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At least 19 recordsLinked to original sources
PubMed2006

Decision-making ability of physical therapists: physical therapy intervention or medical referral.

BACKGROUND AND PURPOSE: Opponents of direct access to physical therapy argue that physical therapists may overlook serious medical conditions. More information is needed to determine the ability of physical therapists to practice safely in direct-access environments. The purpose of this study was to describe the ability of physical therapists to make decisions about the management of patients in a direct-access environment. SUBJECTS: Of a random sample of 1,000 members of the Private Practice Section of the American Physical Therapy Association, 394 participated. METHODS: A survey included 12 hypothetical case scenarios. For each case, participants determined whether they would provide intervention without referral, provide intervention and refer, or refer before intervention. The percentage of correct decisions for each group of scenarios was calculated for each participant, and participants were classified as having made correct decisions for 100% of cases or less for each group. Three sets of logistic regressions were completed to determine the characteristics of the participants in relation to the decision category. RESULTS: The average percentages of correct decisions were 87%, 88%, and 79% for musculoskeletal, noncritical medical, and critical medical conditions, respectively. Of all participants, approximately 50% made correct decisions for all cases within each group. The odds of making 100% correct decisions if a physical therapist had an orthopedic specialization were 2.23 (95% confidence interval=1.35-3.71) for musculoskeletal conditions and 1.89 (95% confidence interval=1.14-3.15) for critical medical conditions. DISCUSSION AND CONCLUSION: Physical therapists with an orthopedic specialization were almost twice as likely to make correct decisions for critical medical and musculoskeletal conditions.

Adult↗
PubMed1999

Cause, prevalence, and response to occupational musculoskeletal injuries reported by physical therapists and physical therapist assistants.

BACKGROUND AND PURPOSE: Physical therapists (PTs) and physical therapist assistants (PTAs) are susceptible to occupational musculoskeletal injuries. The purpose of this study was to examine the reported causes and prevalence of occupational musculoskeletal injuries to PTs and PTAs during a 2-year period. SUBJECTS: A questionnaire was mailed to 500 PTs and 500 PTAs randomly selected from the American Physical Therapy Association 1996 active membership list. Six hundred sixty-seven questionnaires were returned, giving a response rate of 67%. METHOD: Based on a literature review and a pilot study, an occupational injury questionnaire was constructed and mailed. Self-reports of injuries were obtained. RESULTS: Thirty-two percent of the PTs and 35% of the PTAs reported sustaining a musculoskeletal injury. The highest prevalence of injury was to the low back (62% of injured PTs and 56% of injured PTAs). The PTs reported the upper back and the wrist and hand as having the second highest prevalence (23%). The PTAs reported the upper back as having the second highest prevalence (28%). The PTs and PTAs reported making changes in their work habits of improved body mechanics, increased use of other personnel, and frequent change of work position. The majority of PTs and PTAs reported they did not limit patient contact time or area of practice after sustaining an injury. CONCLUSION AND DISCUSSION: Although PTs and PTAs are recognized to be knowledgeable in prevention and treatment of musculoskeletal injuries, they are susceptible to sustaining occupational musculoskeletal injuries because of performing labor-intensive tasks.

Adult↗
PubMed1991

Working with people who have cancer: guidelines for physical therapists.

Physical therapists are frequently called upon to aid in the physical rehabilitation of cancer patients. They also share responsibility for the psychosocial aspects of care with other members of the treatment team. The objective of this paper is to provide guidelines to assist physical therapists in providing psychosocial support to cancer patients referred for therapy around the time of diagnosis or during the initial treatment period. Normal and pathological responses of patients faced with the diagnosis and treatment of cancer, including shock, fear, anger, anxiety and depression, are noted. Special attention is given to the importance of common defense mechanisms--denial, regression, rationalization and projection--and the difficulties faced by caregivers in dealing with these defenses. Principles of psychosocial intervention appropriate for use by physical therapists are presented. Two general types are suggested: the first concerns the patient's responses and feelings about the disease and the second involves educating the patient about how to most effectively deal with the disease. Physical therapists have an obligation to provide more than physical restorative services for cancer patients; they should be able to offer psychosocial support in an effort to enhance successful rehabilitation and reintegration to normal living patterns.

Anxiety↗
PubMed1982

Application of the locality rule and implications for malpractice actions against physical therapists.

