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Results for “Therapist variable”

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At least 55 records · Page 3Linked to original sources
PubMed1995

Use of a spinal model to quantify the forces and motion that occur during therapists' tests of spinal motion.

BACKGROUND AND PURPOSE: Despite the widespread use of spinal mobilization, little is known about the forces used or the accuracy of therapists in estimating the forces they use in administering the technique. The purposes of this study were to quantify the forces used and to determine the accuracy of therapists in applying forces on a mechanical model. SUBJECTS: Ten physical therapists participated. METHODS: A spinal model was used to measure applied force and displacement under different conditions of stiffness. The therapists applied oscillatory posteroanterior mobilizations to the model under three different conditions of stiffness. RESULTS: Mean peak forces across grades and stiffness levels ranged between 57.59 and 178.27 N. The forces were generally lower in the least stiff condition. Displacement varied with stiffness and mobilization grade. In the least stiff condition, the mean displacement varied between 2.25 and 3.45 mm for grades 1 to 4, respectively. CONCLUSION AND DISCUSSION: Inter-therapist variability was high, and there was a systematic bias in underestimating the magnitude of applied force and in overestimating motion. The variability in force application and the general overestimation of motion detection may explain the poor reliability of measurements obtained with clinical tests based on motion palpation.

Adult↗
PubMed1998

The parental alliance following divorce: an overview.

The empirical literature on the postdivorce parental alliance was reviewed with a focus on implications for clinical interventions by family therapists. Variables of cooperation and conflict between parents, individual parenting style, and personal adjustment were significantly interrelated and a range of co-parenting behaviors related to these variables was documented. A typology of divorcing families can be useful in predicting risks for child difficulties and in developing appropriate parenting plans. Clinical interventions need to be tailored to the unique characteristics and resources of a given family and can speak to multiple points of the family system.

Conflict, Psychological↗
PubMed2003

Representations of therapists by patients with personality disorders.

The purpose of this study was to investigate attributes of mental representations of therapists by patients with specific personality disorders (PDs), schizotypal (STPD), borderline (BPD), avoidant (AVPD), and obsessive-compulsive (OCPD), and a comparison group with Major Depressive Disorder and no PD (MDD). The Therapist Representation Inventory-II (TRI) measured characteristics of participants' extra-session thoughts about their therapists. Results showed that patients with STPD had the highest level of mental involvement with therapy outside the session, missing their therapists and wishing for friendship, while also feeling aggressive or negative. Patients with BPD exhibited the most difficulty in creating a benign image of the therapist. Variables such as gender, co-occurring Axis I disorders, and amount of individual psychotherapy received were significant covariates for a number of analyses. The importance of understanding the internal dynamics of patients' thoughts about their treatment relationship was underscored.

Adolescent↗
PubMed2005

Gait cinematic analysis in morbidly obese patients.

BACKGROUND: Functional co-morbidities of excess body weight such as gait problems are never life-threatening like those associated with certain metabolic sequelae. Nevertheless, they may interfere with quality of life and also act as a mirror of muscle, bone and joint stress. In this prospective study, the goal was to document dynamic aspects of gait in severely obese subjects. METHODS: An outpatient population (age 47.2+/-12.9 years, 94.1% females, BMI 40.1+/-6.0 kg/m2, n=34) had their gait analyzed by an experienced physical therapist. Variables included speed, cadence, stride, support base and foot angle, which were compared to reference values for the Brazilian population. RESULTS: All variables were significantly lower in the obese patients, except for support base which was increased. Speed was 73.3+/-16.3 vs 130 cm/s, cadence was 1.4+/-0.2 vs 1.8 steps/s, stride was 106.8+/-13.1 vs 132.0 cm, and support was 12.5+/-3.5 vs 10.0 cm (P<0.05). CONCLUSIONS: 1) Widespread cinematic impairment was the rule in the studied population. 2) These findings are consistent with poor skeletal muscle performance, high metabolic expenditure and constant physical exhaustion. 3) Attention should be paid not only to the metabolic management but also to the physical rehabilitation required in cases of advanced obesity.

Body Mass Index↗
PubMed1999

["Ideal" inpatient psychiatric treatment from the viewpoint of the patients].

PURPOSE: In this study "ideal" psychiatric inpatient care from the patient's point of view was examined. METHODS: Based upon a content analysis of 38 interviews a questionnaire containing 39 items was developed to evaluate attributes of ideal psychiatric inpatient care from the patient's viewpoint. 58 of 116 patients completed the questionnaire; the analysis group was representative for acute psychiatric inpatients. RESULTS: The patients ranked highly: successful treatment, upholding of human rights, privacy, empathic doctors, competent doctors, free exit, friendly staff. Factor analysis identified four factors that may be called Psychiatric Treatment, Patient Autonomy. Staff Competence, Appointment. The ratings were not associated with sociodemographic or disease-related variables. Therapists' ratings were mostly in agreement with those of the patients', but therapists underestimated the importance of the items free exit, patients' co-influence in treatment planning, respect among the patients. The aspect of patient autonomy was also rarely found in other professionals' questionnaires. CONCLUSIONS: Findings reflecting patients' expectations regarding "ideal" psychiatric inpatient care vary. Validity of former questionnaires is reduced if important aspects of patient satisfaction are disregarded.

