scholarly journals Physical Therapists' Ways of Talking About Overweight and Obesity: Clinical Implications

2016 ◽  
Vol 96 (6) ◽  
pp. 865-875 ◽  
Author(s):  
Jenny Setchell ◽  
Bernadette M. Watson ◽  
Micheal Gard ◽  
Liz Jones
Keyword(s):  
Physical Therapy ◽  
Qualitative Methodology ◽  
Physical Therapists ◽  
Weight Stigma ◽  
Overweight And Obesity ◽  
Clinical Implications ◽  
Negative Attitudes ◽  
Data Collection And Analysis ◽  
Ways Of Thinking ◽  
Insight Into

Background How people think and talk about weight is important because it can influence their behavior toward people who are overweight. One study has shown that physical therapists have negative attitudes toward people who are overweight. However, how this finding translates into clinical practice is not well understood. Investigating physical therapists' ways of thinking and speaking about overweight and obesity in the context of their work can provide insight into this underresearched area. Objectives The purpose of this study was to investigate physical therapists' ways of talking about overweight individuals and discuss clinical implications. Design An interpretive qualitative design was used. Methods The research team used discourse analysis, a type of inductive qualitative methodology, to guide data collection and analysis. The data came from 6 focus groups of 4 to 6 physical therapists in Queensland, Australia, who discussed weight in a physical therapy environment. Participants (N=27) represented a variety of physical therapy subdisciplines. Results Data analysis identified 4 main weight discourses (ways of thinking and speaking about weight). Participants described patients who are overweight as little affected by stigma and difficult to treat. Furthermore, participants portrayed weight as having simple causes and being important in physical therapy. Alternate weight discourses were less frequent in these data. Conclusions The results indicated that some physical therapists' understandings of weight might lead to negative interactions with patients who are overweight. The findings suggest physical therapists require more nuanced understandings of: how patients who are overweight might feel in a physical therapy setting, the complexity of causes of weight, and possible benefits and disadvantages of introducing weight-management discussions with patients. Therefore, education should encourage complex understandings of working with patients of all sizes, including knowledge of weight stigma.

scholarly journals Work-Related Musculoskeletal Disorders and the Culture of Physical Therapy

2002 ◽  
Vol 82 (5) ◽  
pp. 459-472 ◽  
Author(s):  
Jean E Cromie ◽  
Valma J Robertson ◽  
Margaret O Best
Keyword(s):  
Physical Therapy ◽  
Cultural Values ◽  
Musculoskeletal Disorders ◽  
Physical Therapists ◽  
Attitudes And Beliefs ◽  
Ability To Work ◽  
Potential Conflict ◽  
Work Related ◽  
Work Related Musculoskeletal Disorders ◽  
Insight Into

Abstract Background and Purpose. Knowledge, skills, relationships, and attitudes of caring and working hard are all thought to be valued by physical therapists. This article explores how physical therapists see themselves, in light of some of these values, when they experience work-related musculoskeletal disorders (WMSDs). The article also explores the ways in which these values may compete with each other, and it suggests how this may contribute to the onset of WMSDs and to therapists' behavior following a WMSD. Subjects and Methods. Eighteen therapists who had made a career change after a WMSD participated in interviews that were designed to gain insight into the attitudes and beliefs of therapists who had had a WMSD. Results. Participants did not anticipate WMSDs, and they typically believed their physical therapy knowledge and skills would have prevented WMSDs from occurring. They saw themselves as knowledgeable and caring and indicated that these characteristics were highly valued by the profession. Their need to demonstrate these attributes sometimes resulted in behaviors that contributed to the development of their WMSDs and made them worse after their onset. Discussion and Conclusion. The cultural values of physical therapists may make it difficult for them to do their jobs in a way that minimizes the risk of WMSDs. The study identified a potential conflict between the therapists' need to (1) demonstrate their ability to work hard and care for their patients and (2) appear knowledgeable and skilled by remaining injury free.

scholarly journals Variables Influencing Physical Therapists’ Perceptions of Continuing Education

2007 ◽  
Vol 87 (8) ◽  
pp. 1023-1036 ◽  
Author(s):  
Tricia M Austin ◽  
Kim C Graber
Keyword(s):  
Physical Therapy ◽  
Continuing Education ◽  
Qualitative Methodology ◽  
Physical Therapists ◽  
Physical Therapist ◽  
The Core ◽  
Core Set ◽  
Analyze Data

