Volume 4, Issue 2, December 2018, Page: 40-53
Reliability of ‘ACAPN’ Clinical Assessment Tool for Differential Diagnoses of Pathologies in Clinical Physiotherapy
Onigbinde Ayodele Teslim, Institute of Consortium for Advanced Leadership and Academic Training, Association of Clinical and Academic Physiotherapists of Nigeria, Ile - Ife, Nigeria
Awotidebe Taofik Oluwole, Institute of Consortium for Advanced Leadership and Academic Training, Association of Clinical and Academic Physiotherapists of Nigeria, Ile - Ife, Nigeria
Wahaab Oluwaseyi David, Institute of Consortium for Advanced Leadership and Academic Training, Association of Clinical and Academic Physiotherapists of Nigeria, Ile - Ife, Nigeria
Received: Nov. 14, 2018;       Accepted: Dec. 19, 2018;       Published: Mar. 7, 2019
DOI: 10.11648/j.ijcda.20180402.11      View  15      Downloads  3
The standardization of assessment procedures is to ensure high quality clinical care. Considering variations in clinical training backgrounds of physiotherapists, there may be inconsistency in methods of documentation. The aims of this study were to develop a standard assessment tool and also determine its internal consistency (reliability). The tool was developed using the guidelines of University College London Guide. The tool was divided into 7 sections: sociodemographic data, history, vital signs, physical diagnostic tests, problem lists, differential diagnoses and therapeutic interventions. Ninety-five physiotherapists from purposively selected government hospitals participated in the cross-sectional survey study. They chose the level of agreement for each section of the developed tool on a 5 points likert scale (scored as 1 – 5). The same questionnaire was re-administered to same respondents with test-retest interval of 2 weeks. Cumulative agreement score was computed to have global scores for days 1 and 2. Descriptive Statistics of mean, frequency and percentages were used to summarize the data. Cronbach alpha was used to determine the internal consistency of the assessment tool. Spearman Rho was used to determine the relationship between the agreement scores of the two days. Alpha level was set at P<0.05. The mean age of the respondent was 33.62 ± 10.26 years while years of experience was 10.36 ± 6.22 years. The Cronbach Alpha obtained for the tool was 0.9 while that of individual sections ranged from 0.53 to 0.86. The mean global agreement score for day 1 was 169.44 ± 13.78 and after test-retest, it was 169.20 ± 13.61 (day 2). The result of the Spearman's rho showed that there was significant correlation between global agreement score for days 1 and 2 (r = 0.99, p = 0.001). There was also significant correlation between the age and experience of the respondent (r = 0.77, p = 0.01). In conclusion, the developed assessment tool has internal consistency and it was found to be reliable as a means of documentation for evaluating patients.
Clinical Assessment Tool, Differential Diagnoses, Pathologies, Physiotherapy
To cite this article
Onigbinde Ayodele Teslim, Awotidebe Taofik Oluwole, Wahaab Oluwaseyi David, Reliability of ‘ACAPN’ Clinical Assessment Tool for Differential Diagnoses of Pathologies in Clinical Physiotherapy, International Journal of Clinical and Developmental Anatomy. Vol. 4, No. 2, 2018, pp. 40-53. doi: 10.11648/j.ijcda.20180402.11
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Phillips A, Stiller K, Williams M. Medical record documentation: The quality of physiotherapy entries. The International Journal Allied Health Science and Practice 20064(3): 1 17.
Richoz C, Ayer A, Berchtold A, Richoz S. Record keeping by Swiss physiotherapists. Euro Journal of Medical Science 2008; 10:4414.
Ioanna, P., Stiliani, K., Vasiliki, B. (2007). Nursing documentation and recording systems of nursing care. Health Science Journal, (4)
World Health Organization-Regional Office for South-East Asia coding workshop; Guidelines for Medical Record and Clinical Documentation. 2007:2-3
Gumery L, Sheldon H, Bayliss H, Mackle R, Stableforth D, Honeybourne D. Do physiotherapy records meet international standard. Physiotherapy; 2001:86:655‑9.
World Confederation for Physical Therapy. Draft Position Statement Appendix to Physical Therapy Record Keeping, Storage and Retrieval. Available from http://www.wcpt.org [Accessed on 2018 Jun 20].
Louisa C, Arisa H, Chrishan G, Paul D. University College London guide to clerking; How to investigate, form differential diagnoses and a management plan. 2014; 3-5.
Nicholas J. T, Simon O’Connor. Clinical Examination: A systemic guide to physical diagnosis 6th edition; Churchill Living stone. 2010; 1:16.
Jij. Chow, Camille. Y, Tim. S. How complete are our clerkings? A project aim improving the quality of medical records by using a standardized proforma; Medway NHS Trust BMJ Quality Improvement Reports 2014. 1:1.
Sanders L; Every Patient Tells a Story; Medical mysteries and the act of diagnosis; New York: Broadway Books. 2009:6-91.
Longson D. The clinical consultation Journal of the Royal College Physicians London1983:17:192-195.
Nardone D. A., Johnson G. K, Faryna A, Coulehan J. L, Parrino T. A. A model for the diagnostic medical interview: nonverbal, verbal and cognitive assessments. Journal of General Internal Medicine. 1992;7:437-442.
Reilly B. M, Lancet. (2003); Physical examination in the care of medical inpatients: an observational study. 362(9390):1100-1105.
Paley L., Zornitzki T, Cohen J, Friedman J, Kozak N, Schattner (2011); A. Utility of clinical examination in the diagnosis of emergency department patients admitted to the department of medicine of an academic hospital. Archives of Internal Medicine. 171(15):1394-1396.
