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Background and Significance: In patients with chronic joint pain, the therapeutic intervention of physical activity has been reported to be highly effective, yet underutilized. Depression is a common reason for this underutilization and may coexist in up to 48% of patients. By increasing screening for coexistent depression

Background and Significance: In patients with chronic joint pain, the therapeutic intervention of physical activity has been reported to be highly effective, yet underutilized. Depression is a common reason for this underutilization and may coexist in up to 48% of patients. By increasing screening for coexistent depression in patients with chronic joint pain using interprofessional collaboration (IPC), depression can be detected. If managed appropriately patients may interrupt the pain-depression cycle, increase utilization of physical activity and thereby improve outcomes for chronic joint pain sufferers.

Purpose/Aims: The purpose of this project was to increase the rate of depression screening for patients with chronic musculoskeletal disorders in the physical therapy setting.

Methods: The institutional review board at Arizona State University approved this study with exempt status.

Depression screening with a Patient Health Questionnaire (PHQ-9) was completed by adult clients in three outpatient physical therapy clinics in the Midwest and Southwest United States (n=165). Degree of depression and patient response rates were measured and analyzed using descriptive statistics.

Staff were surveyed prior to and post project completion regarding their viewpoints on IPC and depression in this patient population. Staff demographics were analyzed and they were evaluated on their change in perception of the problem and their likelihood of sustainability with a Wilcoxin Signed Ranks Test.

Outcomes: Patient response rate was 91.5% (n=165) exposing a mean PHQ-9 score of 5.01 (mild depression). More notably, patients whom had an existing diagnosis of depression had a mean PHQ-9 score 10.47 (moderate depression) indicating poorly controlled symptoms.

After an educational session to increase knowledge, staff perception of the problem did not significantly change, with a mean score of 2.25 out of 5 predicting “somewhat” likelihood of project sustainability.

Conclusion: Implementing a PHQ-2 rather than PHQ-9 depression screening into patient’s electronic medical records would resolve staff and patient concerns of time consumption while simultaneously improving the rates of depression screening and management in patients with chronic musculoskeletal disorders.
ContributorsMcKiver, Megan (Author)
Created2016-05-02
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Description

Gestational diabetes mellitus (GDM) is a well-established predictor for the development of type II diabetes mellitus (T2DM) later in life. The incidence of GDM has been on the rise over the past 30 years and is the leading co-morbidity during pregnancy (Ferrara, 2007). Physical activity (PA) in combination with nutritional

Gestational diabetes mellitus (GDM) is a well-established predictor for the development of type II diabetes mellitus (T2DM) later in life. The incidence of GDM has been on the rise over the past 30 years and is the leading co-morbidity during pregnancy (Ferrara, 2007). Physical activity (PA) in combination with nutritional therapy has been shown to achieve glycemic control in women with GDM and is therefore first line therapy for management (American College of Obstetrics and Gynecology [ACOG], 2017; Center for Disease Control and Prevent [CDC], 2018).

Recommendations for PA in pregnancy include 150 minutes of moderate intensity exercise most days of the week (ACOG 2015; U.S. Department of Health & Human Services, 2018). Because of this, an innovative project was created to determine the feasibility of adding a walking plan into GDM care. Participants in the project received verbal and written instruction on an unsupervised structured walking plan set up for a beginner to gradually increase PA to the recommended time of 150 minutes per week for a total of four weeks. Eight women were interested, recruited, and enrolled in the project.

Results show that overall, participant PA increased. One hundred percent agreed that the walking plan was useful and increased their awareness about PA. The addition of a walking plan in GDM teaching is an effective strategy to lower serum blood glucose (SBG) levels and for meeting PA recommendations during pregnancy.

ContributorsWhitney, Brittney (Author) / Santerre, Jennifer (Author, Thesis advisor)
Created2019-04-29
Description

Purpose: The purpose of this project was to implement health promotion education for overweight and obese adults with endocrine disorders. The overarching goal was to change dietary intake and improve exercise to reduce the incidence, prevalence, and impact of comorbidities associated with obesity.

