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Walløe S, Roikjær SG, Hansen SMB, Zangger G, Mortensen SR, Korfitsen CB, Simonÿ C, Lauridsen HH, Morsø L. Content validity of patient-reported measures evaluating experiences of the quality of transitions in healthcare settings-a scoping review. BMC Health Serv Res 2024; 24:828. [PMID: 39039533 PMCID: PMC11265152 DOI: 10.1186/s12913-024-11298-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/10/2024] [Indexed: 07/24/2024] Open
Abstract
No reviews so far have been conducted to define the constructs of patient-experienced quality in healthcare transitions or to identify existing generic measures of patients' experience of the quality within healthcare transitions. Our aim was to identify domains relevant for people experiencing healthcare transitions when evaluating the quality of care they have received, map the comprehensiveness of existing patient-reported experience measures (PREM), and evaluate the PREMs' content validity. The method was guided by the Joanna Briggs Institutes' guidance for scoping reviews. The search was performed on 07 December 2021 and updated 27 May 2024, in the electronic databases Medline (Ovid), Embase (Ovid), and Cinahl (EBSCO). The search identified 20,422 publications, and 190 studies were included for review. We identified 30 PREMs assessing at least one aspect of adults' experience of transitions in healthcare. Summarising the content, we consider a model with two domains, organisational and human-relational, likely to be adequate. However, a more comprehensive analysis and adequate definition of the construct is needed. None of the PREMs were considered content valid.
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Affiliation(s)
- Sisse Walløe
- Department of Clinical Research, Research Unit OPEN, University of Southern Denmark, Odense, Denmark.
- Department of Physio- and Occupational Therapy, Research- and Implmentation Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark.
| | - Stine Gundtoft Roikjær
- Department of Physio- and Occupational Therapy, Research- and Implmentation Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
- Department of Neurology, Center for Neurological Research, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
- Department of Health, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Sebrina Maj-Britt Hansen
- Department of Clinical Research, Research Unit OPEN, University of Southern Denmark, Odense, Denmark
| | - Graziella Zangger
- Department of Physio- and Occupational Therapy, Research- and Implmentation Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
| | - Sofie Rath Mortensen
- Department of Physio- and Occupational Therapy, Research- and Implmentation Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, University of Southern Denmark, Odense, Denmark
| | - Christoffer Bruun Korfitsen
- Department of Clinical Research, Research Unit OPEN, University of Southern Denmark, Odense, Denmark
- Department of Clinical Research, Cochrane Denmark & Centre for Evidence-Based Medicine Odense (CEBMO), University of Southern Denmark, Odense, Denmark
| | - Charlotte Simonÿ
- Department of Physio- and Occupational Therapy, Research- and Implmentation Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
- Department of Health, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Henrik Hein Lauridsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lars Morsø
- Department of Clinical Research, Research Unit OPEN, University of Southern Denmark, Odense, Denmark
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Capdevila E, Portell M, Penelo E, Rodríguez-Bailón M. Measurement properties of the Spanish COPM in older adult rehabilitation inpatients. Scand J Occup Ther 2024; 31:2377175. [PMID: 39034887 DOI: 10.1080/11038128.2024.2377175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 07/03/2024] [Indexed: 07/23/2024]
Abstract
AIMS To analyse the measurement properties of the Spanish version of the COPM (Canadian Occupational Performance Measure) in older adult rehabilitation inpatients. METHOD A sample of 172 users from 17 inpatient care facilities for older adults (47% nursing homes) participated in a quantitative prospective study. We examined validity by correlating the COPM with the Barthel Index (BI), the Lawton Instrumental Activities of Daily Living scale (IADL), the EuroQol-five domains-three level questionnaire (EQ-5D-3L), and the Client-Centred Rehabilitation Questionnaire (CCRQ) and by examining associations with demographic variables. Reliability was evaluated through test-retest and responsiveness through differences in change scores in two types of care facilities. RESULTS Participants prioritised 637 occupational performance problems, mainly in the area of self-care (70.5%). The COPM scale scores were significantly correlated with BI, IADL, EQ-5D-3L (except the pain dimension), and CCRQ (except the family involvement and continuity dimensions). COPM scores did not show statistically significant differences concerning educational level. Regarding reliability, high test-retest correlations were obtained (>.80). Nursing home users showed less responsiveness to rehabilitation than other users (change score < 2 vs. > 2 points). CONCLUSION AND SIGNIFICANCE The Spanish COPM provides satisfactory measurement properties as a client-centred instrument in older adult rehabilitation inpatient.
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Affiliation(s)
- Elisabet Capdevila
- Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa (EUIT). Universitat Autònoma de Barcelona (UAB), C/de la Riba, Terrassa, Spain
| | - Mariona Portell
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Eva Penelo
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - María Rodríguez-Bailón
- Department of Physiotherapy (Occupational Therapy). Facultad Ciencias de la Salud, Universidad de Málaga (UMA). C/Arquitecto Francisco Peñalosa, Málaga, Spain
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Bontea M, Bimbo-Szuhai E, Macovei IC, Maghiar PB, Sandor M, Botea M, Romanescu D, Beiusanu C, Cacuci A, Sachelarie L, Huniadi A. Anterior Approach to Hip Arthroplasty with Early Mobilization Key for Reduced Hospital Length of Stay. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1216. [PMID: 37512027 PMCID: PMC10384527 DOI: 10.3390/medicina59071216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/17/2023] [Accepted: 06/25/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: This study aimed to explore the preoperative factors related to early mobilization and length of stay (LOS) after total hip arthroplasty and the benefits of the anterior approach over the traditional lateral approach. Materials and Methods: Every patient benefits from information regarding details of the surgery approach, possible intra, and postoperative complications, post-operator medical care, and steps in the early mobilization protocol. The patient underwent a pre-anesthetic evaluation, was checked for preoperatory vital function, and was reevaluated for mobilization at 6, 12, 24, 36, 48, and 96 h after total hip arthroplasty using the anterior versus lateral approach. Results: The result of the statistical calculations indicates the independent negative risk factors for reaching the mobilization target: age with a coefficient of -0.046, p = 0.0154 and lateral approach with a relative risk of 0.3802 (95% CI: 0.15-0.90), p = 0.0298. Statistical data concerning the length of stay (LOS) showed significant differences in the total days spent in the hospital. The patients who were operated on using the lateral approach presented a higher body mass index than those with the anterior approach, but this difference did not reach the threshold of statistical significance. Conclusions: In our study, patient mobilization is crucial to reduce LOS.
