Hand injury is the second most common work-related musculoskeletal injury among physical therapists （PTs） and other manual therapy professionals such as osteopaths, physiotherapists, chiropractors, acupuncturists an...Hand injury is the second most common work-related musculoskeletal injury among physical therapists （PTs） and other manual therapy professionals such as osteopaths, physiotherapists, chiropractors, acupuncturists and massage therapists. However, the nature and extent of this problem have not been fully explored yet. Therefore, the objective of this study was to review the existing literature published on the prevalence, risk factors, consequences, and prevention of hand injuries among PTs and similar healthcare professionals. The lifetime prevalence of hand injuries was about 15%-46%, and the annual prevalence was reported as 5%-30%. Thumb injuries were found to be the most prevalent of all injuries, accounting more than 50% of all hand-related problems. The most significant risk factors for job-related hand injuries were performing manual therapy techniques, repetitive workloads, treating many patients per day, continued work while injured or hurt, weakness of the thumb muscles, thumb hypermobility, and instability at the thumb joints. Frs reported modifying treatment technique, taking time off on sick leave, seeking intervention, shifting the specialty area, and decreasing patient contact hours as the major consequences of these injuries. The authors recommend that PTs should develop specific preventive strategies and put more emphasis on the use of aids and equipment to reduce the risk of an unnecessary injury.展开更多
In 21st century, more and more people see medical services of sport therapists as a promising industry due to global aging population and high biotechnology development. Hence, understanding medical word-of-mouth (WOM...In 21st century, more and more people see medical services of sport therapists as a promising industry due to global aging population and high biotechnology development. Hence, understanding medical word-of-mouth (WOM) process among patients in medical services of sport therapists could be interesting and useful. This study would find out the role of WOM on patients psychology when choosing the sport therapists, understand how patients look for sport therapists’ information and which information source is important to them. As a pioneer, this study would like to improve medical WOM marketing of sport therapists. The authors designed a questionnaire based on how patients choosing sport therapists, including questions search importance of different information sources of sport therapists with medical service decision, and respondents’ psychological demographics. We released 253 questionnaires of judo therapy clinics inTaiwan. More than half of the respondents see sport therapists due to others’ recommendations (referral of family, friends and professionals). Women are more likely to seek medical word-of-mouth information than men;and respondents who think choosing sport therapists are important tend to seek medical word-of-mouth information. Further, patients focus on “therapist’s behavior”, “therapist’s skills”, and “therapist’s ethic”.展开更多
Background:Jay Haley’s contributions to bioethics introduced a systemic and interventionist perspective on clinical responsibility,autonomy,and ethical governance.His directive therapeutic methods redefined clinical ...Background:Jay Haley’s contributions to bioethics introduced a systemic and interventionist perspective on clinical responsibility,autonomy,and ethical governance.His directive therapeutic methods redefined clinical practice as a domain of ethical action,emphasizing relational accountability and structured decision-making at the core of medical and psychotherapeutic ethics.Haley challenged dominant models of patient autonomy and informed consent by highlighting the clinician’s active role in guiding ethical outcomes within complex relational systems.He positioned therapeutic influence within broader debates on medical authority and ethical boundaries.By integrating medical hypnosis and family systems therapy,Haley’s work bridges clinical practice and bioethical principles,reshaping the ethics principles of psychotherapy.Methods:This medical history study employs a historiographical approach,analyzing over one hundred primary and secondary sources including Haley’s published works,archival audiovisual materials,and contemporaneous policy documents.Systematic source classification,triangulation with independent evaluations,and explicit disclosure of author positionality ensure methodological rigor.Interpretive source analysis and intellectual history frameworks enable a thorough reconstruction of Haley’s bioethical contributions within broader historical and philosophical contexts,with particular attention to the philosophical assumptions underlying his strategic interventions.Results:New findings identifies