Background/Synthesis: Obesity is a significant epidemic facing the

Purpose: The purpose of this project was to implement health promotion education for overweight and obese adults with endocrine disorders. The overarching goal was to change dietary intake and improve exercise to reduce the incidence, prevalence, and impact of comorbidities associated with obesity.

Background/Synthesis: Obesity is a significant epidemic facing the nation today with multiple impacts on the national healthcare system. There is often an association between obesity and endocrine disorders such as type 2 diabetes and prediabetes. Both obesity and diabetes cost the nation billions of dollars annually in healthcare costs. Evidence shows that lifestyle modifications related to nutrition and physical activity are effective in weight reduction and prevention of chronic disease, especially when given by a healthcare provider.

Methods: Fifteen adult patients at an endocrinology office in Arizona received individual counseling using the teach-back method focusing on health promotion behaviors through nutrition and exercise with a two-week follow-up phone call. Short-term outcomes measured in this project included changes in dietary intake and exercise behaviors through a pre- and post-test adapted from an obesity-screening tool developed by Greenwood et al. (2008).

Outcomes/Results: Participants were primarily Caucasian and Hispanic, married, female, average age of 50 years, average BMI of 34.5, and some college education. There was a statistically significant increase in health promoting behavior on posttest scores (M=66, SD=6.23, range=58-76) compared to pretest scores (M=61, SD=4.72, range=50-66), t(14)=-2.55, p=0.023.

Conclusions and Implications: Overall, patient health promotion behaviors increased with this educational intervention. Clinical implications include a potential decrease in patient comorbidities related to overweight and obesity. Implications for the greater healthcare system include decreased comorbidities, utilization of healthcare resources, and costs associated with overweight and obesity. Future recommendations would include determining weight and BMI changes over a longer period of time for even better outcome measures.

Keywords: obesity, obese, overweight, health promotion, health education, diet, exercise, nutrition

ContributorsDeVeau, Kristina (Author) / Velasquez, Donna (Thesis advisor)
Created2016-05-06
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Description
Purpose: To assess study participants behavioral responses and perception of effectiveness of an activity tracking device to increase physical activity. Obesity is an endemic health issue in the U.S. and continues to gain concern for increasing morbidity and mortality rates. Benefits of physical activity are firmly established across healthcare disciplines

Purpose: To assess study participants behavioral responses and perception of effectiveness of an activity tracking device to increase physical activity. Obesity is an endemic health issue in the U.S. and continues to gain concern for increasing morbidity and mortality rates. Benefits of physical activity are firmly established across healthcare disciplines to combat and prevent obesity, yet sedentary behaviors continue to be on the rise. The use of wearable technology, that provides real-time feedback of activity, has been identified as a promising tool for increasing physical activity.

Methods: Analysis of a subset of questions from a larger survey was used to evaluate wearable device attitudes and behavior changes over time. Convenience sample (n=10), ages >18, required enrollment in a clinic-based weight and wellness program (WWP) to participate. The survey questions assessed effectiveness of wearable device on a 0-10 motivation scale to increase physical activity and a self- assessment of behavioral changes at specific intervals over a 6-month period. Descriptive statistics and non-parametric, two-tailed tests will be used to analyze the data. Due to the necessity of detecting minute differences with the small sample size, the significance level will be tested at the p<0.10.

Results: Participants >18 years of age, enrolled in a WWP (n=10) included 20% male and 80% female. Although a 12.3% increase in the mean score was found from week-1 to 6-months, the results were not statistically conclusive to the effectiveness of self-motivation to increase activity by participants wearing an activity tracking device; however, results are statistically significant for participants to increase activity with behavior changes based on device dashboard.

Conclusions: It is recommended for primary care providers to encourage the use of an activity tracking wearable device for behavior change to increase activity.
ContributorsCarroccio, Tanya (Author) / Nunez, Diane (Thesis advisor)
Created2018-04-28