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Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

Everyday uses of standardized test information in a geriatric setting: a qualitative study exploring occupational therapist and physiotherapist test administrators’ justifications

Authors: Kariann Krohne, Sandra Torres, Åshild Slettebø, Astrid Bergland

Published in: BMC Health Services Research | Issue 1/2014

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Abstract

Background

Health professionals are required to collect data from standardized tests when assessing older patients’ functional ability. Such data provide quantifiable documentation on health outcomes. Little is known, however, about how physiotherapists and occupational therapists who administer standardized tests use test information in their daily clinical work. This article aims to investigate how test administrators in a geriatric setting justify the everyday use of standardized test information.

Methods

Qualitative study of physiotherapists and occupational therapists on two geriatric hospital wards in Norway that routinely tested their patients with standardized tests. Data draw on seven months of fieldwork, semi-structured interviews with eight physiotherapists and six occupational therapists (12 female, two male), as well as observations of 26 test situations. Data were analyzed using Systematic Text Condensation.

Results

We identified two test information components in everyday use among physiotherapist and occupational therapist test administrators. While the primary component drew on the test administrators’ subjective observations during testing, the secondary component encompassed the communication of objective test results and test performance.

Conclusions

The results of this study illustrate the overlap between objective and subjective data in everyday practice. In clinical practice, by way of the clinicians’ gaze on how the patient functions, the subjective and objective components of test information are merged, allowing individual characteristics to be noticed and made relevant as test performance justifications and as rationales in the overall communication of patient needs.
Literature
1.
go back to reference Cartwright LR: The challenge of interpreting test scores. Clin commun disord. 1993, 3 (3): 17-25.PubMed Cartwright LR: The challenge of interpreting test scores. Clin commun disord. 1993, 3 (3): 17-25.PubMed
2.
go back to reference Atkinson P: Medical talk and medical work: the liturgy of the clinic. 1995, London: Sage Atkinson P: Medical talk and medical work: the liturgy of the clinic. 1995, London: Sage
3.
go back to reference Turkstra LS, Coelho C, Ylvisaker M: The use of standardized tests for individuals with cognitive-communication disorders. Semin Speech Lang. 2005, 26 (04): 215-222. 10.1055/s-2005-922101.CrossRefPubMed Turkstra LS, Coelho C, Ylvisaker M: The use of standardized tests for individuals with cognitive-communication disorders. Semin Speech Lang. 2005, 26 (04): 215-222. 10.1055/s-2005-922101.CrossRefPubMed
4.
go back to reference Fawcett AJL: Principles of assessment and outcome measurement for occupational therapists and physiotherapists: theory, skills and application. 2007, Chichester: Wiley Fawcett AJL: Principles of assessment and outcome measurement for occupational therapists and physiotherapists: theory, skills and application. 2007, Chichester: Wiley
6.
go back to reference Sullivan M: The new subjective medicine: taking the patient’s point of view on health care and health. Soc Sci Med. 2003, 56 (7): 1595-1604. 10.1016/S0277-9536(02)00159-4.CrossRefPubMed Sullivan M: The new subjective medicine: taking the patient’s point of view on health care and health. Soc Sci Med. 2003, 56 (7): 1595-1604. 10.1016/S0277-9536(02)00159-4.CrossRefPubMed
7.
go back to reference Thornquist E: Musculoskeletal suffering: diagnosis and a variant view. Sociol Health Illn. 1995, 17 (2): 166-192. 10.1111/1467-9566.ep10933380.CrossRef Thornquist E: Musculoskeletal suffering: diagnosis and a variant view. Sociol Health Illn. 1995, 17 (2): 166-192. 10.1111/1467-9566.ep10933380.CrossRef
8.
go back to reference Foucault M: The birth of the clinic: an archaeology of medical perception. 2003, London: Routledge, [1963] Foucault M: The birth of the clinic: an archaeology of medical perception. 2003, London: Routledge, [1963]
9.
