A method for evaluating treatment course and outcome for clinicians
Scientific article in Fysioterapeuten 9/14.
Anne Marit Mengshoel, professor/dr.philos/fysioterapeut, Avdeling for helsefag, Inst. Helse og Samfunn, Universitetet i Oslo. firstname.lastname@example.org.
Anoop Chowdhury, vitenskapelig assi-stent/MSc manuellterapi/fysioterapeut, Avdeling for helsefag, Inst. Helse og Samfunn, Universitetet i Oslo. Sentrum Fysikalske Institutt, Halden.
Wenche Schrøder Bjorbækmo, postdoktor/PhD/fysioterapeut, Avdeling for helsefag, Inst. Helse og Samfunn, Universitetet i Oslo.
Purpose: Examine whether a design and an outcome measure developed for research purpose might be feasible and relevant for clinicians to evaluate and document effectiveness of physiotherapy practice in primary health care in Norway.
Methods: The principles of Single Subject Experimental Design were followed implying to perform repetitive measures of outcome variables before, during and after a treatment period. Outcomes were measured by the Patient-Specific Functional Scale (PSFS) which assesses a patient’s problems to execute self-defined customized activities on a scale from 0-10. Afterwards the patients and physiotherapists were interviewed about the feasibility and clinical relevance of the methods applied.
Results: Apart from performing assessments several times before treatment started, the physiotherapists found the repetitive assessments easy to perform in practice. The graphs showed the outcomes in an explicit and understandable way that could be used as guidance for doing adjustments during the treatment course and communicate outcomes to others afterwards. Both the patients and the physiotherapists meant it could be challenging to concretize the activities mirroring the treatment targets. How-ever, it could also promote communication and collaboration about reaching a shared treatment goal.
Conclusion: Application of the PSFS and performing assessment at start of treatment period, several times during a treatment course, and after completed treatment seems to be a way for clinicians to evaluate and document effectiveness of their clinical practice.
Keywords: Single Subject Experimental Design, Patient-Specific Functional Scale, clinical practice, clinical documentation.