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1.
PLoS One ; 16(5): e0251843, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34019557

RESUMO

Studies on physiotherapists are generally focused on clinical professionalism, with very few examining job performance from a management standpoint. To address this gap, this study sought to investigate the relationship between impression management and organizational citizenship behavior and job performance. This study targeted medical institutions offering rehabilitation and physiotherapy services and conducted a questionnaire survey based on scales developed by domestic and foreign scholars. A total of 600 questionnaires were distributed and 523 valid ones collected. The data was tested and verified using regression analysis and hierarchical linear modeling (HLM). In the survey, the Impression Management Scale, Organizational Citizenship Behavior Scale, and Job Performance Scale indicated that at the individual level, the impression management of physiotherapists is significantly related to their organizational citizenship behaviors and job performance. The organizational citizenship behaviors were also found to have a mediating effect between impression management and job performance. At the group level, impression management had a conditioning effect on organizational citizenship behaviors and job performance. In terms of statistical methods, group-level variables act as moderators, which affects the power of individual-level explanatory variables on outcome variables, i.e., the influence of the slope. The job behaviors of physiotherapists entail direct service and their performance is closely related to organizational development. Impression management gives people certain purposes and behaviors while organizational citizenship behaviors are a type of non-self-seeking, selfless dedication behaviors. Therefore, the motivation of physiotherapists who demonstrate organizational citizenship behaviors should be further explored.


Assuntos
Atitude do Pessoal de Saúde , Cultura Organizacional , Fisioterapeutas/psicologia , Desempenho Profissional/estatística & dados numéricos , Adulto , Altruísmo , Feminino , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Motivação , Lealdade ao Trabalho , Conformidade Social , Inquéritos e Questionários , Taiwan , Desempenho Profissional/ética
2.
NeuroRehabilitation ; 48(4): 505-512, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33967067

RESUMO

BACKGROUND: Independent mobility is the most important determinant of quality of life after stroke and it is vital that training aimed at restoration of gait is based on contemporary evidence. Despite several practice guidelines for gait rehabilitation after stroke existing globally, their feasibility of application in low-resource settings is often questionable. OBJECTIVE: To investigate the current practices in gait training among Indian physiotherapists involved in the rehabilitation of stroke survivors. METHODS: A questionnaire on the various aspects of gait training was developed and the content was validated by experts. The survey was made available online and distributed among Indian physiotherapists working in the field of stroke rehabilitation, using snowball sampling. Frequency distribution was used to summarize responses to each component of the questionnaire. RESULTS: Responses were obtained from 250 practicing physiotherapists. The majority of the respondents (55%) reported that they initiate gait training within seven days after stroke. Gait training sessions ranged from 15-30 minutes (55%), once every day (44%), and the majority (89%) reported use of subjective outcome measures to evaluate gait. Although most respondents agreed on the use of assistive aids, 24% indicated that their use may deter gait, rather than improve it. Nearly 86% of the respondents reported that they do not follow standard guidelines pertaining to gait rehabilitation for stroke survivors. CONCLUSION: The findings of the study point toward a lack of evidence-based practice among Indian physiotherapists while training gait after stroke. This implied the urgent need for development and implementation of country specific guidelines for stroke rehabilitation.


Assuntos
Atitude do Pessoal de Saúde , Custos e Análise de Custo , Prática Clínica Baseada em Evidências/métodos , Terapia por Exercício/métodos , Marcha , Reabilitação do Acidente Vascular Cerebral/métodos , Prática Clínica Baseada em Evidências/economia , Terapia por Exercício/economia , Humanos , Índia , Fisioterapeutas/psicologia , Qualidade de Vida , Reabilitação do Acidente Vascular Cerebral/economia , Inquéritos e Questionários
3.
PLoS One ; 16(4): e0249279, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33886555