go back to reference Timmermans S, Berg M: Standardization in action: achieving local universality through medical protocols. Soc Stud Sci. 1997, 27 (2): 273-305. 10.1177/030631297027002003.CrossRef Timmermans S, Berg M: Standardization in action: achieving local universality through medical protocols. Soc Stud Sci. 1997, 27 (2): 273-305. 10.1177/030631297027002003.CrossRef
11.
go back to reference Kane RL, Kane RA, Eells M: Assessing older persons: measures, meaning, and practical applications. 2000, Oxford: Oxford University Press Kane RL, Kane RA, Eells M: Assessing older persons: measures, meaning, and practical applications. 2000, Oxford: Oxford University Press
12.
go back to reference Rockwood K, Fillit H, Brocklehurst JC, Woodhouse K: Brocklehurst’s textbook of geriatric medicine and gerontology. 2010, Philadelphia: Saunders Elsevier Rockwood K, Fillit H, Brocklehurst JC, Woodhouse K: Brocklehurst’s textbook of geriatric medicine and gerontology. 2010, Philadelphia: Saunders Elsevier
13.
go back to reference Fals-Stewart W: Ability of counselors to detect cognitive impairment among substance-abusing patients: an examination of diagnostic efficiency. Exp Clin Psychopharmacol. 1997, 5 (1): 39-50.CrossRefPubMed Fals-Stewart W: Ability of counselors to detect cognitive impairment among substance-abusing patients: an examination of diagnostic efficiency. Exp Clin Psychopharmacol. 1997, 5 (1): 39-50.CrossRefPubMed
14.
go back to reference Stewart S: The use of standardised and non-standardised assessments in a social services setting: implicationas for practice. Br J Occup Ther. 1999, 62 (9): 417-423.CrossRef Stewart S: The use of standardised and non-standardised assessments in a social services setting: implicationas for practice. Br J Occup Ther. 1999, 62 (9): 417-423.CrossRef
15.
go back to reference DeLuca JW, Putnam SH: The professional/technician model in clinical neuropsychology: deployment characteristics and practice issues. Prof Psychol- Res Pr. 1993, 24 (1): 100-106.CrossRef DeLuca JW, Putnam SH: The professional/technician model in clinical neuropsychology: deployment characteristics and practice issues. Prof Psychol- Res Pr. 1993, 24 (1): 100-106.CrossRef
16.
go back to reference Krohne K, Torres S, Slettebø Å, Bergland A: Individualizing standardized tests: physiotherapists’ and occupational therapists’ test practices in a geriatric setting. Qual Health Res. 2013, 23 (9): 1168-1178. 10.1177/1049732313499073.CrossRefPubMed Krohne K, Torres S, Slettebø Å, Bergland A: Individualizing standardized tests: physiotherapists’ and occupational therapists’ test practices in a geriatric setting. Qual Health Res. 2013, 23 (9): 1168-1178. 10.1177/1049732313499073.CrossRefPubMed
17.
go back to reference Olufowote JO: A dialectical perspective on informed consent to treatment: an examination of radiologists’ dilemmas and negotiations. Qual Health Res. 2011, 21 (6): 839-852. 10.1177/1049732311402097.CrossRefPubMed Olufowote JO: A dialectical perspective on informed consent to treatment: an examination of radiologists’ dilemmas and negotiations. Qual Health Res. 2011, 21 (6): 839-852. 10.1177/1049732311402097.CrossRefPubMed
18.
go back to reference Dingwall KM, Pinkerton J, Lindeman MA: “People like numbers”: a descriptive study of cognitive assessment methods in clinical practice for Aboriginal Australians in the Northern Territory. BMC Psych. 2013, 13: 42-10.1186/1471-244X-13-42.CrossRef Dingwall KM, Pinkerton J, Lindeman MA: “People like numbers”: a descriptive study of cognitive assessment methods in clinical practice for Aboriginal Australians in the Northern Territory. BMC Psych. 2013, 13: 42-10.1186/1471-244X-13-42.CrossRef
19.
go back to reference Marlaire CL, Maynard DW: Standardized testing as an interactional phenomenon. Sociol Edu. 1990, 63 (2): 83-101. 10.2307/2112856.CrossRef Marlaire CL, Maynard DW: Standardized testing as an interactional phenomenon. Sociol Edu. 1990, 63 (2): 83-101. 10.2307/2112856.CrossRef
20.
go back to reference Maynard DW, Marlaire CL: Good reasons for bad testing performance: the interactional substrate of educational exams. Qual Sociol. 1992, 15 (2): 177-202. 10.1007/BF00989493.CrossRef Maynard DW, Marlaire CL: Good reasons for bad testing performance: the interactional substrate of educational exams. Qual Sociol. 1992, 15 (2): 177-202. 10.1007/BF00989493.CrossRef
21.
go back to reference Antaki C: Interviewing persons with a learning disability: how setting lower standards may inflate well-being scores. Qual Health Res. 1999, 9 (4): 437-454. 10.1177/104973299129121983.CrossRef Antaki C: Interviewing persons with a learning disability: how setting lower standards may inflate well-being scores. Qual Health Res. 1999, 9 (4): 437-454. 10.1177/104973299129121983.CrossRef
