Stephanie Stelten, Marieke R Ten Tusscher, Martijn M Stuiver, Yvonne A W Hartman, Luc R C W van Lonkhuijzen, Gemma G Kenter, Marike van der Leeden, Meeke Hoedjes, Laurien M Buffart
{"title":"针对接受化疗的癌症卵巢患者的不良反应和现有合并症,制定运动和饮食干预措施:一项针对专业理疗师和营养师的临床小插曲研究。","authors":"Stephanie Stelten, Marieke R Ten Tusscher, Martijn M Stuiver, Yvonne A W Hartman, Luc R C W van Lonkhuijzen, Gemma G Kenter, Marike van der Leeden, Meeke Hoedjes, Laurien M Buffart","doi":"10.1080/09638288.2023.2265820","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to capture the complex clinical reasoning process during tailoring of exercise and dietary interventions to adverse effects and comorbidities of patients with ovarian cancer receiving chemotherapy.</p><p><strong>Methods: </strong>Clinical vignettes were presented to expert physical therapists (<i>n</i> = 4) and dietitians (<i>n</i> = 3). Using the think aloud method, these experts were asked to verbalize their clinical reasoning on how they would tailor the intervention to adverse effects of ovarian cancer and its treatment and comorbidities. Clinical reasoning steps were categorized in <i>questions</i> raised to obtain additional information; anticipated <i>answers</i>; and <i>actions</i> to be taken. Questions and actions were labeled according to the evidence-based practice model.</p><p><strong>Results: </strong><i>Questions</i> to obtain additional information were frequently related to the patients' capacities, safety or the etiology of health issues. Various hypothetical <i>answers</i> were proposed which led to different actions. Suggested <i>actions</i> by the experts included extensive monitoring of symptoms and parameters, specific adaptations to the exercise protocol and dietary-related patient education.</p><p><strong>Conclusions: </strong>Our study obtained insight into the complex process of clinical reasoning, in which a variety of patient-related variables are used to tailor interventions. This insight can be useful for description and fidelity assessment of interventions and training of healthcare professionals.</p>","PeriodicalId":50575,"journal":{"name":"Disability and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Tailoring of exercise and dietary interventions to adverse effects and existing comorbidities in patients with ovarian cancer receiving chemotherapy: a clinical vignettes study among expert physical therapists and dietitians.\",\"authors\":\"Stephanie Stelten, Marieke R Ten Tusscher, Martijn M Stuiver, Yvonne A W Hartman, Luc R C W van Lonkhuijzen, Gemma G Kenter, Marike van der Leeden, Meeke Hoedjes, Laurien M Buffart\",\"doi\":\"10.1080/09638288.2023.2265820\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study aims to capture the complex clinical reasoning process during tailoring of exercise and dietary interventions to adverse effects and comorbidities of patients with ovarian cancer receiving chemotherapy.</p><p><strong>Methods: </strong>Clinical vignettes were presented to expert physical therapists (<i>n</i> = 4) and dietitians (<i>n</i> = 3). Using the think aloud method, these experts were asked to verbalize their clinical reasoning on how they would tailor the intervention to adverse effects of ovarian cancer and its treatment and comorbidities. Clinical reasoning steps were categorized in <i>questions</i> raised to obtain additional information; anticipated <i>answers</i>; and <i>actions</i> to be taken. Questions and actions were labeled according to the evidence-based practice model.</p><p><strong>Results: </strong><i>Questions</i> to obtain additional information were frequently related to the patients' capacities, safety or the etiology of health issues. Various hypothetical <i>answers</i> were proposed which led to different actions. Suggested <i>actions</i> by the experts included extensive monitoring of symptoms and parameters, specific adaptations to the exercise protocol and dietary-related patient education.</p><p><strong>Conclusions: </strong>Our study obtained insight into the complex process of clinical reasoning, in which a variety of patient-related variables are used to tailor interventions. This insight can be useful for description and fidelity assessment of interventions and training of healthcare professionals.</p>\",\"PeriodicalId\":50575,\"journal\":{\"name\":\"Disability and Rehabilitation\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Disability and Rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/09638288.2023.2265820\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/10/10 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Disability and Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/09638288.2023.2265820","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/10 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
Tailoring of exercise and dietary interventions to adverse effects and existing comorbidities in patients with ovarian cancer receiving chemotherapy: a clinical vignettes study among expert physical therapists and dietitians.
Purpose: This study aims to capture the complex clinical reasoning process during tailoring of exercise and dietary interventions to adverse effects and comorbidities of patients with ovarian cancer receiving chemotherapy.
Methods: Clinical vignettes were presented to expert physical therapists (n = 4) and dietitians (n = 3). Using the think aloud method, these experts were asked to verbalize their clinical reasoning on how they would tailor the intervention to adverse effects of ovarian cancer and its treatment and comorbidities. Clinical reasoning steps were categorized in questions raised to obtain additional information; anticipated answers; and actions to be taken. Questions and actions were labeled according to the evidence-based practice model.
Results: Questions to obtain additional information were frequently related to the patients' capacities, safety or the etiology of health issues. Various hypothetical answers were proposed which led to different actions. Suggested actions by the experts included extensive monitoring of symptoms and parameters, specific adaptations to the exercise protocol and dietary-related patient education.
Conclusions: Our study obtained insight into the complex process of clinical reasoning, in which a variety of patient-related variables are used to tailor interventions. This insight can be useful for description and fidelity assessment of interventions and training of healthcare professionals.
期刊介绍:
Disability and Rehabilitation along with Disability and Rehabilitation: Assistive Technology are international multidisciplinary journals which seek to encourage a better understanding of all aspects of disability and to promote rehabilitation science, practice and policy aspects of the rehabilitation process.