RESUMO

BACKGROUND AND PURPOSE: With the availability and development of disease-modifying therapies for individuals with spinal muscular atrophy (SMA), new emerging phenotypes must be characterized, and potential new treatment paradigms tested. There is an urgent demand to develop an educational program that provides physical therapists (PTs) worldwide the necessary knowledge and training to contribute to best-practice care and clinical research. A competency based education framework is one that would focus on outcomes not process and where progression of learners would occur only after competencies are demonstrated. The first step toward such a framework is defining outcomes. The purpose of this Delphi study was to develop consensus on those competencies deemed essential within the SMA PT community. METHODS: Purposive selection and snowball sampling techniques were used to recruit expert SMA PTs. Three web-based survey rounds were used to achieve consensus, defined as agreement among >80% of respondents. The first round gathered demographic information on participants as well as information on clarity and redundancy on a list of competencies; the second round, collected the same information on the revised list and whether or not participants agreed if the identified domains captured the essence of a SMA PT as well as the definitions for each; and the third asked participants to rank their agreement with each competency. RESULTS: Consensus revealed 35 competencies, organized under 6 domains, which were deemed essential for a PT working with persons with SMA. DISCUSSION: In order to develop a curriculum to meet the physical therapy needs of persons with SMA, it is imperative to establish defined outcomes and to achieve consensus on those outcomes within the SMA community. CONCLUSIONS: This study identified essential competencies that will help to provide guidance in development of a formal education program to meet these defined outcomes. This can foster best-practice care and clinical decision-making for all PTs involved in the care of persons with SMA in a clinical and research setting.


Assuntos
Competência Clínica , Atrofia Muscular Espinal/terapia , Fisioterapeutas/psicologia , Adolescente , Adulto , Criança , Pré-Escolar , Técnica Delfos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Atrofia Muscular Espinal/patologia , Fisioterapeutas/educação , Inquéritos e Questionários , Adulto Jovem
4.
J Marital Fam Ther ; 47(2): 244-258, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33774847

RESUMO

Fifty-five clinicians who provided teletherapy to couples, partnerships, families, and kin networks during the first two months of the coronavirus pandemic responded to a survey about their most and least meaningful experiences. Reflexive thematic analysis indicated that the participants experienced adjustments to their schedule or routines, they used technology glitches to promote client growth, and they altered how they engaged clients. Participants noted shifts in their personal and relational dynamics. They reported feeling fatigued and resilient. Participants described their adaptability, gratitude, digital and relational connectivity, and an ability to reframe negative experiences into opportunities for growth.


Assuntos
Atitude do Pessoal de Saúde , Terapia de Casal/organização & administração , Terapia Familiar/organização & administração , Fisioterapeutas/psicologia , Consulta Remota/organização & administração , Telerreabilitação/organização & administração , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Fisioterapeutas/estatística & dados numéricos , Inquéritos e Questionários , Telemedicina/estatística & dados numéricos
5.
J Marital Fam Ther ; 47(2): 289-303, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33751596

RESUMO

The COVID-19 pandemic has transformed healthcare for both clinicians and patients. This conceptual article uses ideas from the moral distress literature to understand the challenges MedFTs and physicians face during the COVID-19 pandemic. The authors highlight earlier themes from the moral distress literature and share current reflections to illustrate similar challenges. Some clinicians who were already experiencing a rise in burnout due to the mass digitization of healthcare are now facing increased moral distress due to ethical dilemmas, pervasive uncertainty, boundary ambiguity, isolation, and burnout brought about by emerging COVID-19 policies. Fears about personal safety, exposing loved ones, financial concerns, self-doubt, and frustrations with telehealth have contributed to increased moral distress during the COVID-19 pandemic. Building resilience by setting one's personal moral compass can help clinicians avoid the pitfalls of moral distress. Five steps for developing resilience and implications for guiding trainees in developing resilience are discussed.


Assuntos
Esgotamento Profissional/psicologia , Terapia de Casal/organização & administração , Terapia Familiar/organização & administração , Fisioterapeutas/psicologia , Consulta Remota/organização & administração , Resiliência Psicológica , Atitude do Pessoal de Saúde , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Fisioterapeutas/estatística & dados numéricos , Inquéritos e Questionários
6.
J Marital Fam Ther ; 47(2): 304-319, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33721348

RESUMO

The novel Coronavirus pandemic (COVID-19) and subsequent social distancing practices have altered the way we move through the world and access physical and mental healthcare. While researchers and clinicians have begun to explore the impact of telehealth delivery on psychotherapy and treatment outcomes, the purpose of this study was to explore the lived experiences of individuals in teletherapy, specifically those engaging in teletherapy with a romantic partner or family member. Using a thematic analysis of open-ended online survey questions, we explored the experiences of 25 individuals who engaged in couple or family teletherapy after social distancing began. The resulting themes included "making do," safe therapeutic space, convenience, logistical challenges, and therapist accommodation. We discuss the clinical implications of these themes to support effective couple and family teletherapy and offer suggestions and considerations for remote clinical interventions and practices. [Correction added on 22 March 2021, after first online publication: The term '19' has been changed to '(COVID-19)' in the first line of the Abstract section, in this version.].