six interrelated domains in Haley’s ethical approach that emphasize core bioethical principles:autonomy,beneficence,nonmaleficence,justice,and accountability.Haley’s methods demonstrate brief,goal-directed,and ethically accountable interventions aligned with principlism,virtue ethics,and communitarian ethics.Key findings include critiques of psychoanalytic neutrality,the use of metaphor and hypnosis to support informed client engagement without coercion,and integration of systemic factors into ethical decision-making.These insights extend knowledge by showing how Haley’s work advanced ethical standards influencing contemporary clinical governance frameworks such as the AAMFT Code of Ethics.Conclusion:By cataloguing Haley’s corpus and mapping his bioethical emphases across domains,this study extends existing knowledge,positioning Haley as a foundational bioethical theorist in systemic therapy.His work reframes therapy as a relational and ethically governed intervention,offering enduring insights for clinical governance,professional ethics,and therapeutic practice.These findings enrich the historiography of medical ethics by positioning Haley as a foundational bioethical theorist whose work continues to inform therapeutic practice and ethical deliberation.展开更多
1.IntroductionPassive movement is a 200+year-old manipulation involving the external movement of an individuals’limbs or body absent voluntary effort or muscle contraction.1The original application of passive movemen...1.IntroductionPassive movement is a 200+year-old manipulation involving the external movement of an individuals’limbs or body absent voluntary effort or muscle contraction.1The original application of passive movement was therapist-guided limb manipulation to increase range of motion and blood supply following acute and chronic injury.展开更多
Background:Research on therapeutic processes has explored the elements that enhance psychotherapy’s effectiveness,particularly the role of common factors across various models.The therapist’s use of directiveness an...Background:Research on therapeutic processes has explored the elements that enhance psychotherapy’s effectiveness,particularly the role of common factors across various models.The therapist’s use of directiveness and support,as common variables,is crucial for effective treatment.Effective therapists adapt their level of directiveness and support according to the treatment phase,the issue being addressed,and the patient’s characteristics.This study examines the importance therapists attribute to directiveness and support,as well as its relationship with theoretical orientation,access to research publications,and stance on the similar effectiveness of different psychotherapeutic models.It aims to determine whether therapists’attributions regarding this variable are in line with the importance it is given in process research.Methods:Responses from 69 psychotherapists to the Psychotherapeutic Effectiveness Attribution Questionnaire(PEAQ-12),which assesses the importance therapists place on key psychotherapeutic process variables,including the directiveness and support provided,were analyzed.Theoretical orientations,ages,and experience levels were considered.Non-parametric tests,contingency tables,χ^(2)tests,t-tests,and ANOVAs were used to assess the variation in responses.Results:Common factors were often identified as key contributors to therapeutic healing,though these differences were not statistically significant(χ^(2)(2,N=67)=3.701,p=0.157).For the“directiveness and support from the therapist”variable,significant differences were observed:Cognitive-behavioral therapists valued directiveness and support more than psychodynamic therapists(t(20)=−3.569,p=0.002;Cohen’s d=1.18).Therapists who view cognitive-behavioral therapies as most effective also rated this variable higher(t(38)=3.816,p<0.001;Cohen’s d=1.21).Those regularly accessing specialized psychotherapy research publications valued this variable less than those who do so occasionally(t(64)=−2.693,p=0.009;Cohen’s d=0.65).Therapists who support the similar effectiveness of different models tend to favor common factors,including directiveness and support(χ^(2)(2,N=66)=12.522,p=0.002).Conclusions:Therapists express doubts about the factors influencing psychotherapy’s effectiveness,reflecting the ongoing debate.They align their views on the importance of directiveness and support with their theoretical orientation and positioning on the similar effectiveness of psychotherapies.The importance of analyzing therapists’attributions about the factors responsible for therapeutic change is emphasized,which will impact clinical practice.Advocacy for therapist flexibility and adaptation of therapy to the patient’s needs,including the level of directiveness and support provided,has been shown to be essential for effective psychotherapy.展开更多
