Role Of Therapist Research Articles

Primary Care Physical Therapists' Experiences When Screening for Serious Pathologies Among Their Patients: A Qualitative Study.

ObjectiveA vital part of the initial examination performed by a physical therapist is to establish whether the patient would benefit from physical therapist intervention. This process includes knowledge about contraindications for treatment and screening for serious pathologies. However, little is known about the physical therapists' views and thoughts about their own practice when screening for serious pathologies. The purpose of this study was to explore the experience gained by physical therapists when screening for serious pathologies among their patients.MethodsThis was a qualitative study based on individual semi-structured interviews with 9 primary care physical therapists. The interviews were analyzed using reflexive thematic analysis, and generated themes were explained and reported with relevant quotes.ResultsThree overall themes were generated: (1) the role of physical therapists in the diagnostic process; (2) responsibility from the individual to the group; and (3) the difficult task of cooperation. The physical therapists described how they relied more on their clinical suspicion than on asking red-flag questions when screening for serious pathologies. They also questioned their differential diagnostic abilities. Finally, they saw a potential to further enhance their confidence in the area by reflecting on the matter with colleagues and by receiving more feedback about their clinical reasoning regarding serious pathologies from general practitioners.ConclusionThese findings suggest that physical therapists primarily rely on their clinical suspicion when screening for serious pathologies but at the same time are uncertain about their differential diagnostic abilities.ImpactThese findings can inform future interventions targeting the physical therapists' abilities to detect serious pathology.

The Perception of Allied Health Professionals on Occupational Therapy.

Occupational therapy is a client-centered health profession and is a part of an interdisciplinary team. Effective interdisciplinary practice occurs when each professional understands the role of another professional in the team. This resulted in optimal referral among the professionals that can benefit the clients to receive good care and service. However, it seems that referrals to occupational therapy are becoming lesser by day in specific settings and hospitals in Malaysia. This brings a perspective if other professions in the healthcare team understand the role of occupational therapists. This study is aimed at exploring the perception and misconceptions of allied health professionals on the roles of occupational therapists. A focus group discussion was conducted among seven allied health professionals using a heuristic approach. The interview data were analyzed thematically. Themes developed were (i) awareness of occupational therapy ecosystem, (ii) in cooperating togetherness for the benefit of the client, and (iii) addressing the limitation to enhance the occupational therapy visibility. Findings found that the knowledge of other healthcare practitioners and clients on the occupational therapist's role is still limited. Role confusion and overlapping are common among other allied health professionals. Occupational therapy needs to continually promote the profession's role and identity for the maximum benefit to the client and overall improvement.

Therapists’ Emotional Reactions to Patients with Obsessive–Compulsive Disorder: The Role of Therapists’ Orientation and Perfectionism

Therapist’s emotional response towards patients with obsessive–compulsive disorder (OCD) is under-investigated. This aspect might provide valuable information about therapists’ difficulties during sessions and support supervisory practice, since a proportion of OCD patients drop out due to issues related to the therapeutic relationship. In a sample of therapists, we explored the effects of therapists’ orientation (cognitive behavioural versus psychodynamic) and perfectionistic traits on their emotional responses towards patients with OCD, controlling for other variables potentially related to emotional response towards patients (i.e., therapists’ gender/age and patient’s comorbid personality disorders). Ninety-four therapists (74 women and 20 men; mean age = 42.07 ± 10.17 years), of which 47 (50%) had a cognitive behavioural therapy (CBT) and 47 (50%) a psychodynamic orientation matched on gender and age, completed the Therapist Response Questionnaire and Frost Multidimensional Perfectionism Scale. Therapists with a CBT orientation reported less negative emotional responses, i.e., lower overwhelmed/disorganized, hostile/angry, criticised/devalued, parental/protective and special/over-involved emotions towards patients than therapists with a psychodynamic orientation. Therapists with higher perfectionistic traits (i.e., parents’ expectations/evaluation) had higher hostile/angry reactions, those with higher concerns over mistakes and doubts about actions had more intense criticised/devalued emotions, while those with stronger concerns with precision, order and organization had lower disengagement responses. The present study is the first investigation which sheds some light on the emotional responses of therapists towards OCD patients. Therapists’ CBT orientation and lower perfectionistic traits might be associated with better emotions. Therapists’ emotional responses, their psychotherapeutic orientation and levels of perfectionism should be considered during supervisory practice.