Assuntos
Terapia de Casal/métodos , Terapia Familiar/métodos , Satisfação do Paciente/estatística & dados numéricos , Fisioterapeutas/estatística & dados numéricos , Relações Profissional-Paciente , Telemedicina/estatística & dados numéricos , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Fisioterapeutas/psicologia , Inquéritos e Questionários
7.
J Marital Fam Ther ; 47(2): 225-243, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33742712

RESUMO

The unprecedented times of the novel Coronavirus quarantine and subsequent stay-at-home orders have changed the way many couple therapists provide clinical services. Understanding couple therapists' experiences with teletherapy is important for optimizing future telehealth delivery with couples. Thus, the purpose of this mixed methods survey study was to explore couple therapists' experiences of transitioning from in-person/traditional therapy to online/telehealth delivery. A total of 58 couple therapists completed an online survey for this study. Reported are both quantitative and qualitative findings. Overall, this study found that couple therapists experienced a positive shift from traditional/in-person therapy to online/telehealth therapy, with a majority of couple therapists (74%) reporting they would continue providing teletherapy after the novel Coronavirus pandemic and social distancing regulations had ended. Thematic analysis was used to identify themes from couple therapists' experiences related to advantages, challenges, and recommendations for practice. Implications for clinical training and future research are discussed.


Assuntos
Terapia de Casal/organização & administração , Terapia Familiar/organização & administração , Fisioterapeutas/estatística & dados numéricos , Consulta Remota/organização & administração , Telerreabilitação/organização & administração , Atitude do Pessoal de Saúde , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Fisioterapeutas/psicologia , Inquéritos e Questionários , Telemedicina/estatística & dados numéricos
8.
Phys Ther ; 101(6)2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33693829

RESUMO

OBJECTIVE: The purpose of this study was to investigate the physical therapy process of care, clinical practices, and the self-reported psychosocial impact of working during the 2020 pandemic on physical therapists and physical therapist assistants. METHODS: An electronic survey including closed and open-ended questions was distributed to physical therapists employed in a range of health care settings across the United States. RESULTS: Physical therapy use and process of care varied across settings. Feasibility of performing an assessment was the main driver for selection of outcome measures. Interventions were mainly geared toward improving respiratory function and deconditioning. Prone patient positioning, now commonplace, was used infrequently by therapists in acute care prior to coronavirus disease 2019 (COVID-19). Similarly, outpatient and home care settings noted an increase in the use of respiratory-driven interventions such as incentive spirometry and breathing exercises. Qualitative data analysis revealed both physical barriers (personal protective equipment [PPE]) and social barriers to care. Therapists noted challenges in discharge planning and patient/family education due to the impact of social isolation. They also noted difficulty maintaining productivity standards because of additional time spent in changing PPE and following safety measures. Participants dealt with rapid changes in their role, changing productivity standards, and needing to increase their knowledge in a short amount of time. CONCLUSION: Physical therapy use varied widely across settings. Despite some concern for personal health, respondents felt that the COVID-19 pandemic increased a sense of togetherness among team members and promoted greater appreciation for life and work. IMPACT: This exploration of the process of care and current clinical practices across settings provides important knowledge about the role of physical therapists and physical therapist assistants in the care of patients with COVID-19. Gaining an understanding of the psychosocial impact of the pandemic among therapists could assist in creating solutions to better support clinicians' well-being.


Assuntos
COVID-19/terapia , Fisioterapeutas/psicologia , Modalidades de Fisioterapia , Pneumonia Viral/terapia , Adulto , COVID-19/epidemiologia , Cuidados Críticos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , SARS-CoV-2 , Inquéritos e Questionários , Estados Unidos/epidemiologia
10.
J Marital Fam Ther ; 47(2): 359-374, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33600613

RESUMO

During the coronavirus pandemic, many behavioral health professionals providing psychotherapeutic services, including couple/marriage and family therapists (C/MFTs), quickly changed from providing in-person services to telebehavioral health (TBH) services, with specific reliance on teleconferencing. Many therapists were thrust into telehealth with minimal or no prior telebehavioral health experience, education, or training. Although TBH services have been shown to be effective and efficient with mental health and substance abuse problems, the teaching and learning of telebehavioral competencies have generally not been included in the formal education and training received by C/MFTs. This article presents an existing interprofessional telebehavioral health competencies framework not before published in C/MFT journals. This article will also demonstrate how those competencies are applicable to the education, training, and practice of telebehavioral health by C/MFTs. Implications for educational, service, and regulatory organizations are presented.


