Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Therapist variable”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources
PubMed1991

Applying statistical control theory to bring together clinical supervision and psychotherapy research.

A three-factor experiment was designed to evaluate the potential for improving first-session performance of 6 trainee-therapists as measured by postsession client ratings (N = 48). Rather than through standardizing therapist behavior by using a training manual beforehand, therapist effects were handled through statistical control. This method not only provided control so that findings were not confounded with some kinds of therapist effect but also identified which therapists needed supervision to bring their performance more in line with others in the group. Reducing the number of therapists requiring "standardization" should lower training costs and enhance individual freedom. In the present study, more frequent empathic responses led to statistically significant beneficial effects on five of seven outcome measures. Suggestions volunteered by therapists improved overall session ratings on three variables and increased scores on a measure of passive dependence. Whether or not therapists asked questions had no main effects on any tested outcome measure.

Adult↗
PubMedDate not supplied

Attitudes of occupational therapists toward spirituality in practice.

OBJECTIVE: This study examined (a) occupational therapists' attitudes about spirituality in practice on the basis of whether they identified themselves as religious, (b) whether their personal definition of spirituality related to their religiousness, (c) whether their definition related to their attitude about spirituality in practice, and (d) the methods they used to address the spiritual needs of clients. METHOD: An attitude questionnaire was developed and mailed to 396 American occupational therapists. Fifty-two percent (n = 206) of the mailed questionnaires were analyzed. RESULTS: Overall, participants indicated a slightly positive attitude toward spirituality in occupational therapy practice. Participants who considered themselves to be religious indicated a more positive view toward spirituality in practice than those who did not consider themselves to be religious. Religiousness accounted for only 28% of the variance in choice of spirituality definition, indicating that additional variables account for what determines therapists' definitions of spirituality. No relationship was found between personal definition choice and attitude regarding spirituality in practice. The three methods most commonly used to address the spiritual needs of their clients were to (a) pray for a client, (b) use spiritual language or concepts with a client, and (c) discuss with clients ways that their religious beliefs were helpful. CONCLUSION: Therapists' conceptualization of spirituality and attitudes about spirituality in occupational therapy practice are quite diverse.

Attitude of Health Personnel↗
PubMed1994

Intrinsic and extrinsic predictors of work satisfaction in ambulatory care and hospital settings.

This study assessed the ability of selected intrinsic and extrinsic variables to predict allied health practitioners' work satisfaction in ambulatory care and hospital settings. A total of 413 occupational and physical therapists in Virginia, North Carolina, and South Carolina provided data via a mailed survey. Multiple regression analyses examined the predictive power of selected intrinsic and extrinsic variables upon therapists' work satisfaction in the ambulatory care and hospital setting. The regression model for therapists in ambulatory care settings was a better predictor of work satisfaction than the model for therapists in the hospital setting. Results indicated that respondents' intrinsic orientation toward their work, and their perception of the general working conditions in the organization were two of the strongest predictors of their work satisfaction in the ambulatory care and hospital setting. The findings provide information that can be useful in developing recruitment and retention strategies in both work settings.

Adult↗
PubMed1993

Preliminary evaluation of high-frequency chest compression for secretion clearance in mechanically ventilated patients.

BACKGROUND: A high-frequency chest compression (HFCC) device called the ThAIRapy System has been developed to provide secretion clearance therapy. We evaluated the safety, efficacy, and utility of the device in long-term mechanically ventilated patients. DESCRIPTION OF DEVICE: The primary components of the device are an air-pulse generator and an inflatable vest. Small gas volumes are alternately injected into and withdrawn from the vest by the air-pulse generator at a fast rate, creating an oscillatory or vibratory motion. The pulses cause the vest to inflate and deflate against the thorax of the patient. EVALUATION METHODS: We evaluated HFCC by comparing it to percussion and postural drainage therapy (P&PD); sputum production, patient comfort (PC), pulse-oximetry saturation (SpO2), heart rate (HR), and blood pressure (BP) data were collected and compared between the 2 methods. We monitored the reliability of the device and distributed a survey questionnaire to the entire respiratory therapy staff to assess utility. EVALUATION RESULTS: Nine patients completed the safety and efficacy portion of our evaluation. No significant difference was found between P&PD and HFCC in the wet weight of collected sputum, the mean change-in-percent of SpO2 or the mean percent change from baseline in HR, BP, or PC. All therapists believed that the ThAIRapy System was easy to learn, and 70% considered it an acceptable alternative to P&PD. Of the staff members surveyed, 80% believed that use of the HFCC device resulted in time savings in all or most cases. There were no equipment malfunctions in 225 hours of use. CONCLUSIONS: Compared to P&PD, HFCC via the ThAIRapy System may be equally efficacious in promoting secretion clearance in long-term mechanically ventilated patients. HFCC is neither more nor less safe for patients than is P&PD using SpO2, HR, BP, and PC as outcome variables. Most of our respiratory therapists perceived HFCC as an acceptable alternative to P&PD.

