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Bartlett DJ. Advancing the Evidence Base of Pediatric Physical Therapy: "Sincerely, From the Heart". Pediatr Phys Ther 2020; 32:172-179. [PMID: 32604355 DOI: 10.1097/pep.0000000000000704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To share reflections on themes that have become important to me as a developing pediatric physical therapy researcher contributing to knowledge generation in our field. KEY POINTS The themes are: select strong mentors, assemble a research team with diverse perspectives and strengths, be family-centered, be rigorous in approaches to study design to match the research question, mentor the next generation, and engage in knowledge translation and exchange. CONCLUSIONS I encourage everyone to reflect on who has been or could be your mentors or mentees, and on how you can be a part of an effective, family-centered research team, by encouraging a breadth of research designs to answer the many research questions that remain and by assisting in the implementation of knowledge to practice. CLINICAL RELEVANCE Outcomes for children and families receiving pediatric physical therapy services are enhanced through the use of evidence-based knowledge.
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Affiliation(s)
- Doreen J Bartlett
- School of Physical Therapy, Western University, London, Ontario, Canada
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A Strength-Based Intervention to Increase Participation in Leisure Activities in Children with Neuropsychiatric Disabilities: A Pilot Study. Occup Ther Int 2020; 2020:1358707. [PMID: 32454804 PMCID: PMC7154983 DOI: 10.1155/2020/1358707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 03/10/2020] [Indexed: 11/18/2022] Open
Abstract
The aim is to evaluate the feasibility of an intervention model with a client-centered goal-directed approach with the aim to enhance the child's participation in leisure activities, self-efficacy, and activity performance. A pilot intervention using a client-centered goal-directed approach and a single-subject design was performed. Two Swedish boys with neuropsychiatric diagnosis aged 12 and 14 years old were included, and 3 leisure activity goals were identified. The intervention was carried out over 8 weeks and took place in the adolescent's everyday environment and at the pediatric rehabilitation center. The goal attainment of participation goals (GAS), the perceived performance ability according to the Canadian Occupational Performance Measure (COPM), the self-efficacy, and the participants' satisfaction were used to study the effect. The participants succeeded in attaining their leisure goals as specified by the GAS by achieving +2 on one goal and +1 on the other two goals. They estimated higher performance ability and self-efficacy in their goal performance. Participants, parents, and therapists were overall satisfied and found the intervention to be applicable and helpful in optimizing leisure participation. The intervention model with a client-centered goal-directed approach in which participants define their own leisure activity goals appears to be effective in increasing participation in leisure activities.
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Engel-Yeger B. The involvement of altered sensory modulation in neurological conditions and its relevance to neuro-rehabilitation: a narrative literature review. Disabil Rehabil 2019; 43:2511-2520. [PMID: 31829745 DOI: 10.1080/09638288.2019.1699175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Neurological conditions are frequently described and treated with emphasis on primarily body dysfunctions that appear in the diagnostic criteria. This perspective paper aims to provide knowledge about the involvement of secondary body dysfunctions - altered sensory modulation - in neurological conditions and their relevance to neuro-rehabilitation. This paper refers to children and adults, to provide a life span view. Health models and approaches are discussed to bring ideas for optimizing rehabilitation. METHODS Perspective based on narrative literature review. RESULTS Altered sensory modulation is prevalent in neurological conditions. It is related to clinical symptoms, comorbidities and severity level. Many studies focus on specific modalities and on laboratory/clinical measurements. However, information gathered from subjective measures reflects the alterations in various sensory modalities and their negative impacts on the individuals' daily activity performance, participation and quality of life (QOL). CONCLUSIONS Neuro-rehabilitation should consider altered sensory modulation in neurological conditions, apply health models with broad perspective, as the ICF, with multi-disciplinary team, objective and subjective measures to understand how pathogenic mechanisms in primary and secondary body dysfunctions impact the performance and participation in daily life. This approach may optimize the individuals' involvement in therapy, enhance daily function and QOL and elevate intervention success.Implications for rehabilitationSensory modulation should be evaluated in children and adults with neurologic conditions.The evaluation and intervention should refer to the involvement of altered sensory modulation in the conditions' clinical characteristics, severity and comorbidities.In case altered sensory modulation is found, the evaluation and intervention should incorporate a multi-disciplinary collaboration and health models such as the ICF model, to optimize neuro-rehabilitation efficiency.Objective measures should be applied to profile altered sensory modulation and its role in pathogenic mechanisms.Subjective measures should also be used to reflect the expressions of altered sensory modulation as experienced by the individual (and family members), in daily life scenarios.By bridging between the clinic and the individuals' real-life context, rehabilitation process and outcomes may be optimized, in terms of the individual's greater involvement in therapy, better function and quality of life.
