Subject(s)
COVID-19 , Periodicals as Topic , COVID-19/epidemiology , Evidence-Based Medicine , HumansSubject(s)
Betacoronavirus , Telemedicine , COVID-19 , Coronavirus Infections , Humans , Pandemics , Pneumonia, Viral , SARS-CoV-2 , UncertaintySubject(s)
Attitude of Health Personnel , Betacoronavirus , Cooperative Behavior , Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Health Personnel/psychology , International Cooperation , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Adult , Attitude to Health , COVID-19 , Female , Humans , Male , Middle Aged , SARS-CoV-2ABSTRACT
BACKGROUND: In response for the need of a freely available, stand-alone, validated outcome measure for use within musculoskeletal (MSK) physiotherapy practice, sensitive enough to measure clinical effectiveness, we developed an MSK patient reported outcome measure. OBJECTIVES: This study examined the validity and reliability of the newly developed Brighton musculoskeletal Patient-Reported Outcome Measure (BmPROM) within physiotherapy outpatient settings. METHODS: Two hundred twenty-four patients attending physiotherapy outpatient departments in South East England with an MSK condition participated in this study. The BmPROM was assessed for user friendliness (rated feedback, N = 224), reliability (internal consistency and test-retest reliability, n = 42), validity (internal and external construct validity, N = 224), and responsiveness (internal, n = 25). RESULTS: Exploratory factor analysis indicated that a two-factor model provides a good fit to the data. Factors were representative of "Functionality" and "Wellbeing". Correlations observed between the BmPROM and SF-36 domains provided evidence of convergent validity. Reliability results indicated that both subscales were internally consistent with alphas above the acceptable limits for both "Functionality" (α = .85, 95% CI [.81, .88]) and 'Wellbeing' (α = .80, 95% CI [.75, .84]). Test-retest analyses (n = 42) demonstrated a high degree of reliability between "Functionality" (ICC = .84; 95% CI [.72, .91]) and "Wellbeing" scores (ICC = .84; 95% CI [.72, .91]). Further examination of test-retest reliability through the Bland-Altman analysis demonstrated that the difference between "Functionality" and "Wellbeing" test scores did not vary as a function of absolute test score. Large treatment effect sizes were found for both subscales (Functionality d = 1.10; Wellbeing 1.03). CONCLUSION: The BmPROM is a reliable and valid outcome measure for use in evaluating physiotherapy treatment of MSK conditions.
Subject(s)
Musculoskeletal Diseases/rehabilitation , Patient Reported Outcome Measures , Physical Therapy Modalities , Surveys and Questionnaires , Adolescent , Adult , Aged , Aged, 80 and over , England , Factor Analysis, Statistical , Female , Humans , Male , Middle Aged , Reproducibility of Results , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: Research has shown that patients' expectations of health care and health-care practitioners are complex and may have a significant impact on outcomes of care. Little is known about the expectations of osteopathic patients. OBJECTIVES: To explore osteopathic patients' expectations of private sector care. DESIGN: Focus groups and individual interviews with purposively selected patients; this was the qualitative phase of a mixed methods study, the final phase being a patient survey. SETTING AND PARTICIPANTS: A total of 34 adult patients currently attending for treatment at private osteopathic practices across the United Kingdom. INTERVENTION: Focus group discussions and individual interviews around expectations before, during and after osteopathic care. OUTCOME MEASURES: Thematic analysis of text data to identify topics raised by patients and to group these into broad themes. RESULTS: Many components of expectation were identified. A preliminary conceptual framework describing the way the therapeutic encounter is approached in osteopathy comprised five themes: individual agency, professional expertise, customer experience, therapeutic process and interpersonal relationship. DISCUSSION AND CONCLUSION: The components of expectation identified in this phase of the study provided potential question topics for the survey questionnaire in the subsequent phase of the investigation. The model developed in this study may add a new perspective to existing evidence on expectations. Further research is recommended to test the findings both within private practice and the National Health Service.
Subject(s)
Osteopathic Medicine , Patient Satisfaction , Physician-Patient Relations , Female , Focus Groups , Health Policy , Humans , Male , Osteopathic Medicine/methods , Osteopathic Physicians , Private Practice , United KingdomABSTRACT
A move towards self-management is central to health strategy around chronic low back pain, but its concept and meaning for those involved are poorly understood. In the reported study, four distinct and shared viewpoints on self-management were identified among people with pain and healthcare providers using Q methodology. Each construes self-management in a distinctive manner and articulates a different vision of change. Identification of similarities and differences among the viewpoints holds potential for enhancing communication between patients and healthcare providers and for better understanding the complexities of self-management in practice.