Shifting to tele-creative arts therapies during the COVID-19 pandemic: An international study on helpful and challenging factors

The COVID-19 pandemic has led to an unprecedented shift to online treatment. For the creative arts therapies (CATs) – a healthcare profession that involves the intentional use of the visual art, drama, music, dance, and poetry within a therapeutic relationship – this shift has been highly consequential for practice. This study examined (a) how the COVID-19 pandemic has impacted clinical practice in the CATs, and (b) the features characterizing online practice in an international sample of 1206 creative arts therapies aged 22–86 (92% female). It aimed to identify changes in the use of the arts in therapy, resources that contributed to the delivery of therapy, and the role of therapists’ creative self-efficacy in adapting to these changes. Respondents completed close and open-ended questions providing examples of what does and does not work in online practice. The results indicate that creative self-efficacy plays a meaningful role in buffering the impact of therapists’ computer comfort on their perceived difference in online clinical practice; confidence in one’s abilities positively contributed to their adaptation to online practice. The qualitative analysis yielded four main categories: the challenges of tele-CATs, continuing the therapeutic process through tele-CATs, adaptations for tele-CATs, and future directions. Overall, the results present a timely report on the inevitable transition of the CATs to online practice.

The perceptions, needs and preferences of informal caregivers of nursing home residents with dementia regarding physical therapy: A qualitative study

IntroductionInformal caregivers often support nursing home residents with dementia in making therapeutic decisions. We explored the perceptions, needs and preferences of informal caregivers of nursing home residents with dementia regarding physical therapy. MethodWe conducted eleven semi-structured interviews. Thematic analysis was used. ResultsFive themes emerged: 1) visibility and familiarity; 2) communication; 3) aim and content; 4) dosage and location; 5) level of expertise and the role of the physical therapist within the interdisciplinary team. Informal caregivers’ perceptions of physical therapy included a lack of visibility and familiarity. They needed more communication, and empathic communication skills of the physical therapists. Preferences included physical therapy to be enjoyable, accessible and tailored to the needs of the resident. ConclusionPhysical therapists need to involve informal caregivers in physical therapy care. Implementing shared decision-making will help to get informal caregivers more involved, but has yet to be studied in this setting.

Parental Perspectives on Their Grade 4 Children with Reading and Writing Difficulties in Mainstream Government Schools in Mauritius

Reading and writing difficulties (RWD) in learners pose significant challenges not just for children but also for parents. While there is limited support available for children with RWD and their parents in Mauritian schools, research may reveal areas of parental need that speech-language therapists may address. The aim was to determine parents’ perspectives regarding their Grade 4 children with RWD in mainstream government schools in Mauritius. Teachers identified children with RWD with the Screening Tool for Learning Disorder, and parents were requested to participate in the study. Sixty-seven parents completed a questionnaire investigating their perspectives on the symptoms and causes of their child’s RWD and the ways in which they assist their child. The screening tool differentiated between children at risk of specific learning disorder (SLD) and children who indicated clear symptoms of SLD. The results of the tool did not correspond closely with the participants’ satisfaction with their child’s academic performance. The majority of participants could, however, identify RWD in their children when descriptions were given. Parents mostly cited laziness as the main cause of their child’s RWD. The results showed that participants had limited information about the causes and symptoms of RWD and SLD. There is a lack of awareness about the role of speech-language therapists in the intervention of RWD. There are limited resources and support for children with RWD, despite an inclusive education policy in Mauritius. Speech-language therapists and teachers should collaborate to support children with RWD and their parents using inclusive education strategies.

