From Data to Dialogue. Towards Implementation of Patient-Reported Outcome Measures and Shared Decision-Making in Pediatric Physical Therapy

This thesis focuses on the integration of patient-reported outcome measures (PROMs) and shared decision-making (SDM) in pediatric physical therapy. The first part of this thesis examines which patient-reported outcomes (PROs) and PROMs are used in pediatric physical therapy. The findings show substantial heterogeneity in the outcomes and instruments used, limiting comparability across studies and implementation in practice. To address this, a generic core set of PROs and PROMs was developed for children in pediatric physical therapy. The second part explores how SDM can be applied in primary care pediatric physical therapy. A goal-based SDM model was adapted to this setting, explicitly incorporating the roles of children and parents or caregivers. The third part describes the adaptation of the KLIK PROM portal for pediatric physical therapy. This tailored portal supports structured PROM administration, feedback and visualization of PROM results, helping children, parents and pediatric physical therapists discuss relevant health domains, set goals and evaluate treatment progress. The fourth part evaluates the implementation of PROMs and SDM through KLIK Physiotherapy in daily practice. The findings show that implementation is influenced by factors at the individual, organizational and system levels, and requires iterative and adaptive strategies. Overall, this thesis provides a foundation for the implementation of PROM-informed shared decision-making in pediatric physical therapy. Show more