The Journal of Korean Physical Therapy

  • 제24권5호
  • /
  • Pages.377-382
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  • 2012
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  • 1229-0475(pISSN)
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  • 2287-156X(eISSN)
대한물리치료학회 (The Korean Society of Physical Therapy)
권호 표지

우리나라 소아 물리치료사의 임상적 추론

Clinical Reasoning by Pediatric Physical Therapists in South Korea

  • 이혜영 (대구대학교 대학원 재활과학과) ;
  • 이인희 (계명대학교 동산의료원 재활의학과) ;
  • 김경 (대구대학교 재활과학대학 물리치료학과)
  • Lee, Hye-Young (Department of Rehabilitation Science, Graduate School, Daegu University) ;
  • Lee, In-Hee (Department of Physical Medicine and Rehabilitation, Keimyung University Dongsan Medical Center) ;
  • Kim, Kyoung (Department of Physical Therapy, College of Rehabilitation Science, Daegu University)
  • 투고 : 2012.09.25
  • 심사 : 2012.10.17
  • 발행 : 2012.10.25
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초록

Purpose: The purpose of this qualitative study was to understand the application of clinical reasoning throughout clinical and therapeutic knowledge of clinical pediatric physical therapists under physician prescriptions. Methods: Purposive sampling techniques were used in selection of nine clinical pediatric physical therapists in South Korea. Open and semi structured interviews were conducted, and were thoroughly examined and reviewed, followed by analysis of the clinical reasoning portion. Results: Pediatric physical therapists have been influenced by information gathering, physical function and evaluation of their patients, hypothesis-orientation, and re-evaluation and self-monitoring. Novice physical therapists were more dependent on physician prescriptions and parent's hope than the result of their own evaluation and critical pathway. Middle experienced pediatric physical therapists were more dependent on rapport with children and their parents. Highly experienced pediatric physical therapists were more reliant on hypothesis-orientation and self-monitoring. As reports on clinical experience of pediatric physical therapists have accumulated, clinical reasoning of pediatric physical therapists has been influenced by their experience, such as education, clinical pathology conference, their own clinical experience and rapport with patients and their parents than physicians' prescriptions. Conclusion: The findings of the current study are generally consistent with existing research on clinical reasoning. The results of the current study may be used by educators for enhancement of clinical reasoning abilities and knowledge of students or novices as well as development of a guide for use by suitable novices or students, and could provide important information for use in physical therapy practice and research.

키워드

참고문헌

  1. Payton OD. Clinical reasoning process in physical therapy. PhysTher. 1985;65(6):924-8.
  2. Ryu YU, Park JS. Medical and narrative use of physical therapy knowledge in clinical reasoning by Korean physical therapists. J Phys Ther Sci. 2011;23(2):251-4. https://doi.org/10.1589/jpts.23.251
  3. May BJ, Newman J. Developing competence in problem solving. A behavioral model. Phys Ther. 1980;60(9):1140-5.
  4. May BJ, Dennis JK. Expert decision making in physical therapy--a survey of practitioners. Phys Ther. 1991;71(3):190-202.
  5. Jensen GM, Gwyer J, Shepard KF. Expert practice in physical therapy. Phys Ther. 2000;80:28-43.
  6. Edwards I, Jones M, Carr J, et al. Clinical reasoning strategies in physical therapy. Phys Ther. 2004;84:312-30.
  7. Edwards I, Braunack-Mayer A, Jones M. Ethical reasoning as a clinical- reasoning strategy in physiotherapy. Physiotherapy. 2005;91(4):229-36. https://doi.org/10.1016/j.physio.2005.01.010
  8. Smart K, Doody C. Mechanisms-based clinical reasoning of pain by experienced musculoskeletal physiotherapists. Physiotherapy. 2006;92(3):171-8. https://doi.org/10.1016/j.physio.2006.04.004
  9. Embrey DG, Guthrie MR, White OR, Dietz J. Clinical decision making by experienced and inexperienced pediatric physical therapists for children with diplegic cerebral palsy. Phys Ther. 1996;76(1):20-33.
  10. Lee IH, Lee HY. Clinical decision making development of clinical physical therapists under the fee for service and the prescription of physician. J Korean Soc Phys Ther. 2012;24(3):171-80.
  11. Jones MA. Clinical reasoning in manual therapy. Phys Ther. 1992;72(12):875-84.
  12. Jensen GM, Shepard KF, Hack LM. The novice versus the experienced clinician: insights into the work of the physical therapist. Phys Ther. 1990;70(5):314-23.
  13. Lee HS, Lee JH, Kim JH. The comparison of the curriculums of physical therapy education department in the world. J Korean Soc Phys Med. 2010;5(2):151-64.
  14. Kim JG. Factors influencing the motor development of children with cerebral palsy: differences in pediatric physical therapists' perceptions. J Korean Soc Phys Ther. 2011;23(4):7-13.
  15. Shim JH, Yoon TH. Analysis of factors that influence the job satisfaction of physical therapists. J Korean Soc Phys Ther. 2011;23(1):67-75.
  16. Lee HY, Kim K, Cha YJ. A survey on stress and coping style in mothers of cerebral palsied children. J Korean Soc Phys Ther. 2012;24(2):98-106.
  17. Kwon MJ. Satisfaction of utilization of physical therapy and quality of life for caregivers of cerebral palsy children. J Korean Soc Phys Ther. 2009;21(2):55-63.