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Affiliation(s)
- Mihaela Bontea
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
| | - Erika Bimbo-Szuhai
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
- Pelican Hospital, Corneliu Coposu Street 2, 410450 Oradea, Romania
| | - Iulia Codruta Macovei
- Pelican Hospital, Corneliu Coposu Street 2, 410450 Oradea, Romania
- Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
| | - Paula Bianca Maghiar
- Pelican Hospital, Corneliu Coposu Street 2, 410450 Oradea, Romania
- Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
| | - Mircea Sandor
- Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
| | - Mihai Botea
- Pelican Hospital, Corneliu Coposu Street 2, 410450 Oradea, Romania
- Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
| | - Dana Romanescu
- Pelican Hospital, Corneliu Coposu Street 2, 410450 Oradea, Romania
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
| | - Corina Beiusanu
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
| | - Adriana Cacuci
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
| | - Liliana Sachelarie
- Department of Prelinical Discipline, Apollonia University, 700511 Iasi, Romania
| | - Anca Huniadi
- Pelican Hospital, Corneliu Coposu Street 2, 410450 Oradea, Romania
- Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
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Wasilewski MB, Szigeti Z, Sheppard CL, Minezes J, Hitzig SL, Mayo AL, Robinson LR, Lung M, Simpson R. Patients, Caregivers, and Healthcare Providers' Experiences with COVID Care and Recovery across the Care Continuum: A Qualitative Study. Int J Integr Care 2023; 23:27. [PMID: 37333775 PMCID: PMC10275165 DOI: 10.5334/ijic.6952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/01/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction During the COVID-19 pandemic, discharge timelines were accelerated and patients were moved across the continuum of care, from acute to post-acute care, to relieve the strain in health system capacity. This study aimed to investigate the COVID-19 care pathway from the perspective of patients, caregivers, and healthcare providers to understand their experiences with care and recovery within and across care settings. Methods A qualitative descriptive study. Patients and their families from an inpatient COVID-19 unit and healthcare providers from an acute or rehabilitation COVID-19 unit were interviewed. Results A total of 27 participants were interviewed. Three major themes were identified: 1) The perceived quality and pace of COVID-19 care improved from acute care to inpatient rehabilitation; 2) Care transitions were especially distressing; and 3) Recovery from COVID-19 stagnated in the community. Conclusion Inpatient rehabilitation was viewed as higher quality due to the slower paced care. Care transitions were distressing for stakeholders and enhanced integration between acute and rehabilitation care were suggested to improve patient handover. A lack of rehabilitation access led to recovery stagnating for patients discharged to the community. Telerehab may improve the transition to home and ensure access to adequate rehabilitation and support in the community.
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Affiliation(s)
- Marina B. Wasilewski
- St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Occupational Science and Occupational Therapy & Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, CA
| | - Zara Szigeti
- St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, CA
| | | | - Jacqueline Minezes
- Musculoskeletal/STAR Rehab and Restorative Transitional Unit, St. John’s Rehab, Sunnybrook Health Sciences Centre, CA
| | - Sander L. Hitzig
- St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Occupational Science and Occupational Therapy & Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, CA
| | - Amanda L. Mayo
- St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, CA
| | - Lawrence R. Robinson
- St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, CA
| | - Maria Lung
- Musculoskeletal/STAR Rehab and Restorative Transitional Unit, St. John’s Rehab, Sunnybrook Health Sciences Centre, CA
| | - Robert Simpson
- Department of Physical Medicine and Rehabilitation & Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, CA
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Capdevila E, Rodríguez-Bailón M, Szot AC, Gálvez-Ruiz P, Portell M. Cross-cultural adaptation and validation of the Spanish version of the Client-Centred Rehabilitation Questionnaire (CCRQ). Disabil Rehabil 2023; 45:310-321. [PMID: 35075950 DOI: 10.1080/09638288.2022.2028021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE The aim of the study is to present the process of translation, adaptation and validation of the Client-Centred Rehabilitation Questionnaire (CCRQ) in the Spanish context. METHODS The process integrates two sequential phases. Phase 1 consists of a questionnaire translation and back-translation process conducted by a panel of experts, and a pilot study. In phase 2, CCRQ-e (Spanish version) was administered to 305 rehabilitation inpatients to collect evidence on the reliability and validity of the instrument. RESULTS The exploratory and confirmatory analysis confirmed seven original domains, eliminating four items from the original scale. CCRQ-e has a good internal consistency. Discriminative construct validity distinguished significant differences based on age, educational level, and severity of diagnosis. Criterion validity of the CCRQ and EQ-5D showed negative significant correlations between CCRQ-e and the general perception of health EQ-VAS, and a positive correlation between CCRQ-e and EQ pain and EQ anxiety (higher scores in CCRQ-e mean lower client-centered practice perceived). CONCLUSIONS The Spanish version of the CCRQ is suitable for evaluating person-centered rehabilitation from the person's perspective. It includes aspects related to the comfort, decision-making, and participation of the client, as well as questions about the provision of service and the environment.Implications for rehabilitationThe original seven domains of the CCRQ could be replicated in the sample of patients from Spanish rehabilitation services.By eliminating four items from the original scale, the validated scale, known as the CCRQ-e (Spanish version), was obtained.The CCRQ-e allows a reliable and valid evaluation of the perception of the person-centeredness of the Spanish rehabilitation services.The CCRQ-e is the first self-reported measure in Spanish of an individual's experience during the rehabilitation service.