Assuntos
Competência Clínica , Terapia de Casal/organização & administração , Terapia Familiar/organização & administração , Fisioterapeutas/estatística & dados numéricos , Consulta Remota/organização & administração , Telerreabilitação/organização & administração , Atitude do Pessoal de Saúde , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Fisioterapeutas/psicologia , Telemedicina/estatística & dados numéricos
11.
Phys Ther ; 101(4)2021 04 04.
Artigo em Inglês | MEDLINE | ID: mdl-33517462

RESUMO

OBJECTIVE: Knowledge of the experiences of health care professionals who have actively worked on the first line of the COVID-19 pandemic could help to identify specific professional duties focused on health assistance objectives. No qualitative study has yet been published, to our knowledge, describing the experience of physical therapists during the COVID-19 pandemic. The purpose of this study was to describe and explore the experiences and perspectives of physical therapists working in public hospitals in Madrid, Spain, during the COVID-19 pandemic. METHODS: A qualitative exploratory study was conducted based on an interpretive framework. Thirty physical therapists working at 11 national public hospitals during the COVID-19 outbreak were recruited by purposeful sampling and snowball techniques. In-depth interviews and researchers' field notes were used to collect data. Interviews were transcribed verbatim. Inductive thematic analysis was used to identify emerging themes. RESULTS: After identifying 3912 codes and 13 categories, 3 themes emerged. The first theme was "call of duty"; as COVID-19 infection dramatically spread, the hospitals were contaminated and overwhelmed, and all floors were converted into COVID-19 wards. The second theme was "working in war time." Every day, therapists were given "the war report," receiving their orders, meeting protective personal equipment requirements, and confronting fear. The third theme was "when I arrive at home." Working during the pandemic had an impact on the therapists' families and the information shared with them. CONCLUSIONS: Physical therapists described the COVID-19 outbreak as an apocalyptic and unexpected war. Comprehensive support is needed for all frontline health care professionals. The COVID-19 outbreak revealed that health care systems were not prepared for a pandemic. IMPACT: To our knowledge, this is the first qualitative study to be published describing the experience of physical therapists during the COVID-19 pandemic.


Assuntos
COVID-19/epidemiologia , Hospitais Públicos/normas , Fisioterapeutas/psicologia , Adulto , Feminino , Hospitais Públicos/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Masculino , Equipamento de Proteção Individual/provisão & distribuição , Pesquisa Qualitativa , Espanha
12.
Work ; 68(2): 285-295, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33492259

RESUMO

BACKGROUND: Occupational burnout, which is more and more commonly encountered among medical professionals and investigated by researchers worldwide, may in particular affect health care workers during the COVID-19 pandemic. OBJECTIVES: The aim of the study was to assess the risk of occupational burnout among physiotherapists working actively in clinical hospitals in south-eastern Poland during the COVID-19 pandemic. METHODS: The level of burnout among the studied physiotherapists was assessed using the Polish version of the Maslach Burnout Inventory by Maslach (MBI). The study was conducted from 20 March to 3 May, 2020 among physiotherapists working professionally during the COVID-19 pandemic in the south east of Poland, during which time health services related to therapeutic rehabilitation were suspended. The study was conducted among 1,540 physiotherapists with a license to practice who worked in clinical departments. Considering the inclusion and exclusion criteria, 106 physiotherapists were qualified for the study. RESULTS: The current findings show that during the COVID-19 pandemic physiotherapists present high burnout rates in all three dimensions: EE (Mean 32.31; CI 29.47-35.15); DP (Mean 16.25; CI 14.48-18.03); PA (Mean 26.25; CI 24.41-28.10). As for gender-related effects, higher burnout rates were observed in the male workers, compared to the females, in all three domains: EE (Men: Mean 34.70; CI 29.90-39.50 -Women: Mean 31.03; CI 27.45-34.60); DP (Men: Mean 18.78; CI 15.98-21.59 -Women: Mean 14.90; CI 12.64-17.16) and PA (Men: Mean 24.54; CI 21.32-27.76 -Women: Mean 27.17; CI 24.90-29.44). The highest burnout rates, presented by the physiotherapists working in the profession for more than 20 years, were identified in the domain of EE (Mean: 35.30; CI 30.51-40.10) and in those with 10-15 years of experience, in the domains of DP (Mean: 18.31; CI 14.89-21.73) and PA (Mean: 23.97; CI 20.13-27.81). The highest rate of occupational burnout, reflected by the scores in all three domains (EE, DP, PA), was identified in Department I -Intensive Care and Anaesthesiology Department: EE - (Mean: 40.89, CI 35.27-46.52); DP - (Mean: 21.39, CI 17.90-24.88); and PA - (Mean: 23.07, CI 20.04-26.10), compared to the other departments. The subjects who rarely participated in courses or training programs showed the highest burnout rates (EE- Mean: 33.55, CI 29.33-37.77; DP- Mean: 16.71, CI 13.99-19.43; PA- Mean: 25.45, CI 22.47-28.43). CONCLUSIONS: Occupational burnout during the COVID-19 pandemic is noticeable among physiotherapists working in clinical departments. The current findings show high burnout rates in all three domains: emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA). A comparative analysis of these findings with reference to related studies published before the pandemic shows that the burnout rates among physiotherapists may have significantly increased during the COVID-19 pandemic. However, given the scarcity of scientific evidence related to this specific problem in Poland and worldwide, it is necessary to continue research in occupational burnout affecting physiotherapists, particularly during the second wave of the pandemic, in order to gain a better understanding of the possible effects of social isolation and greater personal work-related health risks on the mental health of these medical professionals.


