Background
Methods
Participants
Procedures
Statistical analysis
Results
Participants’ characteristics
Variable | N | Percentage | Percentage of respondents that uses outcome measures |
---|---|---|---|
Gender | |||
Male | 75 | 41.7 | 64.0 |
Female | 105 | 58.3 | 60.0 |
Years of physical therapist practice | |||
< 3 years | 42 | 23.3 | 50.0 |
3–5 years | 27 | 15.0 | 74.1 |
6–10 years | 52 | 28.9 | 73.1 |
11–20 years | 41 | 22.8 | 60.0 |
> 20 years | 18 | 10.0 | 39.0 |
Professional degree | |||
Diploma | 21 | 11.7 | 23.8 |
Baccalaureate | 135 | 75.0 | 63.0 |
Master’s | 24 | 13.3 | 85.7 |
Specialty certification | |||
None | 94 | 52.2 | 74.4 |
Orthopedic | 32 | 17.8 | |
Neurology | 18 | 10.0 | |
Pediatric | 6 | 3.3 | |
Manual therapy | 17 | 9.4 | |
Hand therapy | 3 | 1.7 | |
Sports | 2 | 1.1 | |
Cardiovascular | 2 | 1.1 | |
Geriatric | 1 | 0.6 | |
Other | 5 | 2.8 | |
Type of work facility | (1 missing) | ||
Acute care | 58 | 32.4 | 74.1 |
Sub-acute care | 37 | 20.7 | 73.0 |
Extended care | 37 | 20.7 | 43.2 |
Outpatient clinic | 31 | 17.3 | 45.2 |
Private clinic | 13 | 7.3 | 53.8 |
University | 3 | 1.3 | 74.1 |
Use of standardized outcome measure | |||
Yes | 111 | 61.7 | |
No | 69 | 38.3 | |
Region | |||
Riyadh | 142 | 79.0 | |
Makkah | 25 | 14.0 | |
Al Madinah Almunawrah | 5 | 3.0 | |
Eastern province | 8 | 4.4 | |
Age, years (majority of patients) | |||
Treat all patients | 25 | 13.9 | |
< 21 years | 19 | 10.6 | |
21–40 years | 45 | 25.0 | |
41–60 years | 72 | 40.0 | |
61–75 years | 18 | 10.0 | |
> 75 years | 1 | 0.6 | |
Conditions | |||
Musculoskeletal | 158 | 56.7 | |
Neurology | 132 | 32.8 | |
Cardiovascular-pulmonary | 60 | 6.4 | |
Women’s health | 17 | 2.6 | |
Mixed | 97 | 11.0 | |
Integumentary | 22 | 2.4 | |
Do not manage patients | 2 | 0.2 | |
\( \overline{X} \)
| |||
Treatment sessions per 8-h day | 9.3 |
Perceptions of standardized outcome measures
Perception of benefits
Benefits | Agree | Agree somewhat | Disagree | |||
---|---|---|---|---|---|---|
N | Percent | N | Percent | N | Percent | |
“Helping to direct the plan of care”. | 75 | 67.6 | 35 | 31.5 | 1 | 0.9 |
“Enhancing communication between therapist and patient”. | 81 | 72.9 | 30 | 27.1 | 0 | 0 |
“Enhancing communication with third-party payers, physicians, and other providers”. | 64 | 57.7 | 42 | 37.8 | 5 | 4.5 |
“Helping patients feel that therapists are thorough in their examination”. | 74 | 66.7 | 46 | 41.4 | 1 | 0.9 |
“Increasing the efficiency of examinations”. | 82 | 73.9 | 27 | 24.3 | 2 | 1.8 |
“Helping to focus choice of interventions”. | 83 | 74.8 | 28 | 25.2 | 0 | 0 |
“Attaining better patient outcomes”. | 79 | 71.2 | 32 | 28.8 | 0 | 0 |
“Helping to motivate and encourage patients”. | 81 | 72.9 | 30 | 27.1 | 0 | 0 |
“Decreasing the rates of denial from third-party payers”. | 47 | 42.3 | 56 | 50.5 | 8 | 7.2 |
“Enhanced marketing of my practice or services”. | 56 | 50.5 | 40 | 36.1 | 15 | 13.5 |
Barriers
Barriers | Agree | Agree somewhat | Disagree | |||
---|---|---|---|---|---|---|
N | Percent | N | Percent | N | Percent | |
“Confusing to patients”. | 35 | 31.3 | 55 | 49.1 | 21 | 18.9 |
“Difficult for patients to complete independently”. | 42 | 37.8 | 58 | 52.3 | 11 | 9.9 |
“Require too high a reading level for many patients”. | 39 | 35.1 | 59 | 53.2 | 13 | 11.7 |
“English language in which many of my patients are not fluent”. | 59 | 53.2 | 35 | 31.5 | 17 | 15.3 |
“Not sensitive to the cultural/ethnic concerns of many patients”. | 32 | 28.8 | 53 | 47.7 | 26 | 23.4 |
“Make patients anxious”. | 8 | 7.2 | 52 | 46.8 | 51 | 45.9 |
“Take too much time for patients to complete”. | 53 | 47.7 | 47 | 42.3 | 11 | 9.9 |
“Take too much of clinicians’ time to analyze/calculate/score”. | 48 | 43.2 | 44 | 39.6 | 19 | 17.1 |
