Evidence into Practice Integrating Judgment, Values, and Research

ISBN-10: 0803618085
ISBN-13: 9780803618084
Edition: 2013
List price: $58.95 Buy it from $6.74
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Book details

List price: $58.95
Copyright year: 2013
Publisher: F. A. Davis Company
Publication date: 1/3/2013
Binding: Paperback
Pages: 368
Size: 6.75" wide x 9.75" long x 0.75" tall
Weight: 1.694
Language: English

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Opening Words
Introduction
Approaches to Decision Making
Finding the Right Answer at the Right Time
Obligations of Care
Using This Book
Learning Tools Within the Chapters
Conclusion
Clinical Judgment
The Language of Practice
Introduction
Describing Our Patients
The Biopsychosocial Model
Development of Models for Enablement/Disablement
Expansion of the Nagi Model
International Classification of Functioning Model
Describing the Process and Outcomes of Our Care
The Guides Patient Care Management Model
Conclusion
How Physical Therapists Make Clinical Decisions
Introduction
The Context of Clinical Reasoning
First Things First: Is This My Patient?
Diagnostic Clinical Reasoning
Shoe On, Shoe Off- What Has Happened to Your Ankle?
Types of Diagnostic Decision Making
Patient Management Reasoning
Developing or Improving Clinical Reasoning Skills
Conclusion
Mistakes and Errors: When Clinical Decisions Go Wrong
Introduction
Describing Misses and Mistakes in Health Care
Creating a Taxonomy
Cognitive Errors in Physician Decision Making
Errors in Physical Therapy and Occupational Therapy Practice
Errors and Error Prevention Across Patient/Client Care Management Model
Implications of Errors in Physical Therapy Practice
Decision Making Under Uncertainty
Expected Value of Alternatives
Concept of Probability
Conclusion
Biases in Clinical Reasoning: "Most of My Patients Are Helped by This Treatment"
Introduction
Biases in Decision Making
Confirmation Bias
Follow-up Bias for Patients You Treat
Spectrum Bias
Wishful Thinking or Value-induced Bias
Ease of Recall
Conclusion
Clinical Decision Making Tools
Introduction
Process Approaches to the Way We Think
Enablement/Disablement Models
Patient/Client Management Model
The Hypothesis-Oriented Algorithm for Clinicians
Content Approaches to What We Think
Guidelines
Options
Clinical Guidance
Conclusion
Understanding and Respecting Patient Values and Circumstances
Bridging the Differences of Diversity: Communicating in the Borderlands
Introduction
Context for Cross-Cultural Communication and the Therapeutic Alliance
Communication Skills as a Scaffold for the Therapeutic Alliance
Verbal and Nonverbal Communication
Miscommunication
Barriers to Communication
Building the Therapeutic Alliance
Bridging Differences: Communicating in the Borderlands
Conditions Supporting Cross-Cultural Communication
Working Within the Borderlands
Conclusion
The Patient Interview
Introduction
The Interview as a Diagnostic Instrument
Objectivity
Precision
Sensitivity and Specificity
Reliability
Skill
Establishing a Therapeutic Relationship
The Interview in Building a Therapeutic Relationship
Respect
Genuineness
Empathy
Nonverbal Communication
Kinesics
Paralanguage
Responding to Nonverbal Communication
Conclusion
Learning About Patients' Perspectives: Qualitative Research
Introduction
The Qualitative Research Paradigm
Perspectives in Qualitative Research
Phenomenology
Ethnography
Grounded Theory
Methods of Qualitative Data Collection
Observation
Interviews
Data Analysis and Interpretation
Trustworthiness and Generalizability
Sampling
Summary of Methods in Qualitative Research
Use of Qualitative Research in Evidence Based Practice
Clinical Decision Making That Fully Engages Patient Values and Circumstances
Learning About Patients' Values Through Qualitative Research
Qualitative Research and an Understanding of the Clinician's Willingness to Use Evidence in Practice
Role of Qualitative Research
Conclusion
The Health Care System and Patient Circumstances
Introduction
Overview of the Health Care System
Kissick's Model: The Iron Triangle of Health Care
Elements of the Health Care System
Impact of Rising Health Care Costs
Markets
Regulatory Infrastructure
