Award Date

5-11-2018

Degree Type

Dissertation

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

Advisor 1

Daniel Young

First Committee Member

Merrill Landers

Second Committee Member

Daniel Young

Number of Pages

25

Abstract

Purpose/Hypothesis: Research has demonstrated that physical therapy plays a crucial role in patient recovery in the acute hospital setting. Despite known benefits, scheduled sessions do not always occur and are called nontreatment (NT) events. Reported NT ranges from 15% to 26% of scheduled sessions. Previous studies have found an association between NT and patient diagnosis as well as between NT and day of the week on which treatment was scheduled. Identifying additional factors that affect NT is important if therapists and administrators are to make improvements. The purpose of this study is to determine if an association exists between physical therapist attributes and NT risk among their patients. A secondary aim of this study is to confirm that patient diagnosis and day of the week change the odds of NT, as those results were only seen in one prior study at a single hospital. Subjects: 36 physical therapists and 623 of their consecutive adult patients who were scheduled for physical therapy during their hospital stay. Materials/Methods: A cross-sectional, medical record review of 623 consecutive patients over 3 months scheduled for 2,419 physical therapy sessions. Results: The overall NT proportion of planned therapy sessions was 13.2%, it was 4.8% for the first scheduled session, and 16.1% among remaining sessions. NT proportions for individual therapists ranged from 1.7% to 22.6% among therapists with at least 30 planned sessions. When male patients were scheduled for therapy with a female therapist, 25.5% of sessions resulted in NT. NT was 15.0% when female patients were scheduled for therapy with a male therapist, and 16.1% when the sex of the patient and therapist matched. As in previous studies, patients were less likely to experience NT if they had a musculoskeletal condition. Conclusions: Findings from previous studies that patient diagnoses were associated with NT were confirmed. While the mean proportion of NT was around 15%, individual physical therapists may be much higher or lower. The sex of patients and therapists was associated with significantly different NT proportions and should be evaluated further. Future research efforts should include other therapist traits that may influence NT. Clinical Relevance: With a better understanding of reasons for NT, therapists and administrators may be able to match patients with therapists most likely to be successful in treatment. The relationship between sex of the patient and therapist may have an impact on the occurrence of NT. Hospital and rehabilitation department policies need to be evaluated in an effort to reduce the higher percentage of NT among patients without musculoskeletal diagnoses.

Keywords

Hospital; Nontreatment; Participation; Physical therapy

Disciplines

Physical Therapy

File Format

pdf

File Size

437 Kb

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

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