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Purpose: This study aimed to develop and validate a patient-reported experience measure (PREM) to examine the patients' perspectives on the quality of outpatient physiotherapy and occupational therapy rehabilitation. Materials and methods: A systematic literature search in PubMed, Embase, Scopus, and Cinahl was conducted to identify relevant themes for the questionnaire. Fourteen studies were analyzed through a systematic text condensation to identify quality aspects in the rehabilitation from patients' perspectives. Further, based on the analysis, 13 items with answers on a five-point Likert scale were developed. Face validity and content validity were established during interviewing 14 municipality outpatients. Finally, to determine the construct validity and internal consistency, the questionnaire was distributed to 385 patients with various diagnoses. Results: The final questionnaire, Outpatients' Experience of quality in Rehabilitation (OPER), demonstrated good face and content validity and covered patients' experience of quality in municipal rehabilitation. Data from 307 respondents established construct validity and high internal consistency and showed, in general, a positive experience of outpatient rehabilitation. Conclusions: The OPER demonstrates satisfactory psychometric properties based on an extensive development and validation process. By assessing outpatients' experience of the rehabilitation process, OPER offers a measurement of the quality of therapists' practice of patient-centered rehabilitation. IMPLICATIONS FOR REHABILITATION: Quality in outpatient rehabilitation should be measured with patient-reported experience measures (PREMs) that encompass patients' experience of the rehabilitation process. Based on analyses of the literature and a thorough validation process, the study developed a PREM for outpatient rehabilitation: OutPatients' Experience of quality in Rehabilitation (OPER). OPER demonstrates satisfying psychometric properties in an outpatient population with various diagnoses. OPER is based on patient-centeredness in meeting with physiotherapists and occupational therapists. [ABSTRACT FROM AUTHOR]

Fractures following trauma affect physical and mental health for working-age persons, and the International Classification of Functioning, Disability, and Health (ICF) can help therapists understand the fractures' impact on daily lives. To examine self-reported functioning and outcomes six months after upper and lower body fractures and compare limitations using the ICF. Data were collected from 160 patients with fractures as part of a prospective cohort study. The primary outcome measure was the Short Musculoskeletal Function Assessment questionnaire that covers all domains of the ICF. Moreover, sick leave, sense of coherence, and physical activity were reported. Six months after the injury, function had improved significantly, but patients reported problems on all domains in the ICF with few differences between the upper and lower body groups. Leisure activities caused problems for 63 (38.8%) of the patients and bothered 86 (53.8%). Problems performing work bothered 63 (39.4%) with no significant difference between the groups, although a significantly higher proportion in the upper body group had returned to work within two months (p <.001). Six months after fractures, adults reported problems on all ICF domains, especially on the participation dimension, which therapists should address in the rehabilitation process. [ABSTRACT FROM AUTHOR]

The aim of this classic grounded theory study was to develop a substantive theory explaining variations in patients' expectations of physiotherapists when contacting a clinic. The study was nested in a survey cohort study, and data constituted a single open-ended question: State what you expect the physiotherapist to help you with. Responses were obtained from patients before attending the clinic. Statements were analysed using classic grounded theory with open, selective, and theoretical coding. The authors concurrently used memos and constant comparison until theoretical saturation was achieved, categories were identified, and a theoretical model was developed. Based on 292 statements from patients primarily suffering from musculoskeletal problems, the theory grounded in data Expectations as a continuum was developed. Four typologies created the theory: (1) Doing something, so it is again possible to..., (2) Finding out what is wrong with me, (3) Relieving/getting rid of symptoms, and (4) Help to self-help. The theory Expectations as a continuum illuminates that patients' expectations range from helplessness to being competent to act and reflect the social cognitive theories health locus of control and self-efficacy. Patients' abilities for self-management are different, and physiotherapists should carefully adjust the requirements for self-management. [ABSTRACT FROM AUTHOR]

Physical activity is important for health but injuries might affect the level of activity. The aim of this study was to evaluate change in physical activity after fracture and to determine predictors for return to a previously high/moderate level of physical activity at 6 months following injury. A cohort study was conducted that included 201 people aged 18–64 years who suffered fractures. Participants reported their level of physical activity prior to the injury and perceived change after six months (n = 164). Subgroup analysis of 95 preinjury physical active participants was performed with logistic regression analysis and odds ratio (OR). Totally, 27.4% (n = 45) returned to their previous level of physical activity and for the 95 pre-injury physically active participants it was 27.3% (n = 26). Low income OR 3.15 (95% CI 1.78–28.05), not receiving rehabilitation OR 0.09 (95% CI 0.02–0.37), and sustaining upper limb fractures compared to lower limb fractures OR 0.09 (95% CI 0.02–0.51) were positively associated with return to preinjury physical activity levels at 6 months after controlling for significant factors. Fracture affects physical activity at six months even for pre-injury active individuals. Therapists should pay attention to guiding patients to perform physical activities despite their injury. [ABSTRACT FROM AUTHOR]