scholarly journals INTER-RATER RELIABILITY OF THE PRONE APPREHENSION RELOCATION TEST (PART)

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0003
Author(s):  
Lauren E. Watchmaker ◽  
Scott J. Hetzel ◽  
Ernest L. Sink ◽  
Andrea M. Spiker
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Hip Dysplasia ◽  
Physical Therapists ◽  
Hip Pain ◽  
Positive Part ◽  
Rater Reliability ◽  
Test Part ◽  
Center Edge ◽  
The Right

Background: Hip dysplasia and related instability can cause pain, limit hip function, and ultimately result in osteoarthritis. The Prone Apprehension Relocation Test (PART) augments existing radiographic markers and clinical provocative maneuvers in diagnosing hip dysplasia. Reproducibility of the PART between examiners has not been previously studied. Hypothesis/Purpose: One measure of the potential clinical utility of the PART depends on the reproducibility of test results by evaluating providers including physicians, licensed athletic trainers, and physical therapists. The purpose of this study is to determine the inter-rater reliability of the PART between health care professionals. Methods: We retrospectively identified patients in our institution’s hip preservation registry who presented between September 2017 and June 2019 for evaluation of hip pain. Patients included in the study had the PART performed by two health care professionals who were blinded to the other’s results. Inter-rater reliability was assessed using the Cohen 𝜅, with a value of 𝜅 ≥ 0.75 considered excellent inter-rater reliability, between 0.75 and 0.40 moderate, and ≤ 0.40 poor. Results: 96 patients (190 hips) were included, with 63 females and 35 males, average age 32 ± 12.1 years. 23 hips had a positive PART from both examiners. Inter-rater reliability was excellent between health care professionals for the PART when evaluating the right hip (𝜅 = 0.80), left hip (𝜅 = 0.82), and when combining the results for left and right (𝜅 = 0.81). A sub-analysis of patients who had a positive PART from both raters demonstrated that 19 of the 23 hips had a lateral center edge angle > 25°. Conclusion: Our study demonstrates that the PART is a reliable physical exam maneuver in the evaluation of hip pain.

scholarly journals Interrater Reliability of the Prone Apprehension Relocation Test

2021 ◽  
Vol 9 (9) ◽  
pp. 232596712110322
Author(s):  
Lauren E. Watchmaker ◽  
Scott J. Hetzel ◽  
Ernest L. Sink ◽  
Andrea M. Spiker
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Interrater Reliability ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Care Providers ◽  
Positive Part ◽  
Level Of Evidence ◽  
Center Edge

Background: The Prone Apprehension Relocation Test (PART) augments existing radiographic measures and clinical provocative maneuvers in diagnosing hip instability. One measure of the potential clinical utility of the PART depends on the reproducibility of test results by evaluating providers including physicians, licensed athletic trainers, and physical therapists. Purpose: To determine the interrater reliability of the PART among health care providers. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: We retrospectively identified patients in our institution’s hip preservation registry who presented between September 2017 and June 2019 for evaluation of hip pain. Patients included in the study had the PART performed by a single physician as well as 1 of 12 physician extenders (a licensed athletic trainer or a physical therapist). The providers were blinded to the findings of the other examining professional. Interrater reliability was assessed using the Cohen κ (≥0.75 was considered excellent; between 0.75 and 0.40, moderate; and ≤0.40, poor). Results: A total of 96 patients (190 hips) were included in this study (61 women and 35 men, average age 32 ± 12.1 years). A total of 23 hips had a positive PART from both examiners. Interrater reliability was excellent between health care professionals for the PART when evaluating the right hip (κ = 0.80), left hip (κ = 0.82), and when combining the results for left and right (κ = 0.81). A subanalysis of patients with a positive PART from both raters demonstrated that 19 of the 23 hips had a lateral center-edge angle >25°. Conclusion: Our study demonstrated excellent interrater reliability of the PART, supporting its use in the physical evaluation of painful hips.

Regional shortages in a small country: how to provide the right care in the right place?

