=−.018 to .144).LimitationsOnly 13 out of 125 therapists who were personally contacted agreed to participate.ConclusionShared decision making was not applied; although patients preferred to share decisions or at least provide their opinion about the treatment, physical therapists did not often recognize this factor. The participating physical therapists were more likely to make decisions in the best interest of their patients; that is, these therapists tended to apply a paternalistic approach rather than involving the patient.


2021 ◽  
Author(s):  
Erin E Wentz ◽  
Julia Looper ◽  
Kristi S Menear ◽  
Dipika Rohadia ◽  
Nora Shields

Abstract Children with Down syndrome often have lower physical activity levels compared to their peers with typical development and face challenges such as medical co-morbidities, access issues and societal stigma, to being physically active. Physical therapists are experts in exercise prescription and physical activity and are thus uniquely qualified to successfully promote participation among children with Down syndrome in spite of inherent challenges. Our perspective is that a shift in physical therapy service delivery is needed. We suggest that physical therapists change the focus of their interventions for children with Down syndrome from underlying impairments such as low tone or joint laxity, or from developing motor skills in isolation and ‘correct’ movement patterns. Instead, physical therapists should allow the physical activity preferences and the environmental contexts of the children and adolescents they are working with to direct the treatment plan. In this way, physical therapy intervention becomes more child centered by concentrating on developing the specific skills and strategies required for success in the child’s preferred physical activity. In this paper, we consider the role of pediatric physical therapists in the United States, as well as in low- and middle- income countries, in promoting and monitoring physical activity in children with Down syndrome from infancy through adolescence. Examples of physical therapist interventions such as tummy time, movement exploration, treadmill training, bicycle riding and strength training are discussed, across infancy, childhood and adolescence, with a focus on how to successfully promote lifelong participation in physical activity.


2006 ◽  
Vol 86 (5) ◽  
pp. 735-743 ◽  
Author(s):  
Stephen M Haley ◽  
Maria A Fragala-Pinkham

Abstract Over the past decade, the methods and science used to describe changes in outcomes of physical therapy services have become more refined. Recently, emphasis has been placed not only on changes beyond expected measurement error, but also on the identification of changes that make a real difference in the lives of patients and families. This article will highlight a case example of how to determine and interpret “clinically significant change” from both of these perspectives. The authors also examine how to use item maps within an item response theory model to enhance the interpretation of change at a content level. Recommendations are provided for physical therapists who are interpreting changes in the context of clinical practice, case reports, and intervention research. These recommendations include a greater application of indexes that help interpret the meaning of clinically significant change to multiple clinical, research, consumer, and payer communities.


2017 ◽  
Vol 25 (2) ◽  
pp. 374-388 ◽  
Author(s):  
Justin A Haegele ◽  
Patrick B Wilson ◽  
Xihe Zhu ◽  
T Nicole Kirk

The purpose of this study was to examine the meaning that individuals with psoriasis ascribed to their youth physical activity experiences. This qualitative, retrospective inquiry was based on an interpretative phenomenological analysis. A purposive sample of six participants (ages 20–46; four female, two male) residing in the United States were included. Semi-structured, audio-taped telephone interviews and reflective field notes acted as sources of data for this study. Thematic development was undertaken using a four-step interpretative phenomenological analysis process and themes identified across participants were summarized, presented as results, and discussed concurrently. Based on the data analysis, three interrelated themes were constructed from the participant transcripts: (a) “I just stopped signing up”: the impact of physical discomfort; (b) “kids started calling me ‘Flake’”: embarrassment, social anxiety, and bullying; and (c) “I felt like he was calling me out”: disclosing psoriasis to stakeholders. These three constructed themes provide unique insight into the embodied experiences of those with psoriasis, and fill a previous gap in the extant literature. Practitioners aiming to increase physical activity engagement among this population can use these findings to design more effective programmes and strategies that address the needs identified in this investigation.


