{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T14:43:56Z","timestamp":1792680236630,"version":"4.5.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"ABSTRACT<\/jats:title>\n \n Importance<\/jats:title>\n Physical therapists routinely make discharge recommendations for patients in the hospital, yet the reasoning that drives these decisions is poorly characterized.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The objective was to describe contemporary acute care physical therapists\u2019 discharge reasoning and examine associations between reasoning constructs and recommended discharge intensity.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n This study used a cross-sectional clinical vignette-based survey. Therapists provided a discharge recommendation and supporting rationale. Free-text rationales were analyzed using directed content analysis, and quantitative associations between coded reasoning constructs and discharge recommendation intensity were examined using regression modeling.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n The survey was conducted electronically with United States physical therapists practicing in hospitals.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Participants were eighty-nine acute care physical therapists who completed discharge recommendations and free-text rationales for 10 vignettes.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n none<\/jats:p>\n <\/jats:sec>\n \n Main outcomes<\/jats:title>\n The three main outcomes for this study included: (1) Frequency and co-occurrence of coded reasoning constructs; (2) therapist-level reasoning profiles; and (3) associations between constructs and discharge intensity.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Across 1604 construct code applications, 3 constructs dominated discharge reasoning: therapist prior experience (29.6%), patient functioning and disability (26.3%), and patient life context (25.3%). The majority (69.7%) of therapists demonstrated mixed reasoning patterns while less than one-third demonstrated a dominant reasoning profile. Patient functioning and disability was the only construct statistically associated with recommending more intensive post-acute care in ordered (OR = 1.70; 95% CI = 1.22\u20132.39) and binary (OR = 2.21; 95% CI = 1.30\u20133.74) models.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Acute care discharge reasoning concentrates on functional status, professional experience, and patient life context, with other domains functioning mainly as situational amplifiers.<\/jats:p>\n <\/jats:sec>\n \n Relevance<\/jats:title>\n A refined framework for discharge reasoning may support clearer interdisciplinary communication, inform targeted education, and guide efforts to optimize post-acute care utilization.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ptj\/pzag114","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T11:44:38Z","timestamp":1792583078000},"source":"Crossref","is-referenced-by-count":0,"title":["Discharge Decision Making and the Contemporary Weighting of Clinical and Contextual Factors: A Survey of Acute Care Physical Therapists"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0019-1471","authenticated-orcid":false,"suffix":"Jr","given":"James P","family":"Crick","sequence":"first","affiliation":[{"name":"Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University , Columbus, OH ,","place":["United States"]},{"name":"Learning Health Systems Collaborative, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University Wexner Medical Center , Columbus, OH ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9883-5724","authenticated-orcid":false,"given":"Thomas Gus","family":"Almonroeder","sequence":"additional","affiliation":[{"name":"Doctor of Physical Therapy Program, Brooks College of Health Professions, Trine University , Fort Wayne, IN ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tricia","family":"Widenhoefer","sequence":"additional","affiliation":[{"name":"Doctor of Physical Therapy Program, Brooks College of Health Professions, Trine University , Fort Wayne, IN ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,22]]},"container-title":["Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ptj\/advance-article-pdf\/doi\/10.1093\/ptj\/pzag114\/72358144\/pzag114.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ptj\/advance-article-pdf\/doi\/10.1093\/ptj\/pzag114\/72358144\/pzag114.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T14:16:35Z","timestamp":1792678595000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ptj\/advance-article\/doi\/10.1093\/ptj\/pzag114\/8979317"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,22]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/ptj\/pzag114","relation":{},"ISSN":["0031-9023","1538-6724"],"issn-type":[{"value":"0031-9023","type":"print"},{"value":"1538-6724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,22]]},"article-number":"pzag114"}}