Data Collection↗
PubMed2003

Patient-practitioner agreement: does it matter?

BACKGROUND: Good communication is a crucial clinical skill. Previous research demonstrated better clinical outcomes when practitioners and patients agree about the nature of patients' core presenting complaints. We investigated the nature of this agreement and its impact on outcome among depressed primary care patients. METHOD: We compared presenting problem formulations completed by patients, GPs and therapists in a primary care randomized controlled trial of cognitive-behavioural therapy and non-directive counselling for depression. Participants compiled formulations from a list of 13 potential problems of self-completed questionnaires. Subjects scored at least 14 on the Beck Depression Inventory (BDI) at baseline. Outcome measure for this study included BDI at 4 and 12 months, failure to attend for therapy when referred, dropout from therapy and patient satisfaction. RESULTS: Among 464 trial patients, 395 received therapy. Patient baseline problem formulations included significantly more items than GPs, who identified significantly more items than therapists. Agreement levels varied according to a range of patient and professional variables. While patients in complete agreement with their therapists about their main problem after assessment had lower average BDI scores at 12 months (9.7 v. 12.8, P=0.03); we found no other significant associations between the extent of agreement and clinical outcome. There were significant (but relatively weak) associations between agreement and aspects of patient satisfaction. CONCLUSION: Our results suggest that detailed mutual understanding of the presenting complaints may be less important than agreement that the core problem is psychological, and that referral for psychological therapy is appropriate.

Adolescent↗
PubMed1988

Effects of intimacy of therapist's self-disclosure and formality on perceptions of credibility in an initial interview.

A therapist's expertness, trustworthiness, empathy, and attractiveness were evaluated by 300 subjects after viewing a 5-min. videotape of a therapist-client interaction. Therapist's level of self-disclosure and formality were the independent variables. Ratings of trustworthiness were highest when the therapist was informal. Therapist's high disclosure of depression yielded decreased ratings of attractiveness, empathy, and expertness in comparison with no disclosure by the therapist.

Adult↗
PubMed1992

Retention of cocaine abusers in outpatient psychotherapy.

Retention in outpatient psychotherapy of 148 crack and cocaine abusers was examined. The clients were predominantly Black (63%) and Hispanic (21%), predominantly male (87%), and the majority (66%) had completed no more than 12 years of high school. Clients entered treatment in a low-cost treatment center in New York City between June 1987 and November 1988. Forty-two percent (62) of the subjects were seen for one or two research interviews only, and did not return to begin therapy. Of the 86 persons who came to at least one therapy session, 30% (26) dropped out before the third session, 28% (24) dropped out between the third and fifth sessions, and 42% (36) were retained for six or more sessions. Short-term and longer-term retentions were analyzed separately, using a battery including sociodemographic variables, treatment history, psychiatric symptomatology, number of arrests, and drug use variables. None of the variables considered was significantly related to short-term retention. There were large although not significant differences in longer term retention by therapist. Longer-term retention was associated significantly with being White (contrasted with being Black) and being young. Nonsignificant but large associations were found between longer-term retention and having few arrests, being Hispanic (contrasted with being Black), and having low SCL-90 scores. Results are compared with previous findings about retention in drug and alcohol treatment. It is suggested that future research on retention in treatment focus less on client variables and more on therapist and program variables.

Adult↗
PubMed1995

[Prognostic factors for the success of psychoanalytically founded inpatient psychotherapy].

In the scope of our study for evaluation of the differential effect of inpatient psychotherapy we investigated by retrospective analysis of data at admission and 6. week of treatment, which factors were prognostic relevant for therapy success. We defined therapy-success as an equally weighted combination of patients' assessment of satisfaction with treatment success, which was evaluated by the Helping Relationship Questionnaire of Luborsky (1984), and the therapists' assessment of symptomatic and ego-structural improvement of the patients. For the variables, which were related to the patients or therapists, especially the therapists' judgement of the ego-structural disturbance of the patients (r = -.43, N = 218, p < 0.1) and motivation for psychotherapy (r = .27, N = 70, p < .01) exhibited relevant prognostic potency. The variables concerning the therapeutic relationship however gained increased prognostic value first after six weeks of treatment duration.

Adolescent↗
PubMed2006

Using HFMEA to assess potential for patient harm from tubing misconnections.