2005 ◽  
Vol 85 (9) ◽  
pp. 872-886 ◽  
Author(s):  
Janet K Freburger ◽  
Timothy S Carey ◽  
George M Holmes

Abstract Background and Purpose Little information is available on factors associated with physical therapist use by people with back or neck pain. Identifying the characteristics of people who seek care from physical therapists is a useful first step in determining whether there is appropriate use of physical therapy services. The purpose of this study was to identify factors associated with physical therapist use by people with back or neck pain. Subjects The subjects were 29,049 people who had back pain or neck pain, or both, and who were seen for an initial evaluation at 1 of 21 US spine care centers. Each subject and evaluating physician completed a written survey at the time of the initial evaluation. Methods Multiple logistic regression analyses were conducted to identify factors associated with physical therapist use. Results Several measures of health and illness severity were associated with physical therapist use. Age and being male were negatively associated with physical therapist use. Education level, having workers' compensation coverage, and being in litigation were positively associated with physical therapist use. Physical therapist use also varied by previous physician use and census region. Discussion and Conclusion The results suggest that variations in physical therapist use are associated with factors other than health and illness severity. The results also suggest that people who would benefit from physical therapy may not be receiving it or that people who would not benefit from physical therapy are receiving it, or both.


Author(s):  
Domingo Palacios-Ceña ◽  
César Fernández-de-las-Peñas ◽  
Lidiane L. Florencio ◽  
María Palacios-Ceña ◽  
Ana I. de-la-Llave-Rincón

This qualitative exploratory study addressed the perspectives of Spanish physical therapists (PTs) regarding (a) the organization of their work during the first wave of the pandemic; (b) their role within the intensive care units (ICUs); (c) management of COVID-19 survivors; (d) potential future challenges identified for the physical therapy profession. Thirty PTs who had worked at a National Public Hospital in Madrid during the first COVID-19 outbreak were recruited by purposeful sampling and snowball techniques. In-depth interviews and researcher field notes were used to collect data. Interviews were transcribed verbatim. An inductive thematic analysis was used to identify emerging themes. After identifying 1110 codes, four themes emerged. Throughout the first wave of the pandemic, the role and work of PTs in hospitals experienced a change. These changes took place at their organizational level, affecting the distribution of PTs in the hospital, and the role of PTs in front-line COVID units such as ICUs, as well as direct management of outpatients at the onset of the pandemic, and after discharge from the ICUs. This situation has led to PTs foreseeing challenges and developing new expectations concerning their role and the physical therapy profession in the future.


2019 ◽  
Vol 5 (2) ◽  
pp. 17 ◽  
Author(s):  
V.V. Vitomskyi ◽  
О.B. Lazarіeva ◽  
S.М. Fedorenko ◽  
M.V. Vitomskа

<p><strong>Objective</strong>: to identify the main approaches in the management and motivation of the staff of the center to improve the effectiveness of physical therapy in orthopedic disorders, to form ways to take these features into account in managing the process of physical therapy.</p><p><strong>Methods</strong>: theoretical analysis and generalization of literary sources, method of systematization of scientific information.</p><p><strong>Results</strong>. It is advisable to use a fairly wide range of management techniques in the management of staff to provide physical therapy services, since it is about the impact on a rather complex system - the team of physical therapists, which in turn have a controlling influence on the not less complex systems - patients. The use of management methods can potentially contribute to a number of positive changes in the activities of the staff of physical therapists. The additional impact of these methods will be directed at the patient, in particular, in improving the quality of services. The work of a physical therapist is rather debilitating both from the physical side and from the psychological one. Therefore, the motivation of the staff is important in the management of physical therapists, as well as other employees of the Center for the provision of physical therapy services to patients with orthopedic profile. The study of the problem of motivation has a significant theoretical and practical significance, since the most valuable resource in the current conditions of the market of physical therapy services is personnel, not equipment. Therefore, the responsibility of the leader of a successful center for the provision of physical therapy services is that the motivational goals of the employees are largely correlated with the interests of the center and led to the final result to success, which can be characterized as achieving a useful result immediately to all participants in the system " the head is a physical therapist - a patient. " In a team of physical therapy center, as in any enterprise, there are different types of workers, and the choice of one concept of motivation is mainly determined by the majority of employees of a certain type in the team. The paper outlines the features of the selection and use motivational concepts for the staff center physical therapy. The theory of motivation is considered. Economic and non-economic motivational factors are allocated within the framework of the center for providing physical therapy services, the model of motivation of the personnel is given.</p><p><strong>Conclusio</strong><em>n</em>. The quality and performance of physical therapists in today's market conditions depends not only on professionalism and competence, but also on management, motivation, satisfaction of their needs and loyalty.</p>


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