22.
go back to reference Antaki C, Young N, Finlay M: Shaping clients’ answers: departures from neutrality in care-staff interviews with people with a learning disability. Disabil Soc. 2002, 17 (4): 435-455. 10.1080/09687590220140368.CrossRef Antaki C, Young N, Finlay M: Shaping clients’ answers: departures from neutrality in care-staff interviews with people with a learning disability. Disabil Soc. 2002, 17 (4): 435-455. 10.1080/09687590220140368.CrossRef
23.
go back to reference Houtkoop-Steenstra H: Interaction and the standardized survey interview: the living questionnaire. 2000, Cambridge: Cambridge University PressCrossRef Houtkoop-Steenstra H: Interaction and the standardized survey interview: the living questionnaire. 2000, Cambridge: Cambridge University PressCrossRef
24.
go back to reference Suchman L, Jordan B: Interactional troubles in face-to-face survey interviews. J Am Stat Assoc. 1990, 85 (409): 232-241. 10.1080/01621459.1990.10475331.CrossRef Suchman L, Jordan B: Interactional troubles in face-to-face survey interviews. J Am Stat Assoc. 1990, 85 (409): 232-241. 10.1080/01621459.1990.10475331.CrossRef
25.
go back to reference Lee D, Reynolds CR, Willson VL: Standardized test administration: why bother?. J Forensic Neuropsychol. 2003, 3 (3): 55-81. 10.1300/J151v03n03_04.CrossRef Lee D, Reynolds CR, Willson VL: Standardized test administration: why bother?. J Forensic Neuropsychol. 2003, 3 (3): 55-81. 10.1300/J151v03n03_04.CrossRef
26.
go back to reference Tyson S, Greenhalgh J, Long AF, Flynn R: The use of measurement tools in clinical practice: an observational study of neurorehabilitation. Clin Rehabil. 2010, 24 (1): 74-81. 10.1177/0269215509341527.CrossRefPubMed Tyson S, Greenhalgh J, Long AF, Flynn R: The use of measurement tools in clinical practice: an observational study of neurorehabilitation. Clin Rehabil. 2010, 24 (1): 74-81. 10.1177/0269215509341527.CrossRefPubMed
27.
go back to reference Greenhalgh J, Flynn R, Long AF, Tyson S: Tacit and encoded knowledge in the use of standardised outcome measures in multidisciplinary team decision making: A case study of in-patient neurorehabilitation. Soc Sci Med. 2008, 67 (1): 183-194. 10.1016/j.socscimed.2008.03.006.CrossRefPubMed Greenhalgh J, Flynn R, Long AF, Tyson S: Tacit and encoded knowledge in the use of standardised outcome measures in multidisciplinary team decision making: A case study of in-patient neurorehabilitation. Soc Sci Med. 2008, 67 (1): 183-194. 10.1016/j.socscimed.2008.03.006.CrossRefPubMed
28.
go back to reference Berg KO, Wood-Dauphinee SL, Williams JI, Maki B: Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992, 2: 7-11. Berg KO, Wood-Dauphinee SL, Williams JI, Maki B: Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992, 2: 7-11.
29.
go back to reference Podsiadlo D, Richardson S: The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991, 39 (2): 142-148.CrossRefPubMed Podsiadlo D, Richardson S: The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991, 39 (2): 142-148.CrossRefPubMed
30.
go back to reference Folstein MF, Folstein SE, McHugh PR: “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychol Res. 1975, 12 (3): 189-198. 10.1016/0022-3956(75)90026-6.CrossRef Folstein MF, Folstein SE, McHugh PR: “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychol Res. 1975, 12 (3): 189-198. 10.1016/0022-3956(75)90026-6.CrossRef
31.
go back to reference Shulman KI: Clock-drawing: is it the ideal cognitive screening test?. Int J Geriatr Psychiatry. 2000, 15 (6): 548-561. 10.1002/1099-1166(200006)15:6<548::AID-GPS242>3.0.CO;2-U.CrossRefPubMed Shulman KI: Clock-drawing: is it the ideal cognitive screening test?. Int J Geriatr Psychiatry. 2000, 15 (6): 548-561. 10.1002/1099-1166(200006)15:6<548::AID-GPS242>3.0.CO;2-U.CrossRefPubMed
32.
go back to reference Critchley N: The parietal lobes. 1966, New York: Hafner Critchley N: The parietal lobes. 1966, New York: Hafner
33.
go back to reference Reitan RM: The relation of the trail making test to organic brain damage. J Consult Psychol. 1955, 19 (5): 393-394.CrossRefPubMed Reitan RM: The relation of the trail making test to organic brain damage. J Consult Psychol. 1955, 19 (5): 393-394.CrossRefPubMed
34.
go back to reference Reitan RM: Validity of the trail making test as an indicator of organic brain damage. Percept Mot Skills. 1958, 8: 271-276. 10.2466/pms.1958.8.3.271.CrossRef Reitan RM: Validity of the trail making test as an indicator of organic brain damage. Percept Mot Skills. 1958, 8: 271-276. 10.2466/pms.1958.8.3.271.CrossRef