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Hansen ◽  
R Batenburg ◽  
E Vis ◽  
L Van der Velden
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Professionals ◽  
Hospital Care ◽  
Ageing Population ◽  
Regional Collaboration ◽  
Care Workers ◽  
Vested Interests ◽  
More Care ◽  
The Right

Abstract Background The Netherlands, though being a relatively small and densely populated country, is faced with a similar challenge as other countries in terms of regional differences in access to care and attractiveness for care workers to build their careers. Both in primary care and hospital care new solutions are being sought which should help resolve these growing difficulties. Methods We conducted a literature review, survey and registry analysis, and held interviews with key stakeholders. Results Substantial differences exist between regions in the supply of both primary care and hospital care doctors. Particular and less populated regions appear to be hit in multiple ways, both with an extra ageing population requiring more care as well as by limited attractiveness for both primary care and hospital care workers. Solutions being used so far are mostly initiated by individual health care settings, such as strategic personnel management, redistribution of tasks and campaigns to increase the inflow of staff. Increasingly, solutions are also being explored at regional level, including a growing emphasis on regional collaboration, both in providing the right care in the right place as well as in terms of joint recruitment strategies. Still, such approaches only have a limited effect as a result of which new approaches are needed. Conclusions Strategies to improve the attractiveness of particular regions are now often fragmented, both between types of professions and sectors and different regions. In addition, innovative and new solutions appear to be hampered by vested interests of stakeholders. If new solutions are to be developed it is key that stakeholders are willing to compromise, be it when it comes to the autonomy of health care professionals and their associations and to the financial commitments required from government and insurer side.

An Exploration of the Relationship Between Patient Autonomy and Patient Advocacy: implications for nursing practice

2002 ◽  
Vol 9 (5) ◽  
pp. 472-482 ◽  
Author(s):  
Deirdre Hyland
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Patient Autonomy ◽  
Positive Outcome ◽  
Care Provision ◽  
Patient Advocates ◽  
The Right ◽  
The Relationship ◽  
Paternalistic Approach

The purpose of this article is to examine whether patient/client autonomy is always compatible with the nurse’s role of advocacy. The author looks separately at the concepts of autonomy and advocacy, and considers them in relation to the reality of clinical practice from professional, ethical and legal perspectives. Considerable ambiguity is found regarding the legitimacy of claims of a unique function for nurses to act as patient advocates. To act as an advocate may put nurses at personal and professional risk. It may also be deemed arrogant and insulting to other health care professionals. Patient autonomy can be seen as a subcategory of the right of every individual to self-determination, and as such is protected by law. However, it is questionable whether the traditionally paternalistic approach to health care provision truly respects the autonomous rights of each patient. The author considers examples and cases from the literature that resulted in professional and/or personal difficulties for the nurses involved, and also reflects on an incident from her own practice where a positive outcome was achieved that demonstrated compatibility between the concepts under consideration.

scholarly journals The Experience of Providing Physical Therapy in a Changing Health Care Environment

2002 ◽  
Vol 82 (7) ◽  
pp. 648-657 ◽  
Author(s):  
Rosemary Blau ◽  
Sarah Bolus ◽  
Terrence Carolan ◽  
Daniel Kramer ◽  
Elizabeth Mahoney ◽  
...  
Keyword(s):  
Health Care ◽  
Work Environment ◽  
Health Care Professionals ◽  
Phenomenological Study ◽  
Physical Therapists ◽  
Medical Center ◽  
Systemic Change ◽  
Academic Medical Center ◽  
Health Care Environment ◽  
Care Environment

Abstract Background and Purpose. The changes in the health care environment during the last decade have had an impact on the roles and responsibilities of all health care professionals. The purpose of this phenomenological study was to describe the experience of staff physical therapists during a time of systemic change within a large urban academic medical center. Subjects and Methods. Participants were 5 physical therapists working in various clinical settings within the medical center. The participants were interviewed and asked the question “Over the past 4 years, there have been major changes in your work environment. What has it been like for you working as a clinician during this time of change?” Interviews were recorded, transcribed, and analyzed to find thematic patterns of responses. Results. Four common themes emerged in which participants described experiencing loss of control, stress, discontent, and disheartenment. A fifth theme showed that despite these negative feelings, participants were able to “find the silver lining” in their daily work lives (ie, they were able to find positive aspects of their professional lives despite the perceived unpleasant changes with which they had to cope). Discussion and Conclusion. This study provides insight into the experiences of a group of staff physical therapists during a time of systemic change in their work environment. Although the themes reflect largely unsettling and negative experiences, there seems to be an underlying ability to find affirmative aspects of work.

