Evaluating the clinical decision making of physiotherapists in the assessment and management of paediatric shoulder instability

Authors: Philp, F., Faux-Nightingale, A., Woolley, S., de Quincey, E. and Pandyan, A.

Journal: Physiotherapy (United Kingdom)

Volume: 115

Pages: 46-57

eISSN: 1873-1465

ISSN: 0031-9406

DOI: 10.1016/j.physio.2021.12.330

Abstract:

Objective: To elicit what information and clinical decision-making processes physiotherapists use in the assessment and management of paediatric shoulder instability. Design: Qualitative study. A modified nominal focus group technique, involving three clinical vignettes, was used to elicit physiotherapists’ decision-making processes. Setting: Physiotherapy departments from across four separate clinical sites. Subjects: Twenty-five physiotherapists, (18F:7M), ranging from two to 29 years post qualification. Outcomes measures: Thematic analysis. The initial round of coding was used to draw up a quantitative assessment of the diagnoses and map information used for clinical decision-making against the International Classification of Functioning (ICF) framework. Results: The themes identified related to ‘Differences in diagnoses, classification and diagnostic processes’, ‘Diagnostic process occurs over a long period of time’, ‘Management and prognosis are influenced by a number of factors’ and ‘Diagnostic test choices and prognosis influenced by factors beyond the patient injury’. Conclusion: Current methods of assessment are prone to bias and error and may lead to inconsistent or delayed provision of essential care. Further work is needed to develop methods of measurement and frameworks which can accurately identify relevant physiological mechanisms and personal factors associated with shoulder instability as a part of the assessment/diagnostic process.

https://eprints.bournemouth.ac.uk/36772/

Source: Scopus

Evaluating the clinical decision making of physiotherapists in the assessment and management of paediatric shoulder instability.

Authors: Philp, F., Faux-Nightingale, A., Woolley, S., de Quincey, E. and Pandyan, A.

Journal: Physiotherapy

Volume: 115

Pages: 46-57

eISSN: 1873-1465

DOI: 10.1016/j.physio.2021.12.330

Abstract:

OBJECTIVE: To elicit what information and clinical decision-making processes physiotherapists use in the assessment and management of paediatric shoulder instability. DESIGN: Qualitative study. A modified nominal focus group technique, involving three clinical vignettes, was used to elicit physiotherapists' decision-making processes. SETTING: Physiotherapy departments from across four separate clinical sites. SUBJECTS: Twenty-five physiotherapists, (18F:7M), ranging from two to 29 years post qualification. OUTCOMES MEASURES: Thematic analysis. The initial round of coding was used to draw up a quantitative assessment of the diagnoses and map information used for clinical decision-making against the International Classification of Functioning (ICF) framework. RESULTS: The themes identified related to 'Differences in diagnoses, classification and diagnostic processes', 'Diagnostic process occurs over a long period of time', 'Management and prognosis are influenced by a number of factors' and 'Diagnostic test choices and prognosis influenced by factors beyond the patient injury'. CONCLUSION: Current methods of assessment are prone to bias and error and may lead to inconsistent or delayed provision of essential care. Further work is needed to develop methods of measurement and frameworks which can accurately identify relevant physiological mechanisms and personal factors associated with shoulder instability as a part of the assessment/diagnostic process.

https://eprints.bournemouth.ac.uk/36772/

Source: PubMed

Evaluating the clinical decision making of physiotherapists in the assessment and management of paediatric shoulder instability

Authors: Philp, F., Faux-Nightingale, A., Woolley, S., de Quincey, E. and Pandyan, A.

Journal: PHYSIOTHERAPY

Volume: 115

Pages: 46-57

eISSN: 1873-1465

ISSN: 0031-9406

DOI: 10.1016/j.physio.2021.12.330

https://eprints.bournemouth.ac.uk/36772/

Source: Web of Science (Lite)

Evaluating the clinical decision making of physiotherapists in the assessment and management of paediatric shoulder instability.

Authors: Philp, F., Faux-Nightingale, A., Woolley, S., de Quincey, E. and Pandyan, A.

Journal: Physiotherapy

Volume: 115

Pages: 46-57

eISSN: 1873-1465

ISSN: 0031-9406

DOI: 10.1016/j.physio.2021.12.330

Abstract:

Objective

To elicit what information and clinical decision-making processes physiotherapists use in the assessment and management of paediatric shoulder instability.

Design

Qualitative study. A modified nominal focus group technique, involving three clinical vignettes, was used to elicit physiotherapists' decision-making processes.

Setting

Physiotherapy departments from across four separate clinical sites.

Subjects

Twenty-five physiotherapists, (18F:7M), ranging from two to 29 years post qualification.

Outcomes measures

Thematic analysis. The initial round of coding was used to draw up a quantitative assessment of the diagnoses and map information used for clinical decision-making against the International Classification of Functioning (ICF) framework.

Results

The themes identified related to 'Differences in diagnoses, classification and diagnostic processes', 'Diagnostic process occurs over a long period of time', 'Management and prognosis are influenced by a number of factors' and 'Diagnostic test choices and prognosis influenced by factors beyond the patient injury'.

Conclusion

Current methods of assessment are prone to bias and error and may lead to inconsistent or delayed provision of essential care. Further work is needed to develop methods of measurement and frameworks which can accurately identify relevant physiological mechanisms and personal factors associated with shoulder instability as a part of the assessment/diagnostic process.

https://eprints.bournemouth.ac.uk/36772/

Source: Europe PubMed Central

Evaluating the clinical decision making of physiotherapists in the assessment and management of paediatric shoulder instability

Authors: Philp, F., Faux-Nightingale, A., Woolley, S., de Quincey, E. and Pandyan, A.

Journal: Physiotherapy (United Kingdom)

Volume: 115

Issue: June

Pages: 46-57

ISSN: 0031-9406

Abstract:

Objective: To elicit what information and clinical decision-making processes physiotherapists use in the assessment and management of paediatric shoulder instability. Design: Qualitative study. A modified nominal focus group technique, involving three clinical vignettes, was used to elicit physiotherapists’ decision-making processes. Setting: Physiotherapy departments from across four separate clinical sites. Subjects: Twenty-five physiotherapists, (18F:7M), ranging from two to 29 years post qualification. Outcomes measures: Thematic analysis. The initial round of coding was used to draw up a quantitative assessment of the diagnoses and map information used for clinical decision-making against the International Classification of Functioning (ICF) framework. Results: The themes identified related to ‘Differences in diagnoses, classification and diagnostic processes’, ‘Diagnostic process occurs over a long period of time’, ‘Management and prognosis are influenced by a number of factors’ and ‘Diagnostic test choices and prognosis influenced by factors beyond the patient injury’. Conclusion: Current methods of assessment are prone to bias and error and may lead to inconsistent or delayed provision of essential care. Further work is needed to develop methods of measurement and frameworks which can accurately identify relevant physiological mechanisms and personal factors associated with shoulder instability as a part of the assessment/diagnostic process.

https://eprints.bournemouth.ac.uk/36772/

Source: BURO EPrints