Terapia Ocupacional, pluralidades e infâncias: o brincar como atividade significativa de crianças ao sul de Moçambique

Introduction: Recent studies on children and childhood on the world stage have pointed to an understanding of children as sociocultural beings and active agents in the productions of the world around them, allowing for the rereading of worlds and actions from sociocultural perspectives, especially with respect to play. This paper presents longitudinal research conducted in Mozambique with children from three to fifteen years of age, in which a discussion about playing and its relationship with occupational therapy is presented. Objective: The goal of this study was to understand playing as a significant activity of children, as well as understanding the role of occupational therapists as researchers. Material and Methods: We utilized ethnography with field research in Mozambique in the communities of Matola A, Mabotine and Nhandlovo between 2014 and 2018. Results: The data collected and analysed in this study involved children playing and building toys from disuse material (discard), playing and its relationship with nature and landscapes, images of play and the use of photography. The results point to a kaleidoscope of diversity and languages used by children in play, which is understood as a way of being both in the world and from their space-time relationships. Conclusion: This research contributes to studies of children and childhood in occupational therapy, covering children in their lifestyles and historical contexts, and expands the possibilities of actions and research in sociocultural contexts and perspectives.

Exposure in Vivo as a Treatment Approach to Target Pain-Related Fear: Theory and New Insights From Research and Clinical Practice

For patients with chronic pain who have elevated pain-related fear (PRF), exposure is the treatment of choice. This Perspective highlights the inhibitory learning approach, summarizes mechanistic work from experimental psychology and neuroimaging regarding PRF in chronic pain, and describes possible clinical applications of EXP in chronic secondary pain as well as in primary care.

Occupational Therapists on The Front Line

Introduction. There is a growing focus on the need for an increased number of allied health professionals to reduce the pressure on acute hospitals through admission avoidance. There is little in the way of guidelines on how services should be delivered and a lack of evidence base demonstrating effectiveness. Methods. An audit has been carried out by the occupational therapy team in the Emergency Department to capture the total number of referrals to the occupational therapy service in the Emergency Department at Royal Berkshire Hospital and to capture discharge decisions made following occupational therapy input. Results. The occupational therapy team in the Emergency Department focuses particularly on admission avoidance using a home first approach to prevent patients from being admitted to acute wards. The results showed that the service was beneficial regarding both the number of referrals and the utilisation of various discharge destinations from the Emergency Department. Conclusion. The report has identified several areas for further research by the same team and implications for the wider literature base. The hope is that this report would highlight the role of occupational therapists working in the emergency department at Royal Berkshire Hospital and encourage the completion of further research in this area of practice.

The influence of the role of physical therapists in the interdisciplinary team on the need for special forms and approaches to higher education

The influence of the role of physical therapists in the interdisciplinary team on the need for special forms and approaches to higher education

What Role Expectations Do Primary Care Physicians in Japan Hold for Physical Therapists Regarding Primary Care?

This study aimed to clarify what primary care physicians (PCPs) in Japan understand of the role of physical therapists (PTs) through the experience of working with PTs in hospitals, and what roles PCPs expect for PTs in future primary care. Semi-structured interviews were conducted individually with 9 purposively sampled PCPs with sufficient experience of collaboration with PTs. Interview data were analyzed by theme analysis focusing on "What does the PCP understand about the role of PTs through the experience of working with PTs in hospitals?" and "What roles and purposes does the PCP wish for PTs in primary care settings?" PCPs viewed PTs as providers of rehabilitation in the traditional medical model, and understood their role as an occupation having a mono-causal viewpoint, namely a specific and well-defined outcome for individual patients, and intervening with patients within a short clinical course with the aim of improvement or maintenance of the patient's condition. With regard to future primary care, PCPs expected that PTs would interpret various factors related to patient lives from the viewpoint of causal interactions; become important stakeholders in the community; and respond flexibly to patients and the environmental factors around them with continued support to the individual. PCPs understood the role of PTs in hospitals as "Rehabilitation in the traditional medical model," and expected the future role of PTs in primary care as "Rehabilitation in integrated community care."

‘There’s this big fear around palliative care because it’s connected to death and dying’: A qualitative exploration of the perspectives of undergraduate students on the role of the speech and language therapist in palliative care

