Matching the perceived benefits of Transcutaneous Electrical Nerve Stimulation (TENS) for chronic musculoskeletal pain against Patient Reported Outcome Measures using the International Classification of Functioning, Disability and Health (ICF)

Physiotherapy ◽  
2020 ◽  
Vol 106 ◽  
pp. 128-135
Author(s):  
Peter W. Gladwell ◽  
Fiona Cramp ◽  
Shea Palmer
Keyword(s):  
Musculoskeletal Pain ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
International Classification Of Functioning ◽  
Disability And Health ◽  
Electrical Nerve Stimulation ◽  
Patient Reported

scholarly journals Assessing Professional Students' Application of the International Classification of Functioning, Health, and Disability Model and Patient-Reported Outcome Measures During Patient Care

2021 ◽  
Vol 16 (4) ◽  
pp. 316-320
Author(s):  
Sara L. Nottingham
Keyword(s):  
Clinical Practice ◽  
Patient Care ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
International Classification Of Functioning ◽  
Actual Patient ◽  
Patient Reported ◽  
Icf Model

Context The International Classification of Functioning, Health, and Disability (ICF) model and patient-reported outcome measures (PROMs) are concepts that must be addressed in professional education. Objective Describe a class assignment that allows students to integrate the concepts of the ICF model and PROMs into actual patient care. Background Adult learners, including professional athletic training students, thrive on learning experiences where they can apply concepts and integrate new knowledge with existing knowledge. In addition, existing research suggests that most athletic trainers are not integrating PROMs into their clinical practice; therefore, students are most likely not seeing the use of PROMs during clinical education. Faculty can facilitate the application of the ICF model and PROMs into patient care with a course-based assignment. Description The assignment requires students to use the ICF model as an assessment tool with an actual patient, which helps shape their therapeutic interventions. Students recorded baseline and follow-up PROMs with this patient over a time period of at least 3 weeks while documenting their interventions and the patient's change over time. Students addressed reflection prompts in the assignment by describing their successes and challenges, in addition to describing their future plans for integrating the ICF model and PROMs into their clinical practice. Clinical Advantage(s) Students described this assignment as beneficial because it helped them treat their patients more holistically. Students self-reported increased knowledge and confidence with using the ICF model and PROMs in their clinical practice. Students described a plan to integrate these concepts into their clinical practice in a limited fashion. Conclusion(s) Faculty may consider integrating an applied, patient-based assignment such as this to assess students' application of the ICF model and PROMs to an actual patient. This assignment can also be easily condensed or expanded to fit different courses, student background knowledge, and assessment of different curricular content standards.

scholarly journals A comparative performance analysis of the International Classification of Functioning, Disability and Health and the Item-Perspective Classification framework for classifying the content of patient reported outcome measures

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Derek Rosa ◽  
Joy MacDermid ◽  
Dorota Klubowicz
Keyword(s):  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
International Classification ◽  
International Classification Of Functioning ◽  
Coding System ◽  
Coding Efficiency ◽  
Classification Framework ◽  
Patient Reported

Abstract Background Standardized coding of the content presented in patient reported outcome measures can be achieved using classification frameworks, and the resulting data can be used for ascertaining content validity or comparative analyses. The International Classification of Functioning (ICF) is a framework with a detailed conceptual structure that has been successfully utilized for such purposes through established coding procedures. The Item Perspective Classification (IPC) framework is a newly developed relational coding system that classifies the respondent perspective and conceptual domains addressed in items. The purpose of this study was to compare and describe the performance of these two frameworks when used alone, and in conjunction, for the generation of data pertaining to the content of patient reported outcome measures. Methods Six health-related quality of life questionnaires with a total of 159 items were classified by two raters using the Item Perspective Classification framework in conjunction with the International Classification of Functioning. Framework performance indicators included: classification capacity (percent of items amenable to successful classification), coding efficiency (number of codes required to classify items), and content overlap detection (percent of items sharing identical classification codes with at least one other item). Inter-rater reliability of item coding was determined using Krippendorff's alpha. Results Classification capacity of the IPC framework was 97%, coding efficiency 26, and content overlap detection was 95%; whereas respective values for the ICF were 68%, 114, and 58%. When used in conjunction values were 63%, 129, and 30%. Krippendorff's alpha exceeded 0.97 for all 3 classification indices. Conclusion Inter-rater agreement on classification data was excellent. The IPC framework provided a unique classification of the respondent’s judgment during item response and classified more items using fewer categories, indicated greater content overlap across items and was able to describe the relationship between multiple concepts presented within the context of a single item. The ICF provided a unique classification of item content relating to aspects of disability and generated more detailed and precise descriptions. A combined approach provided a rich description (detailed codes) with each framework providing complementary information. The benefits of this approach in instrument development and content validation require further investigation.

scholarly journals Problems, Solutions, and Strategies Reported by Users of Transcutaneous Electrical Nerve Stimulation for Chronic Musculoskeletal Pain: Qualitative Exploration Using Patient Interviews

2016 ◽  
Vol 96 (7) ◽  
pp. 1039-1048 ◽  
Author(s):  
Peter William Gladwell ◽  
Kathryn Badlan ◽  
Fiona Cramp ◽  
Shea Palmer
Keyword(s):  
Clinical Practice ◽  
Data Analysis ◽  
Musculoskeletal Pain ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Chronic Musculoskeletal Pain ◽  
Pain Clinic ◽  
Electrical Nerve Stimulation ◽  
Primary Data Analysis ◽  
Semistructured Interviews

Abstract Background Transcutaneous electrical nerve stimulation (TENS) could offer a non-drug form of pain relief, but there is no consensus regarding its effectiveness for chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methods identified significant problems with low treatment fidelity. There is little information available to inform the development of a pragmatic implementation design for a TENS evaluation. Objectives The aim of this study was to explore the experiences of patients who were receiving secondary care in a pain clinic and who had expertise in using TENS to manage chronic musculoskeletal pain. These key informants were selected because they had the potential to generate knowledge that could inform research design and clinical practice. Design A qualitative method using individual semistructured interviews with open questions was selected for its capacity to generate rich data. Methods Semistructured interviews were conducted with 9 patients (6 women, 3 men). Thematic analysis was used as the primary data analysis method, and this analysis was enhanced by a case-level analysis of the context and processes of TENS use of each individual. Results Data analysis indicated that patients learned to address a range of problems in order to optimize TENS use. Patients may need to personalize the positioning of electrodes and the TENS settings and to readjust them over time. Patients learned to use TENS in a strategic manner, and the outcomes of each strategy varied. Conclusions The findings indicated that a pragmatic TENS evaluation may need to incorporate a learning phase to allow patients to optimize this complex pattern of TENS usage, and evaluation may need to be sensitive to the outcomes of strategic use. These findings also have implications for clinical practice.

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