Assuntos
Esgotamento Profissional/epidemiologia , COVID-19/psicologia , Saúde do Trabalhador , Fisioterapeutas/psicologia , Estresse Fisiológico , Adulto , Esgotamento Profissional/psicologia , COVID-19/epidemiologia , Emoções , Feminino , Mão de Obra em Saúde , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Especialidade de Fisioterapia , Polônia/epidemiologia , SARS-CoV-2 , Inquéritos e Questionários , Carga de Trabalho
13.
Phys Ther ; 101(1)2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33395477

RESUMO

OBJECTIVE: The purpose of this study was to describe physical therapists' attitudes, knowledge, and behaviors regarding the use of diagnostic imaging. METHODS: Physical therapists in the United States were recruited from July 2018 through May 2019 to complete a web-based, cross-sectional survey. Participants were asked about demographics, their perceived knowledge base and skills for recommending or ordering different imaging modalities, and their behaviors regarding diagnostic imaging. Descriptive statistics were used to characterize the participants' demographics and responses to all questions. Chi-square tests were performed to compare responses by characteristics of survey participants and Wilcoxon signed-rank tests to compare levels of agreement. RESULTS: The mean age was 43 years, and of the 739 respondents, 58% (n = 417) were female. Ninety-two percent of respondents (n = 595) reported having recommended diagnostic imaging to another provider at least once. Only 11.6% (n = 75) reported having ever directly ordered diagnostic imaging. Participants' attitudes about their knowledge base and skills for recommending or ordering plain radiographs were stronger compared with any other imaging modalities followed by magnetic resonance imaging (MRI) over other imaging techniques. Participants' attitudes on recommending plain radiographs or MRI differed by professional education level, board-certification status, fellowship completion, and years since graduation. CONCLUSION: It is common for physical therapists to recommend imaging, but few have directly ordered imaging. Most survey participants believed that they have an adequate knowledge base and skills for recommending and ordering plain radiographs and MRI. IMPACT: These results can serve as a benchmark for future comparison as policies and educations evolve. Understanding physical therapists' attitudes, knowledge, and use of diagnostic imaging is important to inform research, policy, and education.


Assuntos
Competência Clínica , Diagnóstico por Imagem , Conhecimentos, Atitudes e Prática em Saúde , Fisioterapeutas/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Estados Unidos
14.
CMAJ Open ; 9(1): E29-E37, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33436453