Background: Speech and language therapy in palliative care is a developing discipline of clinical practice. Research literature has highlighted that undergraduate palliative care education in speech and language therapy is inconsistent and inadequate. However, limited research has been carried out to date in relation to student speech and language therapists and palliative care. Aim: To explore the role of speech and language therapists in palliative care from the perspective of speech and language therapy students in Ireland. Design: A qualitative descriptive research study was conducted, involving focus group interviews. Setting/participants: Purposive sampling was used to recruit 12 student speech and language therapists from one university site for this study. Undergraduate second, third and fourth year students were eligible for inclusion. Results: This study revealed that undergraduate student speech and language therapists collectively agree that there is a role for speech and language therapy in palliative care. Although students acknowledged that speech and language therapists can make a positive difference to patients’ lives, and academic lectures were positively received, insufficient exposure to palliative care has resulted in fear, uncertainty and a lack of confidence amongst student speech and language therapists. Conclusions: A greater emphasis on palliative care is needed in undergraduate speech and language therapy education to ensure confidence and competency development. An exploration of student speech and language therapists’ experiences in a specialist palliative care unit would be advantageous to determine the appropriateness of this setting for clinical placements.

Professional Roles of Oncologic Specialty Physical Therapists in the United States

Background: Oncologic specialty physical therapists (OncPTs) are a growing discipline in the cancer workforce. The complexities of cancer care delivery and the multidimensional nature of cancer care teams require oncology providers to serve in professional roles beyond clinical care. This project aims to assess the professional roles that OncPTs play in cancer care delivery. Methods: A 27-item survey was developed by the Oncologic Specialty Council of the American Board of Physical Therapy Specialties and sent electronically to board-certified oncologic clinical specialists in the United States. The survey was open for 45 days. Demographics of the population and frequency data were analyzed in Qualtrics. Results: Fifty-seven complete surveys were received out of 106 eligible specialists (response rate 53%). Respondents were predominantly female (91%) and White (78%). Fifty-six percent (n = 32) had greater than 15 years of practice experience and 68% (n = 39) held DPTs. Seventy-three percent reported greater than 50% of their work week dedicated to oncology practice and 52.6% reported providing consultations or treatment in the physical space of a cancer center. All respondents have been board-certified OncPTs for at least 1 year. Providing clinical care accounted for 71% of the cohorts' work time and 14% was spent in program development (outside of clinical care). Specialists reported oncology-specific program development responsibilities across 3 themes: workforce development (mentoring and teaching peers and staff), establishing clinical practice standards (standardizing assessment tools and clinical pathways), and program assessment (quality improvement and research). The OncPT professional roles included leadership responsibilities within their health system (n = 24) and leadership or committee roles in rehabilitation-specific professional organizations (n = 55). No respondents reported serving in roles regarding research mentorship or advising on state policy or payer issues, and 1 respondent identified a role in advising on federal policy issues. Conclusion: Oncologic specialty physical therapists primarily serve clinical patient care roles. Aside from clinical practice, program development roles focus on rehabilitation-centric staff and student education and clinical pathways for rehabilitation care delivery. However, at the cancer care delivery system level, participation in professional roles beyond the rehabilitation clinic is less frequent. Gaps in participation are identified at the societal level with no representation from this cohort in payment and policy initiatives at the state and federal levels. We provide a roadmap to action that describes multilevel interventions to improve the integration of OncPTs into cancer care delivery. These findings may inform competencies for clinical specialists and guide residency program development.

Integration of Psyche and Matter and Sandplay Therapy in the Era of Pandemic (Mask, Tal)

In this paper, the symbolic meaning of the pandemic and the role of the sandplay therapist in integration of psyche and matter were attempted to be understood from an analytical psychology perspective. Traditionally, in Korean culture, when an epidemic spreads, mask dance plays such as Byeolshin Tal Chum Gut Nori, which is a shamanistic mask dance where individuals play, and rituals such as these were offered to appease the gods who brought diseases, hoping the god would leave minimal damage while the people waited for it to pass. In that sense, the expression ‘Byeolshin’ refers to both a god and a contagious disease: smallpox as a pandemic in ancient times. The use of the mask, tal, in these shamanistic mask dance plays and rituals is related to the meaning of the ‘mask’. The word “mask” in Korean means mask, but it is also a word that means diseases, problems, breakdowns, shortcomings, difficulties, etc. Also, the “playing” is an interesting part of the ritual, which means that playing has a healing effect and is a way to appease the archetypal fears and anxieties caused by the divine plague. Just as our traditional culture did, in the era of the corona pandemic (mask, mask), sandplay therapists are in a time and situational position to play a role in making clients realize that matter and psyche/spirit, that is, external things, are internal projections. This is because sandplay therapy is a way of playing and a ritual, and it is a symbolic and healing approach that allows each person to meet their inner ‘god’, that is, their true Self. This process must occur first in the therapist, and only the therapist who has experienced such a process can understand the client's process in terms of the archetypal transference-countertransference relationship. Also, it tries to explain the archetypal fear of the pandemic by linking it with the personal complex, and the symbol of the pandemic that appears in sandplay therapy was presented along with the symbols of the earthquake disaster in Nepal.