Germany↗
PubMed2000

Cognitive and family therapies for adolescent depression: treatment specificity, mediation, and moderation.

The specificity of cognitive and family therapies, and potential treatment mediators and moderators, was examined in a randomized clinical trial for adolescent depression. After acute treatment, cognitive-behavioral therapy (CBT) exerted specific effects on cognitive distortions relative to either systemic-behavioral family therapy (SBFT) or nondirective supportive therapy (NST). At 2-year follow-up, SBFT was found to impact family conflict and parent-child relationship problems more than CBT; NST and CBT tended to show a greater reduction in anxiety symptoms than SBFT. Nonspecific therapist variables qualified few outcome analyses. No measures of cognitive distortion or family dysfunction mediated or moderated treatment outcome. As in adult studies, relatively few areas of treatment specificity or mediation were identified. The implications of these findings for clinical treatment and research in adolescent depression are discussed.

Adolescent↗
PubMed1997

Manual development for the treatment of child and adolescent disorders.

There has been a proliferation of treatment manuals in the past decade as part of an effort to operationalize treatment applications and standardize treatments across subjects, settings, and therapists. In this article we present the essential elements needed to develop manuals for the psychosocial and psychopharmacological treatments of child and adolescent disorders, using one modality or in multimodal treatment trials. We delineate how to integrate various treatment components for psychosocial and psychopharmacological manuals, as well as those for control conditions. We also examine the therapist variable as it concerns training and adherence to the structured or flexible scripted manuals. Finally, we discuss the advantages and disadvantages of manuals in terms of how they may affect outcome, recommending that treatments be both empirically grounded and clinically meaningful.

Adolescent↗
PubMed2005

Estimating variability in outcomes attributable to therapists: a naturalistic study of outcomes in managed care.

To estimate the variability in outcomes attributable to therapists in clinical practice, the authors analyzed the outcomes of 6,146 patients seen by approximately 581 therapists in the context of managed care. For this analysis, the authors used multilevel statistical procedures, in which therapists were treated as a random factor. When the initial level of severity was taken into account, about 5% of the variation in outcomes was due to therapists. Patient age, gender, and diagnosis as well as therapist age, gender, experience, and professional degree accounted for little of the variability in outcomes among therapists. Whether or not patients were receiving psychotropic medication concurrently with psychotherapy did affect therapist variability. However, the patients of the more effective therapists received more benefit from medication than did the patients of less effective therapists.

Adult↗
PubMed1994

Sequences of emotional distress expressed by clients and acknowledged by therapists: are they associated more with some therapists than others?

When clients come to psychotherapy they are distressed, this distress usually being expressed in the form of anxiety, hostility, depression and helplessness. This study explored the sequences of emotional distress expressed by clients and acknowledged by therapists, and examined their associations with other factors. The transcripts of five therapists (two single sessions each) were content-analysed: they used personal construct, client centered, rational-emotive, Gestalt and transactional analysis therapy. Log-linear analyses of appropriate contingency table cell frequencies were conducted to test associations between identified sequences and the two variables of therapist and timing of completion of the sequence. Therapist-client sequences of Anxiety-Anxiety, Anxiety-Hostility and Helplessness-Hostility were found to be associated more with the personal construct and client centred therapists than with the rational-emotive therapist. Client-therapist sequences of Anxiety-Anxiety, Helplessness-Anxiety and Helplessness-Helplessness were more often found with the client centred therapist than the other therapists. For most of these sequences timing had an effect, yet timing rarely interacted with the therapist variable. The findings are discussed in terms of their relevance to the theoretical positions represented, the shortcomings of the research and the value of this methodology in studies linking therapy process with outcome.

Anxiety↗
PubMed1979

Epidemiology of hip fracture. A review with implications for the physical therapist.

Patient variables associated with the occurrence of hip fracture are reviewed, with advanced age, the female sex, and the white race being the most notable variables. Findings from studies relating patient variables to treatment results are also presented. The strongest predictors of poor treatment results are 1) age greater than 75 years, 2) cerebral dysfunction, 3) multiple secondary problems, and 4) low prefracture functional status. Relevance of this knowledge for physical therapists engaged in education, research, and clinical practice is discussed, concluding that knowledge of epidemiology is important to physical therapists' general information on hip fracture.