Quality indicators in healthcare refer to measurable and quantifiable parameters used to assess and monitor the performance,effectiveness,and safety of healthcare services.These indicators provide a systematic way to ...Quality indicators in healthcare refer to measurable and quantifiable parameters used to assess and monitor the performance,effectiveness,and safety of healthcare services.These indicators provide a systematic way to evaluate the quality of care offered,and thereby to identify areas for improvement and to ensure that patient care meets established standards and best practices.Respiratory therapists play a vital role in areas of clinical administration such as infection control practices and quality improvement initiatives.Quality indicators serve as essential metrics for respiratory therapy departments to assess and enhance the overall quality of care.By systematically tracking and analyzing indicators related to infection control,treatment effectiveness,and adherence to protocols,respiratory care practitioners can identify areas to improve and implement evidence-based changes.This article reviewed how to identify,implement,and monitor quality indicators specific to the respiratory therapy departments to set benchmarks and enhance patient outcomes.展开更多
This work was a prospective transversal study over 6 (six) months from May 2 to December 31, 2017 at the Reference Health Center of Commune I and the Chérif la Confessional Health Center in Bamako. The aim was to...This work was a prospective transversal study over 6 (six) months from May 2 to December 31, 2017 at the Reference Health Center of Commune I and the Chérif la Confessional Health Center in Bamako. The aim was to study the knowledge, attitudes and behavioral practices linked to hemorrhoids in Commune I of the Bamako district, to evaluate the frequency of hemorrhoidal disease, to determine the knowledge, attitudes and behavioral practices linked to hemorrhoids among patients, their companions and traditional therapists in Commune I of the district of Bamako and the factors which influence the motivations and decisions to resort to medical-surgical care and traditional medicine in patients suffering from hemorrhoids in order to analyze the results of the management of hemorrhoidal disease at Cs Ref CI. We collected 36 patients with hemorrhoidal disease, 25 caregivers and 15 traditional hemorrhoidal disease therapists. The sex ratio was 1.25 for patients;6.5 for traditional therapists and 1.5 for accompanying people. The average age of the patients was 32.75 years;49 years for traditional therapists and 28.76 years for those accompanying them. 55.6% of patients claim to know about hemorrhoidal disease;100% of traditional therapists and 80% of accompanying people. The dietary factor of hemorrhoidal disease was mentioned by 90% of patients;66.7% of traditional therapists and 100% of caregivers. Most patients initially resorted to traditional treatment out of fear of surgery and its after-effects. The patients were treated medically and surgically.展开更多
Spinal manipulation has been an effective intervention for the management of various musculoskeletal disorders. However,the mechanisms underlying the pain modulatory effects of spinal manipulation remain elusive. Alth...Spinal manipulation has been an effective intervention for the management of various musculoskeletal disorders. However,the mechanisms underlying the pain modulatory effects of spinal manipulation remain elusive. Although both biomechanical and neurophysiological phenomena have been thought to play a role in the observed clinical effects of spinal manipulation, a growing number of recent studies have indicated peripheral, spinal and supraspinal mechanisms of manipulation and suggested that the improved clinical outcomes are largely of neurophysiological origin. In this article, we reviewed the relevance of various neurophysiological theories with respect to the findings of mechanistic studies that demonstrated neural responses following spinal manipulation. This article also discussed whether these neural responses are associated with the possible neurophysiological mechanisms of spinal manipulation. The body of literature reviewed herein suggested some clear neurophysiological changes following spinal manipulation, which include neural plastic changes, alteration in motor neuron excitability,increase in cortical drive and many more. However, the clinical relevance of these changes in relation to the mechanisms that underlie the effectiveness of spinal manipulation is still unclear. In addition,there were some major methodological flaws in many of the reviewed studies. Future mechanistic studies should have an appropriate study design and methodology and should plan for a long-term follow-up in order to determine the clinical significance of the neural responses evoked following spinal manipulation.展开更多
