scholarly journals What Really Works in Intervention? Using Fidelity Measures to Support Optimal Outcomes

2020 ◽  
Vol 100 (5) ◽  
pp. 757-765
Author(s):  
Mihee An ◽  
Stacey C Dusing ◽  
Regina T Harbourne ◽  
Susan M Sheridan ◽  
Keyword(s):  
Physical Therapy ◽  
Physical Therapist ◽  
Measurement Instrument ◽  
Critical Factor ◽  
Intervention Fidelity ◽  
Optimal Outcomes ◽  
Research Findings ◽  
Fidelity Measures ◽  
The Right ◽  
Correct Implementation

Abstract A critical factor to move the field of physical therapy forward is the measurement of fidelity during comparisons of interventions. Fidelity translates as “faithfulness”; thus, fidelity of intervention means faithful and correct implementation of the key components of a defined intervention. Fidelity measurement guards against deviations from, or drift in, the delivery of a targeted intervention, a process necessary for evaluating the efficacy of rehabilitation approaches. Importantly, attention to fidelity measurement differentiates rehabilitation approaches from each other. However, earlier research comparing physical therapist interventions often reported findings without careful attention to fidelity measurement. The purpose of this paper is 2-fold: (1) to support the development of intervention-specific fidelity measures in physical therapy research as the gold standard for translating research findings to clinical practice, and (2) to describe the process of creating a multi-dimensional fidelity measurement instrument in rehabilitation intervention. Improved attention to fidelity measurement will allow the rehabilitation field to communicate interventions clearly with a direct link to outcomes and target the implementation of our improved intervention for the right patient problem with the right dose and the right ingredients at the right time.

scholarly journals The Contribution of Conceptual Frameworks to Knowledge Translation Interventions in Physical Therapy

2015 ◽  
Vol 95 (4) ◽  
pp. 630-639 ◽  
Author(s):  
Anne Hudon ◽  
Mathieu-Joël Gervais ◽  
Matthew Hunt
Keyword(s):  
Physical Therapy ◽  
Knowledge Translation ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Positive Impact ◽  
Conceptual Frameworks ◽  
Research Findings ◽  
Potential Benefits ◽  
Practice Gap ◽  
Knowledge Translation Interventions

There is growing recognition of the importance of knowledge translation activities in physical therapy to ensure that research findings are integrated into clinical practice, and increasing numbers of knowledge translation interventions are being conducted. Although various frameworks have been developed to guide and facilitate the process of translating knowledge into practice, these tools have been infrequently used in physical therapy knowledge translation studies to date. Knowledge translation in physical therapy implicates multiple stakeholders and environments and involves numerous steps. In light of this complexity, the use of explicit conceptual frameworks by clinicians and researchers conducting knowledge translation interventions is associated with a range of potential benefits. This perspective article argues that such frameworks are important resources to promote the uptake of new evidence in physical therapist practice settings. Four key benefits associated with the use of conceptual frameworks in designing and implementing knowledge translation interventions are identified, and limits related to their use are considered. A sample of 5 conceptual frameworks is evaluated, and how they address common barriers to knowledge translation in physical therapy is assessed. The goal of this analysis is to provide guidance to physical therapists seeking to identify a framework to support the design and implementation of a knowledge translation intervention. Finally, the use of a conceptual framework is illustrated through a case example. Increased use of conceptual frameworks can have a positive impact on the field of knowledge translation in physical therapy and support the development and implementation of robust and effective knowledge translation interventions that help span the research-practice gap.

scholarly journals Variation in Preoperative and Postoperative Physical Therapist Management of Patients Opting for Elective Abdominal Surgery

2019 ◽  
Vol 99 (10) ◽  
pp. 1291-1303 ◽  
Author(s):  
Christel A van Beijsterveld ◽  
Aniek F Heldens ◽  
Bart C Bongers ◽  
Nico L van Meeteren
Keyword(s):  
Physical Therapy ◽  
Abdominal Surgery ◽  
Latent Class Analysis ◽  
Latent Class ◽  
Physical Therapist ◽  
Daily Practice ◽  
Survey Study ◽  
Class Analysis ◽  
Postoperative Physical Therapy ◽  
Research Findings