Preventing exclusion: the role of therapists and parents in the inclusion of a disabled child in the education system

Choosing an educational system for a disabled child already at the stage of pre-school education is a difficult and stressful experience for parents, which regardless of the final decision, raises many doubts. Certain questions arise: ‘where there is a place in the education system for the child with a disability certificate?’, ‘where the child can develop best?’, but also ‘where the child simply feels happy and does not experience exclusion?’. Many things depend on the level of the child’s disability, on key choices made by parents, and on the quality of cooperation, both in the three-way parent-therapist-child relationship, but also in the two-way parent-child and therapist-child relationships. Parents more and more often make decisions about inclusive education, where a child can develop amongst non-disabled peers. This article focuses primarily on the role of parents and therapists in the process of including a disabled child in the education system, the potential of cooperation, but also the fears, difficulties and expectations accompanying both sides.

The Impact of COVID-19: Perspectives of Recreational Therapists Working with Older Adults

This study aims to determine the changes in consumption of fruits and vegetables of older adults before and since the COVID-19 pandemic. The data collection was administered by Qualtrics through an online survey conducted in August and September 2020. The total participants were 10,050. Differences between consumption of fruits (fresh, canned, frozen) and vegetables (carrots, sweet potatoes, broccoli, spinach) before and since COVID-19. Date were analyzed using the Wilcoxon’s signed-rank test. Among participants, 5,767 females (57.4%) and 4,283 males (42.6%) and the average age of 62.09 (SD=11.22). 7.1% were Asian (N=701), 4.3% were Hispanic (N=429), 14.1% were African Americans (N=1393), and 74.5% were White (N=7,390). For total participants, consumption of fruits decreased significantly (p<0.001) since COVID-19. The decrease in consumption of fruits was larger in females (p<0.001) than males (p=0.026). It is likely because consumption of fruits by males was already low before the pandemic at 27% of the amount consumed by females. The decrease in consumption of fruits was not statistically significant in Asian (p=0.096) and African American (p=0.07), but significant in Hispanic (p=0.008) and White (p<0.001) participants. African American and Hispanic participants consumed a lower number of fruits before the pandemic compared to Asian and White participants. Consumption of vegetables had no significant change since COVID-19 for total participants regardless of gender and race. This study reported a significant decrease in the consumption of fruits, but not vegetables by older adults since COVID-19 pandemic.

The Impact of COVID-19: Perspectives of Recreational Therapists Working with Older Adults

This study explored the perspectives of recreational therapists (RT) from Pennsylvania and Michigan and how COVID-19 has impacted older adults and their roles in various settings. COVID-19 safety restrictions limiting social interaction with both peers and families had the potential for negatively impacting the social and emotional well-being of older adults (Van Orden et al., 2020) and the roles of therapists who work with them. Because peer socialization and physical activity programs prevent falls (Cameron et al., 2018) and improve depressive symptoms (Harvey et al., 2015), a better understanding of COVID-19 impact is significant. From a qualitative viewpoint, 14 RTs from various levels of care were interviewed to better understand their perspective on the impacts of COVID on older adults and their own practice. Hour long interviews conducted via zoom focused on organizational changes, role changes, and impact on older adults. After recordings were transcribed, multiple researchers classified, summarized, and tabulated the data. A consensus method determined common themes. From the RT’s perspective, older adults have not only been negatively impacted in the social domain. While many older adults showed resilience, others were impacted physically, emotionally, and cognitively. Moreover, an increased importance on meaningful engagement, recreation, and leisure emerged. Technology became an essential tool in interpersonal connection. Teamwork, personal self-care, and coping were integral to providing effective care. Post pandemic, RTs are concerned about the challenge of reengaging older adults in groups but are certain that technology will continue to be used in a more expansive way in programs.

