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Will patients stick to physical therapy? Questionnaire can help doctors predict
Date:9/30/2008

eatments I need to do at home.

"Essentially, the test places patients on a continuum of activation ranging from those who don't see an active role on their part as necessary to those who are highly motivated to take an active role in their own health care," says Skolasky.

The researchers recruited 65 Johns Hopkins patients to participate in the study, funded by the Agency for Healthcare Research and Quality. All underwent their first surgical treatment for a degenerative spine disease between August 2005 and May 2006. Eighty-nine percent were non-Hispanic white and 58 percent were female. The mean age was 58 years old.

Before the surgery, each patient completed a PAM questionnaire. Then, for the next six weeks after surgery, patients recorded how often they attended prescribed physical therapy sessions. After the last therapy session, therapists scored the patients' engagement in physical therapy by rating their attitude, need for prompts, understanding the importance of therapy, and activity during sessions.

Results showed that attendance rose in direct correlation to PAM scores. Patients who had the lowest PAM scores attended 55.6 percent of their therapy sessions. In contrast, those with the highest PAM scores attended physical therapy 94.1 percent of the time. Similarly, engagement scale scores also went up as PAM scores increased.

"These results were very encouraging, and since the PAM is easy to administer, it may provide a practical component to a patient's preoperative treatment," says Skolasky.

Skolasky said that before they can bring the PAM into the examination room, they will need to develop a protocol for improving PAM scores. He and his colleagues are planning a randomized clinical trial in which trained interviewers will meet with patients who score low on the PAM and employ various techniques to improve involvement in their own care. Surgical outcomes for these patients would be compared to outc
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Contact: Eric Vohr
evohr1@jhmi.edu
410-955-8665
Johns Hopkins Medical Institutions
Source:Eurekalert

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