Abstract Background Evidence about the role of physical therapy in perioperative care pathways to improve postoperative outcomes is growing. However, it is unclear whether research findings have been translated into daily practice. Objective The objectives of this study were to describe the current content and between-hospital variability of perioperative physical therapist management for patients undergoing colorectal, hepatic, or pancreatic resection in the Netherlands and to compare currently recommended state-of-the-art physical therapy with self-reported daily clinical physical therapist management. Design This was a cross-sectional survey study. Methods Hospital physical therapists were asked to complete an online survey about pre- and postoperative physical therapy at their hospital. To explore the variability of perioperative physical therapist management between hospitals, frequency variables were clustered to determine the level of uniformity. Latent class analysis was performed to identify clusters of hospitals with certain homogeneous characteristics on a 19-item dichotomous scale. Results Of 82 eligible Dutch hospitals, 65 filled out the survey (79.3%). Preoperative physical therapy was performed in 34 hospitals (54.0%; 2/65 responding hospitals were excluded from the data analysis). Postoperative physical therapy was performed in all responding hospitals, focusing mainly on regaining independent physical functioning. Latent class analysis identified a 3-class model. Hospitals in classes I and II were more likely to provide preoperative physical therapist interventions than hospitals in class III. Limitations The use of self-reported answers can lead to bias. Conclusions There was a wide degree of variability between hospitals regarding pre- and postoperative clinical physical therapist practice for patients opting for major abdominal surgery. Three different classes of daily practice were identified. Further translation of key research findings into clinical physical therapist practice is advised, especially for hospitals in which the physical therapist is not involved preoperatively. Moreover, improving uniformity by developing up-to-date clinical guidelines is recommended.

scholarly journals The Effect of Respiratory Physical Therapy on the Lеvel of Free Fluid in Pleural Cavities after Cardiac Surgery

2021 ◽  
Vol 6 (2) ◽  
pp. 189-195
Author(s):  
V. V. Vitomskyi ◽  
◽  
Keyword(s):  
Cardiac Surgery ◽  
Physical Therapy ◽  
Physical Therapist ◽  
Pairwise Comparison ◽  
Free Fluid ◽  
Negative Effect ◽  
Number Of Cycles ◽  
The Right ◽  
Previous Group ◽  
Incentive Spirometry

The purpose of the study was to investigate the effect of respiratory physical therapy on the level of free fluid in the pleural cavities after cardiac surgery. Materials and methods. The study involved 138 patients. The patients were randomly divided into three groups: control (respiratory physical therapy was limited to cough), group of incentive spirometry (in classes with a physical therapist patients performed additional 3 approaches of 10 breaths through the simulator; they received recommendations for hourly performance of a similar number of cycles of exercise), a group of patients who received additional respiratory physical therapy with positive expiratory pressure in the form of exhalation into a bottle of water through a tube (number of repetitions and recommendations are similar to those received by the previous group). All groups underwent the same protocol of mobilization and use of therapeutic physical exercises in the procedure of therapeutic gymnastics. Performing exercises with breathing simulators began on the 1st postoperative day. Results and discussion. The results of ultrasound examinations of the level of free fluid in the left and right pleural cavities, which were performed according to the postoperative protocol, were studied. The first ultrasound examination, which was analyzed, was performed on the seventh postoperative day, and in the absence of the study on this day, the data of the next study were selected with the registration of the postoperative day number. In addition, the indicators of the final studies of the level of free fluid of the pleural cavities were compared. The position of the patient during the examinations was a sitting one. Analysis of the level of pleural effusion did not establish the benefits of using additional respiratory physical therapy in both groups. The results of studies of the right pleural cavities did not differ in groups of patients, but those of the left ones differed. Conclusion. Pairwise comparison of the groups confirmed the presence of statistically worse results of examinations of the left pleural cavities in the group of incentive spirometry, as well as the absence of statistical differences between the results of the other two groups. The negative effect of incentive spirometry should be confirmed by additional studies, as its effect differed for the results of the left (negative effect) and right (no advantage) pleural cavity

Managing Landscape Irrigation to Avoid Soil and Nutrient Losses

EDIS ◽  
2013 ◽  
Vol 2013 (11) ◽  
Author(s):  
George Hochmuth ◽  
Laurie Trenholm ◽  
Don Rainey ◽  
Esen Momol ◽  
Claire Lewis ◽  
...  
Keyword(s):  
Natural Environment ◽  
Management Practices ◽  
Root Zone ◽  
Irrigation Management ◽  
Critical Factor ◽  
Nutrient Losses ◽  
County Agents ◽  
The Right ◽  
Soil And Water