L. K. J. Baartman, T. J. Bastiaens, P. A. Kirschner, C. P. M. van der Vleuten. The wheel of competency assessment: presenting quality criteria for competency assessment programs Studies in Educational Evaluation, 32 (2006), pp. 153-170.
Epstein R. M., Hundert E. M. Defining and assessing professional competence Journal of American Medical Association, 287 (2002), pp. 226-235.
Roberts C., Newble D., Jolly B., Reed M., Hampton K. Assuring the quality of high-stakes undergraduate assessments of clinical competence Medical Teacher, 28 (2006), pp. 535-543.
Swinkels R. A. H. M., Van Peppen R. P. S., Wittink H., Custers J. W. H., Beurskens A. H. M. (2011); Current use and barriers and facilitators for implementation of standardised measures in physical therapy in the Netherlands. BMC Musculoskeletal Disorders. 12(1), 106.
Aylott M (2006) Developing rigour in observation of the sick child. Paediatric Nursing. 18(8):38-44.
Jill, C. M (2014). The importance of the history and physical in diagnosis The Nurse Practitioner Vol. 39, No. 31-34
Crumbie A. (2006); Taking a history. In Walsh M (Ed) Nurse Practitioners: Clinical Skills and Professional Issues. Second edition. Butterworth Heinemann, Edinburgh, 14-26.
Moulton L. (2007); The Naked Consultation: A Practical Guide to Primary Care Consultation Skills. Radcliffe Publishing, Abingdon
Lloyd H, Craig S (2007) A guide to taking a patient’s history. Nursing Standard. 22, 13, 42-48.
Kaufman Gerri (2008) Patient assessment: effective consultation and history taking. Nursing Standard. 23, 4, 50-56.
Peter R. Lichstein. Clinical Methods; The Medical Interview 3rd edition. Chapter 3; the History, Physical, and Laboratory Examinations. (1990).
Grahame-Smith D. G, Aronson J. K. The drug history and the clinical examination and investigation of drug effects. In: The Oxford Textbook of Clinical Pharmacology and Drug Therapy, 3rd edn, ed. Graheme– Smith DG, Aronson JK. Oxford: Oxford University Press, (2002); 167–70.
Onigbinde A. T., Adedoyin R. A., Johnson O. E. (2006) Effect of Physical Therapy Intervention on Pharmacokinetic Variables. Nigerian Journal of Medical Rehabilitation; 11: 6 - 9.
Jessica Hegg (2016) Medical Monitoring: 5 Vital Signs You Should Be Checking Regularly.
Anne Fetterman, Steven.k (2017). Vital Signs (Body Temperature, Pulse Rate, Respiration Rate, Blood Pressure) University of Rochester Medical Center Rochester, New York.
Ruth F Craven, Constance J Himle Fundamental of nursing; human health and function philaelphia, Lippincott Williams & wilkins (2007)
Steven l. Berk, Abraham Verghese Chapter 217 Clinical Methods; The History, Physical and laboratory Examinations; (1990)
Cook, K and Montgomery, H (2010) Assessment. In: Trigg, E and Mohammed T, A. (Ed.s) Practices in Children’s Nursing. London. Churchill Livingstone Elsevier. pp. 67-80.
Royal College of Nursing (2017). Standards for Assessing, Measuring and Monitoring Vital Signs in Infants, Children and Young People. Second Edition: May 2017 Publication code: 005 942 ISBN: 978-1-910672-90-7.
Council of Licensed Practical Nurses of BC (2005); Patient assessment; Self-assessment tool.
Myles Sheehan, S. J, Patient Centered Medicine; Chapter 2 (General Appearance) (2005).
American Occupational Therapy Association. (2008); Occupational therapy practice framework: Domain and process (2nd ed.).
Bottari, C., Swaine, B., Dutil, E. (2007). Interpreting activity of daily living errors for treatment and discharge planning: The perception of occupational therapists. Journal of Head Trauma Rehabilitation. 22, 26-30.
Brentnall, J., Bundy, A. C (2009). The concept of reliability in the context of observational assessments. OTJR:Occupation, Participation, and health, 29, 63-71.
Canadian Association of Occupational Therapists. (1999/2009). Joint Position Statement on Evidence-based Occupational Therapy. Retrieved April 4, 2011, from http://www.caot.ca/default.asp?ChangeID=166&pageID=156.
Cooke, D. M., McKenna, C., & Fleming, J. (2005). Development of a standardized occupational therapy screening tool for visual perception in adults. Scandinavian Journal of Occupational Therapy, 12, 59-71. doi: 10.1080/11038120410020683.
Charlie Goldberg (2015); Lung & Thorax Exams, University of California, San Diego; School of Medicine from A Practical Guide to Clinical Medicine https://meded.ucsd.edu/clinicalmed/introduction.htm.
Rodger Henderson, Cathy Jackson Respiratory System History and Examination December, (2015).
Robert, J. N, Gwendolen, A. J, Bill, V., Michel, W. C., (2012); The validity of upper-limb neurodynamic tests for detecting peripheral neuropathic pain; journal of orthopedic and sports physical therapy 42(5):413–424.
Jepsen J. R, L. H, Laursen, C. G Hasgert, S. Kreiner, A. ILarsen (2006) Diagnostic accuracy of the neurological upper limb examination 1:inter-rater reproducibility of selected findings and patterns. BMC Neurology 2006, 6:10 doi: 10.1186/1471-2377-6-10.
American Physical Therapy Association; Outcome Measures in Patient Care 2017.
Cheryl H., Abbot J. H, G. D Baxter, Richard A.; Outcome measurement in clinical practice: practical and theoretical issues for health related quality of life (HRQOL) questionnaires 2011. Physical Therapy Reviews Vol. 16 NO. 3 16(3):155-167.
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