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Biomedical subjects

Cheryl A Cott

Publications and source records attributed to Cheryl A Cott.

4 recordsLinked to original sources

Reliability and construct validity of the client-centred rehabilitation questionnaire.

PURPOSE: A key component in assessing the performance of rehabilitation services is the client's perspective. The purpose of this paper is to report on the development of a publicly available measure of client-centred rehabilitation (CCRQ) that can be used for discriminative and evaluative purposes. METHOD: Mixed qualitatative and quantitative methods were used. Phase 1: Identification of seven domains of client-centred rehabilitation based on a literature review, focus groups with clients, and review by content experts. Phase 2: Item generation for the seven conceptually derived subscales and cognitive interviews with inpatient rehabilitation patients. Phase 3: Psychometric testing for internal reliability, test-retest reliability and discriminative construct validity using data from a mailed, self-administered survey to 1,568 patients discharged from two large inpatient rehabilitation facilities. RESULTS: The seven conceptually derived subscales all have strong internal (0.72 - 0.87) and test-retest reliability (0.74 - 0.85). Discriminative construct validity is demonstrated by the ability of subscales to identify significant differences between programs within two rehabilitation facilities. CONCLUSIONS: The results for the reliability and validity of this measure support its value for use in clinical and quality improvement work as well as research.

Adolescent↗

Physical therapy services for older adults with at least moderately severe hip or knee arthritis in 2 Ontario counties.

OBJECTIVE: Physical therapy (PT) is a recommended treatment for the management of arthritis. We investigated factors related to referral to PT services in people with hip or knee arthritis and describe characteristics of treatment received. METHODS: As part of a longitudinal study of the population aged > or = 55 years with at least moderately severe hip or knee arthritis in 2 Ontario counties (n = 1350), participants were surveyed in the third year of followup about use of PT. Participants were categorized as to whether they had total joint replacement surgery in the past year (TJR group, n = 52) or did not (non-TJR group, n = 1298). Multivariate logistic regression was used to identify determinants of referral to PT considering sociodemographic characteristics, comorbidity, use of prescribed arthritis medication, and arthritis severity (WOMAC summary score). RESULTS: Overall, 18.7% of the cohort was referred to PT in the past year: 65.4% of the TJR group and 16.8% of the non-TJR group. The only significant predictor of PT in the TJR group was current use of prescribed arthritis medication. Greater arthritis severity, current use of prescribed arthritis medication, and greater comorbidity were significant independent predictors of referral to PT for the non-TJR group in multivariate logistic regression. The Ontario Health Insurance Plan paid for the majority of PT received. CONCLUSION: Low rates of referral to PT in the previous year suggest possible underutilization. Further research is needed to examine patterns of use of PT throughout the course of the arthritis disease process and to examine barriers to PT access.

Aged↗

Client-centred rehabilitation: client perspectives.

PURPOSE: The purpose of this research is to understand the important components of client-centred rehabilitation from the perspective of adult clients with long-term physical disabilities. METHOD: Focus groups were conducted with adult clients who had completed at least one course of rehabilitation in the publicly-funded rehabilitation system in Ontario. Data were analysed using an iterative inductive approach. RESULTS: The major theme underlying all of the participants' comments was the need for better transitions between rehabilitation programs and the community. Participants felt ill-prepared for community living and the emotional challenges of living with a long-term condition and, once discharged from rehabilitation, felt isolated and had difficulty finding out about and accessing community services. CONCLUSIONS: The findings demonstrate that client-centred rehabilitation encompasses much more than goal-setting and decision-making between individual clients and professionals. It refers to a philosophy or approach to the delivery of rehabilitation services that reflects the needs of individuals and groups of clients. This entails a shift from an acute-illness, curative model to one that acknowledges the long-term nature of the career of chronic illness or disability. Definitions of evidence that is deemed credible need to be broadened beyond expert, 'scientific' evidence to include multiple dimensions of evidence including the expertise of the client.

Adult↗

The effects of a walking/talking program on communication, ambulation, and functional status in residents with Alzheimer disease.

The purpose of this study was to investigate the effects of a walking/talking program on residents' communication, ambulation, and level of function when there were two residents to one care provider (2:1). A randomized control trial design was used. Subjects were residents with Alzheimer disease in three geriatric long-term care facilities in Metropolitan Toronto. Residents who met the inclusion criteria were randomly assigned to one of three groups: walk-and-talk group (30 min, 5 times per week for 16 weeks, walking/talking in pairs), talk-only group (30 min, 5 times per week for 16 weeks, talk only in pairs), or no intervention. The outcome measures were the Functional Assessment of Communication Skills for Adults, the 2-min walk test, and London Psychogeriatric Rating Scale. Residents who received the walk-and-talk intervention did not demonstrate statistically significant differences in the outcome variables measured posttest when compared with residents who received the talk-only intervention or no intervention, even after controlling for individual differences. Variability in the outcomes measured posttest is explained by differences in the residents' level of cognitive impairment before the study rather than by study group membership. These findings are contradictory to those of previous studies.

Activities of Daily Living↗