scholarly journals The Needs and Experiences of Patients on Pain Education and the Clinical Reasoning of Physical Therapists Regarding Cancer-Related Pain. A Qualitative Study

2021 ◽  
Vol 2 ◽  
Author(s):  
Tessa Eisen ◽  
Eline Menje Kooijstra ◽  
Ruud Groeneweg ◽  
Michelle Verseveld ◽  
Janine Hidding
Keyword(s):  
Qualitative Study ◽  
Cancer Treatment ◽  
Clinical Reasoning ◽  
Physical Training ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Additional Treatment ◽  
Treatment Needs ◽  
Pain Education ◽  
Patients With Cancer

Objective: This study offers direction for interaction between physical therapists and patients about cancer-related pain during physical training. The study may increase awareness of rehabilitation strategies for cancer-related pain during and after cancer treatment.Methods: Qualitative study, evaluating results of two qualitative studies. Data has been collected using semi-structured interviews, in which topics were discussed with patients and physical therapists. Respondents were adult patients with cancer in the Northern Netherlands with moderate to severe pain who followed physical training with a (oncologic) physical therapist. The physical therapists were respondents specialized in oncology and working with patients with cancer in a primary care setting in in the Netherlands. Data were analyzed using thematic analysis.Results: Eighteen patients and fifteen physical therapists were interviewed. Data was categorized in statements regarding “patients' needs”, “patients' experiences” and “clinical reasoning of the physical therapist”. “Patients' needs” for education were personal and included needs for information about the cause, course and effect of pain in relation to cancer and/or medical treatment, needs for practical tools for reducing pain, needs for strategies dealing with pain in daily activities, and needs for information about additional treatment and care options. When discussing ‘patients’ experiences', patients mentioned that physical therapists are cautious to express their expectations of the progress of pain and to offer pain education with respect to the cause of pain, dealing with pain and limitations in daily life, exercising, posture, learning self-care and information about additional treatment and care options in cancer-related pain. Patients provided insight into their educational, mental, and social support relative to experiences with physical therapists. Additionally, when discussing the communication they experienced with physical therapists, patients used descriptors such as accessibility, empathy, trust, knowledge and eliminating uncertainties. Interviews with physical therapists regarding their clinical reasoning process in cancer-related pain described that they identified pain from anamnesis (medical history review) and performed screening and analysis for pain secondary to cancer (treatment), as type of pain and pain influencing factors. Thoughts and experiences about pain, the use of pain clinometry, the establishment of objectives and interventions for physical therapy and multidisciplinary treatment of cancer-related pain were also described.Conclusion: Patients with cancer-related pain during physical training have personal needs regarding pain education and experience that specialized oncologic physical therapists focus on patient-centered information and self-management support. Specialized oncologic physical therapists analyze pain in the anamnesis and keep in mind the origin and impact of pain for the patient during screening and treatment. Different methods of pain management are used. It is recommended that physical therapists who give physical training take the initiative to repeatedly discuss pain.

Dificuldades do Profissional Enfermeiro ao Cuidar de Pacientes Pediátricos Portadores de Câncer/ Difficulties of the Professional Nurse when Taking Care of Pediatric Patients with Cancer

1970 ◽  
Vol 4 (3) ◽  
pp. 41-47
Author(s):  
Renata Pinto Ribeiro ◽  
Teresa Francisca Moraes Pinto ◽  
Clarissa Santos Carvalho Ribeiro ◽  
Valdinéa Luiz Hertel
Keyword(s):  
Qualitative Study ◽  
Pediatric Patients ◽  
Structured Interview ◽  
Coping Mechanisms ◽  
Emotional Involvement ◽  
Children With Cancer ◽  
Professional Nurse ◽  
Patients With Cancer ◽  
Oncological Diseases ◽  
Taking Care