Proper irrigation management is critical to conserve and protect water resources and to properly manage nutrients in the home landscape. How lawns and landscapes are irrigated directly impacts the natural environment, so landscape maintenance professionals and homeowners must adopt environmentally-friendly approaches to irrigation management. After selecting the right plant for the right place, water is the next critical factor to establish and maintain a healthy lawn and landscape. Fertilization is another important component of lawn and landscape maintenance, and irrigation must be applied correctly, especially following fertilization, to minimize potential nutrient losses. This publication supplements other UF/IFAS Extension publications that also include information on the role of soil and the root zone in irrigation management. This publication is designed to help UF/IFAS Extension county agents prepare materials to directly address nutrient losses from lawns and landscapes caused by inadequate irrigation management practices. This 6-page fact sheet was written by George Hochmuth, Laurie Trenholm, Don Rainey, Esen Momol, Claire Lewis, and Brian Niemann, and published by the UF Department of Soil and Water Science, October 2013. http://edis.ifas.ufl.edu/ss586

The Impact of Internal Work Environment on the Retention of Healthcare Providers at Turaif General Hospital

2019 ◽  
Vol 10 (12) ◽  
pp. 1183-1199
Author(s):  
Mohammed Alrouili ◽  
Keyword(s):  
Work Environment ◽  
General Hospital ◽  
Professional Growth ◽  
Healthcare Providers ◽  
Entire Study ◽  
Internal Work ◽  
Research Findings ◽  
Study Population ◽  
The Right ◽  
The Impact

This study attempted to identify the impact of internal work environment on the retention of healthcare providers at Turaif General Hospital in the Kingdom of Saudi Arabia. In particular, the study aimed to identify the dimensions of work circumstances, compensation, and relationship with colleagues, professional growth, and the level of healthcare providers’ retention. In order to achieve the study goals, the researcher used the descriptive analytical approach. The researcher used the questionnaire as the study tool. The study population comprised all the healthcare providers at Turaif General Hospital. Questionnaires were distributed to the entire study sample that consisted of 220 individuals. The number of questionnaires valid for study was 183 questionnaires. The research findings were as follows: the participants’ estimate of the work circumstances dimension was high (3.64), the participants’ estimate of the compensation dimension was moderate (3.32), the participants’ estimate of the relationship with colleagues dimension was high (3.62), the participants’ estimate of the professional growth dimension was weak (2.39), and the participants’ estimate of healthcare providers’ retention level was intermediate (2.75). Accordingly, the researcher’s major recommendations are: the need to create the right atmosphere for personnel in hospitals, the interest of the hospital to provide the appropriate conditions for the staff in terms of the physical and moral aspects for building the work adjustment in the staff, and conducting training courses and educational lectures for personnel in hospitals on how to cope with the work pressures.

scholarly journals Physical Therapist–Established Intensive Care Unit Early Mobilization Program: Quality Improvement Project for Critical Care at the University of California San Francisco Medical Center

2013 ◽  
Vol 93 (7) ◽  
pp. 975-985 ◽  
Author(s):  
Heidi J. Engel ◽  
Shintaro Tatebe ◽  
Philip B. Alonzo ◽  
Rebecca L. Mustille ◽  
Monica J. Rivera
Keyword(s):  
Quality Improvement ◽  
Physical Therapy ◽  
San Francisco ◽  
Physical Therapist ◽  
Medical Center ◽  
Early Mobilization ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Icu Admission ◽  
Number Of Patients