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Affiliation(s)
- Batya Engel-Yeger
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
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Ezekiel L, Collett J, Mayo NE, Pang L, Field L, Dawes H. Factors Associated With Participation in Life Situations for Adults With Stroke: A Systematic Review. Arch Phys Med Rehabil 2019; 100:945-955. [DOI: 10.1016/j.apmr.2018.06.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 01/09/2023]
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Brun-Cottan N, McMillian D, Hastings J. Defending the art of physical therapy: Expanding inquiry and crafting culture in support of therapeutic alliance. Physiother Theory Pract 2018; 36:669-678. [DOI: 10.1080/09593985.2018.1492656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
| | - Danny McMillian
- School of Physical Therapy, University of Puget Sound, Tacoma, WA, USA
| | - Jennifer Hastings
- School of Physical Therapy, University of Puget Sound, Tacoma, WA, USA
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Madden RH, Bundy A. The ICF has made a difference to functioning and disability measurement and statistics. Disabil Rehabil 2018; 41:1450-1462. [PMID: 29433362 DOI: 10.1080/09638288.2018.1431812] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIMS Fifteen years after the publication of the International Classification of Functioning, Disability and Health (ICF), we investigated: How ICF applications align with ICF aims, contents and principles, and how the ICF has been used to improve measurement of functioning and related statistics. METHODS In a scoping review, we investigated research published 2001-2015 relating to measurement and statistics for evidence of: a change in thinking; alignment of applications with ICF specifications and philosophy; and the emergence of new knowledge. RESULTS The ICF is used in diverse applications, settings and countries, with processes largely aligned with the ICF and intended to improve measurement and statistics: new national surveys, information systems and ICF-based instruments; and international efforts to improve disability data. Knowledge is growing about the components and interactions of the ICF model, the diverse effects of the environment on functioning, and the meaning and measurement of participation. CONCLUSION The ICF provides specificity and a common language in the complex world of functioning and disability and is stimulating new thinking, new applications in measurement and statistics, and the assembling of new knowledge. Nevertheless, the field needs to mature. Identified gaps suggest ways to improve measurement and statistics to underpin policies, services and outcomes. Implications for Rehabilitation The ICF offers a conceptualization of functioning and disability that can underpin assessment and documentation in rehabilitation, with a growing body of experience to draw on for guidance. Experience with the ICF reminds practitioners to consider all the domains of participation, the effect of the environment on participation and the importance of involving clients/patients in assessment and service planning. Understanding the variability of functioning within everyday environments and designing interventions for removing barriers in various environments is a vital part of rehabilitation planning.
