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- Elvén, Maria, 1973-, et al.
(författare)
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Assessing clinical reasoning in physical therapy : discriminative validity of the Reasoning 4 Change instrument
- 2022
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Ingår i: Physiotherapy. - : Elsevier BV. - 0031-9406 .- 1873-1465. ; 117, s. 8-15
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate discriminative validity of the Reasoning 4 Change (R4C) instrument by investigating differences in clinical reasoning skills between first semester, final semester physical therapy students and physical therapy experts.Design:Cross-sectional designSetting: University and physical therapy practiceParticipantsStudents from the first (n = 87) and final semester (n = 47) of an entry-level physical therapy program and experts in physical therapy with a behavioral medicine approach (n = 14).Methods: The students and experts answered the web-based R4C instrument on one occasion. The R4C instrument includes four domains designed to assess physical therapists’ clinical reasoning skills with a focus on supporting clients’ behavior change and has demonstrated acceptable content validity, convergent validity and reliability. Data was analyzed with one-way analysis of variance and Games-Howell post hoc test.Results: Differences in all domains and subscale scores were found between the three groups. Pairwise comparisons demonstrated that experts scored higher (better clinical reasoning skills) than first semester students in all domains and subscales; and higher scores than final semester students, except for two subscales. Final semester students scored higher than first semester students, except for one subscale.Conclusions: The findings highlight differences in clinical reasoning skills focusing on clients’ behavior change among physical therapy students with different degrees of training and education in clinical reasoning and physical therapists with extensive experience and expertise. The results provide evidence for the discriminative validity of the R4C instrument which support the use of the R4C instrument in education, research and clinical practice.
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| 3. |
- Sandborgh, Maria, 1955-, et al.
(författare)
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Integration of Behavioral Medicine Competencies into Physical Therapy Curriculum in an Exemplary Swedish Program : Rationale, Process and Ten-year Review
- 2020
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Ingår i: Physiotherapy Theory and Practice. - Philadelphia : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 36:3, s. 365-377
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Forskningsöversikt (refereegranskat)abstract
- In 2004, Mälardalen University, Sweden, introduced a new undergraduate entry-level physiotherapy program. Program developers constructed the curriculum with behavioral medicine content that reflected the contemporary definition and values of the physiotherapy profession aligning it with current best practices, evidence, and the International Classification of Functioning, Disability, and Health (ICF). The new curriculum conceptualized movement and function as modifiable behaviors in that they reflect behavioral contingencies, perceptions, beliefs, and lifestyle factors as well as pathophysiology and environmental factors. The purpose of this article is to describe how one university accordingly structured its new curriculum and its review. We describe the rationale for the curriculum's behavioral medicinecontent and competencies, its development and implementation, challenges, long-term outcomes, and its related research enterprise. We conclude that physiotherapy practiced by our graduates augments that taught in other programs based on accreditation reviews. With their expanded practice scope, graduates are systematically practicing within the constructs of health and function conceptualized within the ICF. Our intent in sharing our experience is to exemplify one university's initiative to best prepare students with respect to maximizing physiotherapy outcomes as well as establish a dialogue regarding minimum standards of behavioral medicine competencies in physiotherapy education and practice.
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| 4. |
- Söderlund, Anne, 1957-, et al.
(författare)
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Implementing a behavioral medicine approach in physiotherapy for patients with musculoskeletal pain : a scoping review
- 2020
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Ingår i: Pain Reports. - 2471-2531. ; 5:5
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Forskningsöversikt (refereegranskat)abstract
- In intervention research on musculoskeletal pain, physiotherapists often study behavioral and cognitive components. Evidence on applying these components has increased during the past decade. However, how to effectively integrate behavioral and cognitive components in the biopsychosocial management of musculoskeletal pain is challenging. The aim was to study the intervention components and patient outcomes of studies integrating behavioral and cognitive components in physiotherapy, to match the interventions with a definition of behavioral medicine in physiotherapy and to categorize the behavior change techniques targeted at patients with musculoskeletal pain in (1) randomized controlled effect trials or (2) implementation in clinical practice trials. A scoping review was used to conduct this study, and the PRISMA-ScR checklist was applied. Relevant studies were identified from the PubMed, MEDLINE, PsycINFO, CINAHL Plus, and Web of Science Core databases separately for the (1) randomized controlled effect trials and (2) implementation in clinical practice trials. Synthesis for the matching of the patient interventions with the existing definition of behavior medicine in physiotherapy showed that the interventions mostly integrated psychosocial, behavioral, and biomedical/physical aspects, and were thus quite consistent with the definition of behavioral medicine in physiotherapy. The reported behavior change techniques were few and were commonly in categories such as “information of natural consequences,” “feedback and monitoring,” and “goals and planning.” The patient outcomes for long-term follow-ups often showed positive effects. The results of this scoping review may inform future research, policies, and practice.
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| 7. |
- Dahlén, Micael, et al.
(författare)
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Changes in Physical Activity Are Associated with Corresponding Changes in Psychological Well-Being : A Pandemic Case Study
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601 .- 1661-7827. ; 20, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Societal crises and personal challenges are often followed by substantial changes in physicalactivity. Is there a link between such changes and psychological well-being? Seeking to answerthis question, we conducted a correlational study on a representative sample in Sweden during thefirst year of the COVID-19 pandemic (N = 1035). About 49% of the sample had decreased theirphysical activity compared to their self-reported activity level prior to the pandemic, whereas 32%had increased it. The results showed a positive and robust association between changes in dailyactivity level and corresponding changes in psychological well-being. Specifically, individuals whohad reduced their physical activity over the last year reported lower life satisfaction than before, andindividuals who had increased their physical activity reported higher life satisfaction than before.The amount of complete physical inactivity (sitting) showed a similar pattern as the exercise data,meaning that individuals who reported increasing inactivity per day also reported a greater declinein life satisfaction. Additional analyses showed that the association between daily activity level andlife satisfaction was somewhat stronger for men than for women, but there was no difference whencomparing individual versus organized activities. The current study was based on a cross-sectionaldesign, measuring self-reported change over time. Recent work from other research teams have usedlongitudinal data and experience-sampling in different settings, finding similar results. We concludethat there is good reason to recommend physical exercise as a coping strategy in difficult times.
