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Pediatric Physical Therapy:
doi: 10.1097/PEP.0b013e3181fabe95
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Commentary on Use of Diagnosis and Prognosis by Pediatric Physical Therapists

Nesbit, Kathryn PT, DPT, MS, PCS; McEwen, Irene R. PT, DPT, PhD, FAPTA

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Loudoun County Public Schools, Ashburn, Virginia

Department of Rehabilitation Sciences, University of Oklahoma, Health Sciences Center, Oklahoma City, Oklahoma

“How could I apply this information?”

The results of this study are based on qualitative analysis of participants' responses to 2 subquestions on a survey the authors1 previously published. The article includes a link to the survey (www.links.com/A996), which provides an excellent example of how looking at a survey can help to interpret results.

The 2 main questions asked whether respondents thought changes were necessary in the diagnosis section and prognosis section of the Guide to Physical Therapist Practice2 practice patterns. If they thought, “the information should be more specific” or “more generic,” they were asked to explain how. The third option was that the information “is not consistent with my practice” and the follow-up question was “how do you define and use (diagnosis or prognosis) in your practice?”

The most common response of the total sample was that no changes were necessary. The participants who indicated that changes were necessary were asked to respond to the subquestions that this article reports.

Considering the context of the survey, many pediatric therapists believe that the Guide's diagnosis and prognosis sections in the practice patterns are useful. This study suggests that possible barriers for application are a perceived lack of relevance to pediatric practice and lack of clarity of the concepts.

“What should I be mindful about in applying this information?”

The results of this study were based on responses from a small subset of the 475 useful responses (9.6% response rate) the authors received. As Tables 4 and 5 indicate, the number of responses to the questions for the qualitative analysis ranged from 7 to 68. Because the largest number of respondents said that they would make no changes to the Guide, the authors' conclusion that “diagnosis and prognosis remain difficult concepts” represents a minority opinion. Another conclusion that application of diagnosis and prognosis to pediatric practice is limited even though a growing body of research exists also should be interpreted cautiously. Several studies the authors cited are related to prediction and development of examination measures published after the survey was conducted.

Kathryn Nesbit, PT, DPT, MS, PCS Loudoun County Public Schools, Ashburn, Virginia

Irene R, McEwen, PT, DPT, PhD, FAPTA Department of Rehabilitation Sciences, University of Oklahoma, Health Sciences Center, Oklahoma City, Oklahoma

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REFERENCES

1. Johnson CC, Long T. Use of the Guide to Physical Therapist Practice by pediatric physical therapists. Ped Phys Ther. 2009; 21:176–186.

2. American Physical Therapy Association. Guide to Physical Therapist Practice. Rev 2nd ed. Alexandria, VA: American Physical Therapy Association; 2003.

© 2010 Lippincott Williams & Wilkins, Inc.

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