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Affiliation(s)
- Rosamond H Madden
- a Faculty of Health Sciences , University of Sydney , Sydney , Australia
| | - Anita Bundy
- a Faculty of Health Sciences , University of Sydney , Sydney , Australia.,b Department of Occupational Therapy , Colorado State University , Fort Collins , CO , USA
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Beard D, Hamilton D, Davies L, Cook J, Hirst A, McCulloch P, Paez A. Evidence-Based Evaluation of Practice and Innovation in Physical Therapy Using the IDEAL-Physio Framework. Phys Ther 2018; 98:108-121. [PMID: 29077915 DOI: 10.1093/ptj/pzx103] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 09/30/2017] [Indexed: 02/09/2023]
Abstract
The IDEAL framework is an established method for initial and ongoing evaluations of innovation and practice for complex health care interventions. First derived for surgical sciences and embedded at a global level for evaluating surgery/surgical devices, the IDEAL framework is based on the principle that innovation and evaluation in clinical practice can, and should, evolve together in an ordered manner: from conception to development and then to validation by appropriate clinical studies and, finally, longer-term follow-up. This framework is highly suited to other complex, nonpharmacological interventions, such as physical therapist interventions. This perspective outlines the application of IDEAL to physical therapy in the new IDEAL-Physio framework. The IDEAL-Physio framework comprises 5 stages. In stage 1, the idea phase, formal data collection should begin. Stage 2a is the phase for iterative improvement and adjustment with thorough data recording. Stage 2b involves the onset of formal evaluation using systematically collected group or cohort data. Stage 3 is the phase for formal comparative assessment of treatment, usually involving randomized studies. Stage 4 involves long-term follow-up. The IDEAL-Physio framework is recommended as a method for guiding and evaluating both innovation and practice in physical therapy, with the overall goal of providing better evidence-based care.
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Affiliation(s)
- David Beard
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences and RCS Surgical Intervention Trial Unit, University of Oxford, Headington, Oxford, United Kingdom
| | - David Hamilton
- School of Clinical Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Loretta Davies
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences and RCS Surgical Intervention Trial Unit, University of Oxford
| | - Jonathan Cook
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences and RCS Surgical Intervention Trial Unit, University of Oxford
| | - Allison Hirst
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Peter McCulloch
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital
| | - Arsenio Paez
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, Department for Continuing Education, Kellogg College, University of Oxford, Oxford OX1 2JA, United Kingdom, and Department of Physical Therapy, Movement and Rehabilitation Sciences, College of Professional Studies, Northeastern University, Boston, Massachusetts
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Vaughan-Graham J, Cott C. "Letter to the Editor" Author response to: Mepsted R, Tyson S. The Bobath concept. A guru-led set of teachings unsupported by emerging evidence. A response to Vaughan-Graham and Cott. (J Eval Clin Pract. 2016. doi: 10.1111/jep.12751). J Eval Clin Pract. 2017. https://doi.org/10.1111/jep.12791. J Eval Clin Pract 2017; 23:1129-1131. [PMID: 28960729 DOI: 10.1111/jep.12822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 08/07/2017] [Indexed: 11/29/2022]
Affiliation(s)
| | - Cheryl Cott
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
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Bagatto MP, Moodie ST. Relevance of the International Classification of Functioning, Health and Disability: Children & Youth Version in Early Hearing Detection and Intervention Programs. Semin Hear 2016; 37:257-71. [PMID: 27489403 PMCID: PMC4954788 DOI: 10.1055/s-0036-1584406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Early hearing detection and intervention (EHDI) programs have been guided by principles from the Joint Committee on Infant Hearing and an international consensus of best practice principles for family-centered early intervention. Both resources provide a solid foundation from which to design, implement, and sustain a high-quality, family-centered EHDI program. As a result, infants born with permanent hearing loss and their families will have the support they need to develop communication skills. These families also will benefit from programs that align with the framework offered by the World Health Organization's International Classification of Functioning, Disability and Health: Children & Youth Version (ICF-CY). Within this framework, health and functioning is defined and measured by describing the consequences of the health condition (i.e., hearing loss) in terms of body function, structures, activity, and participation as well as social aspects of the child. This article describes the relevance of the ICF-CY for EHDI programs and offers a modified approach by including aspects of quality of life and human development across time.