“Provide information that is too subjective to be useful”. | 21 | 18.9 | 59 | 53.2 | 31 | 27.9 |
“Require more effort than they are worth”. | 20 | 18.1 | 50 | 45.1 | 41 | 36.9 |
“Do not contain information that helps to direct the plan of care”. | 13 | 11.7 | 41 | 36.9 | 57 | 51.4 |
“Difficult to interpret (eg, do not know what norms are, how score relates to severity, or what a clinically important change might be)”. | 14 | 12.6 | 53 | 47.7 | 44 | 39.6 |
“Do not contain the types of items or questions that are relevant for the type of patients I see”. | 15 | 13.5 | 57 | 51.4 | 39 | 35.1 |
“Often do not get completed at discharge, so cannot give information about patients response to treatment”. | 25 | 22.5 | 56 | 50.5 | 30 | 27.1 |
Implementation of SOMs in practice
Health status Questionnaires used for | Yes Routinely | Yes Sometime | No | |||
---|---|---|---|---|---|---|
N | Percent | N | Percent | N | Percent | |
“Answering clinical questions through a traditional research approach”. | 45 | 40.5 | 62 | 55.9 | 4 | 3.6 |
“Quality improvement / assurance activities”. | 59 | 53.2 | 48 | 43.2 | 4 | 3.6 |
“Determining the case mix (complexity) of patients”. | 34 | 30.6 | 66 | 59.5 | 11 | 9.9 |
“Comparing performance across therapists in terms of average patient outcomes”. | 49 | 44.1 | 50 | 45.1 | 12 | 10.8 |
“Comparing one clinic’s performance to that of other clinics”. | 41 | 36.9 | 49 | 44.1 | 21 | 18.9 |
“Comparing average outcomes of patients with different conditions within a practice”. | 45 | 40.5 | 58 | 52.3 | 8 | 7.2 |
“Examining the average change in patients’ health status over their episodes of care to determine a practice’s effectiveness”. | 62 | 55.9 | 45 | 40.5 | 4 | 3.6 |
“Examining the average change in patients’ health status over their episodes of care to determine individual therapists’ effectiveness”. | 55 | 49.5 | 48 | 43.2 | 8 | 7.2 |
“Examining and documenting the status, progress, and/or outcomes of individual patients by individual therapists”. | 63 | 56.8 | 48 | 43.2 | 0 | 0 |
“Communicating with other health care providers and referral sources”. | 59 | 53.2 | 44 | 39.6 | 8 | 7.20 |
N | Percent | |
---|---|---|
“In my practice setting, completion of health status questionnaires is”, | ||
“Mandated/required for all patients”. | 34 | 30.3 |
“Mandated only for patients who have certain types of conditions (eg, low back pain)”. | 27 | 24.1 |
“Routine for all patients/clients, but not mandated/required”. | 11 | 9.8 |
“Routine, but not mandated, only for patients who have certain types of conditions (eg, low back pain)”. | 18 | 16.1 |
“Sporadic, depending on different factors such as time, patient’s characteristics, etc”. | 22 | 19.6 |
“In my practice setting, the types of health status questionnaires used include”, | ||
“Only those that use information derived from patients’ self-report”. | 80 | 72.1 |
“Only those that use information derived from observation of patients’ performance”. | 14 | 12.6 |
“A combination of those that use patient/client self-report and observation of their performance”. | 17 | 15.3 |
“In my practice setting, health status questionnaires are completed”, | ||
“Using paper and therapists review the raw information from the paper version”. | 26 | 23.4 |
“Using paper, analyzed/scored through scanner or computer data entry, and then summary scores are reviewed by therapists”. | 68 | 61.3 |
“Using the computer (no paper), and summary scores are reviewed by therapists”. | 16 | 14.4 |
Other | 1 | 0.9 |
“In my practice setting, when I use questionnaires that require patients self-reports”, | ||
“Patients complete the health status questionnaires by themselves”. | 76 | 67.9 |
“Office staff or aides assist patients/clients in completing health status questionnaires”. | 25 | 22.3 |