Objetivo: O objetivo desse estudo foi de identificar as dificuldades do profissional enfermeiro frente à criança com câncer, verificar se há preparo adequado para atender às necessidades de uma criança com doenças oncológicas; e qual a forma de enfrentamento utilizada pelo profissional diante das dificuldades encontradas, no atendimento a essa criança. Metodologia: Trata-se de uma pesquisa qualitativa, objetivando identificar quais dificuldades o profissional de enfermagem enfrenta no cuidado de criança com câncer e de seus familiares, os mecanismos de enfrentamento dessas dificuldades no atendimento dos mesmos e se há preparo adequado dos mesmos para atender as necessidades dessas crianças. Os sujeitos foram quatro enfermeiras que cuidam ou já cuidaram de crianças com câncer no Hospital Bom Pastor – Varginha/MG. A coleta de dados foi desenvolvida por uma entrevista semiestruturada. Resultados: Constatou-se que as dificuldades são: cuidar de criança em estado grave, seus pais e o envolvimento emocional. Aos meios de enfrentamento referem à oração e a distração. Quanto ao preparo do profissional referem despreparo para atuar nesta área. Conclusão: Conclui-se que há falta de preparo aos profissionais, embora os mesmos cuidem com humanização dessas crianças.  Palavras-chave: Enfermeiro; Crianças; Câncer.   ABSTRACT: Objective: The aim of this study was to identify the difficulties of the professional nurse when taking care of a child with cancer, check the adequate preparation to meet the needs of children with oncological diseases; and what form of coping with the situation the professionals used when taking care of this child. Methodology: This was a qualitative study , aiming to identify the difficulties the professional faces in the care of children with cancer and their families , the coping mechanisms of these difficulties in the care  and if there is adequate preparation thereof to meet the needs of these children. The subjects were four nurses who care or have cared for children with cancer at Good Shepherd Hospital – Varginha/MG. Data collection was carried out by a semi - structured interview. Results: It was found that the difficulties are care of a child in serious condition, his parents and the emotional involvement. Means of coping relate to prayer and distraction. As to their preparation, professionals refer as being unprepared to act in this area. Conclusion: We concluded that there is lack of preparation of professionals, although they take care of these children in a humanistic way  Keywords: Nurse; children; Cancer.

scholarly journals Automatically evaluating balance using machine learning and data from a single inertial measurement unit

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Fahad Kamran ◽  
Kathryn Harrold ◽  
Jonathan Zwier ◽  
Wendy Carender ◽  
Tian Bao ◽  
...  
Keyword(s):  
Machine Learning ◽  
Inertial Measurement Unit ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Model Performance ◽  
Machine Learning Techniques ◽  
Measurement Unit ◽  
Balance Performance ◽  
Inertial Measurement ◽  
Self Assessments

Abstract Background Recently, machine learning techniques have been applied to data collected from inertial measurement units to automatically assess balance, but rely on hand-engineered features. We explore the utility of machine learning to automatically extract important features from inertial measurement unit data for balance assessment. Findings Ten participants with balance concerns performed multiple balance exercises in a laboratory setting while wearing an inertial measurement unit on their lower back. Physical therapists watched video recordings of participants performing the exercises and rated balance on a 5-point scale. We trained machine learning models using different representations of the unprocessed inertial measurement unit data to estimate physical therapist ratings. On a held-out test set, we compared these learned models to one another, to participants’ self-assessments of balance, and to models trained using hand-engineered features. Utilizing the unprocessed kinematic data from the inertial measurement unit provided significant improvements over both self-assessments and models using hand-engineered features (AUROC of 0.806 vs. 0.768, 0.665). Conclusions Unprocessed data from an inertial measurement unit used as input to a machine learning model produced accurate estimates of balance performance. The ability to learn from unprocessed data presents a potentially generalizable approach for assessing balance without the need for labor-intensive feature engineering, while maintaining comparable model performance.

scholarly journals Rethinking Telerehabilitation: Attitudes of Physical Therapists and Patients

2021 ◽  
Vol 8 ◽  
pp. 237437352110343
Author(s):  
Fereshteh Saaei ◽  
Susan G Klappa
Keyword(s):  
Patient Population ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Patient Survey ◽  
Patient Perspectives ◽  
Remote Care ◽  
Virtual Therapy ◽  
Therapy Sessions

COVID-19 has accelerated the adoption of telehealth among various specialties, including rehabilitation. The fast-paced implementation of telerehabilitation has laid bare its challenges, providing an opportunity for innovation in order to enhance the experience of remote care. The purpose of this study sought to understand the attitudes toward telerehabilitation from physical therapist (PT) and patient perspectives. Two surveys administered to PTs, and the general patient population explored beliefs regarding telerehabilitation. There were a total of 289 participant responses in this study. There were 228 PT respondents and 61 patients who responded to the patient survey. Qualitative results describe current attitudes toward telerehabilitation. Results indicated both groups were receptive to virtual therapy sessions; however, some challenges were also reported. Current challenges and trends in utilizing telerehabilitation are further discussed.

scholarly journals Evaluation of Individualized Functional Electrical Stimulation-Induced Acute Changes during Walking: A Case Series in Children with Cerebral Palsy