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Affiliation(s)
- Marlene P. Bagatto
- National Centre for Audiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Sheila T. Moodie
- National Centre for Audiology and School of Communication Sciences and Disorders, Faculty of Health Sciences, Western University, London, Ontario, Canada
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Abstract
PURPOSE To describe the use of practice-based evidence research methodology in a prospective, multisite observational study to investigate changes in students' participation in school activity, self-care, posture/mobility, recreation/fitness, and academic outcomes, and the relationships of these changes to characteristics of school-based physical therapy. METHODS One hundred nine physical therapists completed the training and data collection and 296 students, 5 to 12 years of age (mean age = 7.3 years) had 6 months of complete data. Therapists completed individualized (Goal Attainment Scaling) and standardized (School Function Assessment) outcome measures for students at the beginning and end of the school year and during the year collected weekly data on services to and on behalf of the students. SUMMARY This research design enabled the investigation of complex research questions related to school-based practice. The findings of this study, to be reported later, should influence school-based therapy by providing guidance related to what activities, interventions, and services influence student outcomes.
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Cooney JB, Young J, Luckner JL, Ferrell KA. Learning What Works in Sensory Disabilities: Establishing Causal Inference. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2015. [DOI: 10.1177/0145482x1510900605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This article is intended to assist teachers and researchers in designing studies that examine the efficacy of a particular intervention or strategy with students with sensory disabilities. Ten research designs that can establish causal inference (the ability to attribute any effects to the intervention) with and without randomization are discussed.
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Affiliation(s)
- John B. Cooney
- Office of Academic Affairs, University of Colorado, Campus Box 35 UCA, 1800 Grant Street, Suite 800, Denver, CO 80203
| | - John Young
- Applied Analytics Group, DST Systems, 333 West 11th Street, Kansas City, MO 64105
| | - John L. Luckner
- College of Education and Behavioral Sciences, McKee 29, Campus Box 141, University of Northern Colorado, Greeley, CO 80639
| | - Kay Alicyn Ferrell
- School of Special Education, College of Education and Behavioral Sciences, University of Northern Colorado
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12
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Vaughan-Graham J, Cott C, Wright FV. The Bobath (NDT) concept in adult neurological rehabilitation: what is the state of the knowledge? A scoping review. Part II: intervention studies perspectives. Disabil Rehabil 2014; 37:1909-28. [DOI: 10.3109/09638288.2014.987880] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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13
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A Basic Construct for Improving Outcomes in Rehabilitation. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY AND TRAINING 2013. [DOI: 10.1123/ijatt.18.3.14] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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NiMhurchadha S, Gallagher P, MacLachlan M, Wegener ST. Identifying successful outcomes and important factors to consider in upper limb amputation rehabilitation: an international web-based Delphi survey. Disabil Rehabil 2013; 35:1726-33. [DOI: 10.3109/09638288.2012.751138] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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15
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Ravenek MJ, Skarakis-Doyle E, Spaulding SJ, Jenkins ME, Doyle PC. Enhancing the conceptual clarity and utility of the international classification of functioning, disability & health: the potential of a new graphic representation. Disabil Rehabil 2012; 35:1015-25. [DOI: 10.3109/09638288.2012.717582] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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16
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Ryan SE. An overview of systematic reviews of adaptive seating interventions for children with cerebral palsy: where do we go from here? Disabil Rehabil Assist Technol 2011; 7:104-11. [DOI: 10.3109/17483107.2011.595044] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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17
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Cott CA, Graham JV, Brunton K. When will the evidence catch up with clinical practice? Physiother Can 2011; 63:387-90. [PMID: 22654245 DOI: 10.3138/physio.63.3.387] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Cheryl A Cott
- Department of Physical Therapy, University of Toronto
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18
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Reinhardt JD, Miller J, Stucki G, Sykes C, Gray DB. Measuring impact of environmental factors on human functioning and disability: a review of various scientific approaches. Disabil Rehabil 2011; 33:2151-65. [PMID: 21548824 DOI: 10.3109/09638288.2011.573053] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The objective of this paper is to present a framework for systematically describing different approaches to measure environmental factors (EF) and to discuss some strengths and weaknesses of these approaches. METHODS Identification of suitable criteria for ordering measurements of EF was based on an analysis of existing reviews, a qualitative literature review and feedback from experts. Items of selected EF measures were linked to the International Classification of Functioning, Disability and Health. RESULTS Experimental and observational designs for the study of EF are distinguished and illustrated with examples. Approaches to study EF are differentiated into those directly measuring an environmental interaction with function and those relying on an independent assessment of environmental features. By applying these criteria, a three-dimensional matrix framework for measurement of EF in observational studies is developed. CONCLUSION The acknowledgement of different measurement approaches to the scientific study of EF is one pathway towards an increased understanding of the connection between environments and functioning. Many different measures may be used to approximate the realities of disabling or enabling environments. This review provides an initial framework for improving our fundamental comprehension of the complexity of the measurement of EF in the context of human health and disability.