Background and Purpose: As of October 1, 2002, physical therapy continuing education (CE) in Illinois was mandated. Research examining the recent mandate for physical therapists to engage in CE is limited. The purposes of this study were to examine the perceptions of physical therapist clinicians and managers concerning the barriers to and facilitators of CE and to identify how physical therapists perceive the role of their department in the CE process.Subjects: Participants were 23 physical therapists at 6 hospitals.Methods: Qualitative methodology was used to analyze data.Results: Four themes were identified: negotiating and managing the variables associated with CE, providing and promoting opportunities that meet physical therapists’ CE needs, identifying the elements of employment environments that foster CE, and perceived implications of mandating CE.Discussion and Conclusion: This investigation highlights the need to identify the core set of variables associated with engaging in CE and to promote the elements of employment environments that foster CE.

scholarly journals SAT0611-HPR LOW ADHERENCE TO RECOMMENDED PHYSICAL THERAPY IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS: A MIXED-METHOD CONTENT AND UTILIZATION ANALYSIS.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1266.2-1266
Author(s):  
E. Vanautgaerden ◽  
M. Kaerts ◽  
W. Dankaerts ◽  
K. De Vlam ◽  
T. Swinnen
Keyword(s):  
Physical Therapy ◽  
Disease Activity ◽  
Mixed Method ◽  
Axial Spondyloarthritis ◽  
Physical Therapists ◽  
Skills Training ◽  
Treatment Modalities ◽  
Patient Reported ◽  
Global Disease Activity ◽  
Therapy Sessions

Background:Patients with axial spondyloarthritis (axSpA) encounter limitations during daily activities and societal participation which seriously impart health-related quality of life. Optimal management of axSpA consists of combined pharmacological and non-pharmacological treatment modalities, including the encouragement of exercise and the consideration of physical therapy given the latter’s superior efficacy1. Few studies investigated the use of physical therapy and the alignment of treatment content with practice recommendations among patients with axSpA.Objectives:1) To estimate physical therapy use in patients with axSpA in a real life cohort; 2) to quantitatively and qualitatively describe the content of these physical therapy sessions; 3) explore possible determinants of physical therapy use and content.Methods:This cross-sectional study included 197 patients diagnosed with axSpA (Males/Females: 62.4/37.6%; mean±SD, age 42.6±12.0, BASDAI 3.7±2.1, BASFI 3.6±2.4, BASMI 3.1±1.8) and recruited during their routine consultation. The mixed-method approach included questionnaires (physical therapy use and content, medication, depression/anxiety (HADS), fear (TSK), physician global disease activity (PGDA)) and an in-depth qualitative interview (content of physical therapy). Interviews were analyzed using the Qualitative Analysis Guide of Leuven by two physical therapists. Spearman’s Rho correlations guided the exploration of determinants of physical therapy use and content.Results:Less than half (42.6%, n=84) of the axSpA of patients were in treatment with a physiotherapist. Most patients (40.0%) reported a physical therapy frequency of 1x/week. Session duration was typically 30 minutes (51.7% of the sample) and longer in fewer cases (30.0%). Exercise was in only 31.7% the cornerstone of their sessions. The majority of subjects (53.3%) were classified as receiving ‘passive therapy only’, with 10% of cases in the ‘exercise only’ and 36.7% in the ‘combination therapy’ groups. Interviews also revealed a lack of clear patient-centered treatment goals. We found moderate associations between physical therapy use/content parameters and medication, spinal mobility, fear, anxiety, depression, physician’s global disease activity versus (p<.05), but no relationship with patient-reported pain or disease activity.Conclusion:Despite the importance of exercise and the added value of physical therapy in axSpA, few patients engaged in physical therapy sessions that include exercise training of adequate dosage. Remarkably, physical therapy utilization seems to be predominantly guided by psychological factors. Professional education for physical therapists should therefore include skills training in the management of complex clinical presentations2. Last, future research should prepare the evidence-based implementation of state-of-the-art physical therapy guidelines in axSpA.References:[1]van der Heijde D, et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis. 2017 Jun;76(6):978-991.[2]Swinnen TW, et al. Widespread pain in axial spondyloarthritis: clinical importance and gender differences. Arthritis Res Ther. 2018 Jul 27;20(1):156.Disclosure of Interests:Evelyne Vanautgaerden: None declared, Marlies Kaerts: None declared, Wim Dankaerts: None declared, Kurt de Vlam Grant/research support from: Celgene, Eli Lilly, Pfizer Inc, Consultant of: AbbVie, Eli Lilly, Galapagos, Johnson & Johnson, Novartis, Pfizer Inc, UCB, Thijs Swinnen: None declared

