Quiz 1 Flashcards
Key terms:
- Conceptual Framework
- Disease-oriented measures/evidence (DOE)
- Patient-oriented measures/evidence (POE)
- Global and Region Specific measures
- Measurement:
- Outcome measures:
- Outcomes Instruments
- Pathology
- Treatment Outcomes
- Disability:
- Conceptual Framework: Like a c-map of the disability models???? Like ICF model????
- Disease-oriented measures: Provides insight into the physiology or illness/injury … the pathology. These are not as important to patients, but important to clinicians. It is measures of the disease the Dr. cares about (examples: blood pressure, ROM measure, blood tests)
- Patient-oriented measures: Provides measures that are of interest to the patients, not really the clinicians. (Examples: symptoms, function, quality of life, ADL’s, pain, subjective measures).
- Global and Region Specific measures: Global are surveys that are general to capture general health status. Regional/condition measures might be surveys or measures for specific areas of the body, injuries, conditions, pain, depression, etc.
- Measurement: What you measure (Dr. or patient)
- Outcome measures: How are you going to measure the outcome of an intervention to know if you improved?Outcome measure as a “change in the health of an individual, group of people, or population that is attributable to an intervention or series of interventions.” Outcome measures (mortality, readmission, patient experience, improved ROM, decreased pain, ADL's, etc.) are the quality and cost targets healthcare organizations are trying to improve.
- Outcomes Instruments: Surveys created to assess where a patient is at. Survey, or a goni
- Pathology: Science of the causes and effects of a disease, injury, infection, illness, etc.
- Treatment Outcomes: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
- Disability: inability or limitation in performing socially defined roles/tasks (so not necessarily a long-term handicap)
One of the primary challenges in conducting clinical research is selecting _____________
Appropriate outcome measures to assess in patients as their pathology progresses over time.
You don’t want it too easy/little, or too much/hard
2 examples of disablement models:
Do disablement models focus on DOE or POE
NAGI’s, and ICF model
More geared towards POE (since we care about participation/restrictions and quality of life and function of patient as the outcome measure).
What is Nagi’s Model:
Example of Nagi’s Model:
HRQOL =
Are impairments DOE or POE
Are functional limitations DOE or POE
Are disability and quality of life DOE or POE
Active pathology > impairments > functional limitations > disability = all impact quality of life
Example:
- Pathology: Knee ligament sprain
- Impairment: limited ROM in knee
- Functional limitation: can’t squat or kneel or job
- Disability: Can’t play basketball or walk as well
- Quality of Life: Feel bad, anxiety, weight, FEELING
Health related quality of life (which is not financial or spiritual, just the health side that impacts quality of life)
Impairments are DOE
Both, depending on perspective
POE
Two other Disability Models similar to Nagi’s … and main differences
National Center for Medical Rehabilitation Research (NCMRR). They replace “quality of life” with “societal limitations”
World Health Organization ICF Model (WHO) … add the contextual factors of personal/environmental factors
Would temperature, ROM or BMI be considered DOE or POE
DOE
T or F: When clinicians are asked to subjectively assess their patients outcome or level of disability, clinicians typically rate their patient’s success substantially higher than the patients themselves do?
Would this be DOE or POE
True
DOE
The most common type of POE or measurement outcomes are from patients:
self-reporting (current health status through a survey / outcome instrument)
Examples of common GLOBAL health outcomes instruments:
Examples of common REGIONAL health outcome instruments:
GLOBAL:
Short Form 36 Health survey (SF-36)
Sickness Impact Profile (SIP)
Child Health Questionaire (CHQ)
REGIONAL: Lower Extremity Functional Scale UE DASH FAAM
The most common measures of POE are instruments that require patients to self-report their health status.
ok
Case Reports are important to communicate with other PT’s about clinical practice in PT. Why is this important?
- Share successful and unsuccessful info /interventions.
- Document practices
- Generate hypothesis about future research
- Accumulating info
- Stimulate ideas for further research
Do case reports control against outside things that might impact the intervention?
No
4 primary components of a case report
Intro
Methodology
Outcomes
Discussion
What was the purpose of the big case study paper:
The purpose of this paper is to assist physical therapists in creating high-quality case reports for the peer-reviewed literature, using the ICF model as a guiding framework. Rather than a large research project/study of MANY people, a case report looks at one person and studies them according to the ICF model.
This paper also will introduce a proposal for uniform
requirements that improve the quality and feasibility of
case reporting in physical therapy that are informed by
the ICF model.
Use the ICF model to define patient functioning using uniform terminology by all PT’s. And get more case reports to help further research, but be done in a uniform ICF model way.
Journals in physical therapy should adopt
the ICF model as the basis for documenting
functioning and disability
Establish a standard patient functioning
flow diagram based on the ICF model
Uniform guidelines for case reporting should be adopted by
journals in the field of physical therapy that utilize
the ICF model as a standard nomenclature for
patient functioning and encourage description of
clinical reasoning using the lens of the ICF model. A
movement toward functioning in this manner holds
promise to improve the feasibility, quality and applicability
of clinical case reporting in the physical
therapy literature.
The article we read was about:
The purpose of this case report is to describe PT management of a patient using HMV using ICF model.
PT included progressive resistance training (PRT) and aerobic interval training (AIT). Home-based PT including PRT and AIT is feasible and safe for a patient undergoing HMV and resulted in improved participation in her activities of daily living
COPD really limits a person’s ADL, and often leads to patients needing HMV device to help with breathing.
A home-based PT program consisting of interval
training and resistance training with a patient on HMV
was well tolerated and safe to perform. The patient
experienced improvements in ADL function
