How do physiotherapists understand and interpret the "Pain Attitudes and Beliefs Scale"? A cognitive interview study

Perspectives of aged care home staff and health care professionals on the Psychotropic medicines use in Residents And Culture: Influencing clinical Excellence (PRACTICE) tool ©

INTRODUCTION

High use of psychotropic medications continues to be common in residential aged care homes despite the risk of harm and limited efficacy in people living with dementia. Research has shown that the organizational culture of aged care homes influences psychotropic medication use in residents with dementia. The Psychotropic medicines use in Residents And Culture: Influencing Clinical Excellence (PRACTICE) tool was developed to evaluate the organizational culture of aged care homes specific to the use of psychotropic medications.

OBJECTIVES

To evaluate the comprehensibility, relevance, and comprehensiveness of the PRACTICE tool among end-users.

METHOD

Cognitive interviews were conducted with participants representing a broad range of health disciplines across Australia. Interviews were performed using a combination of the think-aloud technique and verbal probing. Interviews were transcribed and content coded for participants' perceptions of the PRACTICE tool. Items were modified based on findings from the cognitive interviews, participants' suggestions for rewording of items and discussions with the research team.

RESULTS

A total of 20 cognitive interviews were conducted. Based on the cognitive interviews, 48 out of 63 items were modified. Reasons for modification were categorized into three themes: 1) Items changed to align with the aged care home staff's scope of practice; 2) Items adjusted to prevent unintended blame from reading the items; and 3) Items modified to prevent potential misinterpretation of their intended meaning. Three items were added to improve the comprehensiveness of the tool. Most participants reported that they understood the items and considered them as relevant and acceptable for the evaluation of organizational culture and use of psychotropic medication in aged care homes.

CONCLUSION

This study confirms that the PRACTICE tool is a comprehensive tool appropriate for the assessment of organizational culture specific to psychotropic medication use and is important for aged care home settings.

Comparing physical therapy students' attitudes and beliefs regarding chronic low back pain and knee osteoarthritis: an international multi-institutional comparison between 2013 and 2020 academic years

BACKGROUND

In 2013, physical therapy students demonstrated low guideline-adherent recommendations regarding chronic low back pain (CLBP) for spinal pathology, activity, and work.

OBJECTIVES

To assess the differences in physical therapy students' attitudes, beliefs, and adherence to guideline recommendations regarding CLBP and knee osteoarthritis between 2013 and 2020.

METHODS

In 2013 and 2020, second and fourth-year physical therapy students were recruited from 6 Belgian and 2 Dutch institutions. Attitudes and beliefs regarding CLBP and knee OA were evaluated using the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT), the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS), and a questionnaire regarding therapeutic exercise and knee osteoarthritis. A clinical vignette was used to measure guideline-adherent recommendations regarding spinal pathology, activity, and work.

RESULTS

In 2013, 927 second-year and 695 fourth-year students; in 2020, 695 second-year and 489 fourth-year students; were recruited to participate in the study. Compared to 2013, students had less biomedical and stronger biopsychosocial attitudes and beliefs regarding CLBP, more guideline-adherent recommendations for activity, and more biopsychosocial beliefs regarding the benefits of exercise for patients with knee osteoarthritis in both the second and fourth year. Only fourth-year students in 2020 scored significantly better on HC-PAIRS and guideline-adherent recommendation relating to spinal pathology. No differences were found regarding work recommendations.

CONCLUSIONS

Between 2013 and 2020, physical therapy students made a positive shift towards a more biopsychosocial approach to CLBP and knee osteoarthritis management. Guideline-adherent recommendations for CLBP concerning activity improved, however, concerning work and spinal pathology, it remained low.

Development of the Canadian Food Intake Screener to assess alignment of adults' dietary intake with the 2019 Canada's Food Guide healthy food choices recommendations

NOVELTY

The Canadian Food Intake Screener was developed to rapidly assess alignment of adults' dietary intake over the past month with the Food Guide's healthy food choices recommendations. The screener was developed and evaluated through an iterative process that included three rounds of cognitive interviews in each of English and French, along with ongoing feedback from external advisors and face and content validity testing with a separate panel of content experts. The 16-question screener is intended for use with adults, aged 18-65 years, with marginal and higher health literacy in research and surveillance contexts in which comprehensive dietary assessment is not possible.