35.
go back to reference Carr JH, Shepherd RB, Nordholm L, Lynne D: Investigation of a new motor assessment scale for stroke patients. Phys Ther. 1985, 65 (2): 175-180.PubMed Carr JH, Shepherd RB, Nordholm L, Lynne D: Investigation of a new motor assessment scale for stroke patients. Phys Ther. 1985, 65 (2): 175-180.PubMed
36.
go back to reference Malterud K: Qualitative research: standards, challenges, and guidelines. Lancet. 2001, 358 (9280): 483-488. 10.1016/S0140-6736(01)05627-6.CrossRefPubMed Malterud K: Qualitative research: standards, challenges, and guidelines. Lancet. 2001, 358 (9280): 483-488. 10.1016/S0140-6736(01)05627-6.CrossRefPubMed
37.
go back to reference Bilsker D, Goldner EM: Routine outcome measurement by mental health-care providers: is it worth doing?. Lancet. 2002, 360 (9346): 1689-1690. 10.1016/S0140-6736(02)11610-2.CrossRefPubMed Bilsker D, Goldner EM: Routine outcome measurement by mental health-care providers: is it worth doing?. Lancet. 2002, 360 (9346): 1689-1690. 10.1016/S0140-6736(02)11610-2.CrossRefPubMed
38.
go back to reference Greenhalgh J, Long AF, Flynn R, Tyson S: “It’s hard to tell”: the challenges of scoring patients on standardised outcome measures by multidisciplinary teams: a case study of neurorehabilitation. BMC Health Serv Res. 2008, 8: 217-10.1186/1472-6963-8-217.CrossRefPubMedPubMedCentral Greenhalgh J, Long AF, Flynn R, Tyson S: “It’s hard to tell”: the challenges of scoring patients on standardised outcome measures by multidisciplinary teams: a case study of neurorehabilitation. BMC Health Serv Res. 2008, 8: 217-10.1186/1472-6963-8-217.CrossRefPubMedPubMedCentral
39.
go back to reference Matarazzo JD: Psychological assessment versus psychological testing: validation from Binet to the school, clinic, and courtroom. Am Psychol. 1990, 45 (9): 999-1017.CrossRefPubMed Matarazzo JD: Psychological assessment versus psychological testing: validation from Binet to the school, clinic, and courtroom. Am Psychol. 1990, 45 (9): 999-1017.CrossRefPubMed
40.
go back to reference Fujiura GT, Rutkowski-Kmitta V: Counting disability. Handbook of disability studies. Edited by: Albrecht GL, Seelman KD, Bury M. 2001, Thousand Oaks, Calif: Sage Fujiura GT, Rutkowski-Kmitta V: Counting disability. Handbook of disability studies. Edited by: Albrecht GL, Seelman KD, Bury M. 2001, Thousand Oaks, Calif: Sage
41.
go back to reference Polanyi M: The tacit dimension. 1966, Glouchester, Mass: Peter Smith Polanyi M: The tacit dimension. 1966, Glouchester, Mass: Peter Smith
42.
go back to reference Lam A: Tacit knowledge, organizational learning and societal institutions: an integrated framework. Organ Stud. 2000, 21 (3): 487-513. 10.1177/0170840600213001.CrossRef Lam A: Tacit knowledge, organizational learning and societal institutions: an integrated framework. Organ Stud. 2000, 21 (3): 487-513. 10.1177/0170840600213001.CrossRef
43.
go back to reference White S, Stancombe J: Clinical judgement in the health and welfare professions: extending the evidence base. 2003, Buckingham, Phildelphia: Open University Press White S, Stancombe J: Clinical judgement in the health and welfare professions: extending the evidence base. 2003, Buckingham, Phildelphia: Open University Press
44.
go back to reference Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS: Evidence based medicine: what it is and what it isn’t. BMJ. 1996, 312 (7023): 71-72. 10.1136/bmj.312.7023.71.CrossRefPubMedPubMedCentral Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS: Evidence based medicine: what it is and what it isn’t. BMJ. 1996, 312 (7023): 71-72. 10.1136/bmj.312.7023.71.CrossRefPubMedPubMedCentral
45.
go back to reference Krohne K, Slettebø Å, Bergland A: Cognitive screening tests as experienced by older hospitalised patients: a qualitative study. Scand J Car Sci. 2011, 25 (4): 679-687. 10.1111/j.1471-6712.2011.00878.x.CrossRef Krohne K, Slettebø Å, Bergland A: Cognitive screening tests as experienced by older hospitalised patients: a qualitative study. Scand J Car Sci. 2011, 25 (4): 679-687. 10.1111/j.1471-6712.2011.00878.x.CrossRef
Metadata
Title
Everyday uses of standardized test information in a geriatric setting: a qualitative study exploring occupational therapist and physiotherapist test administrators’ justifications
Authors
Kariann Krohne
Sandra Torres
Åshild Slettebø
Astrid Bergland
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-14-72

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