Introduction: Falls are the leading cause of death and disability among people 65 years of age and older. Likewise, falls have psychological consequences which often lead to avoidance of activities, fear of falling, and further disabilities. Even though the impact of falls on one’s daily life and independence are substantial, evidence suggests that falls can be prevented by multi-factorial assessments and client-specific interventions. Objective: The purpose of this study was to determine (a) perceived knowledge of falls, (b) reported confidence in fall prevention, (c) perceived likelihood of implementing falls screening recommendations, (d) reported fear of falling, and (e) perceived value and satisfaction among community-dwelling older adults who attended an interdisciplinary falls screening and education event. Methods: An interdisciplinary group of professionals from behavioral sciences, family medicine, occupational therapy, optometry, pharmacy, and physical therapy screened 33 community dwelling older adult participants (66-84 years of age) using multi-factorial assessments and discipline-specific screening tools. Individualized recommendations were provided to each participant in verbal and written formats. Participants then completed a questionnaire at the conclusion of the event regarding their perceptions of knowledge gained about falls, confidence in preventing falls, perceived likelihood of implementing fall screening recommendations, fear of falling, and overall feedback regarding the event. Results: The majority of the participants indicated increased perceived knowledge of falls, confidence in preventing falls, and perceived high likelihood of implementing recommendations, along with decreased fear of falling. The majority of the participants also found the event to be valuable (85%), enjoyable (94%), and easy to understand (100%). Conclusion: The results of this study suggest that participants found this falls screening event to be valuable and improved their knowledge regarding falls, as well as their confidence in being able to prevent falls. This study highlights the potential value of an interdisciplinary team approach to increase knowledge, enhance prevention, and decrease fear of falling in community dwelling older adults.
Purpose: Community health organizations are expanding in many countries to meet the health and care needs associated with an aging population, an increase in recognition of children with developmental and mental health needs, and escalating healthcare costs. Singapore is no exception. Community organizations, however, are facing challenges in recruiting and retaining early-career therapists to these positions due to competition from acute services and a declining foreign talent pool. At the same time, early-career therapists encounter challenges during the transition from student to professional. Community organizations, therefore, need to identify what makes their organization attractive to early-career therapists and what makes them stay. This study explored factors that attracted and retained early-career therapists in community organizations in Singapore from the perspectives of early-career therapists and supervisors. Methods: Appreciative Inquiry was adopted as a strengths-based approach to guide this qualitative study process. Focus groups were conducted with three groups of early-career therapists and supervisors, to explore perspectives of what attracted them to work in a community health organization and what factors retained them in their roles. Two phases of focus groups were held three-weeks apart, giving early-career therapists and supervisors the opportunity to consolidate and expand their ideas. Focus groups were audio-recorded, transcribed, and thematically analyzed. Results: This study highlighted three key factors which attracted and retained early-career therapists to the Singapore community health organizations: (1) a culture that values learning and professional development; (2) structured supervision that is timely and individualized; and (3) a system that supports job satisfaction and promotes staff wellbeing. Conclusions: This study highlighted that community organizations could enhance their attraction and retention of early-career therapists through a focus on opportunities for early-career therapists’ formal and informal learning and professional development opportunities. Having a clear supervision framework and continuing development for supervisors is another key attraction for early-career therapists. Finally, time and opportunities to develop meaningful relationships with colleagues and clients enhances job satisfaction and wellbeing of early-career therapists. Making explicit the offer in these three areas could enhance applications and the retention of early-career therapists to these services.
Purpose: Research has demonstrated the effectiveness of animal assisted therapy (AAT) for improving the mental health of older adults in residential care. The aim of this rapid review was to synthesise existing research evidence to determine the approaches that AAT should take to enhance outcomes for older adults living in residential care. Methods: A systematic literature search was conducted to identify studies published between 2009 and 2019 that investigated AAT and improvement in physical and/or psychosocial outcomes for adults aged over 65 years, living in residential care. Studies were critically appraised to determine methodological quality, key data were extracted, and a critical narrative synthesis was conducted to determine features of effective AAT intervention. Results: Eighteen studies were identified for inclusion in this review. All eligible studies utilised dogs for AAT. Nearly all studies found positive outcomes from the AAT; however, several features of AAT were associated with better outcomes. AAT was shown to be effective at improving depressive symptoms and socioemotional behaviours regardless of the frequencies, durations, and overall intervention periods employed. Participant quality of life only improved when AAT was conducted up to twice weekly. Physical interaction and combined physical interaction and walking were both associated with positive outcomes. The use of trained/certified therapy dogs was more likely to improve outcomes than using dogs with no reported training. Facilitators provided by AAT organisations, and facilitators with veterinary, nursing, or AAT training were associated with improved outcomes. Group AAT was associated with greater effectiveness than AAT conducted with individual participants. Studies where AAT was conducted in a combined indoor/outdoor or solely indoor setting appeared most likely to improve outcomes. Conclusion: AAT involving dogs was typically associated with positive outcomes for older adults living in residential care; however, some features of AAT were associated with better outcomes. To enhance outcomes, it is recommended that AAT be implemented in a group setting, include physical interaction or combined physical interaction, and walking, and be conducted by trained facilitators.
Purpose: Pain neuroscience education (PNE) is an intervention used for musculoskeletal pain to improve understanding of pain processes; PNE can decrease pain levels, improve function, and lower disability. Clear communication between the patient and provider is important for PNE to be an effective intervention. There is a lack of research on how a language discordance may impact that communication, and therefore the effectiveness of PNE. Purposes: 1) describe the physical therapist management of a Spanish speaking patient with acute low back pain (LBP) while using an off-site telephone interpreting service and 2) examine how PNE treatment was impacted by a language discordance. Methods: A female in her early 40’s presented with LBP two months after a motor vehicle accident. A systems review revealed comorbidities of class 1 obesity and prediabetes and a language discordance between the provider and patient, necessitating the use of a telephone interpreter. While acute LBP is usually self-limiting, the language discordance and comorbidities were expected to negatively impact her functional prognosis. Intervention included PNE, strengthening, directional preference exercises, graded exposure, and body mechanics training. Results: Within 5 weeks, the patient’s self-perceived disability as reported by the Spanish translated and culturally adapted Oswestry Disability Index, thoracolumbo-pelvic hip range of motion, and perceived levels of pain improved significantly. Conclusion: The link between clarity of communication while utilizing PNE and patient comprehension, outcomes, and satisfaction is unclear. While more time consuming, PNE delivered via translations services appears to be an effective physical therapy intervention. However, further research is needed and it is important for physical therapy providers to consider how language discordance could impact the effectiveness of PNE.
Purpose: To investigate the attitudes and beliefs of physical therapy (PT) and physical therapist assistant (PTA) program directors towards interprofessional education (IPE). We hypothesized that Communication and Ethics would be the most important competencies among program directors. Methods: A cross-sectional survey based on previously utilized instruments modified for the profession of PT was sent to PT and PTA program directors. One hundred sixteen responses were analyzed using frequency analysis for demographic data and non-parametric Mann-Whitney U t-test for group differences. Results: While the majority of program directors agree that IPE is important, with Communication as the most important IPE competency, most PTA program directors do not support the importance of accreditation in implementing IPE (pConclusion:Program directors agree that IPE is vital to student learning, with Communication as the most important IPE competency. However, specific differences between PT and PTA program directors emerged primarily on IPE implementation, the role of accreditation, resource support, and resource utilization.