Sensors ◽  
2021 ◽  
Vol 21 (13) ◽  
pp. 4452
Author(s):  
Nicole Zahradka ◽  
Ahad Behboodi ◽  
Ashwini Sansare ◽  
Samuel C. K. Lee
Keyword(s):  
Cerebral Palsy ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Case Series ◽  
Phase Detection ◽  
Lower Extremity Muscle ◽  
Children With Cerebral Palsy ◽  
Muscle Groups

Functional electrical stimulation (FES) walking interventions have demonstrated improvements to gait parameters; however, studies were often confined to stimulation of one or two muscle groups. Increased options such as number of muscle groups targeted, timing of stimulation delivery, and level of stimulation are needed to address subject-specific gait deviations. We aimed to demonstrate the feasibility of using a FES system with increased stimulation options during walking in children with cerebral palsy (CP). Three physical therapists designed individualized stimulation programs for six children with CP to target participant-specific gait deviations. Stimulation settings (pulse duration and current) were tuned to each participant. Participants donned our custom FES system that utilized gait phase detection to control stimulation to lower extremity muscle groups and walked on a treadmill at a self-selected speed. Motion capture data were collected during walking with and without the individualized stimulation program. Eight gait metrics and associated timing were compared between walking conditions. The prescribed participant-specific stimulation programs induced significant change towards typical gait in at least one metric for each participant with one iteration of FES-walking. FES systems with increased stimulation options have the potential to allow the physical therapist to better target the individual’s gait deviations than a one size fits all device.

scholarly journals Physical Therapist Practice in the Acute Care Setting: A Qualitative Study

2011 ◽  
Vol 91 (6) ◽  
pp. 906-919 ◽  
Author(s):  
Pauline M. Masley ◽  
Carey-Leah Havrilko ◽  
Mark R. Mahnensmith ◽  
Molly Aubert ◽  
Diane U. Jette
Keyword(s):  
Qualitative Study ◽  
Acute Care ◽  
Care Setting ◽  
Physical Therapist ◽  
Acute Care Setting

scholarly journals Patient Screening by a Physical Therapist for Nonmusculoskeletal Hip Pain

2009 ◽  
Vol 89 (3) ◽  
pp. 248-256 ◽  
Author(s):  
William R VanWye
Keyword(s):  
Lumbar Spine ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Hip Osteoarthritis ◽  
Care Physician ◽  
Hip Pain ◽  
Screening Tools ◽  
Positive Sign ◽  
Diagnostic Challenge ◽  
Trochanteric Bursitis

Background and Purpose Mechanical hip pain and disease-based hip pain can have similar signs and symptoms, thereby presenting a differential diagnostic challenge for clinicians. Hip pain is a common complaint addressed by physical therapists; therefore, it would be advantageous for them to be knowledgeable about differential diagnosis for hip pain, so that they can screen for possible serious conditions outside the realm of physical therapist practice and make the appropriate referral. Case Description A 77-year-old man was referred for physical therapy by his primary care physician (PCP) with diagnoses of lumbar spine and left hip osteoarthritis and possible trochanteric bursitis. After the examination, the physical therapist determined that the patient should return to his PCP for further testing. Findings leading to this conclusion were pain severity out of proportion to the reported injury, the presence of night pain, a positive “sign of the buttock,” and empty end feels of all hip joint motions, which represented a noncapsular pattern of joint restriction. Outcomes The patient was diagnosed later with primary lung adenocarcinoma with widespread metastases. A computerized tomography scan of the left hip revealed a metastatic lesion at the left proximal femur. Discussion Physical therapists’ ability to adequately screen for conditions requiring examination by a physician can lead to a more timely diagnosis of serious medical conditions. Investigators have found published descriptions of end feels, capsular versus noncapsular patterns of restriction, and the sign of the buttock to be beneficial screening tools for use in people with hip, pelvis, or lumbar spine pain.

scholarly journals Economic Realities Associated With Diabetes Care: Opportunities to Expand Delivery of Physical Therapist Services to a Vulnerable Population

2008 ◽  
Vol 88 (11) ◽  
pp. 1417-1424 ◽  
Author(s):  
Rhea Cohn
Keyword(s):  
Health Insurance ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Indirect Costs ◽  
Market Forces ◽  
Employee Productivity ◽  
Newly Diagnosed ◽  
Profit Margins ◽  
Current Trends