BACKGROUND Case studies(CS)are relevant for the development of theoretical and practical competencies in psychotherapy.Despite rapid progress in the development of methods and principles for establishing CS in the las...BACKGROUND Case studies(CS)are relevant for the development of theoretical and practical competencies in psychotherapy.Despite rapid progress in the development of methods and principles for establishing CS in the last three decades,research into the aims of CS,especially in training,or how CS are to be conducted is rare.AIM To elucidate the form and methodology of CS,the objectives of CS used in training institutions(TI),and if/how TIs handle therapist allegiance.Also,this preliminary investigation will suggest avenues for further research and attempt to establish certain guidelines.METHODS In order to counteract researcher bias and enlarge the question-pool,a focus group was established.The recorded and transcribed text was analyzed with Mayring’s method of qualitative content analysis,and the generated categories were formulated as questions.The resulting questionnaire with both qualitative and quantitative queries was sent out(after pre-testing)to all 39 Austrian TIs that provide professional psychotherapy training.The answers and text passages received were then also categorized with qualitative content analysis.Data analysis was discussed by a peer group consisting of three psychotherapists trained in differing schools of psychotherapeutic methods.RESULTS 94%of Austrian institutes use CS as part of their psychotherapeutic training.Understanding of the term“case study”is inconsistent and has a wide variety of interpretations.CS serve mainly:(1)For observation of training/progress in therapeutic practice and knowledge/acquisition of the theory specific to each psychotherapeutic school;(2)To improve(self-)reflection capabilities;and(3)To expand theoretical knowledge.Most of the CS written are not accessible for students nor for the research community.More than two thirds of the CS take only the position of the author into account(the client’s position is not described).15.5%of the TIs do not consider researcher or therapist allegiance at all.CONCLUSION A more precise formulation of the term case study is needed in psychotherapeutic training.The training therapists play a key function,as they exemplify and teach how to deal with distorting factors.General guidelines as to how to conduct CS in training institutions would provide more direction to students,increase scientific rigor,and enhance synergistic effects.展开更多
To aim to inductively clarify the professional identity of occupational therapists who work in a clinical setting, the researchers interviewed the 22 occupational therapists who had a minimum of 5 years or more of pra...To aim to inductively clarify the professional identity of occupational therapists who work in a clinical setting, the researchers interviewed the 22 occupational therapists who had a minimum of 5 years or more of practice in the field. The professional identities of the practicing occupational therapists were constructed by the following two core categories: “harmonizing with a client’s life and the characteristic of a client’s disability”, and “giving clients sovereignties as a mission of the occupational therapists”. The occupational therapist can carry the role of coordinator in an interdisciplinary team for the clients with disability by understanding them. This is achieved based on the core category called “giving clients sovereignties as a mission of the occupational therapists”. Furthermore, in order to achieve the clients’ sovereignties, the occupational therapist can be an operational unit by planning practical strategies and practicing them based on the core category called “harmonizing with a client’s life and the characteristic of a client’s disability”. The fact is often difficult for these clients that they are concerned with how he/she lived actively. It is through unique ways of contributing for the clients in a team of professionals that the occupational therapists try to understand the clients not as “patients” but as “human beings”, and try to harmonize with their life and the characteristics of their disability, then try to support and empower them to reach a stage in which they have the sovereignties of their lives.展开更多
Client attachment to therapist has been long considered a prominent process variable in psychotherapy research. The purpose of this study was to translate in Greek and evaluate the structure, reliability, convergent a...Client attachment to therapist has been long considered a prominent process variable in psychotherapy research. The purpose of this study was to translate in Greek and evaluate the structure, reliability, convergent and discriminant validity of the well-known and widely administered Client Attachment to Therapist Scale (CATS) with exploratory and confirmatory factor analysis in a clinical sample of 153 clients of different treatment modalities and at different agencies. The results indicated that the EFA resulted in a model almost identical to the Mallinckrodt, Gantt and Coble’s [1] original model after the deletion of six items. Moreover, the findings indicated adequate internal consistency, test-retest reliability, convergent and discriminant validity of the three factors. Normalized scores were provided to help mental health professionals interpret the scale scores. In conclusion, CATS is a valid and reliable tool to measure client attachment to therapist, whose use can promote psychotherapeutic process and outcome. Thus, more validation studies should be conducted in several cultural contexts to better understand its structure and psychometric characteristics.展开更多
