Missed Physical Therapy Treatments in the Acute Hospital: Toward a More Complete Understanding

Abstract

Introduction: Therapy sessions that do not result in treatment (nontreatment) occur in 15% to 26% of scheduled sessions. The relationship between therapist personality and nontreatment is unknown. Objective: To determine the relationship between physical therapist personality and nontreatment events in the acute hospital. Methods: The relationship between physical therapist personality (Big Five Inventory) and nontreatment was statistically modeled adjusting for other therapist and patient factors. Results: There were 522 patients and 34 physical therapists with 918 scheduled physical therapy sessions included. The average age of patients was 71 (SD = 16, range = 17-99) and 41 (SD = 7, range 27-54) for therapists. Therapists with higher openness had lower nontreatment, odds ratio 0.93; 95% confidence interval 0.87 to 0.99; P = .045. Conclusions: The positive effect of physical therapy is minimized when scheduled treatment does not occur. Lower nontreatment is associated with more trait openness. Attributes related to openness (eg, inquisitiveness and problem-solving) should be cultivated. More research is needed to understand nontreatment and guide therapists in hospital patient care.

Public Perceptions of Mobility and Exercise in the Hospital and Intensive Care Unit

“…13 Patient refusal is a component of patient-related barriers within existing literature and has been linked to as many as 15% to 26% of physical therapy nontreatment events. [9][10][11] Shan and colleagues 20 reported that patient refusal was the most common reason for nontreatment in hospitalized patients. However, to the authors' knowledge, no studies have been performed to evaluate patient reasoning for refusal in relation to knowledge and understanding of physical therapy, exercise, and mobility for patients in acute care hospitals.…”