Baker S M, Marshak H H, Rice G T, Zimmerman G J
Distance Learning Physical Therapist Assistant Program, Loma Linda University, Huntsville, AL, USA.
Phys Ther. 2001 May;81(5):1118-26.
An important part of treatment planning in physical therapy is effective goal setting. The Guide to Physical Therapist Practice recommends that therapists should identify the patient's goals and objectives during the initial examination in order to maximize outcomes. The purpose of this study was to examine whether therapists seek to involve patients in goal setting and, if so, what methods they use. Therapists' attitudes toward participation and patient satisfaction with the examination were also examined.
Twenty-two physical therapists audiotaped the initial examination of 73 elderly patients (mean of 76.4 years of age, SD = 7.1, range = 65-94). The audiotaped examinations were then scored using the Participation Method Assessment Instrument (PMAI) to determine the frequency of attempts made by therapists to involve patients in goal setting. Therapists and patients completed surveys following the examinations.
Therapists' use of participation methods during examinations ranged from a minimum of 1 to a maximum of 19 out of 21 possible items on the PMAI. The therapists stated that they believed that it is important to include patients in goal-setting activities and that outcomes will be improved if patients participate. Patients also indicated that participation is important to them.
In most cases, the therapists did not fully take advantage of the potential for patient participation in goal setting. Patient and therapist education is needed regarding methods for patient participation during initial goal-setting activities.
物理治疗中治疗计划的一个重要部分是有效的目标设定。《物理治疗师实践指南》建议治疗师在初次检查时应确定患者的目标和目的,以实现最佳治疗效果。本研究的目的是调查治疗师是否寻求让患者参与目标设定,如果是,他们使用何种方法。同时还研究了治疗师对患者参与的态度以及患者对检查的满意度。
22名物理治疗师对73名老年患者(平均年龄76.4岁,标准差=7.1,年龄范围65 - 94岁)的初次检查进行了录音。随后使用参与方法评估工具(PMAI)对录音检查进行评分,以确定治疗师尝试让患者参与目标设定的频率。检查结束后,治疗师和患者完成了调查问卷。
在PMAI上,治疗师在检查过程中使用参与方法的情况从最少1项到最多19项(共21项可能)不等。治疗师表示他们认为让患者参与目标设定活动很重要,并且如果患者参与,治疗效果将会改善。患者也表示参与对他们很重要。
在大多数情况下,治疗师没有充分利用患者参与目标设定的潜力。在初次目标设定活动中,需要对患者和治疗师进行关于患者参与方法的教育。