Each year, more Americans are newly diagnosed with type 2 diabetes mellitus. The costs for managing this disease are high, and the cascade of problems associated with poorly controlled diabetes is significant. At the same time, the number of uninsured or underinsured Americans is growing. This article describes current trends in health insurance availability and coverage for the growing number of people with diabetes and addresses the direct costs associated with treating this disease. The economic burden of health care for people with diabetes continues to escalate. Payers and employers are interested in decreasing their direct and indirect costs, improving profit margins, decreasing employee absenteeism, and increasing employee productivity. For physical therapists to recognize existing or new opportunities to participate in the management of this costly disease, it is critical that they understand how employees, payers, and employers are responding to the changing market forces affecting health insurance.

scholarly journals Management of Sternal Precautions Following Median Sternotomy by Physical Therapists in Australia: A Web-Based Survey

2012 ◽  
Vol 92 (1) ◽  
pp. 83-97 ◽  
Author(s):  
Lara J. Tuyl ◽  
Jennifer H. Mackney ◽  
Catherine L. Johnston
Keyword(s):  
Patient Outcomes ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Median Sternotomy ◽  
Evidence Base ◽  
Cross Sectional ◽  
Web Based ◽  
Wound Breakdown ◽  
Observational Design ◽  
Midline Sternotomy

Background Sternal precautions are utilized within many hospitals with the aim of preventing the occurrence of sternal complications (eg, infection, wound breakdown) following midline sternotomy. The evidence base for sternal precaution protocols, however, has been questioned due to a paucity of research, unknown effect on patient outcomes, and possible discrepancies in pattern of use among institutions. Objective The objective of this study was to investigate and document the use of sternal precautions by physical therapists in the treatment of patients following median sternotomy in hospitals throughout Australia, from immediately postsurgery to discharge from the hospital. Design A cross-sectional, observational design was used. An anonymous, Web-based survey was custom designed for use in the study. Methods The questionnaire was content validated, and the online functionality was assessed. The senior cardiothoracic physical therapist from each hospital identified as currently performing cardiothoracic surgery (N=51) was invited to participate. Results The response rate was 58.8% (n=30). Both public (n=18) and private (n=12) hospitals in all states of Australia were represented. Management protocols reported by participants included wound support (n=22), restrictions on lifting and transfers (n=23), and restrictions on mobility aid use (n=15). Factors influencing clinical practice most commonly included “workplace practices/protocols” (n=27) and “clinical experience” (n=22). Limitations The study may be limited by response bias. Conclusions Significant variation exists in the sternal precautions and protocols used in the treatment of patients following median sternotomy in Australian hospitals. Further research is needed to investigate whether the restrictions and precautions used are necessary and whether protocols have an impact on patient outcomes, including rates of recovery and length of stay.

Development of Active Rehabilitation Device of Hand Joint

2012 ◽  
Vol 591-593 ◽  
pp. 245-250 ◽  
Author(s):  
Hsi Chuan Huang ◽  
W.H. Kao ◽  
T.S. Wei ◽  
S.Y. Liu ◽  
Y.S. Syu ◽  
...  
Keyword(s):  
Control System ◽  
Embedded System ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Operating Conditions ◽  
Control Technology ◽  
Rehabilitation Process ◽  
Processing Control ◽  
Active Rehabilitation ◽  
External Forces

If the hand joints patients have not been taking autonomic or external force rehabilitation, they might become disabled, even leading the cause ofirreversible disability eventually. Generally speaking, the medical treatment of rehabilitation has been doing by physical therapist by providing patients with external forces rehabilitation assistance as far as we know currently. For the purpose of both of reducing the workload of physical therapists and providing the quantitative data obtained during the rehabilitation process so as for physical therapist’s reference. This research will build an automatic finger stretch and grip control system by using the Human- Machine Interface for operation control. It can be done by physical therapist or physical doctor to set the operating conditions so as to help the patients with their finger joints motion so as to achieve the rehabilitation effect of their fingers. This research is trying to integrate the mechanism and control technology mainly. With regards to the control technology, it uses a micro chip so as to lead the motions of the stretch & grip for finger rehabilitation by a signal processing control servo motor. And its operation interface is using an embedded system along with Visual Studio compiling software so as to touch input the operating conditions. The system operation functions are including single finger joint motion orsynchronized actuation of all fingers and the setting of the cycle numbers. Furthermore, in order to soften the finger tendons so as to promote the rehabilitation effect during the rehabilitation process, the system adds external steam in so as to control the internal temperature & humidity of the rehabilitation box and apparently, the whole finger automatic stretch & grip control system will be better owing to it.

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