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Affiliation(s)
- Elisabet Capdevila
- Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa (EUIT), Universitat Autònoma de Barcelona (UAB), Terrassa, Spain
| | - María Rodríguez-Bailón
- Department of Physiotherapy (Occupational Therapy), Facultad Ciencias de la Salud, Universidad de Málaga (UMA), Málaga, Spain
| | - Ana Clara Szot
- Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa (EUIT), Universitat Autònoma de Barcelona (UAB), Terrassa, Spain
| | - Pablo Gálvez-Ruiz
- Faculty of Law and Social Sciences, Valencian International University (VIU), Valencia, Spain
| | - Mariona Portell
- Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Spain
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Quality Measure Concepts for Inpatient Rehabilitation That Are Best Understood From the Patient's Perspective. Rehabil Nurs 2022; 47:210-219. [PMID: 36002927 DOI: 10.1097/rnj.0000000000000385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to identify inpatient rehabilitation quality-of-care concepts that are best understood from the patient perspective. DESIGN We conducted 12 focus groups with 95 former patients, caregivers, and rehabilitation clinicians and asked them to describe high-quality inpatient rehabilitation care. METHODS We independently reviewed the focus group transcripts and then used an iterative process to identify the quality measure concepts identified by participants. RESULTS Based on participants' comments, we identified 18 quality measure concepts: respect and dignity, clinician communication with patient, clinician communication with family, organizational culture, clinician engagement with patient, clinician engagement with family, rehabilitation goals, staff expertise, responsiveness, patient safety, physical environment, care coordination, discharge planning, patient and family education, peer support, symptom management (pain, anxiety, fatigue, sadness), sleep, and functioning. CLINICAL RELEVANCE TO THE PRACTICE OF REHABILITATION NURSING Rehabilitation nurses should be aware of the quality-of-care issues that are important to patients and their caregivers. CONCLUSION Important patient-reported domains of quality of care include interpersonal relationships, patient and family engagement, care planning and delivery, access to support, and quality of life.
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Modernizing Total Hip Arthroplasty Perioperative Pathways: The Implementation of ERAS-Outpatient Protocol. J Clin Med 2022; 11:jcm11123293. [PMID: 35743363 PMCID: PMC9224899 DOI: 10.3390/jcm11123293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/26/2022] [Accepted: 06/06/2022] [Indexed: 12/28/2022] Open
Abstract
Pressure to reduce healthcare costs, limited hospital availability along with improvements in surgical technique and perioperative care motivated many centers to focus on outpatient pathway implementation. However, in many short-stay protocols, the focus has shifted away from aiming to reduce complications and improved rehabilitation, to using length of stay as the main factor of success. To improve patient outcomes and maintain safety, the best way to implement a successful outpatient program would be to combine it with the principles of enhanced recovery after surgery (ERAS), and to improve patient recovery to a level where the patient is able to leave the hospital sooner. This article delivers a case for modernizing total hip arthroplasty perioperative pathways by implementing ERAS-outpatient protocols.
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Hardy A, Gervais-Hupé J, Desmeules F, Hudon A, Perreault K, Vendittoli PA. Comparing ERAS-outpatient versus standard-inpatient hip and knee replacements: a mixed methods study exploring the experience of patients who underwent both. BMC Musculoskelet Disord 2021; 22:978. [PMID: 34814889 PMCID: PMC8611950 DOI: 10.1186/s12891-021-04847-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/05/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Optimizing patients' total hip and knee arthroplasty (THA/TKA) experience is as crucial for providing high quality care as improving safety and clinical effectiveness. Yet, little evidence is available on patient experience in standard-inpatient and enhanced recovery after surgery (ERAS)-outpatient programs. Therefore, this study aimed to gain a more in-depth understanding of the patient experience of ERAS-outpatient programs in comparison to standard-inpatient programs. METHODS We conducted a convergent mixed methods study of 48 consecutive patients who experienced both standard-inpatient and ERAS-outpatient THA/TKA contralaterally. A reflective thematic analysis was conducted based on data collected via a questionnaire. Bivariate correlations between the patient experience and patients' characteristics, clinical outcomes and care components satisfaction were performed. Then, the quantitative and qualitative data were integrated together. RESULTS The theme Support makes the difference for better and for worse was identified by patients as crucial to their experience in both joint replacement programs. On the other hand, patients identified 3 themes distinguishing their ERAS-outpatient from their standard-inpatient experience: 1) Minimizing inconvenience, 2) Home sweet home and 3) Returning to normal function and activities. Potential optimization expressed by patients were to receive more preoperative information, additional postoperative rehabilitation sessions, and ensuring better coherence of care between hospital and home care teams. Weak to moderate positive and statistically significant correlations were found between patients' THA/TKA experience and satisfaction with pain management, hospital stay, postoperative recovery, home care, and overall results (rs = + [0.36-0.66], p-value < 0.01). CONCLUSION Whatever the perioperative program, the key to improving patients' THA/TKA experience lies in improving support throughout the care episode. However, compared to standard-inpatient care, the ERAS-outpatient program improves patients' experience by providing dedicated support in postoperative care, reducing postoperative inconvenience, optimizing pain management, returning home sooner, and recovering and regaining function sooner. Patients' THA/TKA experience could further be enhanced by optimizing the information provided to the patient, the rehabilitation program and the coherence between care teams.
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Affiliation(s)
- Alexandre Hardy
- Department of Biomedical Sciences, Faculty of Graduate and Postdoctoral Studies, Université de Montréal, Montreal, Quebec, Canada
- Hôpital Maisonneuve-Rosemont, Surgery Department, Université de Montréal, Montreal, Quebec, Canada
- Centre de recherche de l'Hôpital Maisonneuve-Rosemont, Quebec, Montreal, Canada
| | - Jonathan Gervais-Hupé
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Quebec, Canada
- Centre de recherche en éthique (CRÉ), Université de Montréal, Montreal, Quebec, Canada
| | - François Desmeules
- Centre de recherche de l'Hôpital Maisonneuve-Rosemont, Quebec, Montreal, Canada
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Anne Hudon
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Quebec, Canada
- Centre de recherche en éthique (CRÉ), Université de Montréal, Montreal, Quebec, Canada
| | - Kadija Perreault
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Quebec, Canada
| | - Pascal-André Vendittoli
- Hôpital Maisonneuve-Rosemont, Surgery Department, Université de Montréal, Montreal, Quebec, Canada.
- Centre de recherche de l'Hôpital Maisonneuve-Rosemont, Quebec, Montreal, Canada.
- Personalized Arthroplasty Society, Atlanta, Georgia, USA.
- Duval Orthopaedic Clinic, Laval, Quebec, Canada.
