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PubMed1998

Gender-based income differences for physical therapist managers.

BACKGROUND AND PURPOSE: The purpose of this study was to determine whether income differences associated with gender exist for therapists in management positions and whether such differences also exist for salaried and self-employed individuals after adjusting for differences due to hours worked, years worked full-time, leave taken from the profession, number of years at a facility, and number of years in a position. SUBJECTS: The subjects were 969 physical therapists who held management positions throughout the United States. METHODS: Subjects responded to a survey designed for male and female administrators. Respondents were assigned to groups of salaried therapists or self-employed therapists, t tests were used to compare characteristics based on gender, and analysis of covariance was used to compare income based on gender after controlling for certain variables. RESULTS: After adjusting for the set of five covariates, the data showed that self-employed female therapists earned 77% of the average salary earned by the self-employed male therapists. A similar analysis revealed that the salaried female managers earned 89% of the average salary earned by male managers. Within the five practice subgroups of salaried managers, salary differences existed only for those therapists working in acute care settings. CONCLUSION AND DISCUSSION: For the physical therapist managers who responded to the survey, there were gender-based salary differences. Regardless of whether the therapists were salaried or self-employed, salary differences existed for some areas of practice but did not appear to exist in other areas of practice.

Administrative Personnel↗

PubMed2005

Self-reported attachment styles and therapeutic orientation of therapists and their relationship with reported general alliance quality and problems in therapy.

The aims of this study were to explore the relationship between therapists' self-reported attachment styles and therapeutic orientation with the self-reported general therapeutic alliance and therapist-reported problems in psychological therapy.A sample of 491 psychotherapists from differing therapeutic orientations responded to a postal questionnaire. The questionnaire contained standardized measures of therapeutic alliance quality, attachment behaviours, a checklist of problems in therapy, and a brief personality inventory.Therapist-reported attachment styles generally explained a significant additional proportion of the variance in alliance and problems in therapy, over and above variance explained by general personality variables. Self-reported secure attachment style was significantly positively correlated with therapist-reported general good alliance. Self-reported anxious attachment styles were significantly negatively correlated with good alliance, and significantly positively correlated with the number of therapist-reported problems in therapy. Therapeutic orientation independently predicted a small but significant amount of the variance in reported general alliance quality in addition to that explained by attachment behaviours.

Anxiety↗

PubMedDate not supplied

Occupational therapy practice errors in physical rehabilitation and geriatrics settings: a national survey study.

OBJECTIVES: The purpose of this survey study was to investigate occupational therapy practice errors in physical rehabilitation and geriatric practice settings. METHOD: Two hundred and forty-five (245) out of 994 surveyed occupational therapists who have practiced or currently practice in physical rehabilitation or geriatrics settings responded to a self-developed questionnaire. Descriptive statistical analysis was used to describe practice errors as to the types, causes, impact on, and responses of occupational therapists and work sites. Inferential statistical analysis was used to explore the relationships among different variables of interest including: the effect of the number of years of practice experience on the perceived impact of making errors on practice; the relationship between disclosure or nondisclosure of errors; and the types of coping strategies used by occupational therapists and work site administrators' responses to errors. RESULTS: The vast majority of practice errors occurred during the intervention phase of the occupational therapy process. Misjudgment, lack of preparation, and lack of experience were reported as the top three causes of practice errors. Various coping strategies-such as compensating for the errors by voluntarily devoting additional time for care of the patient, making and following a corrective plan, concentrating on the next step, or not letting errors interfere with daily work-were used by the occupational therapists when errors occurred. The types of coping strategies and work site responses appeared to be associated with the disclosure or nondisclosure of errors. CONCLUSION: Errors occur in occupational therapy practice. Making errors has considerable impact on occupational therapists as well as their future practice. However, disclosure of errors can often lead to positive outcomes.

Communication↗

PubMedDate not supplied

Psychological influences on pain perception and non-pharmacologic approaches to the treatment of pain.

