Comparing physical therapist clinical specialists to experienced nonspecialists on physical activity education for patients with heart failure: A modified retrospective cohort study

Abstract

Background and aims: The purpose of this study was to compare the knowledge and practices of specialist and experienced nonspecialist physical therapists in performing patient education about physical activity with patients with heart failure (HF).

Methods: Responses on a nationwide anonymous online survey were used to compare specialist and experienced nonspecialist physical therapists on knowledge and frequency of providing physical activity related education to patients hospitalized with acutely decompensated HF. Responses to survey items were scored on 5-point scales ranging from "Strongly agree" to "Strongly disagree" or "Always" to "Never." Mann-Whitney U statistics were used to compare specialist and experienced nonspecialist responses and Wilcoxon signed-ranks tests were used to examine the gap between knowledge and practice.

Results: Twenty-seven specialists and 43 experienced nonspecialists completed the survey. Both groups were similar in age, and experience treating patients hospitalized with acutely decompensated HF. Both groups "strongly agree" that they had the required knowledge and skills to educate patients with HF on the physical activity topics. However, specialists more often than experienced nonspecialists provided education on topics such as how to monitor vital signs during physical activity ("most of the time" vs. "about half of the time") that promoted patient confidence and safety during exercise. Specialists demonstrated a smaller gap between knowledge and frequency of providing patient education than experienced nonspecialists on three of the four patient education topics.

Conclusion: Specialist physical therapists treating patients with HF in the inpatient hospital setting provided patient education on physical activity at a level more closely matching their skills and the clinical practice guideline than did experienced nonspecialists. Physical therapy clinical specialists practicing in the inpatient hospital setting may improve patient outcomes and lower costs to the health care system by improving physical activity adherence and thereby may reduce avoidable hospital readmissions.

Keywords: heart failure; patient education; physical activity; specialization.

Figure 1

Derivation of the study cohort.