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Patient Satisfaction with Private Recovery Services and Importance of Physician Behavior during COVID Time. Healthcare (Basel) 2021; 9:healthcare9080928. [PMID: 34442065 PMCID: PMC8394884 DOI: 10.3390/healthcare9080928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/16/2021] [Accepted: 07/20/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction: Patient satisfaction represents an essential indicator of the quality of care in the medical recuperation sector. This study aimed to identify the degree of satisfaction in patients who benefit from medical recuperation services in one private clinic from Romania and the factors that played a part in this respect. Method: An online questionnaire was completed by 105 patients of a private clinic in the period immediately following the opening of the clinic after the quarantine period due to COVID-19. The following concepts were measured: general satisfaction with clinical recuperation services (SG), physician’s behavior (PB), the impact of interventions on the state of health (IHI), modern equipment (ME), and the intention to return to the clinic (IRC). Based on a linear regression model, the impact of PB, IHI, ME, and IRC variables on general satisfaction (SG) was established. Results: The study results confirm the data from studies carried out in different sociocultural contexts in ordinary time, where physician behavior is the most crucial factor in patients’ satisfaction. Therefore, we can say that the physiotherapist’s behavior has an essential role in determining the patients’ satisfaction both in ordinary time and in COVID-19 time. The data in this study reflect the fact that satisfaction with the services offered by a medical recuperation clinic is a predictor for using the services in the future. Still, our study reflects a moderate relationship in intensity.
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Jesus TS, Papadimitriou C, Bright FA, Kayes NM, Pinho CS, Cott CA. The Person-Centered Rehabilitation Model: Framing the concept and practice of person-centered adult physical rehabilitation based on a scoping review and thematic analysis of the literature. Arch Phys Med Rehabil 2021; 103:106-120. [PMID: 34228955 DOI: 10.1016/j.apmr.2021.05.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/04/2021] [Accepted: 05/11/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To develop a cross-professional model framing the concept and practice of Person-Centered Rehabilitation (PCR) in adult populations, based on a scoping review and thematic analysis of the literature. DATA SOURCES Key databases (PubMed, Scopus, CINAHL), snowballing searches, and experts' consultation were the data sources for English-language empirical or conceptual papers, published from January 2007 to February 2020. STUDY SELECTION Two independent reviewers selected adult-based papers addressing at least one of the six categories of PCR-related content, a priori specified in the published review protocol. From 6527 unique references, 147 were finally included in the analysis. Of those, 26 were exclusively conceptual papers. DATA EXTRACTION Two independent reviewers extracted textual data on what PCR entails conceptually or as a practice. No quality appraisals were performed as is typical in scoping reviews. DATA SYNTHESIS A thematic analysis produced thematic categories that were combined into an emergent model (the PCR Model), which was reviewed by five external experts. PCR was framed as a way of thinking about and providing rehabilitation services "with" the person. PCR is embedded in rehabilitation structures and practice across three levels: 1) the person-professional dyad, 2) the micro-system level (typically an interprofessional team, involving significant others) and 3) a macro-system level (organization within which rehabilitation is delivered). Thematic categories are articulated within each level, detailing both the conceptual and practice attributes of PCR. CONCLUSION The PCR model can inform both clinical and service organization practices. The PCR Model may benefit from further developments including obtaining wider stakeholders' input, determining relevance in different cultural and linguistic groups, and further operationalization and testing in implementation projects.
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Affiliation(s)
- Tiago S Jesus
- Global Health and Tropical Medicine (GHTM) & WHO Collaborating Centre for Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine - NOVA University of Lisbon, Rua da Junqueira 100, Lisbon 1349-008, Portugal.
| | | | - Felicity A Bright
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Nicola M Kayes
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Cátia S Pinho
- ISVOUGA - Superior Institute of Entre Douro e Vouga, Santa Maria da Feira, Portugal
| | - Cheryl A Cott
- Rehabilitation Sciences Institute, Faculty of Medicine; University of Toronto, Toronto, Canada
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Abdolalizadeh M, Mosallanezhad Z, Ghodrati M, Saeedi A, Kamyab H. Cross-cultural adaptation and validation of the Persian version of the Physical Therapy Outpatient Satisfaction Survey. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2020.0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Few satisfaction questionnaires have been available to physical therapists for use in an Iranian population. This study aimed to translate, culturally adapt and validate the Iranian version of the Physical Therapy Outpatient Satisfaction Survey. This was a methodological study in outpatients from the physiotherapy centres in Kerman, Iran. Methods In this study, a cross-sectional and prospective validation study design was used. The Persian version of this questionnaire was prepared using forward and backward translation. The test–retest reliability was examined through interclass correlation coefficient, and absolute reliability was assessed through minimal detectable change and standard error of measurement. Internal consistency reliability was assessed by the Cronbach's alpha coefficients. Concurrent criterion validity was evaluated by assessing the correlation between the subscales of the questionnaire and the global satisfaction index. Divergent validity was measured by comparing the Persian Physical Therapy Outpatient Satisfaction Survey with the visual analogue scale and with the Global Rating of Change. The Statistical Package for the Social Sciences (version 24) was used for statistical analysis. Results A total of 297 individuals completed the questionnaire, and after 5–7 days, 40 participants answered the questionnaire again. The interclass correlation coefficients for the total score of Persian Physical Therapy Outpatient Satisfaction Survey was 0.75 and for the subscales of enhancers, detractors, location and cost were 0.76, 0.79, 0.84 and 0.40 respectively. The coefficient for internal consistency reliability (Cronbach's alpha=0.73) was within the acceptable range. The standard error of measurement and minimal detectable change were 0.5 and 1.4 respectively. The correlation of Physical Therapy Outpatient Satisfaction Survey subscales with global satisfaction was relatively good except for the cost subscale. Divergent validity was significant and poor for the visual analogue scale, r=–0.11 (P=0.04), but non-significant for the Global Rating of Change, r=–0.04 (P=0.40). There were no floor and ceiling effects in the Physical Therapy Outpatient Satisfaction Survey questionnaire subscales scores. Conclusions Although measurement properties of the Physical Therapy Outpatient Satisfaction Survey did not fully achieve measurement properties, the authors believe that the Persian version of the Physical Therapy Outpatient Satisfaction Survey can be used among Persian-speaking outpatient populations.