Pain is a complex process, in part because it is mediated by so many different variables. However, because pain is the primary reason for seeking medical treatment and often a barrier to compliance, therapists treating painful disorders or injuries need to be familiar with those factors that influence pain perception and treatment approaches. How individuals perceive pain, and hence how clinicians treat it, depends upon a wide variety of psychosocial factors, including mood, age, gender, expectations, social support, and perceptions of control. Even the manner with which therapists interact with patients can minimize the pain experience and ultimately impact compliance and recovery rates. This paper overviews the multifaceted nature of pain by outlining how psychologic variables impact pain experiences. In addition, this article reviews a number of nonpharmacologic techniques and approaches (i.e., distraction, imagery, relaxation, biofeedback) that are available for assisting patients in dealing with pain.

Attitude to Health↗

PubMed1987

A natural language teaching paradigm for nonverbal autistic children.

The purpose of this study was to attempt to improve verbal language acquisition for nonverbal autistic children by manipulating traditional teaching techniques so they incorporated parameters of natural language interactions and motivational techniques. Within a multiple baseline design, treatment was conducted in a baseline condition with trials presented serially in a traditional analogue clinical format where the therapist presented instructions, prompts, and reinforcers for correct responses. Then, these variables were manipulated in the natural language teaching condition such that stimulus items were functional and varied, natural reinforcers were employed, communicative attempts were also reinforced, and trials were conducted within a natural interchange. Treatment and generalization data demonstrated that manipulation of these variables resulted in broadly generalized treatment gains. Implications for language intervention are discussed.

Autistic Disorder↗

PubMed2003

Impact of case formulation in cognitive behaviour therapy for psychosis.

Case formulation (CF) is the 'first principle' in cognitive behavior therapy (CBT), and the cornerstone of CT for psychosis. Experiment 1 (E1) assesses impact of CF in CBT for psychosis on perception of therapeutic relationship. Experiment 2 assesses the impact of CF on strength of delusional and self-evaluative beliefs (E2). Both E1 and E2 assess impact of CF on symptoms of anxiety and depression. CF had little or no impact on these variables. Descriptive data suggested there were other benefits for certain participants. Therapists' perception of the therapeutic relationship did improve following CF. Six clients found CF, at least in part, a negative experience.

Adult↗

PubMedDate not supplied

Posteroanterior motion test of a lumbar vertebra: accuracy of perception.

PURPOSE: The aim of this study was to investigate the accuracy of perception of forces applied to and displacement produced in an electromechanical one vertebral spinal model, among inexperienced and experienced physical, therapists performing posteroanterior pressure on a lumbar vertebra, before and after a training session. METHODS: Ten relatively inexperienced physical therapists and ten experienced manual therapists participated. An electromechanical single level spinal model was used for applying oscillatory posteroanterior pressure and measuring the forces on and displacement of the vertebra. A digital oscilloscope was used to give direct feedback to the therapists while performing mobilization to discern the magnitude of these two variables. RESULTS: The inexperienced group estimated the displacement accurately but the experienced group was significantly inaccurate (p<0.02), and both groups were inaccurate in estimating the force (p<0.001), before training. Following training, the inexperienced group maintained their accuracy on displacement and the experienced group improved their accuracy significantly (p<0.001). Both groups approached significance in improving their accuracy of force estimation. CONCLUSION: An electromechanical spinal model can be used as training tool along with an oscilloscope. Longer training may be needed for the force than the displacement for accurate perception.

Adult↗

PubMed2003

Background and educational characteristics of prelingually deaf children implanted by five years of age.