BACKGROUND: Reported cases of tubing misconnections and other tubing errors prompted Columbus Children's Hospital to study their potential for harm in its patient population. A Health Failure Mode and Effects Analysis (HFMEA) was conducted in October 2004 to determine the risks inherent in the use and labeling of various enteral, parenteral, and other tubing types in patient care and the potential for patient harm. METHODS: An assessment of the practice culture revealed considerable variability among nurses and respiratory therapists within and between units. Work on an HFMEA culminated in recommendations of risk reduction strategies. These included standardizing the process of labeling of tubing throughout the organization, developing an online pictorial catalog to list available tubing supplies with all aliases used by staff, and conducting an inventory of all supplies to identify products that need to be purchased or discontinued. Three groups are working on implementing each of the recommendations. RESULTS: Most of the results already realized occurred in labeling of tubing. The pediatric intensive care unit labels all tubing with infused medications 85% of the time; tubings inserted during surgery or in interventional radiology are labeled 53% and 93% of the time. Pocket-size cards with printed labels were tested in three units. DISCUSSION: This proactive risk assessment project has identified failure modes and possible causes and solutions; several recommendations have been implemented. No tubing misconnections have been reported.

Catheterization↗
PubMed2003

Expression of affect as a mediator of the relationship between quality of object relations and group therapy outcome for patients with complicated grief.

In a recent study, the patient characteristic quality of object relations (QOR) was directly related to favorable outcome (reduction of grief symptoms) among a sample of 53 outpatients with complicated grief who completed treatment in 1 of 8 time-limited, interpretive therapy groups. Recent research literature has suggested that patient affect variables may mediate the relationship between QOR and outcome. In the present study, affect variables were investigated as potential mediating variables using the procedure developed by R. M. Baron and K. A. Kenny (1986). The balance of positive and negative affect expressed in therapy as rated by both patients and therapists emerged as a significant mediating variable. Explanations for how this variable works as a mediating variable and why it facilitates favorable outcome were offered. Clinical implications are also considered.

Adult↗
PubMed1990

Loss items on the Schedule of Recent Events (SRE): duration of psychotherapy.

High scores on the Schedule of Recent Events (SRE; Holmes & Rahe, 1967) have been correlated with a high number of subsequent visits for medical or psychological intervention. This study examined the relationship between psychotherapy visits and endorsement of loss items on the SRE. Items that correlated significantly with length or duration of psychotherapy were: divorce (p less than .005); death of a close family member (p less than .07); fired at work (p less than .001); and a son or daughter leaving home (p less than .07). Additional variables are predetermined by the therapist and the clinical setting, so that the observed correlation between high SRE scores and subsequent psychotherapy should be validated in other settings.

Adult↗
PubMedDate not supplied

Reducing venipuncture and intravenous insertion pain with eutectic mixture of local anesthetic: a meta-analysis.

BACKGROUND: The eutectic mixture of local anesthetics (EMLA), by producing dermal anesthesia through contact with intact skin, has become a major indication for the reduction of pain experienced during venipuncture (VE) and intravenous (IV) insertion. OBJECTIVES: The purpose of the study was to determine the mean effect sizes and moderators of EMLA cream application in reducing VE and IV insertion pain. METHOD: A meta-analysis of 20 studies was conducted to determine the magnitude of the effect of EMLA cream on VE and IV insertion pain. Effect sizes were calculated three ways: weighted, unweighted, and weighted by quality index score. Potential moderating variables of sample age, premedication, therapist control, insertion site, application duration, research design, pain scale, and funding, were investigated for their influence on EMLA's effect. RESULTS: EMLA cream had a large significant effect on VE pain (d = 1.05) with a 95% confidence interval from.92 to 1.34 and a large significant effect on IV insertion pain (d = 1.04) with a 95% confidence interval from.84 to 1.46. Subject age (child versus adult), type of pain scale, number of therapists, location of insertion site, premedication, funding, or study design did not appear to act as effect modifiers. CONCLUSIONS: EMLA cream can significantly decrease VE and IV insertion pain in 85% of the population.

Anesthetics, Combined↗
PubMed1992

The reflexive loop of past, present, and future in systemic therapy and consultation.

Time is one of the most basic social constructions. There are several different "times" (individual, social, cultural). This article deals with the time variable in systemic therapy--a most important variable, but often underestimated by therapists--and seeks to illustrate, with clinical examples, the peculiar interplay of past, present, and future in the therapy session. The co-creation of the past and future in the therapeutic system is also considered, together with the different temporal horizons of the family therapist and the observation team. In our view, time is one of the key issues in successful therapy: consideration of time can open new perspectives in both therapy and research.

Family Therapy↗
PubMed2000

Multisystemic therapy: monitoring treatment fidelity.

The challenges of specifying a complex and individualized treatment model and measuring fidelity thereto are described, using multisystemic therapy (MST) as an example. Relations between therapist adherence to MST principles and instrumental and ultimate outcome variables are examined, as are relations between clinical supervision and therapist adherence. The findings provide modest support for the associations between MST adherence measures and instrumental and ultimate outcomes. Results also show that adherence can be altered when clinical supervision and adherence monitoring procedures are fortified. The modest associations between adherence measures and youth outcomes argue for further refinement and validation of the MST adherence measure, especially in light of the well-established effectiveness of MST with challenging clinical populations and the increasing dissemination of MST programs.

