1
|
Barradell S, Scholten I. How, and to what end, is the WHO-ICF framework represented in physiotherapy? Insights from a qualitative research synthesis. Physiother Theory Pract 2024:1-18. [PMID: 38938207 DOI: 10.1080/09593985.2024.2370345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 06/14/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND It has been two decades since the World Health Organization's endorsement of the International Classification of Functioning, Disability and Health (ICF). It is timely to undertake a rigorous search that analyzes the discourses around the ICF's conceptual framework within physiotherapy, the kinds of enquiry to date and the professional areas where this is happening and how. PURPOSE The aim of this research is to synthesize the literature related to how the physiotherapy profession (practice, research and education) thinks about and puts to use the WHO ICF. RESULTS A final sample of 37 papers was agreed. Five overarching third-order interpretations were derived: (i) A way of thinking and practicing, (ii) Endorsed but not embedded, (iii) Striking a balance, (iv) Power of participation and (v) Moving forward. Together, these themes illustrate the evolving role of the ICF in physiotherapy over the previous two decades. They highlight the ICF's potential for shaping the future of physiotherapy practice, education and research. CONCLUSIONS Work is needed to connect existing literature about the ICF and related models and embed the ICF, its language and philosophy across physiotherapy education and practice. Re-representation of the model might help address misinterpretation of the ICF, but fundamentally, embedding the ICF in entry-level curriculum is likely to be the most significant driver of change in practice.
Collapse
Affiliation(s)
- Sarah Barradell
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Ingrid Scholten
- Speech Pathology & Audiology, Flinders University, Adelaide, SA, Australia
| |
Collapse
|
2
|
Tolchin DW, Ankam NS, Rydberg L. Twelve tips for including disability education in undergraduate medical education. MEDICAL TEACHER 2024:1-8. [PMID: 38386799 DOI: 10.1080/0142159x.2024.2317913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
Disability is a large and growing minority population worldwide. People with disabilities continue to experience health and healthcare disparities. Despite multiple calls to action to provide disability education within undergraduate medical education as a strategy to mitigate ongoing inequities, robust disability education is not routinely provided across medical schools. This article provides twelve tips that any medical school faculty can utilize to integrate meaningful disability education within existing core medical education.
Collapse
Affiliation(s)
- Dorothy W Tolchin
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, Spauling Rehabilitation Hospital, Boston, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, MassGeneral Brigham, Boston, Massachusetts, USA
| | - Nethra S Ankam
- Department of Rehabilitation Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Leslie Rydberg
- Shirley Ryan AbilityLab, Chicago, Illinois, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| |
Collapse
|
3
|
Sobantu NA, Tshabalala MD, Chetty V. Exploring the collaborative care of patients with pelvic fractures in Tshwane, South Africa. S Afr Fam Pract (2004) 2023; 65:e1-e9. [PMID: 37265140 DOI: 10.4102/safp.v65i1.5705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Pelvic fractures are complex injuries that lead to long-term disabilities and poor health-related quality of life (HRQoL). Even though pelvic fractures are known to be challenging to manage, there is limited information on guidelines and protocols to ensure that patients receive comprehensive and collaborative healthcare. METHODS A qualitative descriptive phenomenological approach was utilised to explore current practices and innovations of healthcare professionals (HPs) in Tshwane academic hospitals in the collaborative management and rehabilitation of patients with pelvic fractures, using semi-structured interviews. Thematic analysis was used to analyse data. RESULTS Six overarching themes were identified from the interviews with HPs: The biopsychosocial lens of the patient, limitations in approaches to care, contextual impediments to care, the team challenge; the biopsychosocial aspects of care and forging forward to improve care. CONCLUSION A multidisciplinary approach is encouraged for the comprehensive management of pelvic fractures. However, a poor understanding of roles and poor referral structures challenge this approach. Further barriers to caring include staff shortages and limited resources. Healthcare professionals recommended interprofessional education and collaborative practice, student training and using standardised outcome measurement tools to improve care for patients with pelvic fractures.Contribution: This study lays a foundation to initiate conversations about the development of an interprofessional model of care for patients with pelvic fractures. Findings might inform health policies on the management of pelvic fractures. Healthcare professionals might apply strategies that enhance the quality of healthcare provided. Patients with pelvic fractures might receive quality interprofessional healthcare that promotes quality of life, post pelvic fractures.