Health Services Research
Patient Circumstances and Access to Care
Insurance Coverage
Geography
Socioeconomic Status
Race and Ethnicity
Update on Health Care Reform
Conclusion
Analyzing the Evidence in the Literature
Asking Clinical Questions
Introduction
Asking the Question
Structure of Clinical Questions
Choosing the Answers
Types of Evidence
Conclusion
Finding the Evidence
Introduction
Filtered Resources
PEDro
Cochrane Database of Systematic Reviews
The National Guideline Clearinghouse
Unfiltered Resources
Medline/PubMed
CINAHL (Cumulative Index to Nursing and Allied Health Literature)
Tutorials
The Search Strategy
Focus the Question
Select the Best Resource
Formulate the Search Strategy
Review the Results
Search Engines
Access to Resources
Resources Available From the American Physical Therapy Association (APTA)
Managing the Evidence
Reference Management Software
Keeping Current With New Evidence
Blogs, Wikis, and RSS Feeds
Mobile Devices
Conclusion
Elements of Good Research Practice
Introduction
Research Design
Experimental Research Designs
Observational Research Designs
Determining Value in Studies of Clinical Intervention
Criteria for Evaluating Internal Research Validity
Did the Research Design Maximize the Prevention of Bias?
Did the Selection and Treatment of Subjects Avoid the Introduction of Bias?
Did the Selection and Methods of Interventions and Measurement of Outcomes Avoid the Introduction of Bias?
Evaluating External Validity
Evaluating Statistical Conclusion Validity
Evaluating Outcomes: Effect Size and Number Needed to Treat
Summary of Statistical Conclusion Validity
Determining Value in Studies of Diagnostic/Prognostic Accuracy
Did the Selection of Subjects Avoid the Introduction of Bias?
Did the Selection of Measures and Procedures Avoid the Introduction of Bias?
Were the Statistical Estimates Developed and Presented Without Bias or Error?
Other Statistics Found in Observational Research
Conclusion
The Individual Study as a Source of Evidence
Introduction
Studies
Studies Focused on Physical Therapy
Assessing Studies of Diagnostic/Prognostic Accuracy
Assessing Studies of Clinical Interventions
Conclusion
Synopses of Studies
Introduction
Synopses of Studies
Published Synopses That Apply to Physical Therapist Practice
Collections of Synopses Relevant to Physical Therapy
Creating Synopses
Appraisal Worksheets
Critically Appraised Topics
Conclusion
Synthesis of Studies Through Systematic Reviews and Meta-Analyses
Introduction
Systematic Reviews and Meta-Analyses
Finding Systematic Reviews and Meta-Analyses
Assessing the Quality of Reviews
Ten Questions to Help You Make Sense of Reviews
Synthesis Conclusion
Synopses of Syntheses
Conclusion
Summaries and Systems
Introduction
Summaries
Practice Guidelines
Clinical Decision/Prediction Rules
Systems
Quality of Decision Support Systems
Conclusion
Evidence Based Practice: Does It Work in Practice?
Translating Evidence Into Practice
Introduction
Dissemination of Innovation
Perceptions of Innovation
Dissemination in Physical Therapy
Dissemination of Evidence to Consumers
Practitioner Acceptance
Practitioners' Perspectives
Practitioners' Innovation Adoption Patterns
Organizational Characteristics
Additional Perspectives on Knowledge Translation
Conclusion
Documentation as Evidence
Introduction
The Health Care Record
Standards for Quality in Documentation
Barriers to Quality Documentation
Focus on Intervention
Payment Incentives
Lack of Standardized Terminology
Improving the Utility of Documentation as a Source of Evidence
Use of Electronic Record-Keeping Systems
Description of Actual Patient Outcomes
Quality Improvement Systems
Conclusion
Quality Improvement in Action
Introduction
Achieving Change in Performance
Reviewing Performance: A Continuous Quality Improvement Approach
Continuous Quality Improvement in Action
Conclusion
Closing Words
Introduction
Concerns About Adopting EBP
EBP Interferes With the Clinician's Decision Making
EBP Is Unethical
Evidence Is Not Always Based on Theory
EBP, Quality, and Costs
EBP in Use in Physical Therapy
What Does the Future Hold?
Conclusion
Appendix: The Case of Sam Ketterman

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