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Affiliation(s)
- Jan D Reinhardt
- Swiss Paraplegic Research, Guido A. ZächStr. 4, Nottwil, 6207, Switzerland.
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Pettersson I, Pettersson V, Frisk M. ICF from an occupational therapy perspective in adult care: an integrative literature review. Scand J Occup Ther 2011; 19:260-73. [DOI: 10.3109/11038128.2011.557087] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dufour SP, Lucy SD. Situating primary health care within the international classification of functioning, disability and health: enabling the Canadian Family Health Team Initiative. J Interprof Care 2011; 24:666-77. [PMID: 20178420 DOI: 10.3109/13561820903550671] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Primary health care (PHC) mandates the provision of services delivered by a collaborative team of providers, ultimately to improve quality of care and health status. Considering the challenges related to interprofessional collaboration within novel PHC models, we explored how the World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF) could facilitate the enactment of PHC teams. The Canadian Family Health Team (FHT) initiative is used as an example. This paper will explore how the ICF could inform the development of a practice model to enable PHC. Three potential barriers to the envisioned enactment of PHC within the espoused Canadian FHT initiative are identified through a critical gaps analysis; lack of (i) philosophical grounding, (ii) developmental and operational directives, and (iii) evaluation methods. An ICF-informed practice model is proposed to overcome these potential barriers. It is argued that the proposed ICF-informed practice model has international implications as a unifying conceptual framework ideally situated to facilitate the provision of comprehensive evidence-based person-centered care by interprofessional collaborative teams within diverse PHC models.
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Affiliation(s)
- Sinéad P Dufour
- Graduate Program in Health & Rehabilitation Science, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
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Cerniauskaite M, Quintas R, Boldt C, Raggi A, Cieza A, Bickenbach JE, Leonardi M. Systematic literature review on ICF from 2001 to 2009: its use, implementation and operationalisation. Disabil Rehabil 2010; 33:281-309. [PMID: 21073361 DOI: 10.3109/09638288.2010.529235] [Citation(s) in RCA: 162] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE To present a systematic literature review on the state of the art of the utilisation of the International Classification of Functioning, Disability and Health (ICF) since its release in 2001. METHOD The search was conducted through EMBASE, MEDLINE and PsychInfo covering the period between 2001 and December 2009. Papers were included if ICF was mentioned in title or abstract. Papers focussing on the ICF-CY and clinical research on children and youth only were excluded. Papers were assigned to six different groups covering the wide scenario of ICF application. RESULTS A total of 672 papers, coming from 34 countries and 211 different journals, were included in the analysis. The majority of publications (30.8%) were conceptual papers or papers reporting clinical and rehabilitation studies (25.9%). One-third of the papers were published in 2008 and 2009. CONCLUSIONS The ICF contributed to the development of research on functioning and on disability in clinical, rehabilitation as well as in several other contexts, such as disability eligibility and employment. Diffusion of ICF research and use in a great variety of fields and scientific journals is a proof that a cultural change and a new conceptualisation of functioning and disability is happening.