Physical therapists are becoming involved increasingly in malpractice actions. The number of such actions will likely increase as the profession moves towards specialized practice and practice without medical referral. This article is intended to clarify some of the major principles of negligence and malpractice law as they apply to physical therapists. There are few reported cases of malpractice involving physical therapists, but an abundance of cases involving physicians. The extent to which physicians and therapists have been treated alike in these past malpractice suits is examined. This article also discusses some of the potential legal implications of specialization and practice without referral and their effect on the physical therapist in general practice and the therapist practicing without referral.

Malpractice↗
PubMed1988

Saying "no" to patients for cost-related reasons. Alternatives for the physical therapist.

Physical therapists express their respect for patients by providing competent, compassionate care. Constraints may be imposed on realizing this ideal when treatment must be refused or discontinued because patients lack the financial resources to pay for physical therapy services. The purposes of this article are 1) to review key features that have contributed to the current high cost of health care, 2) to describe approaches being proposed to curb costs, and 3) to suggest ways physical therapists can have a constructive role in creating rational cost-containment policies that are consistent with professional ideals. Seven activities by which physical therapists can become involved at the health care policy level are discussed.

Cost Control↗
PubMed1980

Role of physical therapists in physical activity programs in nursing homes: a survey.

A survey was conducted to help define the role of physical therapists in physical activity programs in nursing homes. Questionnaires were completed by 64 physical therapists working in nursing homes of 130--150 bed capacity. The major factors studied were employment status, work-time at the facility, interprofessional relationships, and available equipment and space. Of the respondents, 43.7 percent were involved in physical activity programs, the most common roles being staff instruction and consultation. Only a small percentage of the time was used for programs; most of the time was occupied with individual physical therapy treatment. The principal types of programs with physical therapist involvement were ambulation and gait training, bed exercises, and general group exercises. Equipment and space seemed adequate. Physical therapists were likely to be involved in physical activity programs if: 1) they were employed by the nursing homes, were paid on a salary basis, worked at the nursing homes full-time or nearly full-time, and did not work elsewhere; 2) such programs were mentioned during discussion of the work agreement; and 3) the coordinator of the physical activity programs was an occupational therapist or a nurse rather than an activities director or recreational therapist.

Aged↗
PubMedDate not supplied

Attitudes toward people with disabilities: a comparison of rehabilitation nurses, occupational therapists, and physical therapists.

This descriptive study was designed to explore the attitudes of rehabilitation nurses, occupational therapists, and physical therapists toward people with disabilities. Attitudes were measured by using the Attitudes Toward Disabled Persons Scale, Form B (ATDP-B). The sample included 150 rehabilitation nurses, 57 occupational therapists, and 43 physical therapists in southeast Texas. Findings suggest that the majority (67%) of the healthcare professionals had positive attitudes toward people with disabilities. Occupational therapists had significantly higher scores than the rehabilitation nurses and physical therapists. Practice setting, age, educational level, and amount of experience had no significant effect on attitude scores. ATDP-B scores tended to increase with work experience, but not to a statistically significant degree. An analysis of the rehabilitation nurses' attitude scores showed that practice setting, age, and educational level had no significant effect. Experience seemed to be correlated with higher attitude scores, although the relationship was not statistically significant.

Adult↗
PubMed1983

Effects of instruction in basic communication skills on physical therapists and physical therapy students.

The purpose of this study was to test the hypothesis that laboratory instruction within a one-semester course could significantly change the communication skills of physical therapists and physical therapy students in the desired direction. Effective use of communication skills, the dependent variable, is defined in the counseling psychology literature. The independent variables were parts of two academic courses for physical therapists: one for graduate students (physical therapists) and one for undergraduate students. Data from the two groups were treated separately in a one-group, pretest-posttest, quasi-experimental design. The test for overall effect of changes in communication skills of undergraduate students was significant at the .0001 level. Post hoc tests for changes in use of seven specific skills varied in significance level from .8 to .0001. Education techniques, not subject variability, accounted for most of the change. Graduate student data did not reach traditional significance levels, but encouraging trends were noted. Results can be interpreted in terms of education, clinical experience, and measurement tools.

Adult↗
PubMed1999

Uniqueness of physical therapy tasks and its relationship to complexity and delegation: a survey of Pennsylvania physical therapists.

Physical therapists' (PTs') perceptions of 26 physical therapy tasks regarding complexity, uniqueness to PTs, and delegation were studied. A questionnaire describing 26 PT tasks was sent to 200 PTs in Pennsylvania identified as working in acute care, rehabilitation, or private practice. The response rate was 45.5%. Eleven of the 26 tasks identified as most unique to PTs were also identified as highly complex. None of these 11 tasks was delegated frequently to a nurse or a PT aide, and only two were delegated to an occupational therapist. All 11 unique tasks were delegated to the physical therapist assistant (PTA), with some level of supervision provided by the majority of respondents. Results indicated there are activities within patient care that are perceived by PTs to be unique to their profession. Also, the role of the PTA may be expanding, warranting further research in this area.