Family Relations↗
PubMed2006

Correlates of the MMPI-2 restructured clinical (RC) scales in a college counseling setting.

We designed this study to identify empirical correlates on the MMPI-2 (Butcher et al., 2001) restructured clinical (RC) scales in a college counseling setting with a sample of 228 men and 522 women from a university-based psychological clinic. Participants were administered the MMPI-2 at intake and were rated by their therapists on a variety of variables including a 192-item Client Description Form. The findings indicate that the RC scales were generally most strongly correlated with conceptually relevant criteria and generally uncorrelated with conceptually nonrelevant criteria, which replicated findings of convergent and discriminant validity from previous studies. Follow-up analyses indicate that the RC scales have improved discriminant validity in comparison to the clinical scales and stronger convergent validity than a set of alternative MMPI-2 measures.

Adult↗
PubMed1985

The effect of social class and cognitive orientation on clinical expectations.

Therapists have been found to have more favourable expectations of clients from similar social class backgrounds than of clients from dissimilar social class origins. This relationship is unlikely to be simple. Cognitive variables most probably function as mediators between social class and expectations about therapeutic benefit. In particular, it was hypothesized that the variable, locus of control, would mediate therapists' clinical expectations. Two studies, involving clinical psychologists, tested this prediction. Therapists were asked to estimate their likely success with clients presented in the form of vignettes and role plays. The vignettes and role plays depicted the social class and locus of control of clients. Results indicate that there was a significant interaction between client's and therapist's locus of control in relation to therapists' judgements of therapeutic success.

Adult↗
PubMed1992

Application form items as predictors of performance and longevity among respiratory therapists: a multiple regression analysis.

UNLABELLED: Errors in employee selection and consequent high turnover rates are expensive and can result in poor staff morale and possible harm to patients and personnel. METHOD: We investigated the predictive validity of commonly used application blank items as measures of future performance, absenteeism, tardiness, and tenure (the criterion variables) among 100 hospital-employed respiratory therapists and looked at the relationships among the criterion variables. RESULTS: Regression analysis showed the most significant predictive variables to be grade point average in respiratory therapy school, college education in addition to respiratory therapy training (particularly an associate degree in health sciences or a baccalaureate degree), and, surprisingly, the neatness of the application form itself. No important differences were found among the types of respiratory therapy program attended or the length of previous respiratory therapy experience. CONCLUSION: The data offer cautious evidence for the validity of some application items to predict some employee behaviors. The relatively low correlations among the criterion variables (absenteeism, tardiness, tenure, and performance) suggest that these items may be assessing substantially different aspects of employee behavior.

Absenteeism↗
PubMed2005

Initial experience with megavoltage (MV) CT guidance for daily prostate alignments.

PURPOSE: The on-board megavoltage (MV) computed tomography (CT) capabilities of a TomoTherapy Hi*ART unit were used to obtain daily MVCT images of prostate cancer patients. For patient alignment the daily MVCT image needs to be registered with the planning CT image to calculate couch shifts. Three manual techniques of registering the MVCT images with the planning kilovoltage (kV) CT images were evaluated. The techniques are based on visual alignment of (1) fiducial prostate markers, (2) CT anatomy, and (3) kVCT contours. METHODS AND MATERIALS: One hundred and twelve alignments from 3 patients were available for analysis. The radiation therapists visually registered the MVCT images with the planning kVCT images based on fiducial markers for actual patient alignment. Retrospectively, the therapists registered each image set using anatomy and contour-based techniques. In addition to the therapists, a physician retrospectively registered each image set based on each of the three techniques. For each MVCT to kVCT image pair a reference alignment was computed from the center-of-mass (COM) of the three fiducial markers. All registration results were compared with these reference alignments. The physician's image registrations were compared with the radiation therapists' registrations to assess the user variability of the different techniques. RESULTS: The marker-based registration results agree best with the reference alignments, while the contour-based registrations show the least degree of agreement. Using anatomy and contour-based registrations, the radiation therapist's alignments differed by > or = 3 mm from the reference alignments in 24%, 33%, and 3% and 55%, 48%, and 21% of all registrations in the anterior-posterior, superior-inferior, and lateral directions, respectively. The respective values for the marker-based alignments were 3%, 6%, and 3%. The physician's registrations showed the same general trend. The marker-based registrations showed the least amount of inter-user variability while the contour-based ones showed the most. CONCLUSION: The use of fiducial markers for MVCT image guidance is advantageous to reduce the inter-user variability of the image registration. If fiducial markers are not used, anatomy-based registrations outperform contour-based registrations in terms of (1) agreement with a reference alignment and (2) inter-user variability.

Calibration↗