Research Article| Volume 35, ISSUE 2, P233-244, April 2022

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Pediatric hand therapists’ experiences with outcomes measurement: An interpretive descriptive study

Published:April 10, 2022DOI:


      • A gold standard patient reported outcome measure (PROM) for pediatric hand therapy practice is lacking.
      • While barriers to PROM utilization exist, pediatric hand therapists attribute value to using PROMs.
      • Design characteristics for a PROM applicable to a pediatric hand therapy population are elucidated.



      Demonstrating that pediatric hand therapy patients are achieving improved functional and health status outcomes is critical as reimbursement for therapy services shifts to value-based reimbursement. Yet, practice patterns of outcomes assessment in pediatric hand therapy are unknown.


      Explore how pediatric hand therapists describe their experience measuring treatment outcomes and using patient reported outcome measures (PROMs). Secondarily, to elucidate what therapists perceive children and adolescents receiving hand therapy desire as treatment outcomes.

      Study Design

      Interpretive descriptive qualitative study


      Pediatric hand therapists were recruited through an email invitation sent to members of the Pediatric Hand Study Group to participate in one-on-one interviews over a teleconference link. Interviews were transcribed verbatim and coded to derive themes. Data collection and analysis were iterative.


      Ten therapists with a median 13 years (range, 2-25 years) of experience practicing in pediatric hand therapy completed interviews. Overall, participants reported using 52 unique outcomes measures, including 20 PROMs. The following themes were elucidated: (1) Complexity and variability in pediatric hand therapy practice and outcomes assessment; (2) Barriers to PROM use; (3) Value of PROM utilization; (4) Desired characteristics of an optimal PROM for pediatric hand therapy.


      Practice with outcomes assessment is variable. PROM utilization in pediatric hand therapy practice may be improved with the development of a PROM that is aligned with the pediatric population's outcomes priorities.


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      JHT Read for Credit

      Quiz: # 854

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • # 1.
        The study design is
        • a.
          prospective cohort
        • b.
        • c.
        • d.
          case series
      • # 2.
        Interviews were conducted with
        • a.
          pediatric hand therapists
        • b.
          pediatric patients
        • c.
          the parents of pediatric patients
        • d.
          social workers of pediatric patients
      • # 3.
        Of the 10 interviewees
        • a.
          2 were uncooperative during their interviews
        • b.
          none of the 10 worked in clinics requiring the use of PROMs
        • c.
          all 10 worked in clinics requiring the use of PROMs
        • d.
          4 worked in clinics requiring the use of PROMs
      • # 4.
        A commonly cited barrier to PROM utilization was
        • a.
          institutional standards of care
        • b.
          pressure from colleagues
        • c.
          time constraints
        • d.
          resistance by management
      • # 5.
        A better more responsive PROM for the younger patient population is envisioned by the authors
        • a.
        • b.
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.