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Affiliation(s)
- Mahboobeh Abdolalizadeh
- Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Zahra Mosallanezhad
- Department of Physical Therapy and Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Maryam Ghodrati
- Department of Health and Rehabilitation Sciences, University of Western Ontario, London, Canada
| | - Ahmad Saeedi
- Department of Statistical Research and Information Technology, Institute for Research and Planning in Higher Education, Tehran, Iran
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Chi-Lun-Chiao A, Chehata M, Broeker K, Gates B, Ledbetter L, Cook C, Ahern M, Rhon DI, Garcia AN. Patients' perceptions with musculoskeletal disorders regarding their experience with healthcare providers and health services: an overview of reviews. Arch Physiother 2020; 10:17. [PMID: 32983572 PMCID: PMC7517681 DOI: 10.1186/s40945-020-00088-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/15/2020] [Indexed: 12/21/2022] Open
Abstract
Objectives This overview of reviews aimed to identify (1) aspects of the patient experience when seeking care for musculoskeletal disorders from healthcare providers and the healthcare system, and (2) which mechanisms are used to measure aspects of the patient experience. Data sources Four databases were searched from inception to December 20th, 2019. Review methods Systematic or scoping reviews examining patient experience in seeking care for musculoskeletal from healthcare providers and the healthcare system were included. Independent authors screened and selected studies, extracted data, and assessed the methodological quality of the reviews. Patient experience concepts were compiled into five themes from a perspective of a) relational and b) functional aspects. A list of mechanisms used to capture the patient experience was also collected. Results Thirty reviews were included (18 systematic and 12 scoping reviews). Relational aspects were reported in 29 reviews and functional aspects in 25 reviews. For relational aspects, the most prevalent themes were “information needs” (education and explanation on diseases, symptoms, and self-management strategies) and “understanding patient expectations” (respect and empathy). For functional aspects, the most prevalent themes were patient’s “physical and environmental needs,” (cleanliness, safety, and accessibility of clinics), and “trusted expertise,” (healthcare providers’ competence and clinical skills to provide holistic care). Interviews were the most frequent mechanism identified to collect patient experience. Conclusions Measuring patient experience provides direct insights about the patient’s perspectives and may help to promote better patient-centered health services and increase the quality of care. Areas of improvement identified were interpersonal skills of healthcare providers and logistics of health delivery, which may lead to a more desirable patient-perceived experience and thus better overall healthcare outcomes. Trial registration Systematic review registration: PROSPERO (CRD42019136500).
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Affiliation(s)
- Alan Chi-Lun-Chiao
- Duke Department of Orthopedic Surgery, Duke University Division of Physical Therapy, Durham, North Carolina USA
| | - Mohammed Chehata
- Duke Department of Orthopedic Surgery, Duke University Division of Physical Therapy, Durham, North Carolina USA
| | - Kenneth Broeker
- Duke Department of Orthopedic Surgery, Duke University Division of Physical Therapy, Durham, North Carolina USA
| | - Brendan Gates
- Duke Department of Orthopedic Surgery, Duke University Division of Physical Therapy, Durham, North Carolina USA
| | - Leila Ledbetter
- Duke University Medical Center Library, Durham, North Carolina USA
| | - Chad Cook
- Duke Department of Orthopedic Surgery, Duke University Division of Physical Therapy, Duke Clinical Research Institute, Durham, North Carolina USA
| | - Malene Ahern
- University of Wollongong, Australian Health Services Research Institute, Sydney, New South Wales Australia
| | - Daniel I Rhon
- Center for the Intrepid, Brooke Army Medical Center, San Antonio, TX USA
| | - Alessandra N Garcia
- College of Pharmacy & Health Sciences, Physical Therapy Program, Lillington, North Carolina USA
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13
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Manhas KP, Olson K, Churchill K, Faris P, Vohra S, Wasylak T. Measuring shared decision-making and collaborative goal setting in community rehabilitation: a focused ethnography using cross-sectional surveys in Canada. BMJ Open 2020; 10:e034745. [PMID: 32819982 PMCID: PMC7443299 DOI: 10.1136/bmjopen-2019-034745] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To describe and measure the shared decision-making (SDM) experience, including goal-setting experiences, from the perspective of patients and providers in diverse community-rehabilitation settings. DESIGN Prospective, longitudinal surveys. SETTING 13 primary level-of-care community-rehabilitation sites in diverse areas varying in geography, patient population and provider discipline341 adult, English-speaking patient-participants, and 66 provider-participants. MEASURES Alberta Shared decision-maKing Measurement Instrument (dyadic tool measuring SDM), WatLX (outpatient rehabilitation experience) and demographic questionnaire. Survey packages distributed at two timepoints (T0=recruitment; T1=3 months later). RESULTS We found that among 341 patient-provider dyads, 26.4% agreed that the appointment at recruitment involved high-quality SDM. Patient perceptions of goal-setting suggested that 19.6% of patients did not set a goal for their care, and only 11.4% set goals in functional language that tied directly to an activity/role/responsibility that was meaningful to their life. Better SDM was clinically associated with higher total family income (p=0.045). CONCLUSIONS These findings provide evidence for the importance of SDM and goal setting in community rehabilitation. Among patients, lower ratings of SDM corresponded with less recognition of their preferences. Actionable strategies include supporting financially vulnerable patients in realising SDM through training of providers to make extra space for such patients to share their preferences and better preparing patients to articulate their preferences. We recommend more research into strategies that advance highly functional goal setting with patients, and that lessen survey ceiling effects.
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Affiliation(s)
- Kiran Pohar Manhas
- Strategic Clinical Networks, Alberta Health Services, Calgary, Alberta, Canada
| | - Karin Olson
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Katie Churchill
- Health Professions, Strategy & Practice, Alberta Health Services, Calgary, Alberta, Canada
| | - Peter Faris
- Analytics (DIMR), Health Services Statistical & Analytic Methods, Alberta Health Services, Calgary, Alberta, Canada
| | - Sunita Vohra
- Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Tracy Wasylak
- Strategic Clinical Networks, Alberta Health Services, Calgary, Alberta, Canada
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The Impact of Socio-environmental Barriers on the Process of Engagement in Cardiac Rehabilitation Programs. BEHAVIOUR CHANGE 2020. [DOI: 10.1017/bec.2020.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractCardiac rehabilitation (CR) is a multi-disciplinary intervention designed to stabilise, slow, or reverse CVD, restore health following a cardiac event and facilitate the prevention of further events. The Model of Therapeutic Engagement (MTE) is a comprehensive conceptual model for explaining the process of engagement in rehabilitation. Of concern is that the role of socio-environmental factors is absent from explaining individual engagement in the MTE. There is also a lack of prospective studies investigating the impact of socio-environmental barriers on engagement in CR programs over time. This study aimed to expand the MTE, by illuminating the role of socio-environmental barriers in a three-stage process of engagement in CR programs. A prospective study was conducted, with 217 individuals recruited from the Cardiology Ward in the Gold Coast University Hospital (GCUH) and the Robina Cardiac Rehabilitation Centre. The collected data were examined using a structural equation model that added socio-environmental factors into the MTE, using multi-group analyses. In this study, we found that socio-environmental factors were not associated with intention to engage in the CR program, but were related to actual attendance and maintenance of participation in CR programs. Knowing how these socio-environmental barriers affect the process of engagement at different stages may help to tailor more accessible CR programs for the population.