PURPOSE: This study documents child, family and educational characteristics of a large representative sample of 8- to 9-yr-old prelingually deaf children who received a cochlear implant by 5 yr of age. Because pre-existing factors such as the child's gender, family characteristics, additional handicaps, age at onset of deafness and at implant, may affect postimplant outcomes, these variables must be accounted for before the impact of educational factors on performance with an implant can be adequately determined. Classroom variables that may affect postimplant outcomes include placement in public or private, mainstream or special education, oral or total communication environments. Other intervention variables include type and amount of individual therapy, experience of the therapist and parent participation in therapy. Documenting these characteristics for a large representative sample of implanted children can provide clinicians and researchers with insight regarding the types of families who sought early cochlear implantation for their children and the types of educational programs in which they placed their children after implantation. It is important to undertake studies that control for as many of these factors as possible so that the relative benefits of specific educational approaches for helping children to get the most benefit from their cochlear implant can be identified. METHOD: Over a 4-yr period, 181 children from across the US and Canada, accompanied by a parent, attended a cochlear implant research camp. Parents completed questionnaires in which they reported the child's medical and educational history, characteristics of the family, and their participation in the child's therapy. The parent listed names and addresses of clinicians who had provided individual speech/language therapy to the child and signed permission for these clinicians to complete questionnaires describing this therapy. RESULTS: To the extent that this sample is representative of those families seeking a cochlear implant for their child, especially during the initial period of device availability, this population can be characterized as follows. Most parents had normal hearing, were of majority (white) ethnicity and had more education and higher incomes than the general population. The families tended to be intact with both a mother and a father who involved their hearing-impaired child in family activities on a regular basis. The children were enrolled in the full range of educational placements available across the United States and Canada. Fairly even distributions of children from public and private schools, special education and mainstream classes and oral and total communication methodologies were represented. Educational placement changed as children gained increased experience with a cochlear implant. They received an increased emphasis on speech and auditory skills in their classroom settings and tended to move from private school and special education settings to public school and mainstream programs. These data support the position that early cochlear implantation is a cost effective procedure that allows deaf children to participate in a normal school environment with hearing age mates.

Canada↗

PubMed1991

Application of motor learning principles in occupational therapy.

The processes underlying skill acquisition depend on the nature of the task and the stage of the learner. In addition, feedback and practice are two potent learning variables when used appropriately in the instruction of motor tasks. Occupational therapists involved in the training and retraining of motor skills can benefit from knowledge of instructional methods used by coaches and physical educators. This paper reviews commonly accepted principles of motor learning and applies these principles to occupational therapy treatment. The stage of the learner, type of task, feedback, practice, and facilitation of skill acquisition are emphasized. Specific examples of how occupational therapists can use motor learning principles in treatment are given.

Biofeedback, Psychology↗

PubMed1989

Variables affecting specialty choice in occupational therapy.

Over the past 15 years, the number of occupational therapists entering the practice area of mental health has greatly declined. To determine the possible reasons for this decline, a random sample of 450 occupational therapy students who graduated in 1986 was surveyed to identify those factors that influence practice choice. Participants were asked to indicate their practice preferences at five points in time: before admission to the academic program, after completion of the academic program, after completion of Level I fieldwork, after completion of Level II fieldwork, and at first employment. The results from 212 questionnaires (a 47% response rate) indicated that the distribution of practice choices remained relatively consistent over time. After completion of the academic program, the choice of mental health practice was seen as negative. Specific negative influences were topic content, teaching methods, and teacher effectiveness. Level I fieldwork was perceived as a negative experience in all five practice areas, but was perceived most negatively in mental health. Level II fieldwork most influenced practice preferences. Specific positive factors were the student supervisor and the patient caseload.

Career Choice↗

PubMed2003

Interhospital variability in satisfaction with withdrawal of life support: room for improvement?