Age Factors↗
PubMed2006

State regulation and the delivery of physical therapy services.

OBJECTIVE: The study purpose was to examine the relationship between state regulations of physical therapists (PT) and three dependent variables: physical therapist assistant (PTA) utilization more than 50 percent of the time during the treatment episode (high PTA utilization), number of visits, and patient self-reported functional health status (FHS) at discharge. We evaluated regulations governing licensure of PTAs, PT/PTA ratio, frequency of PT re-evaluation, and PTA supervision. DATA SOURCE: The analytic sample included 63,900 patients from 38 states drawn from 395 clinics who participated in the Focus on Therapeutic Outcomes Inc. (Knoxville, TN) database in 2000 and 2001. STUDY DESIGN: Using a Bayesian modeling approach with the Markov Chain Monte Carlo estimation method, we fitted separate multilevel multivariate regression models predicting high PTA utilization, number of visits, and discharge FHS. DATA COLLECTION METHODS: Patients completed FHS surveys at intake and discharge. Clinicians recorded the number of visits and percentage of time a patient spent with each provider. PRINCIPAL FINDINGS: After controlling for patient, therapist, and clinic characteristics, the presence of state regulations regarding PTA supervision was not associated with the likelihood of high PTA utilization. High PTA utilization and regulations requiring full-time onsite supervision were associated with more visits, whereas regulation of PT/PTA ratio was associated with fewer visits. Supervisory regulations were associated with better discharge FHS. High PTA utilization and use of therapy aides were associated with more visits per episode and lower discharge FHS. CONCLUSIONS: The use of care extenders in place of PTs is likely to result in less efficient and lower quality care in outpatient rehabilitation.

Adult↗
PubMed1991

Quality of mental health services and method of payment: an empirical study.

Data from a sample of clinicians are examined to study the relationship of the lower socio-economic client and therapist. Therapist practice variables are regressed on variables measuring client income and contrasting client's use of Medicaid with the use of private insurance or out-of-pocket funds. It is found that therapist practice variables can predict a significant proportion of the variance of these criterion variables. These relationships and their implications for the therapeutic needs of indigent clients with less severely impaired conditions are discussed.

Analysis of Variance↗
PubMed1994

Validity and reliability of a new assessment of lower-extremity dysfunction.

BACKGROUND AND PURPOSE: A 20-variable assessment system for evaluation of lower-extremity dysfunction has been constructed with special consideration of the needs of the physical therapist. The variables are classified into five subgroups: hip impairment, knee impairment, physical disability, social disability, and pain. SUBJECTS: One hundred five patients with osteoarthrosis of the hip and knee, all accepted for total joint replacement arthroplasty, were tested. The mean age of the patients was 69 years (SD = 9.0, range = 46-91). METHODS: The original grouping of the variables was analyzed for content validity with a factor analysis. The results from a subgroup of 42 patients were tested for intertester reliability with the Goodman-Kruskal gamma coefficient. RESULTS: The factor analysis indicated a factor solution consistent with the primary grouping except for two variables. The correlation between two independent physical therapists was .99 to 1.00 for different variables, indicating excellent intertester reliability. CONCLUSION AND DISCUSSION: In the authors' opinion, the new assessment system provides a reasonably valid, reliable, inexpensive, and easy-to-use measurement and fulfills the needs of the physical therapist for functional evaluation of the lower extremity.

Activities of Daily Living↗
PubMed1985

Variables that contribute to leadership among female occupational therapists.

This study determined which variables differentiated occupational therapy leaders from nonleaders and identified factors that contributed to leadership. The subjects were 405 occupational therapists 36 to 74 years old. Some (79) were leaders in the field, and others (326) were randomly selected members of The American Occupational Therapy Association who did not occupy leadership roles. Eighty-nine percent of the questionnaires were returned. Few demographic differences separated the two groups; however, the findings showed that a substantial portion of the leaders shared experiences in childhood, adolescence, and early adulthood that the nonleaders did not share. Leaders viewed themselves as leaders, desired leadership, and saw leadership as an appropriate activity for women. Their view of the female role was less traditional than that of nonleaders. They married much less frequently; those who did marry had fewer children. Most married leaders' husbands highly supported their wives' leadership activities.

Adult↗
PubMed1984

Treatment noncompliance as a function of therapist attributes and social support.

Premature termination of short-term psychotherapy was examined as a function of therapist and social support variables. Patient perceived therapist competence, knowledge, relaxed manner, understanding of the help wanted, attitude, acceptance, listening ability, and sensitivity differentiated Continuers from Terminators. Although few of the social support variables were related to the mode of treatment termination, Continuers were found to be more likely than Terminators to have discussed attendance at the Clinic with others, especially family members. These findings were discussed in terms of their relevance to treatment of the emotionally ill and to the training of clinicians.

Clinical Competence↗