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Patient and Clinician Perspectives on Quality-of-Care Topics for Users of Custom Ankle-Foot Orthoses. Am J Phys Med Rehabil 2020; 99:540-549. [PMID: 31860589 DOI: 10.1097/phm.0000000000001373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE As in all healthcare areas, there is a need to improve quality relevant to orthotic practice, but we lack information as to what aspects of healthcare quality are meaningful to measure. Thus, the objective was to identify issues that are important to the quality-of-care for people who use custom ankle-foot orthoses as identified by ankle-foot orthosis users, orthotists, and physical therapists. DESIGN We conducted focus groups with custom ankle-foot orthosis users, orthotists, and physical therapists. A stenographer took verbatim notes and provided transcripts. Research staff members assessed the transcripts using thematic analysis. RESULTS Participants included 5 ankle-foot orthosis users (1 focus group), 17 orthotists (2 focus groups), and 7 physical therapists (1 focus group). They discussed domains of quality-of-care relevant for people with ankle-foot orthoses. We identified 28 thematic codes addressing 10 broad themes of quality-of-care. Six of the broad themes (organizational characteristics, patient-clinician communication, care coordination, device fit and comfort, body function, activity, and participation) mapped to the National Quality Forum's person- and family-centered care concepts. Environment of care, clinician competencies, and device characteristics and usage were important to orthotic practice but do not map to any National Quality Forum concept. Participants did not mention the National Quality Forum concept of shared decision-making. CONCLUSIONS The quality themes provide information as to what aspects of healthcare quality are meaningful to measure with respect to orthotic care, thus providing guidance on how to measure and improve ankle-foot orthosis service delivery.
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Manhas KP, Olson K, Churchill K, Vohra S, Wasylak T. Experiences of shared decision-making in community rehabilitation: a focused ethnography. BMC Health Serv Res 2020; 20:329. [PMID: 32306972 PMCID: PMC7168887 DOI: 10.1186/s12913-020-05223-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 04/13/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Shared decision-making (SDM) can advance patient satisfaction, understanding, goal fulfilment, and patient-reported outcomes. We lack clarity on whether this physician-focused literature applies to community rehabilitation, and on the integration of SDM policies in healthcare settings. We aimed to understand patient and provider perceptions of shared decision-making (SDM) in community rehabilitation, particularly the barriers and facilitators to SDM. METHODS We used a focused ethnography involving 14 community rehabilitation sites across Alberta, including rural, regional-urban and metropolitan-urban sites. We conducted semi-structured interviews that asked participants about their positive and negative communication experiences (n = 23 patients; n = 26 providers). RESULTS We found SDM experiences fluctuated between extremes: Getting Patient Buy-In and Aligning Expectations. The former is provider-driven, prescriptive and less flexible; the latter is collaborative, inquisitive and empowering. In Aligning Expectations, patients and providers express humility and openness, communicate in the language of ask and listen, and view education as empowering. Patients and providers described barriers and facilitators to SDM in community rehabilitation. Facilitators included geography influencing context and connections; consistent, patient-specific messaging; patient lifestyle, capacity and perceived outlook; provider confidence, experience and perceived independence; provider training; and perceptions of more time (and control over time) for appointments. SDM barriers included lack of privacy; waitlists and financial barriers to access; provider approach; how choices are framed; and, patient's perceived assertiveness, lack of capacity, and level of deference. CONCLUSIONS We have found both excellent experiences and areas for improvement for applying SDM in community rehabilitation. We proffer recommendations to advance high-quality SDM in community rehabilitation based on promoting facilitators and overcoming barriers. This research will support the spread, scale and evaluation of a new Model of Care in rehabilitation by the provincial health system, which aimed to promote patient-centred care.
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Affiliation(s)
- Kiran Pohar Manhas
- c/o Strategic Clinical Networks™, Alberta Health Services, Southport Tower, 10301 Southport Lane SW, Calgary, Alberta, T2W 1S7, Canada. .,Integrative Health Institute, University of Alberta, Edmonton, Alberta, Canada.
| | - Karin Olson
- Integrative Health Institute, University of Alberta, Edmonton, Alberta, Canada.,Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Katie Churchill
- c/o Strategic Clinical Networks™, Alberta Health Services, Southport Tower, 10301 Southport Lane SW, Calgary, Alberta, T2W 1S7, Canada.,Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Occupational Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Sunita Vohra
- Integrative Health Institute, University of Alberta, Edmonton, Alberta, Canada.,Departments of Pediatrics and Psychiatry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Tracy Wasylak
- c/o Strategic Clinical Networks™, Alberta Health Services, Southport Tower, 10301 Southport Lane SW, Calgary, Alberta, T2W 1S7, Canada.,Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
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King G, Chiarello LA, Ideishi R, D'Arrigo R, Smart E, Ziviani J, Pinto M. The Nature, Value, and Experience of Engagement in Pediatric Rehabilitation: Perspectives of Youth, Caregivers, and Service Providers. Dev Neurorehabil 2020; 23:18-30. [PMID: 31042403 DOI: 10.1080/17518423.2019.1604580] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Purpose: To conduct a qualitative investigation of engagement in pediatric rehabilitation therapy.Methods: Interviews were conducted with 10 youth, 10 caregivers, and 10 service providers. Transcripts were analyzed thematically using an inductive approach.Results: Themes illustrated three perspectives: engagement as a connection with components of the therapy process, engagement as working together, and engagement as an affective and motivational process. Engagement created valued connections with therapy components and forward momentum for therapy.Conclusions: The themes supported a view of engagement as complex, transactional, and multidimensional. Participants focused on different, yet not discrepant, aspects of engagement. Youth focused on having fun and personal connection with service providers. Caregivers provided a more complex perspective encompassing both their own and their child's engagement, with an emphasis on relationship, understanding what is taking place, and feeling valued in the process. Service providers highlighted goal attainment and the value of engagement in bringing about outcomes.
