Few Answers Predict Patient's Behaviour

Photo: A woman's back

After spine surgery, physical
therapy is necessary to regain a
strong back; © SXC

The findings could help physicians identify patients who might benefit from additional preoperative preparation to ensure they attend therapy sessions and follow through with prescribed exercise, a factor that can greatly affect their long-term recovery.

In the study, the researchers demonstrated that spine surgery patients who scored high on the Patient Activation Measure (PAM) questionnaire were 38 percent more likely to attend physical therapy and were rated as significantly more engaged in rehabilitation by their physical therapists compared to patients with low PAM scores.

The PAM, developed in 2004, is a participant-completed, 13-item questionnaire that assesses a patient's ability to play an active role in his or her health care. It has been studied before for use with chronic diseases such as HIV and hypertension. The questionnaire asks patients to rate their agreement to a variety of statements, ranging from strongly agree to strongly disagree. Examples of statements include: when all is said and done, I am the person who is responsible for managing my health condition; or: taking an active role in my own health care is the most important factor in determining my health and ability to function.

65 patients took part in the study. All underwent their first surgical treatment for a degenerative spine disease between August 2005 and May 2006. 89 percent were non-Hispanic white and 58 percent were female. The mean age was 58 years old. Before the surgery, each patient completed a PAM questionnaire. Then, for the next six weeks after surgery, patients recorded how often they attended prescribed physical therapy sessions. After the last therapy session, therapists scored the patients' engagement in physical therapy by rating their attitude, need for prompts, understanding the importance of therapy, and activity during sessions.

Results showed that attendance rose in direct correlation to PAM scores. Patients who had the lowest PAM scores attended 55.6 percent of their therapy sessions. In contrast, those with the highest PAM scores attended physical therapy 94.1 percent of the time. Similarly, engagement scale scores also went up as PAM scores increased.

MEDICA.de; Source: Johns Hopkins Medical Institutions