Background: Patient adherence to home exercise programs (HEPs) is low, and poor patient self-efficacy is a barrier clinicians can influence. However, little evidence suggests that clinicians assess level of patient self-efficacy before prescribing HEPs.
Purpose: To determine the importance of patient self-efficacy to physical therapists (PTs) when addressing patient barriers, determine how PTs assess and use patient self-efficacy for HEPs, and describe the barriers facing PTs when assessing patient self-efficacy for HEPs.
Study Design: Survey.
Methods: Practicing PTs were recruited from the American Physical Therapy Association's Orthopedic Section and emailed the electronic survey.
Results: Email invitations were sent to 17730 potential participants, and 462 PTs completed the survey over one month. PTs rated self-efficacy as "very" to "extremely" important for patient adherence (58%, 265/454). Most (71%, 328/462) reported assessing self-efficacy before prescribing HEPs and did so through verbal discussion and observation of the patient (50% and 38% respectively). Half of respondents individualized HEPs through self-efficacy related themes. PTs not assessing self-efficacy reported not knowing how (51%, 68/134), being unsure what to do with the information (24%, 32/134), or reporting other barriers (21%, 28/134).
Conclusions: Most PTs indicated that self-efficacy was important for patient adherence, but assessment strategies reported, such as verbal discussion and observation, may not be the most accurate. PTs who did not assess self-efficacy reported not knowing how or what to do with the information once collected. These findings suggest that there is a gap in knowledge related to how to evaluate self-efficacy for HEPs. Better assessment of self-efficacy may lead to more appropriate and effective implementation strategies.
Level of Evidence: Level II.
Digital Object Identifier (DOI)
Picha, Kelsey J.; Valier, Alison Snyder; Heebner, Nicholas R.; Abt, John P.; Usher, Ellen L.; Capilouto, Gilson J.; and Uhl, Timothy L., "Physical Therapists' Assessment of Patient Self-Efficacy for Home Exercise Programs" (2021). Athletic Training and Clinical Nutrition Faculty Publications. 2.
Table 1: Participant characteristics (n = 462)
fig2.jpg (477 kB)
Table 2: Friedman test results of what physical therapists observe to be barriers to patient exercise adherence
figure_3.jpg (1273 kB)
Table 3: Friedman test results of what physical therapists believe the most negatively influential to patient exercise adherence
table-1-participant-characteristics-n-462.html (2 kB)
Table 4: Themes extracted on how physical therapists individualize home exercise programs based on self-efficacy assessment
table-2-friedman-test-results-of-what-physical-therapists-observe-to-be-barriers-to-patient-exercise-adherence.html (3 kB)
Figure 1: Physical therapists perceived importance of self-efficacy
table-3-friedman-test-results-of-what-physical-therapists-believe-the-most-negatively-influential-to-patient-exercise-adherence.html (3 kB)
Figure 2: Methods of self-efficacy assessment used by physical therapists
table-4-themes-extracted-on-how-physical-therapists-individualize-home-exercise-programs-based-on-self-efficacy-assessment.html (3 kB)
Figure 3: Physical therapist’s barriers to self-efficacy assessment