Relationship Between Hip Dysplasia, Pain, and Osteoarthritis in a Cohort of Patients with Hip Symptoms

2013 ◽  
Vol 40 (9) ◽  
pp. 1583-1589 ◽  
Author(s):  
Johanne Morvan ◽  
Ronan Bouttier ◽  
Bernard Mazieres ◽  
Evelyne Verrouil ◽  
Jacques Pouchot ◽  
...  
Keyword(s):  
Anterior Margin ◽  
Hip Dysplasia ◽  
Acetabular Dysplasia ◽  
Hip Osteoarthritis ◽  
Population Based ◽  
Hip Pain ◽  
Prevalence Survey ◽  
Center Edge ◽  
Study Participants ◽  
The Relationship

Objective.The relationship between acetabular dysplasia (HD) and hip osteoarthritis (OA) remains unclear, especially for mild forms of dysplasia. Our objectives were to estimate the prevalence of HD in a population-based sample with symptoms and to evaluate potential associations linking HD, hip OA, and hip pain.Methods.Individuals 40 to 75 years of age with symptoms in 1 or both hips were recruited during a multiregional prevalence survey. All study participants underwent examination and radiographs. Radiographs were evaluated using Kellgren-Lawrence staging (with stages ≥ 2 indicating hip OA) and HD measures [center-edge (CE) angle, acetabular inclination angle (HTE), acetabular depth (AD), and vertical center-anterior margin angle].Results.We studied both hips of 842 individuals (1684 hips), among whom 203 had hip OA. Compared to left hips, right hips had significantly smaller CE angles and significantly greater AD and HTE values (p ≤ 0.001). Overall, the prevalence of HD ranged from 7.6% to 22.2% of the hips depending on the measure used. The prevalence of HD was higher in individuals with hip OA, with significant differences for abnormal HTE (19.1% vs 11.4%; p < 0.0001) and abnormal CE (11.3% vs 7.5%; p = 0.04). By logistic regression, only abnormal HTE remained associated with OA. Same-side hip pain was not statistically more common in individuals with HD after stratification on OA status (p = 0.12).Conclusion.Our study confirms the relationship between OA and HD, particularly as defined based on the HTE angle.

scholarly journals Building perspective awareness as a workplace practice

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Pia Andersson ◽  
Lotta Dellve ◽  
Gunnar Gillberg ◽  
Hans Lindgren
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Health Care Organization ◽  
Work Organization ◽  
Implementation Process ◽  
Care Organization ◽  
Content Type ◽  
Dialogue Model ◽  
Organizational Conditions ◽  
The Right

Purpose The present study aims to describe the implementation of a facilitated dialogue model intended to improve communication across professional logics and knowledge boundaries in two units of a large health-care organization in Sweden. Design/methodology/approach This is a mixed-methods study with interviews, field observations and follow- up questionnaires that were conducted during the implementation process. Findings The conclusion drawn in this study is that it is possible to change and improve the dialogue between health-care professionals with the help of a tailored, facilitated dialogue model. The authors found that different professional logics can indeed meet and share perspectives if the right conditions are provided. Moreover, an improved dialogue between different professional groups may contribute to work satisfaction, engagement, social cohesion and communication between professionals. Practical implications This study shows that the right organizational conditions, such as support from managers, must exist if the model’s inherent possibilities are to be used. Inhouse facilitation may be a sustainable model for facilitated workplace dialogue when its implementation is supported by the overall organization. Originality/value The contribution is an empirically based analysis of a new form of model for mediating perspectives within an organization with distinct professional roles. This study shows how, under the right conditions, the model can contribute to a perspective awareness and thus a more mature work organization.