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Affiliation(s)
- Milda Cerniauskaite
- Neurology, Public Health and Disability Unit-Scientific Directorate, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
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Abstract
This perspective article provides an example of a study planned using guidelines for comprehensive rehabilitation outcomes research, an approach that is believed to give service providers meaningful evidence to support practice. This line of investigation has been guided by the World Health Organization's International Classification of Functioning, Disability and Health. The short title of a study under way is Move & PLAY (Movement and Participation in Life Activities of Young Children). The article briefly describes the conceptual model, provides guidelines on how indicators and measures are selected, alludes to the details of selected measures, and describes processes of preparing for data collection, including obtaining ethics approval, preparing data collection booklets, training assessors and interviewers, and sampling. The aim of this investigation is to gain a better understanding of the multiple child, family, and service factors associated with changes in mobility, self-care, and play of preschool children with cerebral palsy as a result of using this research method. Comprehensive rehabilitation outcomes research holds promise in providing evidence that supports the complexities of planning rehabilitation services with clients with chronic conditions, such as children with cerebral palsy.
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McDougall J, Wright V, Rosenbaum P. The ICF model of functioning and disability: incorporating quality of life and human development. Dev Neurorehabil 2010; 13:204-11. [PMID: 20450470 DOI: 10.3109/17518421003620525] [Citation(s) in RCA: 104] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Since its 2001 publication, a number of issues have been raised about the ICF. The World Health Organization anticipated the ICF would undergo a continuous process of revision. This paper adds to this process. METHOD This article describes how the ICF framework shares a number of tenets with a systems perspective. An argument is built for why the ICF model of functioning and disability should be expanded to include the concepts of quality of life and human development. A modified model is presented that depicts a person's life quality and his/her potential for development as the outcomes and processes that arise from the interconnected, ever-changing influences of health, functioning and contextual factors. CONCLUSIONS A modified ICF model based on a systems perspective depicts a holistic view that acknowledges health, functioning, life quality and development are intertwined and are essential concepts to consider in the lives of all people.
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Shaw JA, Connelly DM, Zecevic AA. Pragmatism in practice: mixed methods research for physiotherapy. Physiother Theory Pract 2010; 26:510-8. [PMID: 20649500 DOI: 10.3109/09593981003660222] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this paper is to provide an argument for the place of mixed methods research across practice settings as an effective means of supporting evidence-based practice in physiotherapy. Physiotherapy practitioners use both qualitative and quantitative methods throughout the process of patient care-from history taking, assessment, and intervention to evaluation of outcomes. Research on practice paradigms demonstrates the importance of mixing qualitative and quantitative methods to achieve 'expert practice' that is concerned with optimizing outcomes and incorporating patient beliefs and values. Research paradigms that relate to this model of practice would integrate qualitative and quantitative types of knowledge and inquiry, while maintaining a prioritized focus on patient outcomes. Pragmatism is an emerging research paradigm where practical consequences and the effects of concepts and behaviors are vital components of meaning and truth. This research paradigm supports the simultaneous use of qualitative and quantitative methods of inquiry to generate evidence to support best practice. This paper demonstrates that mixed methods research with a pragmatist view provides evidence that embraces and addresses the multiple practice concerns of practitioners better than either qualitative or quantitative research approaches in isolation.
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Affiliation(s)
- James A Shaw
- School of Physical Therapy, The University of Western Ontario, London, Ontario, Canada.
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Fiss AL, McCoy SW, Bartlett DJ, Chiarello LA, Palisano RJ, Stoskopf B, Jeffries L, Yocum A, Wood A. Sharing of lessons learned from multisite research. Pediatr Phys Ther 2010; 22:408-16. [PMID: 21068641 DOI: 10.1097/pep.0b013e3181faeb11] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To highlight key considerations for planning and implementing multisite research based on experiences and reflections in conducting a large, international, multisite study. DESCRIPTION Successes and challenges encountered throughout a multisite study process, and collective recommendations for future researchers are presented. Considerations addressed include creation of the research team and a "community of practice," study preparation and management time, approval by institutional review boards, training of future researchers, recruitment and retention of participants, and dissemination and translation of study materials to consumers. IMPORTANCE TO MEMBERS Multisite research has the potential to create knowledge for pediatric physical therapy through collaboration among knowledgeable researchers and expert practitioners and by increasing the potential for generalization of findings. Effective planning, including anticipation of challenges, is critical to a successful study. Our collective experiences may assist practitioners and researchers in planning, implementing, and completing future multisite studies.