Adult↗
PubMedDate not supplied

Employment patterns and related opinions: a survey of physical therapists.

Physical therapy educators require specific information about the number of graduates who remain in the profession and about their opinions related to undergraduate training and their postgraduate requirements. A mail questionnaire survey of physical therapists who graduated from an Ontario university's physical therapy program between 1969 and 1978 was conducted to determine: occupational patterns, satisfaction with undergraduate preparation for employment, interest in graduate studies and, if the graduate was unemployed at that time, the need for re-entry preparation for employment. With one follow-up mailing to non-respondents, a response rate of 93.4 per cent was obtained. Of the 141 respondents, 110 were working full-time and 15 were working part-time in physical therapy. Eighty-eight per cent of employed physical therapy graduates agreed that their education had prepared them sufficiently for employment. Fifty-three per cent of the graduates indicated that they would like to pursue an area of clinical specialization through graduate study. It is concluded that the graduates of the program under study believe that they have been well prepared for employment; not only do they maintain a clinical interest in the profession, but they aspire to personal and professional advancement through graduate studies.

Allied Health Personnel↗
PubMed2004

Attitudes of physical therapist students toward physical therapist assistants before and after full-time clinical internships.

Development of attitudes of physical therapists (PTs) toward physical therapist assistants (PTAs) begins during their professional education, and attitudes are influenced further by clinical experiences. The purpose of this study was to understand attitudes of student PTs toward PTAs. We surveyed 66 clinical intern students enrolled in an entry-level master of physical therapy program. PT students received the same survey before and after their full-time clinical internship. Eleven Likert scale items were used to assess students' attitudes toward PTAs in the areas of competence, financial remuneration, and job security. One item was designed to determine whether PT students' level of contact with PTAs influenced attitudes. A random sample of 13 (20.9%) students who returned surveys were asked to participate in a telephone interview designed to enrich the quantitative data. After item analysis, five of the scale items were eliminated from the analyses due to poor internal consistency. Cronbach's alpha of the remaining six scale items was 0.75. Survey results reveal that PT students maintain an overall positive attitude toward PTAs before and after full-time clinical internship. Qualitative interview data support this finding. Students' attitudes in specific areas of PTA competence were negative and positive, however. The negative attitude may have been based on the students' beliefs that PTAs are not competent to perform physical therapy in situations that are changing or unpredictable. Positive attitudes may have been reflective of the students' beliefs that PTAs are competent to implement established plans of care. Student ranking of four professional issues showed a significant difference before and after full-time clinical internships.

Adult↗
PubMed2003

Therapeutic approaches to fibromyalgia syndrome in the United Kingdom: a survey of occupational therapists and physical therapists.

BACKGROUND AND PURPOSE: This study sought information from occupational therapists (OTs) and physical therapists (PTs) working in rheumatology in the UK on their usual methods of treatment and management of patients with fibromyalgia syndrome (FMS). METHODS: Data were gathered by self-completion questionnaire on: work setting; referrals of FMS patients; usual treatment objectives; assessment and treatment approaches; perceived responsiveness of patients; and other perceptions of the management of FMS. Most data were in the form of frequency counts, with some ordinal scales and open responses. RESULTS: Responses were obtained from 142 therapists (71% response rate), of whom 47 OTs and 39 PTs managed patients with FMS. The foremost therapeutic objective was increased functional ability for OTs, and increased exercise tolerance and general fitness for PTs. Pain reduction or management was rated as the second objective for both groups. An endurance-based exercise program and energy conservation techniques were the most frequently utilized interventions. Patients with FMS were thought to be 'moderately responsive' to physical management. Predictors of outcome were considered to be largely psychosocial, rather than physical, in nature. CONCLUSION: These data provide a preliminary profile of current practice in the management of FMS among UK therapists and indicate certain differences in approach between OTs and PTs.

Data Collection↗
PubMedDate not supplied

Burnout in occupational therapists and physical therapists working in head injury rehabilitation.

