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Dissertation
Individualized student goals in school-based physical therapy practice: goal development, use, and influence on service delivery and outcomes
Doctor of Philosophy (Ph.D.), Drexel University
May 2018
DOI:
https://doi.org/10.17918/h596-5308
Abstract
Student goals that address participation within the context of school activities or routines are aligned with federal legislation and state, local, and professional guidelines, but are not universally utilized in school-based practice. The purpose of this mixed methods study was to understand how school-based physical therapists develop and use student goals, and how goals influence services and outcomes. Methods: Qualitative: Twenty school-based physical therapists participated in one of five semi-structured focus groups. Researchers conducted thematic analysis of written transcriptions of audio recordings to identify qualitative themes. Quantitative: Secondary data analysis from the PT COUNTS study in which school-based physical therapists provided services to 294 students over 20 weeks. Results: Five themes emerged related to therapists' recommendations for goal development: 1) Understand the student, 2) Teaming, 3) Relevant focus of goal, 4) Best practices, and 5) Develop and write the goal. Four themes emerged related to facilitators and barriers to participation-based goal development: 1) Understand the student, 2) Teaming, 3) Focus of goal, and 4) Awareness of best practices in goal development. Four themes emerged related to how goals impact services: 1) The nature of services, 2) Intervention strategies, 3) Teaming, and 4) Flexibility of services. Three themes emerged related to how goals impact outcomes: 1) Natural linkages among goals, services, and outcomes; 2) Goals impact teaming to achieve outcomes; and 3) Specifics of the goal matter. Therapists also reported a range of student and environmental factors that impact services and outcomes. Students with participation-based goals (n = 181) received a significantly greater proportion of services within a school activity than students without a participation-based goal (n = 113). There was no significant difference for the remaining service variables: proportion of services on behalf of the student, proportion of services addressing functional activities, and student and team educational interventions. There was no significant difference for the outcome variables: goal achievement (Goal Attainment Scaling) and school participation (School Function Assessment). Conclusions: This study helps school-based PTs understand and reflect on goal development and how goals influence services and optimize student outcomes. Therapists' comments reflected a striving to follow ideal practice recommendations and identified many facilitators and barriers to development of participation-based goals. Therapists perceive that goals influence services and outcomes in complex ways. Secondary data analysis demonstrates that participation-based goals affect the context of service delivery.
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Details
- Title
- Individualized student goals in school-based physical therapy practice
- Creators
- Kimberly Dianne Ward Wynarczuk - DU
- Contributors
- Lisa A. Chiarello (Advisor) - Drexel University (1970-)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- xv, 247 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- College of Nursing and Health Professions; Drexel University; Physical Therapy (and Rehabilitation Sciences)
- Other Identifier
- 8862; 991014632447204721