Characteristics and processes of physiotherapy clinical decision making: a study of acute care cardiorespiratory physiotherapy.

Background and Purpose. Physiotherapists have been increasingly interested in investigating physiotherapy clinical reasoning and decision-making processes. Cardiorespiratory physiotherapy has received little attention within this increasing body of research. This study aimed to investigate character...

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Publicado en:Physiotherapy Research International Vol. 13; no. 4; pp. 209 - 223
Autores principales: Smith M, Higgs J, Ellis E
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Dec2008
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2008
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        2010127313
        10.1002/pri.419
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        atl: Characteristics and processes of physiotherapy clinical decision making: a study of acute care cardiorespiratory physiotherapy.
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          Smith M
          Higgs J
          Ellis E
        affil: School of Community Health, Charles Sturt University, Albury, Australia.
      sug:
        subj:
          Acute Care
          Chest Physical Therapy
          Decision Making, Clinical
          Audiorecording
          Australia
          Data Analysis Software
          Decision Making, Clinical Methods
          Descriptive Statistics
          Funding Source
          Interview Guides
          Observational Methods
          Phenomenological Research
          Physical Therapy Methods
          Purposive Sample
          Qualitative Studies
          Reflection
          Semi-Structured Interview
          Treatment Outcomes Evaluation
          Triangulation
          Human
      ab: Background and Purpose. Physiotherapists have been increasingly interested in investigating physiotherapy clinical reasoning and decision-making processes. Cardiorespiratory physiotherapy has received little attention within this increasing body of research. This study aimed to investigate characteristics and processes of cardiorespiratory physiotherapy decision making and to contribute to the broader understanding of physiotherapy reasoning and decision making. Methods. Fourteen cardiorespiratory physiotherapists took part in the study. Qualitative research methods were used, guided by a philosophical hermeneutic approach. Participants were observed undertaking their usual daily patient care activities and were later interviewed about their decision making. In-depth, iterative hermeneutic strategies were used to interpret the texts created by these processes to identify the nature and processes of decision making. Results. Clinical decision making in cardiorespiratory physiotherapy is focused on making decisions about the nature of patients' problems, physiotherapeutic intervention and interaction, and evaluation of effectiveness of actions. Cardiorespiratory physiotherapy decisions varied in their difficulty according to the attributes of the decisions. The variable nature of decisions influenced the reasoning processes used. Clinical decision making involved complex reasoning processes that were cyclic, evolving and flexible in nature, with interdependence and interrelation between the different foci of clinical decision making. Clinical decision making was also found to be a social and collaborative process. Conclusions. This study contributes to the body of literature on physiotherapy reasoning and decision making by revealing details about the characteristics and processes of cardiorespiratory physiotherapy decision making. This research can be used to shape the education of beginning practitioners and provide practicing physiotherapists with a basis for critical appraisal of their decision making. Copyright (c) 2008 John Wiley & Sons, Ltd.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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