Background: Orthopedic surgeons often refer patients to hand therapy following orthopedic injury or surgery to facilitate recovery and maximize outcomes. Patients should be a key part of the shared decision-making pro...Background: Orthopedic surgeons often refer patients to hand therapy following orthopedic injury or surgery to facilitate recovery and maximize outcomes. Patients should be a key part of the shared decision-making process when it comes to their rehabilitation. While there is existing literature investigating factors considered by patients when choosing other medical providers, there are currently no studies investigating factors considered by patients when choosing a hand therapist. Purpose: The purpose of the study is to investigate public perception of factors which are important when choosing a hand therapist. Methods: A convenience sample (N = 220) of adults over the age of 18 completed an anonymous online survey using an internet crowdsourcing platform. Respondents were asked to quantitatively rank the importance of 10 predetermined factors related to selecting a hand therapist. Results: Respondents ranked insurance coverage and credentialing as a certified hand therapist as highest in terms of importance. Conclusion: We found that the factors people consider important when selecting a hand therapist are similar to the factors described in the medical literature that are important when selecting a physician or other healthcare provider. The results have implications for physicians when ensuring continuity of care for their patients.展开更多
文摘Hand injury is the second most common work-related musculoskeletal injury among physical therapists （PTs） and other manual therapy professionals such as osteopaths, physiotherapists, chiropractors, acupuncturists and massage therapists. However, the nature and extent of this problem have not been fully explored yet. Therefore, the objective of this study was to review the existing literature published on the prevalence, risk factors, consequences, and prevention of hand injuries among PTs and similar healthcare professionals. The lifetime prevalence of hand injuries was about 15%-46%, and the annual prevalence was reported as 5%-30%. Thumb injuries were found to be the most prevalent of all injuries, accounting more than 50% of all hand-related problems. The most significant risk factors for job-related hand injuries were performing manual therapy techniques, repetitive workloads, treating many patients per day, continued work while injured or hurt, weakness of the thumb muscles, thumb hypermobility, and instability at the thumb joints. Frs reported modifying treatment technique, taking time off on sick leave, seeking intervention, shifting the specialty area, and decreasing patient contact hours as the major consequences of these injuries. The authors recommend that PTs should develop specific preventive strategies and put more emphasis on the use of aids and equipment to reduce the risk of an unnecessary injury.
文摘In 21st century, more and more people see medical services of sport therapists as a promising industry due to global aging population and high biotechnology development. Hence, understanding medical word-of-mouth (WOM) process among patients in medical services of sport therapists could be interesting and useful. This study would find out the role of WOM on patients psychology when choosing the sport therapists, understand how patients look for sport therapists’ information and which information source is important to them. As a pioneer, this study would like to improve medical WOM marketing of sport therapists. The authors designed a questionnaire based on how patients choosing sport therapists, including questions search importance of different information sources of sport therapists with medical service decision, and respondents’ psychological demographics. We released 253 questionnaires of judo therapy clinics inTaiwan. More than half of the respondents see sport therapists due to others’ recommendations (referral of family, friends and professionals). Women are more likely to seek medical word-of-mouth information than men;and respondents who think choosing sport therapists are important tend to seek medical word-of-mouth information. Further, patients focus on “therapist’s behavior”, “therapist’s skills”, and “therapist’s ethic”.