“Physical therapists complete health status questionnaires with the patients”. | 10 | 8.9 |
Other | 1 | 0.9 |
“Each physical therapist in my practice setting”; | ||
“Uses the same health status questionnaires”. | 75 | 67.0 |
“Chooses the health status questionnaires he or she wants to use for each patient”. | 37 | 33.0 |
“I learned how to use health status questionnaires”, | ||
“In my professional (entry-level) program”. | 38 | 34.2 |
“In my post-professional education”. | 35 | 31.5 |
“From continuing education workshops/conferences”. | 27 | 24.3 |
“From the other therapists or managers in my practice setting”. | 11 | 9.9 |
aReasons | N | Percentage |
---|---|---|
“Can be completed quickly”. | 68 | 61.3 |
“Easy for patients to understand”. | 75 | 67.6 |
“Easy for clinicians to understand/interpret meaning of scores and change in scores”. | 49 | 44.1 |
“Shown to be valid and reliable”. | 56 | 50.5 |
“Seem to be the most common ones used in physical therapist practice”. | 38 | 34.2 |
“Useful for a variety of purposes such as research, quality assurance, patient/client evaluation”. | 27 | 24.3 |
“Can be analyzed electronically (scanner, computer, etc.)”. | 18 | 16.2 |
“Most appropriate for the types of conditions seen in my practice setting”. | 35 | 31.5 |
“Other reason” | 1 | 0.90 |
“Do not know” | 2 | 1.80 |
Reasons for not using SOMs
aReasons | N | Percentage |
---|---|---|
“Confusing to patients”. | 30 | 43.4 |
“Difficult for patients to complete independently”. | 49 | 71.0 |
“Require too high a reading level for many patients”. | 29 | 42.0 |
“English language in which many of my patients are not fluent”. | 30 | 43.4 |
“Not sensitive to the cultural/ethnic concerns of many patients”. | 11 | 15.9 |
“Make patients anxious”. | 8 | 11.5 |
“Take too much time for patients to complete”. | 52 | 75.7 |
“Take too much of clinicians’ time to analyze/calculate/score”. | 35 | 50.7 |
“Provide information that is too subjective to be useful”. | 16 | 23.2 |
“Require more effort than they are worth”. | 17 | 24.6 |
“Do not contain information that helps to direct the plan of care”. | 15 | 21.7 |
“Difficult to interpret (eg, do not know what norms are, how score relates to severity, or what a clinically important change might be)”. | 11 | 15.9 |
“Do not contain the types of items or questions that are relevant for the types of patients I see”. | 8 | 11.5 |
“Often do not get completed at discharge, so are not useful for determining patients’ response to treatment”. | 12 | 17.4 |
“Require training that I do not have”. | 24 | 34.8 |
“Cost too much”. | 6 | 8.8 |
“Require a support structure that I do not have (eg, technology, staffing)”. | 14 | 20.3 |
“Really only useful for research purposes”. | 26 | 37.7 |
“Not relevant because my practice involves consultation, case management, or discharge planning only”. | 8 | 11.5 |
Plan to implement? | ||
Yes | 24 | 34.8 |
No | 10 | 14.5 |
Maybe | 35 | 50.7 |
Participant characteristics influencing the use of standardized outcome measures
Factors | Odd Ratio | P- value | 95% CI | |
---|---|---|---|---|
Lower | upper | |||
Gender | ||||
Male | Reference | 0.6 | ||
Female | 0.8 | 0.5 | 1.6 | |
Years of experience | ||||
< 3 years | Reference | |||
3–5 years | 2.9 | 0.05 | 0.9 | 8.2 |
6–10 years | 2.7 | 0.02 | 1.2 | 6.4 |
11–20 years | 1.6 | 0.32 | 0.7 | 3.7 |
> 20 years | 0.6 | 0.43 | 0.2 | 1.9 |
Professional degree | ||||
Baccalaureate | Reference | |||
Diploma | 0.2 | 0.002 | 0.1 | 0.5 |
Master’s | 3.5 | 0.001 | 0.9 | 12.6 |
Facility | ||||
Acute care | Reference | |||
Sub-acute care | 0.9 | 0.90 | 0.4 | 2.4 |
Extended care | 0.3 | 0.003 | 0.1 | 0.6 |
Outpatient clinic | 0.3 | 0.008 | 0.1 | 0.7 |
Private clinic | 0.4 | 0.16 | 0.1 | 1.4 |
Specialty | ||||
No | Reference | 0.001 | ||
Yes | 2.9 | 1.6 | 5.5 |