OBJECTIVE: To develop instruments to measure the current level of satisfaction with the withdrawal of life support among nurses and respiratory therapists and to use these instruments to determine whether differences in satisfaction levels with the withdrawal of life support could be found among different institutions. DESIGN: A multicenter, self-administered, questionnaire-based study. SETTING: The intensive care units of three academic and 11 community hospitals. SUBJECTS: A total of 412 critical care nurses and 117 respiratory therapists working in these intensive care units. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: After developing two similar questionnaires for critical care nurses and respiratory therapists, we assessed the reliability of the individual items for each questionnaire and only used those found to be reliable in the analyses. We found variability in the satisfaction level of critical care nurses among different intensive care units and among academic and community hospital intensive care units. Being involved in the plan for withdrawal of life support, comfort with the way discussions with the family had gone, comfort with patient sedation, and increasing experience with withdrawal of life support were items associated with increased nurse satisfaction. For respiratory therapists, there seemed to be similar differences among institutions in satisfaction level, although numbers were limited. Having the physician explain the plan to them and becoming more comfortable with withdrawal of life support as a result of increased experience were found to be associated with increased satisfaction levels for respiratory therapists. CONCLUSIONS: Satisfaction levels of intensive care unit nurses and respiratory therapists with the process of withdrawing life support vary among institutions. This variation may represent an opportunity for improvement in the process of withdrawing life support within this region.

Euthanasia, Passive↗

PubMedDate not supplied

[Significance of concepts about illness attribution and treatment expectations in the initial treatment phase].

To evaluate the influence and the consequences of subjective concepts about attribution and treatment expectations of patients and therapists 56 patients of two psychiatric outpatient departments were examined with the inventory for concepts about illness and the Giessen-Test. In addition biographic data and information of the present problems as well the judgment of the therapists were registered. The results show that the subjective concepts of problem attribution and treatment expectations correlate with patient variables as personality, social economic states, social network, anamnestic data, present problems, previous therapeutic experience and vocational situation. Some concepts (e.g. psychologically oriented concepts) and the conformity of therapists and patients are important predictors of indication, prognosis and outcome of therapy. Therapists are especially motivated to work with patients who have similar concepts and a similar social background as themselves. The concepts of the patients assimilate of those of the therapists already after a short period of therapy.

Adolescent↗

PubMed2005

Implementing and evaluating Social Behaviour and Network Therapy in drug treatment practice in the UK: a feasibility study.

This paper reports on the implementation and preliminary evaluation of Social Behaviour and Network Therapy (SBNT) within drug treatment services. SBNT was initially developed and evaluated as part of a trial for alcohol treatment in the UK (UKATT). For the study reported in this paper SBNT was adapted for application with drug users. Therapists (N=20) from community drug services in Birmingham, UK, were trained to deliver the intervention. Training methods were supported by a treatment manual and included a two-day workshop followed by video supervision and monitoring. Following training therapists were asked to implement the treatment within the services in which they worked. Twelve of the therapists that were trained delivered SBNT to 24 clients within the study period of 8 months. Baseline and 3-month follow-up measures were administered using both quantitative and qualitative methods. This paper reports the quantitative results including drug use, levels of dependence, drug users' social network variables and family environment. Results suggest that it was feasible to train a number of therapists to deliver SBNT, and preliminary outcome results are encouraging. Further evaluation is needed in order to continue developing this promising social intervention.

Adult↗

PubMed2005

Meta-analysis of therapeutic relationship variables in youth and family therapy: the evidence for different relationship variables in the child and adolescent treatment outcome literature.

This meta-analysis examines associations between therapeutic relationship variables, and the extent to which they account for variability in treatment outcomes, in 49 youth treatment studies. Correlations between therapeutic relationship variables ranged from modest to strong. Among the best predictors of youth outcomes were counselor interpersonal skills, therapist direct influence skills, youth willingness to participate in treatment, parent willingness to participate in treatment, youth participation in treatment, and parent participation in treatment. Adequacy of current approaches to conceptualizing and measuring therapeutic relationship variables, such as the therapeutic alliance, in youth and family therapy is discussed. This paper represents the most comprehensive analysis of therapeutic relationship constructs in the youth treatment literature.