RESUMO

BACKGROUND: Burnout and distress negatively affect the well-being of health care professionals and the treatment they provide. Our aim was to measure the prevalence of burnout and distress among allied health care staff at a cardiovascular centre of a quaternary hospital network in Canada, and compare outcomes to those for nonphysician employees in the United States. METHODS: We conducted a survey of allied health care staff, including physical, respiratory and occupational therapists, pharmacists, social workers, dietitians and speech-language pathologists, in a cardiovascular centre at 2 quaternary referral hospitals in Toronto, Ontario, between Nov. 27, 2018, and Jan. 31, 2019. The survey tool included the Well-Being Index (WBI), which measures fatigue, depression, burnout, anxiety or stress, quality of life, work-life integration, meaning in work and overall distress; a score of 2 or higher indicated high distress. We carried out standard univariate statistical comparisons using the χ2, Fisher exact or Kruskal-Wallis test as appropriate to perform univariate comparisons in the sample of respondents. We assessed the relation between a WBI score of 2 or higher and demographic characteristics. We compared univariate associations among WBI data for nonphysician employees in the US who completed the WBI to responses from our participants. RESULTS: The response rate to the survey was 86% (45/52). Thirty-three respondents (73%) reported experiencing burnout in the previous month, and 31 (69%) reported emotional problems. Compared to respondents who perceived fair treatment in the workplace, those who perceived unfair treatment (20 [44%]) were more likely to report emotional problems (17 [85%] v. 13 [54%], p = 0.05), to worry that work was hardening them emotionally (15 [75%] v. 8 [33%], p = 0.008), and to feel down, depressed or hopeless (12 [60%] v. 4 [17%], p = 0.005). Twenty-five respondents (56%) and 13 respondents (29%) reported WBI scores consistent with high (≥ 2) or severe (≥ 5) distress, respectively. Respondents were more likely to have a high WBI score if they perceived unfair treatment or inadequate staffing levels. Our respondents had a higher prevalence of burnout (73.3% v. 53.6%, p = 0.008) and a higher average WBI score (2.6 [SD 2.8] v. 1.7 [SD 2.6], p = 0.05) than 9096 nonphysician employees in the US. INTERPRETATION: The prevalence of burnout, emotional problems and distress was high among allied health care staff. Fair treatment in the workplace and adequate staffing may lower distress levels and improve the work experience of these health care professionals.


Assuntos
Pessoal Técnico de Saúde/estatística & dados numéricos , Ansiedade/epidemiologia , Esgotamento Profissional/epidemiologia , Institutos de Cardiologia , Depressão/epidemiologia , Fadiga/epidemiologia , Qualidade de Vida , Pessoal Técnico de Saúde/psicologia , Ansiedade/psicologia , Esgotamento Profissional/psicologia , Estudos Transversais , Depressão/psicologia , Feminino , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Sistemas Multi-Institucionais , Nutricionistas/psicologia , Nutricionistas/estatística & dados numéricos , Terapeutas Ocupacionais/psicologia , Terapeutas Ocupacionais/estatística & dados numéricos , Ontário/epidemiologia , Admissão e Escalonamento de Pessoal , Farmacêuticos/psicologia , Farmacêuticos/estatística & dados numéricos , Fisioterapeutas/psicologia , Fisioterapeutas/estatística & dados numéricos , Angústia Psicológica , Terapia Respiratória , Assistentes Sociais/psicologia , Assistentes Sociais/estatística & dados numéricos , Patologia da Fala e Linguagem , Inquéritos e Questionários , Centros de Atenção Terciária , Equilíbrio Trabalho-Vida
15.
Spine (Phila Pa 1976) ; 46(2): 114-121, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-32947498

RESUMO

STUDY DESIGN: Cross-sectional survey. OBJECTIVE: This study surveyed the attitudes and beliefs of physiotherapists and accredited exercise physiologists (AEP) toward chronic low back pain (CLBP), in Australia. The objective of this study was to investigate the effect of biomedical and biopsychosocial attitudes and beliefs toward CLBP on clinical decision making in exercise-based practitioners. SUMMARY OF BACKGROUND DATA: The attitudes and beliefs of AEPs toward CLBP have not been studied. Literature regarding physiotherapists suggests a biomedical approach leading to more conservative treatment and on occasion, treatment going against practice guidelines. METHODS: Seventy five AEPs and 75 physiotherapists were surveyed using the pain attitudes and beliefs scale for physiotherapists, which consists of both a biomedical and biopsychosocial subscale. Clinical decision making was assessed using two patient vignettes. RESULTS: AEPs held higher biomedical beliefs compared with physiotherapists. No between-group differences were observed on the biopsychosocial subscale. Indeed, biomedical attitudes and beliefs did explain clinical decision making with higher scores reflecting a more conservative approach. However, biomedical beliefs influenced decision making regardless of profession. CONCLUSION: Biomedical attitudes and beliefs regarding CLBP influence clinical decision making in exercise-based practitioners, regardless of profession. AEPs reported higher biomedical scores, suggesting more frequent choice of conservative care. Thus, patients may receive inconsistent care and advice from practitioners within the same field. Based on clinical practice guidelines and the positive associations on clinical decision making of the biopsychosocial model, it is necessary to understand how best to provide exercise-based practitioners with education on how to apply a biopsychosocial approach to CLBP.Level of Evidence: 3.