Background Long-term weakness and disability are common after an intensive care unit (ICU) stay. Usual care in the ICU prevents most patients from receiving preventative early mobilization. Objective The study objective was to describe a quality improvement project established by a physical therapist at the University of California San Francisco Medical Center from 2009 to 2011. The goal of the program was to reduce patients' ICU length of stay by increasing the number of patients in the ICU receiving physical therapy and decreasing the time from ICU admission to physical therapy initiation. Design This study was a 9-month retrospective analysis of a quality improvement project. Methods An interprofessional ICU Early Mobilization Group established and promoted guidelines for mobilizing patients in the ICU. A physical therapist was dedicated to a 16-bed medical-surgical ICU to provide physical therapy to selected patients within 48 hours of ICU admission. Patients receiving early physical therapy intervention in the ICU in 2010 were compared with patients receiving physical therapy under usual care practice in the same ICU in 2009. Results From 2009 to 2010, the number of patients receiving physical therapy in the ICU increased from 179 to 294. The median times (interquartile ranges) from ICU admission to physical therapy evaluation were 3 days (9 days) in 2009 and 1 day (2 days) in 2010. The ICU length of stay decreased by 2 days, on average, and the percentage of ambulatory patients discharged to home increased from 55% to 77%. Limitations This study relied upon the retrospective analysis of data from 6 collectors, and the intervention lacked physical therapy coverage for 7 days per week. Conclusions The improvements in outcomes demonstrated the value and feasibility of a physical therapist–led early mobilization program.

scholarly journals When brain damage “improves” perception: neglect patients can localize motion-shifted probes better than controls

2015 ◽  
Vol 114 (6) ◽  
pp. 3351-3358 ◽  
Author(s):  
Stefania de Vito ◽  
Marine Lunven ◽  
Clémence Bourlon ◽  
Christophe Duret ◽  
Patrick Cavanagh ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Visual Fields ◽  
Critical Factor ◽  
Significant Shift ◽  
Stimulus Motion ◽  
Attentional Processes ◽  
Position Shift ◽  
The Right ◽  
High Level ◽  
Better Than

When we look at bars flashed against a moving background, we see them displaced in the direction of the upcoming motion (flash-grab illusion). It is still debated whether these motion-induced position shifts are low-level, reflexive consequences of stimulus motion or high-level compensation engaged only when the stimulus is tracked with attention. To investigate whether attention is a causal factor for this striking illusory position shift, we evaluated the flash-grab illusion in six patients with damaged attentional networks in the right hemisphere and signs of left visual neglect and six age-matched controls. With stimuli in the top, right, and bottom visual fields, neglect patients experienced the same amount of illusion as controls. However, patients showed no significant shift when the test was presented in their left hemifield, despite having equally precise judgments. Thus, paradoxically, neglect patients perceived the position of the flash more veridically in their neglected hemifield. These results suggest that impaired attentional processes can reduce the interaction between a moving background and a superimposed stationary flash, and indicate that attention is a critical factor in generating the illusory motion-induced shifts of location.

scholarly journals Breathing: A Sign of Life and a Unique Area for Reflection and Action

2008 ◽  
Vol 88 (7) ◽  
pp. 832-840 ◽  
Author(s):  
Kirsten Ekerholt ◽  
Astrid Bergland
Keyword(s):  
Physical Therapy ◽  
Physical Therapist ◽  
Well Being ◽  
Qualitative Approach ◽  
Breathing Patterns ◽  
Daily Lives ◽  
The World ◽  
Body And Soul ◽  
Bodily Sensations ◽  
Conscious Attention

Background and Purpose The aim of this study was to clarify patients’ experiences of breathing during therapeutic processes in Norwegian psychomotor physical therapy (NPMP). Subjects and Methods A qualitative approach was used based on interviews with 9 women and 1 man aged between 41 and 65 years. The data were analyzed with the aid of grounded theory. Results Three categories were identified from the participants’ experiences: (1) “Breathing: An Incomprehensible and Disparate Phenomenon,” (2) “Breathing: Access to Meaning and Understanding,” and (3) “Breathing: Enhancing Feelings of Mastery.” Initially, breathing difficulties and bodily pains were described as physical reactions that seemed utterly incomprehensible to the participants. Communication, both verbal and nonverbal, between the patient and the physical therapist was described as vitally important, as was conscious attention to occurrences during the treatment sessions. The participants learned to recognize changes in their breathing patterns, and they became familiar with new bodily sensations. Consequently, they acquired new understanding of these sensations. The feeling and understanding of being an entity (ie, “body and soul”) emerged during therapy. The participants increased their understanding of the interaction between breathing and internal and external influences on their well-being. Their feelings of mastery over their daily lives were enhanced. The therapeutic dialogues gave them the chance to explore, reflect, and become empowered. Discussion and Conclusion In experiencing their own breathing, the participants were able to access and identify the muscular and emotional patterns that, linked to particular thoughts and beliefs, had become their characteristic styles of relating to themselves and the world.

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