Interprofessional collaboration and job satisfaction of chiropractic physicians

Factors for self-assessment score of interprofessional team collaboration in community hospitals in Japan

Objective

Interprofessional collaboration is considered an important strategy in overcoming the complex issues associated with healthcare outcomes. A nationwide, community-based integrated care system developed for the care of older people in individual communities in Japan requires community hospitals to deliver integrated care to coordinate efforts for creating effective environments for health. This study aimed to explore the factors associated with the self-assessment score of interprofessional collaboration in community hospitals.

Design

Cross-sectional study using the Assessment of Interprofessional Team Collaboration Scale (AITCS).

Setting

This study was conducted in three small community hospitals in Japan.

Participants

All healthcare staff in the hospitals via research collaborators were asked to complete the anonymous self-administered questionnaire of the AITCS comprising questions related to individual factors (age, gender, profession), hospital to which they belonged, relationships with neighbouring facilities, job burden and job satisfaction from July to October 2018. The association between the questionnaire items as explanatory variables and AITCS score as an objective variable was determined using univariate followed by multiple regression analyses.

Results

The data from 325 of 630 participants were analysed, of whom 252 were female (77.5%) and 240 were nurses (73.8%). The mean of the total AITCS score was 117.6 (range 37–185), and the Visual Analogue Scale for relationships with neighbouring facilities, job satisfaction and job burden was 53.0 mm (0–100), 46.1 mm (0–100) and 64.3 mm (0–100), respectively. In univariate analyses of the association with AITCS score, explanatory variables with a significance level of <0.05 were relationships with neighbouring facilities, job satisfaction and job burden. On multiple regression analysis, the total AITCS score was independently associated with age, profession (nurse/non-nurse), relationships with neighbouring facilities and job satisfaction.

Conclusions

Better self-assessment score of interprofessional collaboration is more strongly associated with younger age, a nursing profession, better relationships with neighbouring facilities and greater job satisfaction than with the hospital to which the participant belonged. These findings may help community hospitals enhance the integration of service delivery and benefit to the community through interprofessional collaboration.

Individual-level determinants of interprofessional team collaboration in healthcare

Interprofessional team collaboration (ITC) is pivotal for the safety and the quality of healthcare settings, being associated with higher staff and patient satisfaction. However, individual-level determinants (i.e. socio-demographic and working satisfaction) remain currently largely unexplored. This study aimed to describe the overall ITC (i.e. partnership, cooperation, coordination), identifying the individual-level determinants of each ITC domain. This study had a multicentre approach, using cross-sectional data collection. ITC was assessed using the Interprofessional Team Collaboration Scale II, Italian version (I-AITCS II). The determinants of ITC were investigated through multivariable linear regression models. The study results showed significant associations between the same ITC domains, as well as the important role of work satisfaction in determining cooperation and coordination. Physicians reported more inadequate partnership levels than other healthcare professionals. This study provides insights for future research and gives a useful description of the determinants of ITC for multi-stakeholder healthcare organizations.

Analysing drivers and outcomes of job and professional satisfaction at health centres in Portugal

Purpose

The purpose of this paper is to analyse antecedents, associations and outcomes of job and professional satisfaction of doctors and nurses in Portuguese health centres.

Design/methodology/approach

The authors have used structural equation modelling to examine the causal relationships between multiple variables placed in a path model reflecting the theoretical foundation.

Findings

The percentage of those satisfied or very satisfied with their jobs was just above 50 per cent. Doctors’ satisfaction stems from personal achievement and the formal component of work environment, leading them to strongly recommend their work in the health centre to dear ones but not to put aside other job options. Nurses’ level of job satisfaction seems to be affected by co-workers and interpersonal relationships beside personal achievement and has more strong and multifaceted impact on their feelings and behaviour that goes from recommending their job position to considering to quit job and even regretting the option made in terms of career.

Originality/value

This study represents the first attempt to conceptualise and test a simultaneous model comprising antecedents and outcomes of both job satisfaction and professional satisfaction in primary care, investigating also differences between genders and professions. Results shed light on determinants of satisfaction among specialised staff in Portuguese primary care and how they affect commitment to the organisation and the way career choice is regarded.

How Can Massage Therapy Move Forward? Registered Massage Therapists Touch on Key Points Shaping Their Profession in British Columbia, Canada

Registered Massage Therapists (RMTs) are valuable members of the health care team who assist in creating positive outcomes in health promotion, disease prevention, and rehabilitation. This article explores RMTs’ views regarding the status and future of their profession in British Columbia, Canada. It highlights, for the first time, key issues for advancing the profession from their perspective. RMTs believe increased recognition for their roles in health care would enhance their careers. They note that research on the beneficial aspects of MT and communication of these benefits to other health care professionals, particularly MDs, and the general public, would also help. Some noted that increasing their work within interdisciplinary health care teams, particularly inside publicly funded health care, would elevate the status of their profession. Finally, RMTs discussed their desire to gain recognition of their rigorous education programs by earning degrees instead of diplomas. However, significant barriers to these aspirations exist.

Potential unique causes of burnout for chiropractic professionals

OBJECTIVE

The objective of this narrative review is to discuss the potential for burnout in chiropractic practitioners. This discussion is grounded in the job demands-resource model, the conservation of resources model, the unique profession-specific stressors experienced by chiropractors, and information from similar health care professions.