Effect of Educational Intervention Program on Awareness, Knowledge, Attitude, and Willingness to Recommend Physiotherapy as a Career Among High School Science Teachers

Introduction. Physical therapy (physiotherapy) is an essential part of the health care delivery system. High school students with an interest in science may be suited for a career in health care, including physical therapy. It is important therefore that their teachers have good knowledge and great willingness to recommend physical therapy as a potential career choice to them. Few studies have been carried out on the knowledge about physical therapy among different populations. The previous reports highlighted the need for educational interventions to increase the knowledge about physical therapy. However, no previous study has investigated the effectiveness of these educational interventions. Therefore, this study was aimed at evaluating the effect of an educational intervention in improving the level of knowledge, attitude, and willingness to recommend physical therapy as a potential career choice to students among high (secondary) school science teachers in Nnewi, Anambra State, Nigeria. Review of Literature. Few studies have been carried out on the knowledge about physical therapy among different populations. There is need for educational interventions to increase the knowledge about physical therapy. No previous study has investigated the effectiveness of these educational interventions. Subjects. Consecutively recruited 99 science teachers from purposively selected high schools. Methods. This was a pretest–posttest quasi experimental study. Consecutively recruited 99 science teachers from purposively selected high schools participated in the study. Data were collected preintervention and postintervention using a self-developed instrument. Results. Only 20.2% of the participants had a good knowledge of physical therapy on pretest but the proportion with good knowledge increased to 96% after the intervention. Ninety-nine percent of the respondents also developed a positive attitude towards physical therapy and willingness to recommend physical therapy as a potential career choice to their students after the educational intervention. Discussion and Conclusion. Awareness of physical therapy among science teachers is poor. The effectiveness of the educational intervention program revealed a role for physical therapists who wish to enhance the awareness of counselors. Well-informed teachers and counselors may be equipped with the required knowledge to guide the career choice of their students.

Evaluate and Intervene in Sensory Processing Disorders by Occupational Therapists in Early Intervention Teams of the North of Portugal

Background: The National Early Childhood Intervention System of Portugal is an organized set of services under the responsibility of the Ministries of Health, Labor, and Social Security and Education aimed to support children between 0 and 6 years old and their families, and its mission is to ensure Early Childhood Intervention. At present, there is no research to support the extent of the use of sensory interventions in early intervention teams of Portugal.&#x0D; Aims: This study aims to analyze and understand the role of occupational therapists who support children with Sensory Processing Dysfunction and their families in local Early Intervention Teams.&#x0D; Methods: A qualitative and descriptive research was developed using semi-structured interviews. The interviews were conducted with ten occupational therapists who have worked in Early Intervention Teams in the North of Portugal for at least one year.&#x0D; Results: Modulation and Praxis were the categories of Sensory Processing Dysfunction most identified. Families consider that Sensory Processing Dysfunctions interfere with children's performance in activities of daily living and playing. Early childhood educators report that Sensory Processing Dysfunctions influence the child's participation in food, playing, and in more structured and directed activities. To transfer skills, occupational therapists organize training for professionals, families, and early childhood educators.&#x0D; Conclusion: The importance of collaborative work between professionals and the child's family is evident, and the support they provide in the natural environment and daily routines.

Selecting from their toolbox of interventions – A realist study of the role of occupational therapists in reablement services

Introduction Reablement services support people to regain skills and increase their independence. This aim resonates with occupational therapy philosophy. This article presents results of a study of the role of occupational therapists in reablement services that involve two organisations. Method Theories on the role of occupational therapists in reablement were identified using a realist synthesis approach and were tested and expanded using a qualitative case study design. Each of the three case studies consisted of one reablement service in England. Methods of the study included observations and interviews with occupational therapists, interviews with managers in both organisations and focus groups and interviews with reablement support workers. Findings Findings conclude that occupational therapists’ education and experience underpin their ability to undertake assessments and person-centred goal setting. They utilise a range of intervention techniques selecting from their toolbox of interventions to support people. Occupational therapists have a role in training reablement support workers to work in an enabling way. Regular communication and co-location support levels of trust and shared purpose between members of the reablement team. Conclusion The conceptual framework developed from the study can be used by organisations when commissioning and developing reablement services to consider the different contextual layers of reablement.