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| 8. |
- Dahlén, Micael, et al.
(författare)
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The comeback effect : How happy are people who have recovered from a COVID-19 infection?
- 2022
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Ingår i: International Journal of Wellbeing. - : International Journal of Wellbeing. - 1179-8602. ; 12:2, s. 114-133
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Tidskriftsartikel (refereegranskat)abstract
- There is already a large body of research on the dramatic negative effects of COVID-19 on peoples’ mental and physical health. Millions of people have died, and the pandemic has negatively influenced the lives of billions of people. Luckily however, the vast majority of people infected with the virus, recovers. The happiness and wellbeing of these people have not been extensively studied. In the current paper, we ask the question: Are people who have recovered from a COVID-19 infection happier than those who have not been infected at all? Building on previous research on hedonic adaptation and counterfactual thinking, we hypothesize, and find, that those who have had an infection appear slightly happier than others. The study relies on two surveys conducted in Sweden during the pandemic in 2020 (n=1029) and 2021 (n=1788).
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| 9. |
- Edelbring, Samuel, et al.
(författare)
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Development of a framework for a structured clinical reasoning curriculum : Outcomes from a multiprofessional European project
- 2021
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Konferensbidrag (refereegranskat)abstract
- Background: Despite clinical reasoning standing at the core of health professions practice, it is often taught implicitly and informally within the health professions and there is a lack of its structured education. Multiple professions can gain from a supportive framework with explicit learning objectives and expressed key educational aspects. Our aim was to develop such a framework to support development of a longitudinal and adaptive clinical reasoning curriculum for students and teachers in health professions education.Summary of Work: Educators and researchers from several universities and learning institutions across Europe and the USA gathered to strengthen clinical reasoning education (DID-ACT consortium). As a part of a greater Kern-cycle of curriculum-development, participants worked in multiprofessional groups to identify resources, learning activities and assessments addressing target areas derived from a needs analysis.Summary of Results: The DID-ACT framework is based on a learner-centered and active learning pedagogical approach using contextualized patient-scenarios as point of departure. Thirty-five learning objectives were formulated regarding clinical reasoning theories, cognitive biases, about gathering, interpreting and synthesizing patient information and participation, as well as collaborative aspects of clinical reasoning. Learning activities and assessment methods were constructively aligned using a competence-based approach. Progression was described at novice, intermediate and advanced student levels, and at a teaching level.Discussion and Conclusions: Whereas competence-based learning objectives and curricular goals relating to clinical reasoning exist, DID-ACTs collaborative effort presents a novel contribution. It adds to previous work in its explicit focus on clinical reasoning and multiprofessional approach. The presented framework will be used to develop blended learning for students and educators within the consortium and can contribute to future standardized clinical reasoning curricula.Take-home Messages: Clinical reasoning is often taught implicitly and informally within the health professions. A collaborative effort has developed a curricular framework to buttress students clinical reasoning and support educators. This framework highlights key curricular aspects and presents a range of resources, learning activities and assessments.
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| 10. |
- Edelbring, Samuel, PhD, Docent, 1969-, et al.
(författare)
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Person-Centeredness in Clinical Reasoning of Interprofessional Stroke Teams
- 2023
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Ingår i: Patient Education and Counseling. - : Elsevier. - 0738-3991 .- 1873-5134. ; 109:Suppl., s. 70-70
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Although person-centered care is prioritized in healthcare, challenges remain before such care is integrated in everyday communication and practice. One way to strengthen person-centered care is that health professionals’ clinical reasoning (i.e., assessment and management) is pervaded by patient participation and individualized to patient needs. Interprofessional team meetings, focusing on goals and management planning, is an opportunityt o improve person-centeredness. However, there is a lack of understanding of how person-centeredness is created in the clinical reasoning of teams. This study aims to explore how clinical reasoning is performed from a person-centered perspective in team meetings with patients with stroke and next of kin.Methods: Explorative qualitative design employing a thematic analysis of audio recorded communication at three team meetings. In total, three patients, two next of kin, and 15 professionals representing eight health professions, participated in the meetings.Findings: Four themes and eight subthemes were established: a) Emphasizing the patient’s resources; b) Struggling to find a common understanding, including subthemes: Unite the person’s narrative, the relative’s view, and the expertise of the interprofessional team, missed opportunities to clarify patient needs and wishes, and active listening and receptiveness; c) Balancing the patient’s goals and professionals’ goals, including subthemes: Shared goals, the professionals’ view of appropriate goals, and the professionals’ assessment governs achievement of goals; d) Ambiguity in decisions about the management plan, including subthemes: Initiating shared decision making and lack of clarity and consensus.Discussion: This study reveals how the patient, next of kin and team contribute to shared understanding of the patient’s problem. Goals were guided by the patient’s and professionals’ expertise. To improve person-centeredness in clinical reasoning, the team need to further put the patient’s personal goals and perception of goal-achievement in the forefront as well as improve communication skills to catch patient needs and facilitate shared decisions.
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