文摘Background:Jay Haley’s contributions to bioethics introduced a systemic and interventionist perspective on clinical responsibility,autonomy,and ethical governance.His directive therapeutic methods redefined clinical practice as a domain of ethical action,emphasizing relational accountability and structured decision-making at the core of medical and psychotherapeutic ethics.Haley challenged dominant models of patient autonomy and informed consent by highlighting the clinician’s active role in guiding ethical outcomes within complex relational systems.He positioned therapeutic influence within broader debates on medical authority and ethical boundaries.By integrating medical hypnosis and family systems therapy,Haley’s work bridges clinical practice and bioethical principles,reshaping the ethics principles of psychotherapy.Methods:This medical history study employs a historiographical approach,analyzing over one hundred primary and secondary sources including Haley’s published works,archival audiovisual materials,and contemporaneous policy documents.Systematic source classification,triangulation with independent evaluations,and explicit disclosure of author positionality ensure methodological rigor.Interpretive source analysis and intellectual history frameworks enable a thorough reconstruction of Haley’s bioethical contributions within broader historical and philosophical contexts,with particular attention to the philosophical assumptions underlying his strategic interventions.Results:New findings identifies six interrelated domains in Haley’s ethical approach that emphasize core bioethical principles:autonomy,beneficence,nonmaleficence,justice,and accountability.Haley’s methods demonstrate brief,goal-directed,and ethically accountable interventions aligned with principlism,virtue ethics,and communitarian ethics.Key findings include critiques of psychoanalytic neutrality,the use of metaphor and hypnosis to support informed client engagement without coercion,and integration of systemic factors into ethical decision-making.These insights extend knowledge by showing how Haley’s work advanced ethical standards influencing contemporary clinical governance frameworks such as the AAMFT Code of Ethics.Conclusion:By cataloguing Haley’s corpus and mapping his bioethical emphases across domains,this study extends existing knowledge,positioning Haley as a foundational bioethical theorist in systemic therapy.His work reframes therapy as a relational and ethically governed intervention,offering enduring insights for clinical governance,professional ethics,and therapeutic practice.These findings enrich the historiography of medical ethics by positioning Haley as a foundational bioethical theorist whose work continues to inform therapeutic practice and ethical deliberation.
文摘1.IntroductionPassive movement is a 200+year-old manipulation involving the external movement of an individuals’limbs or body absent voluntary effort or muscle contraction.1The original application of passive movement was therapist-guided limb manipulation to increase range of motion and blood supply following acute and chronic injury.
文摘Background:Research on therapeutic processes has explored the elements that enhance psychotherapy’s effectiveness,particularly the role of common factors across various models.The therapist’s use of directiveness and support,as common variables,is crucial for effective treatment.Effective therapists adapt their level of directiveness and support according to the treatment phase,the issue being addressed,and the patient’s characteristics.This study examines the importance therapists attribute to directiveness and support,as well as its relationship with theoretical orientation,access to research publications,and stance on the similar effectiveness of different psychotherapeutic models.It aims to determine whether therapists’attributions regarding this variable are in line with the importance it is given in process research.Methods:Responses from 69 psychotherapists to the Psychotherapeutic Effectiveness Attribution Questionnaire(PEAQ-12),which assesses the importance therapists place on key psychotherapeutic process variables,including the directiveness and support provided,were analyzed.Theoretical orientations,ages,and experience levels were considered.Non-parametric tests,contingency tables,χ^(2)tests,t-tests,and ANOVAs were used to assess the variation in responses.Results:Common factors were often identified as key contributors to therapeutic healing,though these differences were not statistically significant(χ^(2)(2,N=67)=3.701,p=0.157).For the“directiveness and support from the therapist”variable,significant differences were observed:Cognitive-behavioral therapists valued directiveness and support more than psychodynamic therapists(t(20)=−3.569,p=0.002;Cohen’s d=1.18).Therapists who view cognitive-behavioral therapies as most effective also rated this variable higher(t(38)=3.816,p<0.001;Cohen’s d=1.21).Those regularly accessing specialized psychotherapy research publications valued this variable less than those who do so occasionally(t(64)=−2.693,p=0.009;Cohen’s d=0.65).Therapists who support the similar effectiveness of different models tend to favor common factors,including directiveness and support(χ^(2)(2,N=66)=12.522,p=0.002).Conclusions:Therapists express doubts about the factors influencing psychotherapy’s effectiveness,reflecting the ongoing debate.They align their views on the importance of directiveness and support with their theoretical orientation and positioning on the similar effectiveness of psychotherapies.The importance of analyzing therapists’attributions about the factors responsible for therapeutic change is emphasized,which will impact clinical practice.Advocacy for therapist flexibility and adaptation of therapy to the patient’s needs,including the level of directiveness and support provided,has been shown to be essential for effective psychotherapy.
