The Association Between Communication Impairments and Strategies and the Receipt of Physical and Occupational Therapy for Long-Term Care Residents With Dementia: A Cross-Sectional Study
Bibliographic record
Abstract
PURPOSE: This study aims to examine the association between communication impairments and strategies with the receipt of physiotherapy (PT) and occupational therapy (OT) in long-term care (LTC) residents with dementia. METHOD: LTC residents with dementia from Ontario, Canada, who were assessed by the Resident Assessment Instrument 2.0 between 2015 and 2019 were included in a cross-sectional analysis of secondary data. Adjusted odds ratios and 95% confidence intervals were obtained from a series of multivariable logistic regressions for each individual communication variable with the PT and OT variables. RESULTS: ) to receive PT if they had impaired hearing (-0.07), had an impaired ability to make oneself understood (-0.17), or had an impaired ability to understand others (-0.21). Conversely, residents with dementia were more likely to receive PT with communication strategies in place, including using a hearing aid (0.19), other receptive communication techniques (e.g., lipreading, physical contact, LTC staff writing messages; 0.10), or other modes of expression (e.g., flash cards and electronic devices; 0.13). In contrast, residents with dementia and impaired ability to be understood (0.26), to understand others (0.40), to speak clearly (0.15), or to use speech (0.15) were more likely to receive OT. CONCLUSIONS: Residents with dementia and communication impairments were less likely to receive PT but were more likely to receive OT. When strategies to aid communication were used, residents with dementia were more likely to receive PT. Our work highlights important communication barriers and potential facilitators that must be analyzed to ensure equitable access to rehabilitation in LTC.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".