OBJECTIVES: Burnout has been linked to job retention in occupational therapy, physical therapy, and other health professions. Professional development activities are often suggested to reduce burnout, but little empirical evidence supports this contention. This study explored the prevalence of burnout among occupational and physical therapists working in head injury rehabilitation and evaluated the relationship between burnout and professional development activities. METHOD: Forty therapists working full-time in head injury rehabilitation were surveyed. Correlations between subscale scores of the Maslach Burnout Inventory (i.e., Emotional Exhaustion, Depersonalization, and Personal Accomplishment) and responses to a survey of professional development activities are reported. RESULTS: Professional development activities are most strongly associated with feelings of personal accomplishment. Emotional exhaustion was relatively high among these therapists, but few feelings of depersonalization were evident. CONCLUSIONS: Professional development activities in the workplace may augment feelings of personal accomplishment and minimize burnout as an issue in job retention. Strategies to effectively identify and manage therapists' feelings of emotional exhaustion require further study.

Adult↗
PubMed1985

Perceived role responsibilities of physical therapists and adapted physical educators in the public school setting.

Right to Education legislation has brought physical therapists and adapted physical educators together in the public school setting to serve the child with special needs. Investigation of the role responsibilities of these professionals would facilitate not only communication between the groups, but also understanding of their functions by other school personnel and administrators. We analyzed questionnaires returned by 79 physical therapists and 30 adapted physical educators to determine areas of uniqueness or similarity in 18 identified role responsibilities performed by these two groups. Each subject rated the appropriateness of each role to physical therapists and to adapted physical educators. On 10 of the 18 items, a statistically significant interaction indicated disagreement with regard to the relative contributions of the two professions. On the other 8 items, the two groups agreed that the role responsibility tends to belong to one profession or agreed that either profession could assume the responsibility. These data should provide information to help further delineate the role definitions for each of these professionals. In addition, the most efficient use of available resources may be used to meet the educational needs of these children.

Adolescent↗
PubMed1994

Physical therapists' perceptions of the roles of the physical therapist assistant.

BACKGROUND AND PURPOSE: This longitudinal study investigated physical therapists' perceptions of the roles of physical therapist assistants (PTAs). METHODS AND SUBJECTS: In 1986, a questionnaire describing 79 physical therapy activities was distributed to a random sample (n = 400) of physical therapists derived from the American Physical Therapy Association (APTA) membership. In 1992, a similar questionnaire was distributed to a representative sample (n = 400) of physical therapists derived from the APTA membership. Response rates were 53% and 55% in 1986 and 1992, respectively. Respondents indicated whether each activity was included in the documentation describing PTA roles. RESULTS: Results revealed considerable agreement between therapists' perceptions of PTA roles and those outlined by PTA practice guidelines, and these perceptions changed little over time. Discriminant analyses suggested that therapists' perceptions of PTA roles were, in general, not predicted by supervisory experience with PTAs, therapist experience, or content of entry-level professional education curricula. CONCLUSION AND DISCUSSION: Generally, therapists' perceptions of PTA roles are consistent with published practice guidelines. Therapists' perceptions on selected activities, however, were incongruent with PTA practice guidelines, suggesting the potential for inefficient or inappropriate utilization of the PTA in the delivery of selected services.

Allied Health Personnel↗
PubMed1995

Physical therapist assistants' perceptions of the documented roles of the physical therapist assistant.

BACKGROUND AND PURPOSE: This study investigated physical therapist assistants' (PTAs) perceptions of the documented roles of PTAs and compared those perceptions with those of physical therapists from a previous study. SUBJECTS AND METHODS: A questionnaire that described 79 physical therapy activities was distributed to a sample (n = 400) of PTAs derived from the American Physical Therapy Association membership. The response rate was 56% (n = 225). Respondents indicated whether each activity was included in the documentation describing PTA roles. Discriminant analyses were used to determine whether demographic factors predicted the pattern of responses. In addition, meta-analytic techniques were used to determine whether PTA responses were different from those of physical therapists gathered previously. RESULTS: The greatest agreement of PTA opinions with published guidelines occurred for treatment implementation activities, and the lowest level of agreement occurred for items designated as administrative activities. Responses of PTAs were different from those of physical therapists on 21 of the 79 activities. The greatest number of these differences occurred for evaluative functions (n = 9). Physical therapist assistants' perceptions of documented PTA roles were generally less consistent with published guidelines than were those of physical therapists. CONCLUSION AND DISCUSSION: Physical therapist assistants' perceptions of the roles of the PTA were, for some activities, not consistent with written guidelines. Using the data provided in this study, discussions to revise the documentation of the scope of PTA practice may focus on those activities for which disagreement between PTAs and physical therapists exists and for which opinions differ markedly from published guidelines. [Robinson AJ, DePalma MT, McCall M. Physical therapist assistants' perceptions of the documented roles of the physical therapist assistant.

Allied Health Personnel↗