scholarly journals Working on the Frontlines of the COVID-19 Pandemic: A Qualitative Study of Physical Therapists’ Experience in Spain

2021 ◽  
Author(s):  
Domingo Palacios-Ceña ◽  
César Fernández-de-las-Peñas ◽  
María Palacios-Ceña ◽  
Ana I de-la-Llave-Rincón ◽  
Lidiane L Florencio
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care Professionals ◽  
Physical Therapists ◽  
Health Care Systems ◽  
Public Hospitals ◽  
Purposeful Sampling ◽  
Care Systems ◽  
Field Notes ◽  
Depth Interviews

Abstract Objective Knowledge of the experiences of health care professionals who have actively worked on the first line of the COVID-19 pandemic could help in identifying specific professional duties focused on health assistance objectives. No qualitative study has yet been published describing the experience of physical therapists during the COVID-19 pandemic. The purpose of this study was to describe and explore the experiences and perspectives of physical therapists working in public hospitals in Madrid, Spain, during the COVID-19 pandemic. Methods A qualitative exploratory study was conducted based on an interpretive framework. Thirty physical therapists working at 11 national public hospitals during the COVID-19 outbreak were recruited by purposeful sampling and snowball techniques. In-depth interviews and researchers’ field notes were used to collect data. Interviews were transcribed verbatim. Inductive thematic analysis was used to identify emerging themes. Results After identifying 3912 codes and 13 categories, 3 themes emerged. First theme was “Call of Duty,” COVID-19 infection dramatically spread, the hospitals were contaminated and overwhelmed, and all floors were converted into COVID-19 wards. Second theme was “Working in War Time.” Every day, therapists were given “the war report,” receiving their orders, meeting protective personal equipment requirements, and doing a job with fear. Third theme was “When I Arrive at Home.” Working during the pandemic had an impact on the therapists’ families and the information shared with them. Conclusions Physical therapists described the COVID-19 outbreak as an apocalyptic and unexpected war. Comprehensive support is needed for all frontline health care professionals. The COVID-19 outbreak revealed that health care systems were not prepared for a pandemic. Impact This is the first qualitative study to be published describing the experience of physical therapists during the COVID-19 pandemic.

Doing the Right Things Right or the Wrong Things Well

2014 ◽  
pp. 53-65
Author(s):  
Vahé A. Kazandjian
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Services Quality ◽  
Healthcare Services ◽  
Social Responsibilities ◽  
Specific Disease ◽  
The Social ◽  
Measurement And Evaluation ◽  
The Right

The measurement and evaluation of healthcare services’ quality is faced with the challenge of describing its appropriateness. Is the right service rendered for the specific disease? Or do our measures quantify the efficiency of producing these services without first assessing if they were needed? Eventually, it is a question of accountability about the processes and outcomes of the care, which are expected to both demonstrate the social responsibilities of health care professionals and gauge the expectations of patients, families, and communities. The purpose of this chapter is to explore the determinants of what and why patients expect from healthcare and caring. Within the concept of accountability, the role of physicians as educators rather than exclusively healers of disease is explored.

Patient involvement in clinical ethics services: from access to participation and membership

2009 ◽  
Vol 4 (3) ◽  
pp. 146-151 ◽  
Author(s):  
Gerald Neitzke
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Clinical Ethics ◽  
Policy Development ◽  
Ethics Education ◽  
Patient Involvement ◽  
Ethics Consultation ◽  
Hospital Staff ◽  
Case Consultation ◽  
The Right

Ethics consultation is a novel paradigm in European health-care institutions. In this paper, patient involvement in all clinical ethics activities is scrutinized. It is argued that patients should have access to case consultation services via clearly defined access paths. However, the right of both health-care professionals and patients indicates that patients should not always be notified of a consultation. Ethics education, another well-established function of an ethics committee, should equally be available for patients, lay people and hospital staff. Beyond access and utilization, lay membership on a clinical ethics service is a matter of transparency, equal participation, empowerment and democratization. Lay and patient perspectives will contribute to the quality of ethics services on all levels from case consultations to ethics education and policy development.

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