Adolescent↗

PubMedDate not supplied

The issue of race and the client-therapist assignment.

The client-therapist assignment can play an important part in the client's therapy. The impact of the variable of race within the psychotherapeutic process is an issue of ongoing controversy, and studies supply support for both same-race and differing-race dyads. With same-race assignments not always being accessible, it is the responsibility of the therapist treating the racially differing client to examine his or her own biases, motives, and countertransference problems that arise during the client's course of treatment.

Adolescent↗

PubMed2001

Does experience influence judgments of pain behaviour? Evidence from relatives of pain patients and therapists.

OBJECTIVE: Judgments about an individual's pain can be profoundly important to sufferers. Relatively few studies have examined variables that may affect observers' judgments of the pain of others. The present article reports two studies investigating the relationship between different kinds of exposure to pain problems and observers' ratings of the pain intensity of patients. DESIGN: In the first study, 82 observers were classified into groups with positive and negative family histories of chronic pain. They viewed a videotape showing the facial expressions of shoulder pain patients undergoing physiotherapy assessments and rated the pain experienced by the subjects. In the second study, the data from observers having no experience with pain problems were compared with data collected from therapists having considerable experience with pain problems. RESULTS: Observers with a positive family history of chronic pain attributed greater pain to the patients than those with a negative family history of chronic pain. Professionals' pain judgments were lower than those of control subjects. CONCLUSIONS: Together, the findings imply that one's experiences with the different problems of pain patients may affect pain judgments. Alternative interpretations of the findings are considered.

Adult↗

PubMed1993

Factors associated with burnout of physical therapists in Massachusetts rehabilitation hospitals.

BACKGROUND AND PURPOSE: The purpose of this study was to determine the factors associated with burnout in physical therapists at rehabilitation hospitals. Burnout is a serious concern because it can lead to psychosomatic complaints, work-associated withdrawal behaviors, and a decreased quality of care. SUBJECTS: Full-time, nonadministrative, nonsupervisory, staff physical therapists working in inpatient settings in rehabilitation hospitals in Massachusetts were surveyed. METHODS: The survey included demographic data, the Maslach Burnout Inventory (MBI), and questions designed to address attributes of the work environment and individual personalities. The MBI scores were calculated according to instructions provided by publishers to determine the degree of burnout experienced by this group. Questions involving personality and work environment were submitted to factor analyses. Multivariate analyses were done to determine the factors related to burnout. RESULTS: Forty-six percent of the respondents scored high on the emotional exhaustion subscale of the MBI, 20% scored high on the depersonalization subscale, and 60% scored low on the personal accomplishment subscale. As a whole, the sample demonstrated moderate burnout. Three factors emerged from the factor analysis. The factors communication/connectedness, achievement, and time constraints accounted for 69% of the variability in emotional exhaustion and 73% of the variability in depersonalization and personal accomplishment. Burnout was not significantly associated with the therapists' number of years of practice, number of years on the job, or number of patients seen daily. CONCLUSION AND DISCUSSION: Recognition of factors contributing to burnout may prove to be instrumental in the prevention of burnout in physical therapists and the problems that arise from it.

Adult↗

PubMed1988

Assessing continuing education needs of five allied health professions in rural California.

Meeting the needs of rural health care professionals for continuing education remains a challenge for health planners. An assessment of these needs is the focus of this survey of rural practitioners. A continuing education needs survey of five allied health professions in an agricultural region of California was conducted. Variables selected related to professional education and retention and included paramedics, physical therapists, pharmacists, clinical psychologists, and medical technologists. Results indicated a strong need for high quality, moderate cost, locally offered continuing education seminars. Access to professional literature searches was also regarded as important. Several of the selected health profession groups were concerned about maintaining licensure; most intended to remain in their professions for at least six to ten years. These survey findings clearly suggest a need for centrally coordinated continuing education opportunities for allied health personnel in rural service delivery areas.

Allied Health Personnel↗