scholarly journals Exploring Race Differences in Satisfaction with Rehabilitation Following Total Knee Arthroplasty: a Qualitative Study

2021 ◽  
Author(s):  
Allyn M Bove ◽  
Erin R Dong ◽  
Leslie R M Hausmann ◽  
Sara R Piva ◽  
Jennifer S Brach ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Physical Therapy ◽  
Focus Group ◽  
Knee Arthroplasty ◽  
Physical Therapists ◽  
Race Differences ◽  
Theory Approach ◽  
Focus Group Study ◽  
Black And White ◽  
Total Knee

Abstract Background The purpose of this qualitative focus group study was to explore race differences in the rehabilitation experience and satisfaction with rehabilitation following total knee arthroplasty (TKA). Methods We conducted a series of qualitative focus group discussions with groups of Non-Hispanic White and Non-Hispanic Black older adults who recently underwent TKA. We used grounded theory approach, which asks the researcher to develop theory from the data that are collected. Participants discussed barriers and facilitators to accessing rehabilitation after surgery, opinions regarding their physical therapists, the amount of post-operative physical therapy received, and overall satisfaction with the post-operative rehabilitation process. Results Thirty-six individuals participated in focus groups. Three major themes emerged: (1) Participants reported overall positive views of their post-TKA rehabilitation experience. They particularly enjoyed one-on-one care, the ability to participate in “prehabilitation”, and often mentioned specific interventions they felt were most helpful in their recovery. (2) Despite this, substantial barriers to accessing physical therapy exist. These include suboptimal pain management, copayments and other out-of-pocket costs, and transportation to visits. (3) There were minor differences in the rehabilitation experiences between Black and White participants. Black participants reported longer paths toward surgery and occasional difficulty interacting with rehabilitation providers. Conclusions Individuals undergoing TKA can largely expect positive rehabilitation experiences post-operatively. However, some barriers to post-operative physical therapy exist and may differ between Black and White patients. Physical therapists should increase their awareness of these barriers and work to minimize them whenever possible.

Feasibility of Goal Attainment Scaling in Chronic Low Back Pain: Protocol for Training & Implementation in an Outpatient Physical Therapy Setting (Preprint)

2021 ◽  
Author(s):  
Douglas Haladay ◽  
Rebecca Edgeworth Ditwiler ◽  
Aimee Klein ◽  
Rebecca Miro ◽  
Matthew Lazinski ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Clinical Setting ◽  
Goal Attainment ◽  
Physical Therapists ◽  
The United States ◽  
Goal Attainment Scaling ◽  
Low Back ◽  
Patient Centered ◽  
Patient Reported ◽  
Qualitative Phase

