Elspeth Finch

Sensitivity of Sickness Impact Profile items to measure change over time in a low-back pain patient group.

The purpose of this study was to identify Sickness Impact Profile (SIP) items that are most sensitive to change in patients with low-back pain. Seventy-six patients with low-back pain were administered the SIP at their initial visit and after discharge from physiotherapy treatment. A formal item reduction was performed to identify the most sensitive items. An item was considered sensitive if it showed change in 20% of the patients and had an item-corrected total SIP score correlation greater than 0.30. Twenty items were identified. Seven of the 20 items identified in this study appear on the Roland-Morris disability questionnaire. Also, only 50% of the items identified are from the physical subscale of the SIP.

Career Choice and Professional Preferences in a Group of Canadian Physiotherapy Students

This article focuses on reasons for the career choice and the longitudinal development of attitudes to healthcare work and the physiotherapy profession. The study is part of a larger project on professional development in physiotherapy. A cohort of 60 Canadian physiotherapy students was surveyed on two occasions during their educational programme. The questionnaire was constructed using a theoretical framework about professional socialization. Forty students completed both versions of the questionnaire yielding a response rate of 67%. Seventy-two per cent were women and 28% were men. Job accessibility or economic (25.5%) were the most frequently indicated reasons for the career choice. The most frequently chosen role models were the preceptors in clinical placements (52%). None of the students indicated having a faculty member as a role model. The desire to work in private practice and with adults was ranked highly in both administrations of the questionnaire. Few students regarded home care and community health as preferable healthcare facilities after graduation. Research, managerial work or occupational health were not given as preferable areas of practice. There advantages were statistically significant differences between women and men in their preferences for private practice work and the public sector of healthcare. The results are discussed in relation to gendered division of labour in healthcare and to the development of the profession.

Ethically-based clinical decision-making in physical therapy: process and issues

The identification and consideration of relevant ethical issues in clinical decision-making, and the education of health care professionals (HCPs) in these skills are key factors in providing quality health care. This qualitative study explores the way in which physical therapists (PTs) integrate ethical issues into clinical practice decisions and identifies ethical themes used by PTs. A purposive sample of eight PTs was asked to describe a recent ethically-based clinical decision. Transcribed interviews were coded and themes identified related to the following categories: 1) the integration of ethical issues in the clinical decision-making process, 2) patient welfare, 3) professional ethos of the PT, and 4) health care economics and business practices. Participants readily described clinical situations involving ethical issues but rarely identified specific conflicting ethical issues in their description. Ethical dilemmas were more frequently resolved when there were fewer emotional sequelae associated with the dilemma, and the PT had a clear understanding of professional ethos, valued patient autonomy, and explored a variety of alternative actions before implementing one. HCP students need to develop a clear professional ethos and an increased understanding of the economic factors that will present ethical issues in practice.

Physical Rehabilitation Outcome Measures: A Guide to Enhanced Clinical Decision Making, Second Edition

Part I Principles in Outcome Management 1. Outcome Measurement in Rehabilitation 2. How to Choose Outcomes Relevant to the Client and the Rehabilitation Program 3. How to Choose a Measure for the Relevant Outcomes 4. Why Measurement Properties are Important 5. How Outcome Measures can be used to Enhance Clinical Decision Making about Individual Clients 6. How Outcome Measures can be used to Enhance Decision Making about a Program Part II Outcome Measure Reviews Measure Review Template Outcome Measures Listed Alphabetically Listed by Outcome (Construct) Listed by Client Population (Areas of Practice

Invited Commentary on the Movement Continuum Special Series

The Movement Continuum Theory (MCT), published in 1995,1 built on Hislops notion of pathokinesiology.2 Our intent was to stimulate discussion and debate about theory in physical therapy. Although the MCT has received international attention, most notably as an influence on the World Confederation for Physical Therapys international definition of physical therapy,3 there has not been much academic response or further theoretical development in the physical therapy profession, unlike the occupational therapy4,5 and nursing6,7 professions, both of which have given considerable attention to theory over the years. A theoretical framework is an important indicator of an evolving clinical science,8 and the arguments we put forward in 1995 for the need for a theory of physical therapy remain relevant today. Allens work on further developing the MCT is very welcome, and hopefully her work and this special series will encourage others to enter and continue the debate. The following comments are made in this spirit of advancing debate on physical therapy theory. Perhaps one of the reasons that the MCT has not inspired much empirical research on movement is that the MCT is not actually a theory of movement; rather, it is a theory of how physical therapists conceptualize movement and approach problem solving and decision making with their clients. We identify movement as the central unifying concept of physical therapist practice and attempt to distinguish what makes physical therapy different from other movement sciences. We put forward the MCT as a grand theory of …