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Affiliation(s)
- Alyssa LaForme Fiss
- Department of Physical Therapy, Mercer University, Atlanta, Georgia 30341, USA.
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Conti-Becker A. Between the ideal and the real: Reconsidering the International Classification of Functioning, Disability and Health. Disabil Rehabil 2009; 31:2125-9. [DOI: 10.3109/09638280902912509] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Angela Conti-Becker
- Doctoral Program in Rehabilitation Sciences, The University of Western Ontario, London, Ontario, Canada
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Kinsella EA, Whiteford GE. Knowledge generation and utilisation in occupational therapy: Towards epistemic reflexivity. Aust Occup Ther J 2009; 56:249-58. [DOI: 10.1111/j.1440-1630.2007.00726.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sykes C. The International Classification of Functioning, Disability and Health: Relevance and applicability to physiotherapy. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/14038190802294617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bartlett DJ, Deborah Lucy S, Bisbee L, Conti-Becker A. Understanding the professional socialization of canadian physical therapy students: a qualitative investigation. Physiother Can 2009; 61:15-25. [PMID: 20145748 DOI: 10.3138/physio.61.1.15] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To understand the professional socialization of physical therapy (PT) students. METHOD Forty-two students enrolled in our newly developed master's degree programme wrote three-page reflective journals on a critical learning incident after each of three selected clinical experiences. The journals were coded and analyzed, and major themes were identified and described. A separate cohort of 44 students participated in focus groups after the same three clinical experiences to check the trustworthiness of the results. RESULTS Following the first placement, the main themes coded were emotions, self-confidence, professionalism in the real world, communication, and learning by doing. After the intermediate placement, major themes were idealism versus realism, depth of communication with clients, and breadth of communication with family members and colleagues. Aspects of clinical learning were variable, and self-confidence remained an issue. After the final placement, most students were deeply engaged with their clients and self-confidence had developed to the point of self-efficacy. Tensions increased between the concept of ideal practice and the pragmatics of actual practice, and the concept of self as protégé (rather than as object of the supervisor's evaluation) emerged. The themes were subsequently assembled in a booklet with representative quotations. CONCLUSION These results contribute to foundational knowledge required by PT educators, including clinical instructors, by explicitly describing the professional socialization of PT students.
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Affiliation(s)
- Doreen J Bartlett
- Doreen J. Bartlett, PT, PhD: Associate Professor, School of Physical Therapy, Faculty of Health Sciences, The University of Western Ontario, London, Ontario
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Abstract
BACKGROUND AND PURPOSE The World Health Organization's International Classification of Functioning, Disability and Health (ICF) is gaining recognition in physical therapy. The Extended ICF Core Set for Stroke is a practical tool that represents a selection of categories from the whole classification and can be used along with the ICF qualifier scale to describe patients' functioning and disability following stroke. The application of the ICF qualifier scale poses the question of interrater reliability. The primary objective of this investigation was to study the agreement between physical therapists' ratings of subjects' functioning and disability with the Extended ICF Core Set for Stroke and with the ICF qualifier scale. Further objectives were to explore the relationships between agreement and rater confidence and between agreement and physical therapists' areas of core competence. SUBJECTS AND METHODS A monocentric, cross-sectional reliability study was conducted. A consecutive sample of 30 subjects after stroke participated. Two physical therapists rated the subjects' functioning in 166 ICF categories. RESULTS The interrater agreement of the 2 physical therapists was moderate across all judgments (observed agreement=51%, kappa=.41). Interrater reliability was not related to rater confidence or to the physical therapists' areas of core competence. DISCUSSION AND CONCLUSION The present study suggests potential improvements to enhance the implementation of the ICF and the Extended ICF Core Set for Stroke in practice. The results hint at the importance of the operationalization of the ICF categories and the standardization of the rating process, which might be useful in controlling for rater effects and increasing reliability.
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