Assuntos
Atitude do Pessoal de Saúde , Dor Lombar/terapia , Fisioterapeutas/psicologia , Adulto , Austrália , Estudos Transversais , Exercício Físico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
16.
Scand J Occup Ther ; 28(4): 264-273, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-32412813

RESUMO

BACKGROUND: Interprofessional learning activities can contribute to preparing students to function in health care teams. Although the importance of communication is acknowledged, there is still a lack of understanding about how students learn to communicate interprofessionally. AIM: To explore occupational therapist and physiotherapist students learning of skills in interprofessional communication by studying the students' communication while working together with a virtual patient. MATERIAL AND METHODS: The students carried out a virtual patient encounter in pairs of two, using one computer per student, sitting side by side. The students' actions and conversations were recorded as video films, the oral communication was transcribed and analysed using qualitative content analysis. RESULTS: The students created a social learning environment by posing questions, acknowledging each other and clarifying their professional perspective using familiar professional concepts. Comparing their professional views, students related their peers' statements to their own. Departing from their own profession and using the created open environment, the students' communication led to an interprofessional meaning-making process, with students aiming to understand each other. CONCLUSIONS AND SIGNIFICANCE: A reciprocal learning situation was created when students worked together in a virtual setting. Communicating and making shared decisions about a patient can facilitate learning how to communicate interprofessionally and improve students' understanding of their own profession.


Assuntos
Terapeutas Ocupacionais/educação , Terapeutas Ocupacionais/psicologia , Terapia Ocupacional/educação , Fisioterapeutas/educação , Fisioterapeutas/psicologia , Estudantes/psicologia , Realidade Virtual , Adulto , Comunicação , Comportamento Cooperativo , Feminino , Humanos , Práticas Interdisciplinares , Relações Interprofissionais , Masculino , Grupo Associado , Aprendizagem Baseada em Problemas/métodos , Inquéritos e Questionários , Adulto Jovem
17.
Physiother Theory Pract ; 37(1): 106-114, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31119973

RESUMO

Aim: To explore how students, recent graduates, and qualified physiotherapists experience physiotherapy practice. Design: Two-part phenomenologically oriented study. Thirteen physiotherapy students/recent graduates and 32 qualified physiotherapists were interviewed. The transcripts were analyzed to identify the ways of thinking and practicing (WTP) of physiotherapy. Results: Seven themes representing particular WTP in physiotherapy emerged from the interview data. Six were shared by all participants but understood in different ways. These related to the discovery of new knowledge; problem-solving client-related contexts; adopting a systems-based approach to the body; contributing to a positive therapeutic alliance; developing a sense of self and the profession; and the organization of the workforce. A final theme, professional citizenship, was only described by the qualified practitioners. Conclusion: The results of this study indicate that physiotherapy practice can be characterized in six distinct ways, with a separate integrating idea that represents the relationship the individual practitioner has with the profession. The insights gained from this research suggest that new ways of thinking might benefit the profession, not least of all in relation to entry-level curriculum, contemporary practice and positioning of the profession for current health-care needs.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Fisioterapeutas/psicologia , Modalidades de Fisioterapia , Papel Profissional/psicologia , Estudantes de Ciências da Saúde/psicologia , Aliança Terapêutica , Humanos
18.
Physiother Theory Pract ; 37(1): 149-157, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31172868

RESUMO

Purpose: To explore the perceived barriers and facilitators to participation in physical activity among adults with disability, from the perspective of physiotherapists. Method: A convenience sample of 20 participants recruited from delegates attending a symposium at the 2015 Australian Physiotherapy Association conference. The participants completed a brief questionnaire. Content analysis was completed using an inductive approach. Results: Participants reported 18 facilitators and 18 barriers to participation in physical activity among adults with disability. The top five reported facilitators were as follows: having support (n = 17 responses), having a choice of opportunities (n = 10 responses), access to suitable venues and equipment (n = 10 responses), enjoying physical activity (n = 8 responses), and high self-efficacy (n = 7 responses). The top five reported barriers were as follows: reduced access to programs and opportunities (n = 15 responses), lack of support or social isolation (n = 14 responses), lack of transport (n = 7 responses), financial strain (n = 7 responses), and physical ability (n = 7 responses). Conclusions: Physiotherapists who have a strong interest in the physical activity habits of adults with disabilities recognize a wide range of facilitators and barriers to their participation. Psychosocial beliefs and behaviors (i.e., self-efficacy, motivation, fear, and attitude) of adults with disability might be more important influencers of physical activity participation than impairments of body structure and function.