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Affiliation(s)
- Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,University of Toronto, Toronto, Canada
| | | | - Roger Ideishi
- College of Public Health, Temple University, Philadelphia, PA, USA
| | - Rachel D'Arrigo
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Eric Smart
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Madhu Pinto
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
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18
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Alavinia SM, Hitzig SL, Farahani F, Flett H, Bayley M, Craven BC. Prioritization of rehabilitation Domains for establishing spinal cord injury high performance indicators using a modification of the Hanlon method: SCI-High Project. J Spinal Cord Med 2019; 42:43-50. [PMID: 31573446 PMCID: PMC6783798 DOI: 10.1080/10790268.2019.1616949] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objectives: To prioritize Domains of SCI Rehabilitation Care (SCI-Care) based on clinical importance and feasibility to inform the development of indicators of quality SCI-Care for adults with SCI/D in Canada. Methods: A 17-member external advisory committee, comprised of key stakeholders, ranked 15/37 Domains of rehabilitation previously flagged by the E-scan project team for gaps between knowledge generation and clinical implementation. Priority scores (D) were calculated using the Hanlon formula: D=[A+(2×B)]×C , where A is prevalence, B is seriousness, and C is the effectiveness of available interventions. A modified "EAARS" (Economic, Acceptability, Accessibility, Resources, and Simplicity) criterion was used to rank feasibility on a scale of 0-4 (4 is high). The product of these two scores determined the initial Domain ranking. Following the consensus process, further changes were made to the Domain rankings. Results: Despite a low feasibility score, Sexual Health was ranked as high priority; and, the Community Participation and Employment Domains were merged. The 11 final prioritized Domains in alphabetic order were: Cardiometabolic Health; Community Participation and Employment; Emotional Well-Being; Reaching, Grasping, and Manipulation; Self-Management; Sexual Health; Tissue Integrity; Urinary Tract Infection; Urohealth; Walking, and Wheeled Mobility. Conclusions: The modified Hanlon method was used to facilitate prioritization of 11 of 37 Domains to advance the quality of SCI-care by 2020. In future, the Spinal Cord Injury Rehabilitation Care High Performance Indicators (SCI-High) Project Team will develop structure, process and outcome indicators for each prioritized Domain.
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Affiliation(s)
- S. Mohammad Alavinia
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sander L. Hitzig
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Farnoosh Farahani
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Heather Flett
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Mark Bayley
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - B. Catharine Craven
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada,Correspondence to: B. Catharine Craven, Neural Engineering & Therapeutic Team, Toronto Rehabilitation Institute- University Health Network, Lyndhurst Centre, 520 Sutherland Drive, Toronto, ON, Canada M4G 3V9; Ph: (416) 597-3422 (ext: 6122).
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Jesus TS, Bright FA, Pinho CS, Papadimitriou C, Kayes NM, Cott CA. Scoping review of the person-centered literature in adult physical rehabilitation. Disabil Rehabil 2019; 43:1626-1636. [PMID: 31553633 DOI: 10.1080/09638288.2019.1668483] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE To describe the amount, range, and key characteristics (e.g., publication years, methods, topics) of the person-centered rehabilitation literature in adults with physical impairments. METHOD Following the published scoping review protocol, papers were identified through: three major databases, snowball searches and expert consultation. Two independent reviewers have identified English-language papers on adult person-centered rehabilitation according to six pre-defined inclusion categories - theoretical, quantitative and qualitive research papers are included; and then have extracted their key characteristics (e.g., aims, methods, participants). Descriptive statistics, regression and content analyses were used to synthesize the results. RESULTS Of 5912 deduplicated records initially screened, 170 papers were included: 136 empirical, including 13 systematic reviews. Empirical papers had data from 15264 clients and 4098 providers, in total. Yearly publications grew significantly from 2009 to 2018 (r2 = 0.71; b = 1.98: p < 0.01). Publications were unevenly distributed by countries (e.g., United States' publications per population was 44 times lower than New Zealand's). Most papers focused in more than one profession, setting-type or health conditions. Finally, many empirical papers (n = 67) studied implementation of person-centered rehabilitation approaches, including its effect. CONCLUSION This scoping review synthesizes key characteristics and publication trends in the person-centered rehabilitation literature on adults with physical impairments, a growing but unchartered territory thus far. This large and diverse body of literature can ground further person-centered rehabilitation practices and research, including toward building a transdisciplinary, trans-service model of person-centered rehabilitation.Implications for rehabilitationThe person-centered rehabilitation literature on adults with physical impairments, especially the empirical one, has been growing significantly over time, despite inequitably distributed per countries.Rehabilitation stakeholders, including practitioners, have a growing amount of literature in which they can rely for the operationalization and implementation of person-centered rehabilitation approaches into routine practice.Based on our work, person-centered rehabilitation emerges as a practice requirement that cuts across professional and other rehabilitation silos.
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Affiliation(s)
- Tiago S Jesus
- Global Health and Tropical Medicine (GHTM) & WHO Collaborating Centre for Health Workforce Policy and Planning-Institute of Hygiene and Tropical Medicine: NOVA University of Lisbon, Lisbon, Portugal
| | - Felicity A Bright
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Cátia S Pinho
- ISVOUGA - Superior Institute of Entre Douro e Vouga, Santa Maria da Feira, Portugal
| | | | - Nicola M Kayes
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Cheryl A Cott
- Rehabilitation Sciences Institute, Faculty of Medicine; University of Toronto, Toronto, Canada
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Abstract
AbstractThe primary aim of this study was to test the causal structure of the model of therapeutic engagement (MTE) for the first time, to examine whether the model assists in understanding the process of patient engagement in cardiac rehabilitation (CR) programs. This study used a prospective design, following up patients from the Gold Coast University Hospital Cardiology ward who attended Robina Cardiac Rehabilitation Clinic. A structural equation model of the interactions among the proposed variables within the three stages of the MTE (intention to engage in CR programs, CR initiation, and sustained engagement) revealed significant relationships among these variables in a dataset of 101 patients who attended a CR program. However, no relationship was discerned between outcome expectancies and patient intention to engage in CR. Patients’ willingness to consider the treatment also mediated the relationship between perceived self-efficacy and patient intention to engage in CR. These findings help clarify the process proposed by Lequerica and Kortte (2010) in the context of patient engagement in CR programs. The findings also reveal information on how patients engage in CR programs. Importantly, this provides new information for healthcare providers, enabling them to more effectively engage patients according to their stage of engagement.