METHODS

A search using both the indexed (PubMed and PsychLit) and nonindexed psychosocial literature was used. Other resources included the Cochrane Library, articles from governing bodies of the chiropractic profession, trade magazines, and research conferences and symposium proceedings. Articles were analyzed following the grounded theory principles: open coding and memos for conceptual labeling, axial coding and memos for category building, and selective coding for model building.

RESULTS

Potential stressors unique to doctors of chiropractic include factors associated with physical workload, role stress, and mental and emotional demands.

CONCLUSIONS

There are unique chiropractic-specific occupational characteristics that possibly contribute to burnout in the chiropractic professionals. These findings emphasize the need for assessing and measuring burnout and attrition within the chiropractic profession.

Attitudes of non-practicing chiropractors: a pilot survey concerning factors related to attrition

BACKGROUND

Research into attitudes about chiropractors who are no longer engaged in active clinical practice is non-existent. Yet non-practicing chiropractors (NPCs) represent a valid sub-group worthy of study.

AIM

The purpose of this research was to assess attrition attitudes of NPCs about the chiropractic profession and develop a scale to assess such attitudes.

METHODS

A 48 item survey was developed using the PsychData software. This survey included 35 Likert-style items assessing various aspects of the profession namely financial, educational, psychosocial and political. An internet discussion site where NPCs may be members was accessed for recruitment purposes.

RESULTS

A total of 70 valid responses were received for analysis. A majority of respondents were male with 66% being in non-practice status for 3 to 5 years and less with 43% indicating that they had graduated since the year 2000. Most respondents were employed either in other healthcare professions and non-chiropractic education. A majority of NPCs believed that business ethics in chiropractic were questionable and that overhead expense and student loans were factors in practice success. A majority of NPCs were in associate practice at one time with many believing that associates were encouraged to prolong the care of patients and that associate salaries were not fair. Most NPCs surveyed believed that chiropractic was not a good career choice and would not recommend someone to become a chiropractor. From this survey, a 12 item scale was developed called the "chiropractor attrition attitude scale" for future research. Reliability analysis of this novel scale demonstrated a coefficient alpha of 0.90.

CONCLUSION

The low response rate indicates that findings cannot be generalized to the NPC population. This study nonetheless demonstrates that NPCs attrition attitudes can be assessed. The lack of a central database of NPCs is a challenge to future research. Appropriate investigation of attrition within the chiropractic profession would be helpful in the analysis of attitudes regarding both chiropractic education and practice. Further research is needed in this area.

Exercise prescription for chronic back or neck pain: who prescribes it? who gets it? What is prescribed?

OBJECTIVE

To describe exercise prescription in routine clinical practice for individuals with chronic back or neck pain because, although current practice guidelines promote exercise for chronic back and neck pain, little is known about exercise prescription in routine care.

METHODS

We conducted a computer-assisted telephone survey of a representative sample of individuals (n = 684) with chronic back or neck pain who saw a physician, chiropractor, and/or physical therapist (PT) in the past 12 months. Individuals were asked about whether they were prescribed exercise, the amount of supervision received, and the type, duration, and frequency of the prescribed exercise. Descriptive and multivariable regression analyses were conducted.

RESULTS

Of the 684 subjects, 48% were prescribed exercise. Of those prescribed exercise, 46% received the prescription from a PT, 29% from a physician, 21% from a chiropractor, and 4% from other. In multivariable analyses, seeing a PT or a chiropractor were the strongest predictors of exercise prescription. The likelihood of exercise prescription was increased in women, those with higher education, and those receiving worker's compensation. PTs were more likely to provide supervision and prescribe strengthening exercises compared with physicians and chiropractors, and were more likely to prescribe stretching exercises compared with physicians.

CONCLUSION

Our findings suggest that exercise is being underutilized as a treatment for chronic back and neck pain and, to some extent, that the amount of supervision and types of exercises prescribed do not follow current practice guidelines. Exercise prescription provided by PTs appears to be most in line with current guidelines.

Chiropractic and CAM utilization: a descriptive review

OBJECTIVE

To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions

DATA SOURCES

A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations.

DATA SELECTION

A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions.

DATA SYNTHESIS

Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form.

RESULTS

Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker's compensation papers.

CONCLUSION

Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.

Health Services Research Related to Chiropractic: Review and Recommendations for Research Prioritization by the Chiropractic Profession

PURPOSE

This project updates a previous effort to inventory health services research conducted on chiropractic and makes recommendations for a subsequent research agenda. A qualitative review of social sciences, medical, chiropractic, and health services research literature regarding chiropractic was done with emphasis on research published since the initial health services research agenda effort in 1995. This work informed development of updated health services research recommendations.

METHODS

Literature was gathered through searches of electronic health care database retrieval systems and citation tracking. In addition to general collecting of new studies, the authors considered to what extent the 1995 research recommendations had been addressed in the new literature. A seed set of refined recommendations was formulated and initially distributed expert review and revision. The recommendations were made available for public comment and hearing at the 10th Annual Research Agenda Conference for Chiropractic in March 2005.

DISCUSSION

The past 10 years have seen numerous health service research studies related to chiropractic; however, nearly all of the research priorities identified in 1995 remain unaddressed and remain as important priorities. Thus, recommendations were reprioritized and revised to submit for open comment and hearing.

CONCLUSION

A smaller number of more concise recommendations with more specific action steps are proposed for clinical quality improvement, performing cost analyses, and assessing use barriers for chiropractic.