BACKGROUND Patient engagement in decisions regarding their healthcare may lead to improved outcomes and improved adherence to treatment plans. While there are several options for involving patients in their healthcare, goal setting is a readily accessible method for physical therapists to increase the involvement of patients in healthcare decisions. Physical therapy goals are often provider-generated and based on subjective information or standardized fixed-item patient-reported outcome measures. However, these outcome measures may provide a limited scope of activity and participation limitations which may not capture the needs of individual patients. Goal Attainment Scaling (GAS) is a patient-centered approach to involving patients in setting meaningful goals. While GAS has been shown to be reliable, valid, and sensitive to change in various population, there is limited evidence in the United States about utilizing GAS in the physical therapist management of patients with low back pain (LBP). OBJECTIVE The purpose of this report is to describe the protocol for a study to a) develop an application of GAS procedures to be used by physical therapists treating patients with chronic LBP in the United States and b) to test the feasibility of applying GAS procedures in chronic LBP in an outpatient physical therapy setting. METHODS This study will use a mixed-methods design with two (2) phases (Phase 1: Qualitative, Phase 2: Quantitative). The qualitative phase of the study will employ focus groups of patients with chronic LBP to identify an inventory of goals that are important and measurable. This inventory will be used to develop a series of leading questions that will allow physical therapists to assist patients in establishing goals in the clinical setting. The quantitative phase of the study will pilot-test the inventory developed in the qualitative arm in patients with chronic LBP to determine feasibility, reliability, validity, and responsiveness. We will also compare how well GAS captures change over time as compared to traditional fixed-item patient-reported measures. RESULTS We anticipate that this study will demonstrate that GAS can be implemented successfully by outpatient physical therapists, and it will demonstrate clinically important changes that are important to patients with chronic LBP. CONCLUSIONS GAS represents an opportunity for patient-centered care in the physical therapy management of chronic LBP. While GAS is not new, it has never been studied in a real-world clinical setting for the physical therapy management of chronic LBP which have unique time and productivity constraints. For GAS to be successfully implemented in this environment, we must demonstrate that clinicians can be trained efficiently and reliably, that GAS can be implemented in the clinical setting in under 15 minutes, and that GAS is able to detect clinically meaningful change in patient outcomes. CLINICALTRIAL N/A

scholarly journals Implementation of Clinical Guidelines on Physical Therapy for Patients With Low Back Pain: Randomized Trial Comparing Patient Outcomes After a Standard and Active Implementation Strategy

2005 ◽  
Vol 85 (6) ◽  
pp. 544-555 ◽  
Author(s):  
Geertruida E Bekkering ◽  
Maurits W van Tulder ◽  
Erik JM Hendriks ◽  
Marc A Koopmanschap ◽  
Dirk L Knol ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Patient Outcomes ◽  
Physical Functioning ◽  
Clinical Guidelines ◽  
Physical Therapists ◽  
Low Back ◽  
Active Strategy ◽  
Active Implementation

Abstract Background and Purpose. An active strategy was developed for the implementation of the clinical guidelines on physical therapy for patients with low back pain. The effect of this strategy on patients' physical functioning, coping strategy, and beliefs regarding their low back pain was studied. Subjects. One hundred thirteen primary care physical therapists treated a total of 500 patients. Methods. The physical therapists were randomly assigned to 1 of 2 groups. The control group received the guidelines by mail (standard passive method of dissemination). The intervention group, in contrast, received an additional active training strategy consisting of 2 sessions with education, group discussion, role playing, feedback, and reminders. Patients with low back pain, treated by the participating therapists, completed questionnaires on physical functioning, pain, sick leave, coping, and beliefs. Results. Physical functioning and pain in the 2 groups improved substantially in the first 12 weeks. Multilevel longitudinal analysis showed no differences between the 2 groups on any outcome measure during follow-up. Discussion and Conclusion. The authors found no additional benefit to applying an active strategy to implement the physical therapy guidelines for patients with low back pain. Active implementation strategies are not recommended if patient outcomes are to be improved.

scholarly journals Adjustment of oxygen use by means of pulse oximetry: an important tool for patient safety

2010 ◽  
Vol 8 (4) ◽  
pp. 449-455 ◽  
Author(s):  
Telma de Almeida Busch Mendes ◽  
Paola Bruno de Araújo Andreoli ◽  
Leny Vieira Cavalheiro ◽  
Claudia Talerman ◽  
Claudia Laselva
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Physical Therapy ◽  
Confidence Interval ◽  
Pulse Oximetry ◽  
Patient Care ◽  
Physical Therapists ◽  
Severe Damage ◽  
Margin Of Error

ABSTRACT Objective: To assess patient's level of oxygenation by means of pulse oximetry, avoiding hypoxia (that causes rapid and severe damage), hyperoxia, and waste. Methods: Calculations were made with a 7% margin of error and a 95% confidence interval. Physical therapists were instructed to check pulse oximetry of all patients with prescriptions for physical therapy, observing the scheduled number of procedures. Results: A total of 129 patients were evaluated. Hyperoxia predominated in the sectors in which the patient was constantly monitored and hypoxia in the sectors in which monitoring was not continuous. Conclusions: Professionals involved in patient care must be made aware of the importance of adjusting oxygen use and the risk that non-adjustment represents in terms of quality of care and patient safety.

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