Early mobilization of patients while in hospital has been demonstrated to provide better outcomes for patients, and use less resources. Physiotherapy-based rehabilitation is central to achieving those goals. Successful rehabilitation requires that patient and therapist goals align, and this is commonly the case. However, occasionally physical therapists will come across competent patients who are reluctant to mobilize. This leaves the physical therapist in an ethical quandary; either accept the patient's right to refuse proposed treatment, or, utilize other strategies to encourage the patient to comply. Practically, physical therapists will employ a range of treatment pressures, including persuasion, offering incentives, inducements, and possibly threatening or coercing, and even explicitly overriding the patient's wishes (compulsion). Deciding which treatment pressure is ethically acceptable involves the physical therapist balancing their therapeutic view of what is in a patient's best interests against their ethical responsibility to respect patient autonomy. This paper evaluates some common strategies used by physical therapists to influence, persuade or perhaps pressure patients to adhere to rehabilitation. We utilize the work of Szmukler and Appelbaum in analyzing treatment pressures. We conclude that there is a spectrum of treatment pressures with some (persuasion and incentives) being more acceptable than others (threats and compulsion). As physical therapists balance health system pressures for rapid turnover of beds with obligations to benefit patients within limited reimbursement models, and respect their autonomy, they must be mindful of the effects of treatment pressure on patient care.
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 October 2021.
All research outputs
#15,170,530
of 25,377,790 outputs
Outputs from Physical Therapy
#1,939
of 2,760 outputs
Outputs of similar age
#155,570
of 312,898 outputs
Outputs of similar age from Physical Therapy
#22
of 39 outputs
Altmetric has tracked 25,377,790 research outputs across all sources so far. This one is in the 38th percentile – i.e., 38% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,760 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.5. This one is in the 27th percentile – i.e., 27% of its peers scored the same or lower than it.
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We're also able to compare this research output to 39 others from the same source and published within six weeks on either side of this one. This one is in the 38th percentile – i.e., 38% of its contemporaries scored the same or lower than it.