文摘Quality indicators in healthcare refer to measurable and quantifiable parameters used to assess and monitor the performance,effectiveness,and safety of healthcare services.These indicators provide a systematic way to evaluate the quality of care offered,and thereby to identify areas for improvement and to ensure that patient care meets established standards and best practices.Respiratory therapists play a vital role in areas of clinical administration such as infection control practices and quality improvement initiatives.Quality indicators serve as essential metrics for respiratory therapy departments to assess and enhance the overall quality of care.By systematically tracking and analyzing indicators related to infection control,treatment effectiveness,and adherence to protocols,respiratory care practitioners can identify areas to improve and implement evidence-based changes.This article reviewed how to identify,implement,and monitor quality indicators specific to the respiratory therapy departments to set benchmarks and enhance patient outcomes.
文摘This work was a prospective transversal study over 6 (six) months from May 2 to December 31, 2017 at the Reference Health Center of Commune I and the Chérif la Confessional Health Center in Bamako. The aim was to study the knowledge, attitudes and behavioral practices linked to hemorrhoids in Commune I of the Bamako district, to evaluate the frequency of hemorrhoidal disease, to determine the knowledge, attitudes and behavioral practices linked to hemorrhoids among patients, their companions and traditional therapists in Commune I of the district of Bamako and the factors which influence the motivations and decisions to resort to medical-surgical care and traditional medicine in patients suffering from hemorrhoids in order to analyze the results of the management of hemorrhoidal disease at Cs Ref CI. We collected 36 patients with hemorrhoidal disease, 25 caregivers and 15 traditional hemorrhoidal disease therapists. The sex ratio was 1.25 for patients;6.5 for traditional therapists and 1.5 for accompanying people. The average age of the patients was 32.75 years;49 years for traditional therapists and 28.76 years for those accompanying them. 55.6% of patients claim to know about hemorrhoidal disease;100% of traditional therapists and 80% of accompanying people. The dietary factor of hemorrhoidal disease was mentioned by 90% of patients;66.7% of traditional therapists and 100% of caregivers. Most patients initially resorted to traditional treatment out of fear of surgery and its after-effects. The patients were treated medically and surgically.
文摘Spinal manipulation has been an effective intervention for the management of various musculoskeletal disorders. However,the mechanisms underlying the pain modulatory effects of spinal manipulation remain elusive. Although both biomechanical and neurophysiological phenomena have been thought to play a role in the observed clinical effects of spinal manipulation, a growing number of recent studies have indicated peripheral, spinal and supraspinal mechanisms of manipulation and suggested that the improved clinical outcomes are largely of neurophysiological origin. In this article, we reviewed the relevance of various neurophysiological theories with respect to the findings of mechanistic studies that demonstrated neural responses following spinal manipulation. This article also discussed whether these neural responses are associated with the possible neurophysiological mechanisms of spinal manipulation. The body of literature reviewed herein suggested some clear neurophysiological changes following spinal manipulation, which include neural plastic changes, alteration in motor neuron excitability,increase in cortical drive and many more. However, the clinical relevance of these changes in relation to the mechanisms that underlie the effectiveness of spinal manipulation is still unclear. In addition,there were some major methodological flaws in many of the reviewed studies. Future mechanistic studies should have an appropriate study design and methodology and should plan for a long-term follow-up in order to determine the clinical significance of the neural responses evoked following spinal manipulation.