Collapse
Affiliation(s)
- Ntombenkosi A Sobantu
- Department of Physiotherapy, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa; and, Department of Physiotherapy, Faculty of Health Sciences, University of KwaZulu-Natal, Durban.
| | | | | |
Collapse
|
4
|
Schwab SM, Andrade V, Santos Moreira T, Cavanaugh JT, Vaz DV, Silva PL. Narrowing the physiotherapy knowledge-practice gap: faculty training beyond the health sciences. Physiother Theory Pract 2023; 39:675-689. [PMID: 35068343 DOI: 10.1080/09593985.2022.2027585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Physiotherapists seek to improve client movement and promote function within an individual's unique environmental and social realities. Despite this intention, there is a well-noted knowledge-practice gap, that is, therapists generally lack sufficient foundational preparation to effectively navigate societal challenges impacting contemporary healthcare. As one step toward addressing the issue, we propose an educational solution targeting current and future physiotherapy faculty, whose responsibilities for entry-level course development and curriculum design substantially impact student readiness for clinical practice. We propose that physiotherapy faculty trained via postprofessional education in a non-biomedical field (e.g. psychology, education, and philosophy) will be uniquely prepared to provide students with tools for dealing with complex social issues facing their clients; critical analysis skills; statistical and technological training; and a deeper theoretical and philosophical understanding of practice. Taken together, such interdisciplinary tools could help address the knowledge-practice gap for physiotherapists and promote the ongoing evolution of the profession in concert with contemporary healthcare. Physiotherapists who pursue interdisciplinary studies may more deeply understand the challenges faced by clinicians and may be well-positioned to leverage knowledge and methods in another scientific discipline to expand and transform the scope of solutions to these challenges.
Collapse
Affiliation(s)
- Sarah M Schwab
- Center for Cognition, Action, and Perception, Department of Psychology, Edwards Center 1, University of Cincinnati, Cincinnati, OH, USA
| | - Valéria Andrade
- Center for Cognition, Action, and Perception, Department of Psychology, Edwards Center 1, University of Cincinnati, Cincinnati, OH, USA
| | - Tarcísio Santos Moreira
- Center for Cognition, Action, and Perception, Department of Psychology, Edwards Center 1, University of Cincinnati, Cincinnati, OH, USA
| | - James T Cavanaugh
- Department of Physical Therapy, University of New England, Portland, ME, USA
| | - Daniela V Vaz
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Paula L Silva
- Center for Cognition, Action, and Perception, Department of Psychology, Edwards Center 1, University of Cincinnati, Cincinnati, OH, USA
| |
Collapse
|
5
|
van der Veen S, Evans N, Huisman M, Welch Saleeby P, Widdershoven G. Toward a paradigm shift in healthcare: using the International Classification of Functioning, Disability and Health (ICF) and the capability approach (CA) jointly in theory and practice. Disabil Rehabil 2022:1-8. [PMID: 35732595 DOI: 10.1080/09638288.2022.2089737] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Over the past two decades, healthcare systems have shifted to adopt a more holistic, patient-centered care system. However, operationalization in practice remains challenging. Two frameworks have contributed substantially to the transformation toward more holistic and patient-centered care: the International Classification of Functioning, Disability and Health (ICF) and the capability approach (CA). Using these frameworks jointly can contribute to improved patient-centered care in clinical practice. METHODS This article explores the strengths and weaknesses of the use of the two frameworks in care and investigates whether using them jointly might contribute to more appropriate and patient-centered care. We will present a practical example of this integration in the form of a novel e-health application. RESULTS The exploration indicated that if the frameworks are used jointly, the individual weaknesses can be overcome. The application, used to exemplify the joint use of the frameworks, contains all categories of the ICF. It offers a unique tool that allows a person to self-assess, record, and evaluate their functioning and capabilities and formulate related goals. CONCLUSIONS Using the ICF jointly with the CA can foster holistic, patient-centered care. The e-health application provides a concrete example of how the frameworks can be used jointly. Implications for rehabilitationUsing the International Classification of Functioning, Disability and Health jointly with the capability approach can foster holistic, patient-centered care.The joint use of the frameworks is demonstrated by an e-health application which enables users to evaluate their functioning in relation to their own goals, provides them with the opportunity to increase control over their health and have a more active role in their care.Tools to record both functioning and goals from a patient's perspective can support professionals in offering patient-centered care in daily practice.Individual recording, monitoring and evaluation of functioning, capabilities and goals regarding functioning can provide a basis for research and quality improvement.
