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Perceptions of the role of physical therapy in cardiovascular disease prevention.

(1) Van Zant, Robert S.; (1) Cape, Kelly Jo; (1) Roach, Katrina; (1) Sweeney, Alice. (1) Physical Therapy, The University of Find-lay, Findlay, OH, United States.

Purpose/Hypothesis: The physical therapy profession has noted the importance of meeting the preventative health needs of patients, but little is known about physical therapist's (PT) perceptions regarding the role of the profession in cardiovascular disease (CVD) prevention. The purpose of this study was to survey the perceptions of PT relative to their role in primary and secondary CVD prevention, specifically as it relates to administering the skills of patient education, evaluation, and treatment. Number of Subjects: A total of 2,673 licensed PT were individually contacted for survey participation, with 516 (19.3%) responding. Materials/Methods: A 25-item survey using a five response (strongly agree to strongly disagree) Likert scale was submitted to four expert cardiopulmonary PT for validation. Each question reflected one of four elements of clinical practice behaviors: education of CVD and CVD risk factors (ELE 1), development and administration of primary CVD prevention protocols (ELE 2), identification of underlying (undiagnosed) CVD and CVD risk factors (ELE 3), monitoring cardiovascular status in patients with known CVD (ELE 4). The final version was sent electronically to potential respondents drawn from faculty directories of accredited physical therapy education programs, APTA cardiopulmonary (CP) and oncology section members, and personally recommended PT. One follow-up contact was made a month after the initial mailing. Responses were assigned numeric values (strongly agree = 5 to strongly disagree = 1). Results of individual practice behaviors and mean scores for ELE 1-4 were statistically analyzed. Results: Most respondents were female (73%) and APTA members (95%). A total of 34% were APTA CP section members (42% other section members, 24% non-section members), and a majority had doctoral degrees (63%), practiced over 16 years (71%) and worked in academia (53%). CVD prevention practice be patient education of CVD medications (79%), assessing CVD family history (75%), patient education about blood chemistry (72%), determination of patient BMI (60%) and body composition (33%). ELE 3 (77.2%) was the only practice behavior that failed to reach 80% agreement. APTA CP section members had significantly (p < 0.05) higher agreement mean scores for ELE 1-4 compared to non-section members, and on ELE 1,2 and 4 compared to other section members. Outpatient PT compared to academics agreed significantly less to ELE 1-4, and also agreed less on ELE 4 compared to acute care PT, and all practitioners except home health PT on ELE 3. Conclusions: PT strongly sup-port most CVD prevention behaviors, but showed less sup-port for patient education of CVD medications and blood chemistry results and determination of patient BMI and body composition. APTA CP section members supported ELE 1-4 more than non-section members, and outpatient PT supported ELE 1-4 less than academics and ELE 3 less than most PT. Clinical Relevance: It is important for the profession to understand how PT actually view CVD prevention behaviors in clinical practice.
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Publication:Cardiopulmonary Physical Therapy Journal
Date:Dec 1, 2011
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