文摘BACKGROUND Case studies(CS)are relevant for the development of theoretical and practical competencies in psychotherapy.Despite rapid progress in the development of methods and principles for establishing CS in the last three decades,research into the aims of CS,especially in training,or how CS are to be conducted is rare.AIM To elucidate the form and methodology of CS,the objectives of CS used in training institutions(TI),and if/how TIs handle therapist allegiance.Also,this preliminary investigation will suggest avenues for further research and attempt to establish certain guidelines.METHODS In order to counteract researcher bias and enlarge the question-pool,a focus group was established.The recorded and transcribed text was analyzed with Mayring’s method of qualitative content analysis,and the generated categories were formulated as questions.The resulting questionnaire with both qualitative and quantitative queries was sent out(after pre-testing)to all 39 Austrian TIs that provide professional psychotherapy training.The answers and text passages received were then also categorized with qualitative content analysis.Data analysis was discussed by a peer group consisting of three psychotherapists trained in differing schools of psychotherapeutic methods.RESULTS 94%of Austrian institutes use CS as part of their psychotherapeutic training.Understanding of the term“case study”is inconsistent and has a wide variety of interpretations.CS serve mainly:(1)For observation of training/progress in therapeutic practice and knowledge/acquisition of the theory specific to each psychotherapeutic school;(2)To improve(self-)reflection capabilities;and(3)To expand theoretical knowledge.Most of the CS written are not accessible for students nor for the research community.More than two thirds of the CS take only the position of the author into account(the client’s position is not described).15.5%of the TIs do not consider researcher or therapist allegiance at all.CONCLUSION A more precise formulation of the term case study is needed in psychotherapeutic training.The training therapists play a key function,as they exemplify and teach how to deal with distorting factors.General guidelines as to how to conduct CS in training institutions would provide more direction to students,increase scientific rigor,and enhance synergistic effects.
文摘To aim to inductively clarify the professional identity of occupational therapists who work in a clinical setting, the researchers interviewed the 22 occupational therapists who had a minimum of 5 years or more of practice in the field. The professional identities of the practicing occupational therapists were constructed by the following two core categories: “harmonizing with a client’s life and the characteristic of a client’s disability”, and “giving clients sovereignties as a mission of the occupational therapists”. The occupational therapist can carry the role of coordinator in an interdisciplinary team for the clients with disability by understanding them. This is achieved based on the core category called “giving clients sovereignties as a mission of the occupational therapists”. Furthermore, in order to achieve the clients’ sovereignties, the occupational therapist can be an operational unit by planning practical strategies and practicing them based on the core category called “harmonizing with a client’s life and the characteristic of a client’s disability”. The fact is often difficult for these clients that they are concerned with how he/she lived actively. It is through unique ways of contributing for the clients in a team of professionals that the occupational therapists try to understand the clients not as “patients” but as “human beings”, and try to harmonize with their life and the characteristics of their disability, then try to support and empower them to reach a stage in which they have the sovereignties of their lives.
文摘Client attachment to therapist has been long considered a prominent process variable in psychotherapy research. The purpose of this study was to translate in Greek and evaluate the structure, reliability, convergent and discriminant validity of the well-known and widely administered Client Attachment to Therapist Scale (CATS) with exploratory and confirmatory factor analysis in a clinical sample of 153 clients of different treatment modalities and at different agencies. The results indicated that the EFA resulted in a model almost identical to the Mallinckrodt, Gantt and Coble’s [1] original model after the deletion of six items. Moreover, the findings indicated adequate internal consistency, test-retest reliability, convergent and discriminant validity of the three factors. Normalized scores were provided to help mental health professionals interpret the scale scores. In conclusion, CATS is a valid and reliable tool to measure client attachment to therapist, whose use can promote psychotherapeutic process and outcome. Thus, more validation studies should be conducted in several cultural contexts to better understand its structure and psychometric characteristics.
文摘Background: Orthopedic surgeons often refer patients to hand therapy following orthopedic injury or surgery to facilitate recovery and maximize outcomes. Patients should be a key part of the shared decision-making process when it comes to their rehabilitation. While there is existing literature investigating factors considered by patients when choosing other medical providers, there are currently no studies investigating factors considered by patients when choosing a hand therapist. Purpose: The purpose of the study is to investigate public perception of factors which are important when choosing a hand therapist. Methods: A convenience sample (N = 220) of adults over the age of 18 completed an anonymous online survey using an internet crowdsourcing platform. Respondents were asked to quantitatively rank the importance of 10 predetermined factors related to selecting a hand therapist. Results: Respondents ranked insurance coverage and credentialing as a certified hand therapist as highest in terms of importance. Conclusion: We found that the factors people consider important when selecting a hand therapist are similar to the factors described in the medical literature that are important when selecting a physician or other healthcare provider. The results have implications for physicians when ensuring continuity of care for their patients.