Collapse
Affiliation(s)
- Sabina van der Veen
- Department of Ethics, Law and Humanities, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - Natalie Evans
- Department of Ethics, Law and Humanities, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Patricia Welch Saleeby
- Department of Sociology, Criminology and Social Work, Bradley University, Peoria, IL, USA
| | - Guy Widdershoven
- Department of Ethics, Law and Humanities, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
6
|
Lin Y, Lemos M, Neuschaefer-Rube C. Digital Health and Digital Learning Experiences Across Speech-Language Pathology, Phoniatrics, and Otolaryngology: Interdisciplinary Survey Study. JMIR MEDICAL EDUCATION 2021; 7:e30873. [PMID: 34738911 PMCID: PMC8663699 DOI: 10.2196/30873] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Advances in digital health and digital learning are transforming the lives of patients, health care providers, and health professional students. In the interdisciplinary field of communication sciences and disorders (CSD), digital uptake and incorporation of digital topics and technologies into clinical training programs has lagged behind other medical fields. There is a need to understand professional and student experiences, opinions, and needs regarding digital health and learning topics so that effective strategies for implementation can be optimized. OBJECTIVE This cross-sectional survey study aims to interdisciplinarily investigate professional and student knowledge, use, attitudes, and preferences toward digital health and learning in the German-speaking population. METHODS An open-ended, web-based survey was developed and conducted with professionals and students in CSD including phoniatricians and otolaryngologists, speech-language pathologists (German: Logopäd*innen), medical students, and speech-language pathology students. Differences in knowledge, use, attitudes, and preferences across profession, generation, and years of experience were analyzed. RESULTS A total of 170 participants completed the survey. Respondents demonstrated greater familiarity with digital learning as opposed to eHealth concepts. Significant differences were noted across profession (P<.001), generation (P=.001), and years of experience (P<.001), which demonstrated that students and younger participants were less familiar with digital health terminology. Professional (P<.001) and generational differences were also found (P=.04) in knowledge of digital therapy tools, though no significant differences were found for digital learning tools. Participants primarily used computers, tablets, and mobile phones; non-eHealth-specific tools (eg, word processing and videoconferencing applications); and digital formats such as videos, web courses, and apps. Many indicated a desire for more interactive platforms, such as virtual reality. Significant differences were found across generations for positive views toward digitalization (P<.001) and across profession for feelings of preparedness (P=.04). Interestingly, across profession (P=.03), generation (P=.006), and years of experience (P=.01), students and younger participants demonstrated greater support for medical certification. Commonly reported areas of concern included technical difficulties, quality and validity of digital materials, data privacy, and social presence. Respondents tended to prefer blended learning, a limited to moderate level of interactivity, and time and space-flexible learning environments (63/170, 37.1%), with a notable proportion still preferring traditional time and space-dependent learning (49/170, 28.8%). CONCLUSIONS This comprehensive investigation into the current state of CSD student and professional opinions and experiences has shown that incorporation of digital topics and skills into academic and professional development curricula will be crucial for ensuring that the field is prepared for the ever-digitalizing health care environment. Deeper empirical investigation into efficacy and acceptance of digital learning and practice strategies and systematic training and practical organizational supports must be planned to ensure adaptive education and practice.
Collapse
Affiliation(s)
- Yuchen Lin
- Clinic of Phoniatrics, Pedaudiology & Communication Disorders, Medical Faculty, University Hospital Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen, Germany
| | - Martin Lemos
- Audiovisual Media Center, Medical Faculty, University Hospital Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen, Germany
| | - Christiane Neuschaefer-Rube
- Clinic of Phoniatrics, Pedaudiology & Communication Disorders, Medical Faculty, University Hospital Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen, Germany
| |
Collapse
|
7
|
Shanmugarajah K, Rosenbaum P, Zubairi M, Di Rezze B. A Narrative Review of Function-Focused Measures for Children With Neurodevelopmental Disorders. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:709978. [PMID: 36188829 PMCID: PMC9397797 DOI: 10.3389/fresc.2021.709978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/02/2021] [Indexed: 12/03/2022]
Abstract
Clinical measures in health and rehabilitation settings are often used to examine child functioning to better support the diverse needs of children with neurodevelopmental disorders (NDD) and their families. The WHO's International Classification of Functioning, Disability, and Health (ICF) framework reflects a focus of health beyond biomedical deficits, using the concept of functioning to create opportunities for measurement development involving this construct. In the measures developed in the field of childhood NDD, it is unclear whether and how these tools measure and incorporate the ICF framework and its domains within health care contexts. Understanding how these measures utilize the ICF will enable researchers and clinicians to operationalize function-focused concepts in studies and clinical practice more effectively. This narrative review aims to identify and describe function-focused measures that are based on the ICF for children with NDD, as described in the peer-reviewed literature. This review used a systematic search strategy with multiple health-focused databases (Medline, PsycInfo, EMBASE, EMCARE), and identified 14 clinical measures that provide direct support for children (aged 0-21) with NDD in pediatric health (and other) settings. Results described the measures that were primarily developed for three main diagnostic populations [cerebral palsy, autism spectrum disorder, and communication disorders]; had varying contextual use (clinical-only or multiple settings); and for which authors had conducted psychometric tests in the measure's initial development studies, with the most common being content validity, interrater reliability, test-retest reliability. Participation (79%, n = 11) & Activities (71%, n = 10) were the most common ICF domains captured by the set of measurement tools. Overall (71%, n = 10) of the identified measures utilized multiple ICF domains, indicating that the “dynamic nature” of the interactions of the ICF domains was generally evident, and that this result differentiated from “linking rules,” commonly used in research and clinical practice. The implications of these findings suggest that clinical measures can be an effective application of the ICF's defined concepts of functioning for children with NDD.