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McMurray J, McNeil H, Gordon A, Elliott J, Stolee P. Building a Rehabilitative Care Measurement Instrument to Improve the Patient Experience. Arch Phys Med Rehabil 2019; 100:39-44. [DOI: 10.1016/j.apmr.2018.05.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 05/14/2018] [Accepted: 05/18/2018] [Indexed: 10/28/2022]
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22
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Rossettini G, Latini TM, Palese A, Jack SM, Ristori D, Gonzatto S, Testa M. Determinants of patient satisfaction in outpatient musculoskeletal physiotherapy: a systematic, qualitative meta-summary, and meta-synthesis. Disabil Rehabil 2018; 42:460-472. [PMID: 30428722 DOI: 10.1080/09638288.2018.1501102] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To identify and synthesise patient-identified factors that influence satisfaction with outpatient musculoskeletal physiotherapy (O-MSK).Methods: A systematic, qualitative meta-summary and meta-synthesis was conducted by accessing six electronic databases: CINAHL, Embase, MEDLINE, Scopus, Web of Science, and Wiley Online Library, from inception to March 2017. Additional studies were identified by using a "berry-picking" method. Search limits were: primary studies; English language; and involving human subjects. Qualitative peer-reviewed articles describing patient satisfaction in O-MSK were eligible for inclusion. Two reviewers critically appraised eligible studies independently using the critical appraisal of skills programme tool for qualitative studies. Extracted verbatim data of included studies were synthesised using the meta-summary and meta-synthesis by using a purpose-designed form.Results: Eleven studies were included in the article. Factors influencing patient satisfaction were grouped into six broad themes: 1) clinical outcomes; 2) physiotherapist features; 3) patient features; 4) physiotherapist-patient relationship; 5) treatment features, and 6) healthcare setting features.Conclusions: These findings suggest that patient satisfaction in O-MSK is a multidimensional construct influenced by individual patient/provider, clinical, and contextual factors. Future reviews should include a synthesis of findings from both qualitative and quantitative studies to establish a fully comprehensive understanding of this complex health phenomenon.Implications for rehabilitationPatient satisfaction in outpatient musculoskeletal physiotherapy is affected by different factors, thus reflecting a multidimensional construct;Single determinants are not sufficient to affect patient satisfaction;Patient satisfaction is influenced individual patient/provider, clinical outcomes, and contextual factors;Further studies should be designed to investigate the relationships among these factors.
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Affiliation(s)
- Giacomo Rossettini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy
| | - Teresa Maria Latini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy
| | - Alvisa Palese
- Department of Medical and Biological Sciences, School of Nursing, University of Udine, Udine, Italy
| | - Susan M Jack
- Department of Health Research Methods, School of Nursing, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Diego Ristori
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy
| | - Serena Gonzatto
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy
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McMurray J, McNeil H, Gordon A, Elliott J, Stolee P. Psychometric Testing of a Rehabilitative Care Patient Experience Instrument. Arch Phys Med Rehabil 2018; 99:1840-1847. [DOI: 10.1016/j.apmr.2018.04.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 04/22/2018] [Accepted: 04/26/2018] [Indexed: 10/14/2022]
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Jesus TS, Bright F, Kayes N, Cott CA. Person-centred rehabilitation: what exactly does it mean? Protocol for a scoping review with thematic analysis towards framing the concept and practice of person-centred rehabilitation. BMJ Open 2016; 6:e011959. [PMID: 27436670 PMCID: PMC4964252 DOI: 10.1136/bmjopen-2016-011959] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Person-centredness is a philosophy for organising and delivering healthcare based on patients' needs, preferences and experiences. Although widely endorsed, the concept suffers from a lack of detail and clarification, in turn accounting for ambiguous implementation and outcomes. While a conceptual framework based on a systematic review defines person/patient-centred care components (Scholl et al, 2014), it applies across healthcare contexts and may not be sensitive to the nuances of the rehabilitation of adults with physical impairments. Accordingly, this study aims to build a conceptual framework, based on existing literature, of what person-centredness means in the rehabilitation of adults with physical impairments in the clinical encounter and broader health service delivery. METHODS AND ANALYSIS We will use a scoping review methodology. Searches on relevant databases will be conducted first, combining keywords for 'rehabilitation', 'person-centered' and associated terms (including patient preferences/experiences). Next, snowball searches (citation tracking, references lists) will be performed. Papers will be included if they fall within predefined selection categories (seen as most likely informative on elements pertaining to person-centred rehabilitation) and are written in English, regardless of design (conceptual, qualitative, quantitative). Two reviewers will independently screen titles and abstracts, followed by screening of the full text to determine inclusion. Experts will then be consulted to identify relevant missing papers. This can include elements other than the peer-reviewed literature (eg, book chapters, policy/legal papers). Finally, information that helps to build the concept and practice of person-centred rehabilitation will be abstracted independently by two reviewers and analysed by inductive thematic analysis to build the conceptual framework. DISSEMINATION The resulting framework will aid clarification regarding person-centred rehabilitation, which in turn is expected to conceptually ground and inform its operationalisation (eg, measurement, implementation, improvement). Findings will be disseminated through local, national and international stakeholders, both at the clinical and service organisation levels.
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Affiliation(s)
- Tiago S Jesus
- Portuguese Ministry of Education. Aggregation of Schools of Escariz, Escariz, Portugal
| | - Felicity Bright
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Nicola Kayes
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Cheryl A Cott
- Faculty of Medicine, Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
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McMurray J, McNeil H, Lafortune C, Black S, Prorok J, Stolee P. Measuring Patients' Experience of Rehabilitation Services Across the Care Continuum. Part I: A Systematic Review of the Literature. Arch Phys Med Rehabil 2016; 97:104-20. [DOI: 10.1016/j.apmr.2015.08.407] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/12/2015] [Accepted: 08/03/2015] [Indexed: 10/23/2022]
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