Department of Rehabilitation Sciences, University of Hartford, West Hartford, Connecticut.
McLean Home Care & Hospice, Simsbury, Connecticut.
J Geriatr Phys Ther. 2019 Oct/Dec;42(4):294-303. doi: 10.1519/JPT.0000000000000179.
Home care physical therapists (PTs) are inconsistent regarding cognitive screening, possibly because screening tools were traditionally considered the domain of other home care disciplines, or because therapists perceive their dementia training to be inadequate. A cross sectional study was designed to survey home care therapists' attitudes and beliefs about the management of persons with dementia and to find out whether any specific cognitive tools or measures are currently used.
A 5-point Likert-type survey was administered to home care PTs via an online survey. Three state home care associations and individual home care agencies agreed to share the survey link. The survey was also made available to American Physical Therapy Association members through the Home Health and Geriatric Section listservs.
Two hundred fifty-one PTs opened the survey and 233 completed the survey. Respondents included 180 females and 53 males. Seventy-four had a bachelor's degree (BS), 53 held a master's degree (MS), 104 had achieved a doctor of physical therapy (DPT) or doctor of philosophy (PhD) degree, and 2 did not provide this information. Significant differences were found between those with the highest doctoral degrees and those with master's or bachelor's degrees (P = .01) regarding whether they were qualified to screen (strongly agree, agree) for cognitive deficits. Therapists with the highest degrees also attended continuing education for dementia training more than those with less formal education (P = .042.) Gender differences were found in 2 questions regarding positive outcomes (P = .010 and .42); for both questions, males were more likely to believe that dementia has a negative impact. Eighty-seven percent indicated that PTs are qualified (strongly agree, agree), but only 53% said that they possess the necessary skills (strongly agree, agree) to perform cognitive screens. Specialty certification revealed significant differences in several of the questions. No significance was found for any question regarding years of practice or years in home care. The Mini-Mental State Examination and the Clock Drawing Test were most frequently cited among PTs who conduct cognitive screening.
Physical therapists recognize that they are qualified to perform cognitive screening but may need additional training to utilize cognitive findings to enhance interventions and outcomes in home care. More research is needed to determine which screens are most relevant for therapist use and to examine the effect of cognitive screening on therapy outcomes.
家庭护理物理治疗师（PT）在认知筛查方面不一致，这可能是因为筛查工具传统上被认为是其他家庭护理学科的领域，或者是因为治疗师认为他们的痴呆症培训不足。本研究旨在调查家庭护理治疗师对痴呆症患者管理的态度和信念，并了解是否目前正在使用任何特定的认知工具或措施。
通过在线调查向家庭护理 PT 发放 5 点李克特式调查问卷。三个州的家庭护理协会和个别家庭护理机构同意共享调查链接。该调查还通过美国物理治疗协会家庭健康和老年科列表服务向成员提供。
共有 251 名 PT 打开了调查，233 名完成了调查。受访者包括 180 名女性和 53 名男性。74 人拥有学士学位（BS），53 人持有硕士学位（MS），104 人拥有物理治疗博士（DPT）或哲学博士（PhD）学位，2 人未提供此信息。在是否有资格进行认知缺陷筛查（强烈同意、同意）方面，拥有最高博士学位的人与拥有硕士或学士学位的人之间存在显著差异（P=0.01）。接受过痴呆症培训继续教育的治疗师比接受过较少正规教育的治疗师更有可能（P=0.042）。在关于积极结果的 2 个问题中发现了性别差异（P=0.010 和 0.42），对于这两个问题，男性更有可能认为痴呆症有负面影响。87%的人表示物理治疗师有资格（强烈同意、同意），但只有 53%的人表示他们拥有进行认知筛查的必要技能（强烈同意、同意）。专业认证在几个问题上存在显著差异。关于实践年限或家庭护理年限的任何问题都没有发现显著差异。进行认知筛查的 PT 最常提到的是简易精神状态检查和时钟绘图测试。
物理治疗师认识到他们有资格进行认知筛查，但可能需要额外的培训，以利用认知结果来增强家庭护理干预和结果。需要进一步研究以确定哪些筛查最适合治疗师使用，并研究认知筛查对治疗结果的影响。