Collapse
Affiliation(s)
- Kajaani Shanmugarajah
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
- *Correspondence: Kajaani Shanmugarajah
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
- McMaster Autism Research Team, Hamilton, ON, Canada
| | - Mohammad Zubairi
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
- McMaster Autism Research Team, Hamilton, ON, Canada
| | - Briano Di Rezze
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
- McMaster Autism Research Team, Hamilton, ON, Canada
| |
Collapse
|
8
|
Lin Y, Neuschaefer-Rube C. Digital Learning in Speech-Language Pathology, Phoniatrics, and Otolaryngology: Interdisciplinary and Exploratory Analysis of Content, Organizing Structures, and Formats. JMIR MEDICAL EDUCATION 2021; 7:e27901. [PMID: 34313592 PMCID: PMC8367137 DOI: 10.2196/27901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 05/16/2021] [Accepted: 06/03/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The digital revolution is rapidly transforming health care and clinical teaching and learning. Relative to other medical fields, the interdisciplinary fields of speech-language pathology (SLP), phoniatrics, and otolaryngology have been slower to take up digital tools for therapeutic, teaching, and learning purposes-a process that was recently expedited by the COVID-19 pandemic. Although many current teaching and learning tools have restricted or institution-only access, there are many openly accessible tools that have gone largely unexplored. To find, use, and evaluate such resources, it is important to be familiar with the structures, concepts, and formats of existing digital tools. OBJECTIVE This descriptive study aims to investigate digital learning tools and resources in SLP, phoniatrics, and otolaryngology. Differences in content, learning goals, and digital formats between academic-level learners and clinical-professional learners are explored. METHODS A systematic search of generic and academic search engines (eg, Google and PubMed); the App Store; Google Play Store; and websites of established SLP, phoniatrics, and otolaryngology organizations was conducted. By using specific search terms and detailed inclusion and exclusion criteria, relevant digital resources were identified. These were organized and analyzed according to learner groups, content matter, learning goals and architectures, and digital formats. RESULTS Within- and between-learner group differences among 125 identified tools were investigated. In terms of content, the largest proportion of tools for academic-level learners pertained to anatomy and physiology (60/214, 28%), and that for clinical-professional learners pertained to diagnostic evaluation (47/185, 25.4%). Between groups, the largest differences were observed for anatomy and physiology (academic-level learners: 60/86, 70%; clinical-professional learners: 26/86, 30%) and professional issues (8/28, 29% vs 20/28, 71%). With regard to learning goals, most tools for academic-level learners targeted the performance of procedural skills (50/98, 51%), and those for clinical-professional learners targeted receptive information acquisition (44/62, 71%). Academic-level learners had more tools for supporting higher-level learning goals than clinical-professional learners, specifically tools for performing procedural skills (50/66, 76% vs 16/66, 24%) and strategic skills (8/10, 80% vs 2/10, 20%). Visual formats (eg, pictures or diagrams) were dominant across both learner groups. The greatest between-group differences were observed for interactive formats (45/66, 68% vs 21/66, 32%). CONCLUSIONS This investigation provides initial insights into openly accessible tools across SLP, phoniatrics, and otolaryngology and their organizing structures. Digital tools in these fields addressed diverse content, although the tools for academic-level learners were greater in number, targeted higher-level learning goals, and had more interactive formats than those for clinical-professional learners. The crucial next steps include investigating the actual use of such tools in practice and students' and professionals' attitudes to better improve upon such tools and incorporate them into current and future learning milieus.
Collapse
Affiliation(s)
- Yuchen Lin
- Clinic for Phoniatrics, Pedaudiology & Communication Disorders, University Hospital and Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Christiane Neuschaefer-Rube
- Clinic for Phoniatrics, Pedaudiology & Communication Disorders, University Hospital and Medical Faculty, RWTH Aachen University, Aachen, Germany
| |
Collapse
|