Assuntos
Pessoas com Deficiência/reabilitação , Exercício Físico , Conhecimentos, Atitudes e Prática em Saúde , Acesso aos Serviços de Saúde , Fisioterapeutas/psicologia , Adulto , Humanos , Motivação , Autoeficácia , Apoio Social , Inquéritos e Questionários
19.
Phys Ther Sport ; 48: 67-75, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33378733

RESUMO

OBJECTIVES: To explore and summarise expert physiotherapists' perceptions on their assessment, management and prevention of proximal hamstring tendinopathy (PHT). METHODS: We conducted semi-structured interviews with expert physiotherapists until data saturation was met (n = 13). Interviews were transcribed verbatim and data were analysed systematically and organised into categories and sub-categories according to study aims. RESULTS: Experts report using a clinical reasoning-based approach, incorporating information from the patient interview and results of clinical load-based provocation tests, in the physical examination to diagnose PHT. Experts manage the condition through education and progressive loading targeting the hamstring unit and kinetic chain, avoiding provocative activities in positions of compression in early-mid stage rehab and a gradated and controlled return to sport. Passive therapies including injection therapies and surgery were believed to have limited utility. Prevention of recurrence primarily involved continuation of hamstring and kinetic chain strengthening programs and management of physical workload. CONCLUSION: Experts rely on a combination of information from the patient interview and a battery of pain provocation tests to diagnose PHT. Education and graded exercise of the hamstring group and synergists, minimising early exposure to hip flexion, were the foundation of management of the condition.


Assuntos
Músculos Isquiossurais/patologia , Fisioterapeutas/psicologia , Tendinopatia/diagnóstico , Tendinopatia/terapia , Atitude do Pessoal de Saúde , Exercício Físico , Feminino , Humanos , Entrevistas como Assunto , Masculino , Doenças Musculoesqueléticas/diagnóstico , Doenças Musculoesqueléticas/prevenção & controle , Doenças Musculoesqueléticas/terapia , Dor/epidemiologia , Exame Físico , Esportes , Tendinopatia/prevenção & controle
20.
PLoS One ; 15(12): e0244190, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33347468

RESUMO

BACKGROUND: Few studies have explored evidence-based practice (EBP) knowledge, attitudes and behaviours of health professional graduates transitioning into the workforce. This study evaluated changes in these EBP domains in physiotherapists after one year of working. METHOD: A mixed methods design was used. Participants completed two psychometrically-tested EBP questionnaires at two timepoints. The Evidence-Based Practice Profile questionnaire collected self-report EBP data (Terminology, Relevance, Confidence, Practice, Sympathy) and the Knowledge of Research Evidence Competencies collected objective data (Actual Knowledge). Changes were calculated using descriptive statistics (paired t-tests, 95% CI, effect sizes). Qualitative interview data collected at one timepoint were analysed using a descriptive approach and thematic analysis, to examine the lived experience of participants in the context of their first employment. The aim of the mixed methods approach was a broader and deeper understanding of participants' first year of employment and using EBP. RESULTS: Data were analysed from 50 participants who completed both questionnaires at the two timepoints. After one year in the workforce, there was a significant decrease in participants' perceptions of Relevance (p<0.001) and Confidence with EBP (p<0.001) and non-significant decreases in the other domains. Effect sizes showed medium decreases for Relevance (0.69) and Confidence (0.57), small decreases in Terminology (0.28) and Practice (0.23), and very small decreases in Sympathy (0.08) and Actual Knowledge (0.11). Seven themes described participants experience of using EBP in their first working year. CONCLUSIONS: After a year in the workplace, confidence and perceptions of relevance of EBP were significantly reduced. A subtle interplay of features related to workplace culture, competing demands to develop clinical skills, internal and external motivators to use EBP and patient expectations, together with availability of resources and time, may impact early graduates' perceptions of EBP. Workplace role models who immersed themselves in evidence discussion and experience were inspiring to early graduates.


Assuntos
Prática Clínica Baseada em Evidências , Conhecimentos, Atitudes e Prática em Saúde , Fisioterapeutas/psicologia , Adulto , Emprego/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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