Job strain in physical therapists

The struggle of dealing with uncertainty: a qualitative, phenomenological study about how Dutch novice physical therapists experience their transition from student to professional

OBJECTIVE

To explain how Dutch novice physical therapists experience their transition from student to physical therapist in private practice.

METHODS

A qualitative, phenomenological study was performed in The Netherlands to collect personal experiences from novice physical therapists who graduated <1 year ago. Data were collected with semi-structured interviews and analyzed using interpretative phenomenological analysis.

RESULTS

The transition experience from student to novice physical therapist is a personal, complex, and context-dependent phenomenon. Sixteen novice physical therapists (of whom 10 were still working in private practice) said their transition was liberating, stressful, insecure, unexpected, chaotic, and challenging. The variety in experiences occurred from the fact that the impact of an experience varies from one individual to the other, depending on their previous (life) experiences, uncertainty tolerance, coping, and personal and professional environment. Four overarching themes emerged: (1) 'Suddenly, I was on my own', (2) 'I was unprepared for the hassle and demands of clinical practice', (3) 'I couldn't make the impact I expected', and (4) 'I had to find a new me'.

CONCLUSIONS

A novice physical therapist's transition is a context-related phenomenon, unique for each individual and determined by individual experiences and coping strategies. Novice physical therapists described a feeling of 'faking': they had to pretend to know what they were doing [while treating a patient] while in reality, they felt like they did not. For some novice physical therapists, a primary reason to leave the profession.

Prevalence and risk factors of work-related musculoskeletal disorders among physical therapists in Ho Chi Minh City, Vietnam

BACKGROUND

Understanding risk factors linked to work-related musculoskeletal disorders (WMSDs) is crucial for enhancing health promotion and ensuring workplace safety among healthcare professionals particularly physical therapists (PTs). However, in Vietnam, there has been lack of an investigation. Therefore, this study was to determine whether potential risk factors contributed to the occurrence of WMSDs among PTs in Ho Chi Minh City.

METHOD

An online self-reported questionnaire for WMSDs comprising the Nordic Musculoskeletal Questionnaire (NMQ), Job-risk and Environmental factors, the Perceived Stress Scale (PSS-4) and the coping strategies, were distributed to PTs. They were enrolled if they had: age ≥ 22 years, graduated from PT program, a full-time job with ≥1 year of experience. Unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were determined using Logistic regression.

RESULTS

Our study found that within the past 12 months, the prevalence of WMSDs was 76.4% (n = 204/267): neck 58.4% and lower back 57.3%. PTs aged 22-29 years, < 4 years of education, and < 7 years of working experience were more likely to have WMSDs 2-3 times than those who did not. After adjusting for age, education, and work experience, PTs who engaged in manual techniques/exercises, lifting/transferring patients, and maintaining awkward postures were 5-7 times more likely to have WMSDs in the neck and lower back than those who did not. Environmental and psychological factors, such as number of treatment tables, size of electrotherapy rooms, using PTs modalities, and stress were significantly associated with WMSDs. More than 50% of PTs used modified positions and new treatment/techniques that did not aggravate their symptoms, as coping strategies.

CONCLUSIONS

This study indicates potential risk factors associated with WMSDs, affecting the neck and lower back among PTs in Vietnam. These risk factors should be addressed to improve overall PTs health, retain skilled workers, and encourage them to continue working.

Influences of Financial and Workplace Factors on Physical Therapist Job Satisfaction

OBJECTIVE

The physical therapist labor market has recently noted higher rates of turnover and job vacancies. An understudied factor contributing to these trends in the profession is job satisfaction. The profession continues to experience relatively low wages compared with other health professions, and graduates of Doctor of Physical Therapy programs face increasingly high student debt. This study used the labor-search model as a conceptual framework to understand associations between job satisfaction, income, and educational debt. The purpose of this study is to observe the financial and workplace factors that are associated with higher levels of physical therapist job satisfaction.

METHODS

Data from 4764 physical therapists in 1 state were captured retrospectively through the state's licensure renewal process from 2014 to 2020. A random effects panel analysis, with job satisfaction as the dependent variable, was used to evaluate the relationships between job satisfaction and income, educational debt, and a variety of work-related factors.

RESULTS

Job satisfaction was negatively correlated with educational debt, number of hours worked per week, and some practice settings. Conversely, job satisfaction was positively correlated with the expected age of retirement. The percentage of time spent in research and administration was also positively correlated with job satisfaction, though additional research in this area is needed to draw meaningful conclusions on this association.

CONCLUSION

The results support the conceptual framework, which suggests that early career physical therapists, motivated by high amounts of educational debt, may choose more financially advantageous practice settings and increased working hours to the detriment of job satisfaction.

IMPACT

High levels of job satisfaction among physical therapists are correlated with low levels of educational debt, working 45 hours or less per week, a longer time horizon until retirement, and practice settings other than home health and skilled nursing facilities.

Health Management: Evaluating the Relationship between Organizational Factors, Psychosocial Risks at Work, Performance Management, and Hospital Outcomes

Introduction-Health system (HS) health organizations are complex and are in constant dynamic interaction with multiple elements, including political, environmental, societal, legal, and organizational factors, along with human components, such as human resources, patients, and other stakeholders. Objective-This research aimed to study three HS organizations, identifying and characterizing the elements of health organizations and the factors related to professionals, determining their influence on economic and financial performance results, as well as results related to the professionals and to the patients comprising the institutions. Method-A quantitative study was conducted in which data were collected through questionnaires from various sources to better understand and characterize the factors related to organizations, professionals, and patients (470 health professionals and 768 patients). To test the integrated evaluation model for health organizations, path analysis was used. Results-The results reveal that the organizational culture (OC) presents a positive relationship between the professional's quality of life (QL) and the performance management (PM) of the professionals, along with a negative relationship with the psychosocial work risks (PWR). There is also a relationship between the OC and patient satisfaction (PS), professional job satisfaction (PJS), and economic and financial results (EFR). In the relationship between the processes and the results, there are significant relationships between PM and PJS and PWR and PJS. In terms of the results, there is a significant relationship between the EFR and the PS. Conclusions-This study contributes to a deeper knowledge of the factors that influence the quality of health organizations and their results and produces recommendations for health organizations to address the current challenges.

Feeling exhausted: How outpatient physical therapists perceive and manage job stressors

PURPOSE

Burnout is identified as a workplace problem rather than a worker problem. However, it remains unclear what job stressors are associated with burnout among outpatient physical therapists. Thus, the primary objective of this study was to understand the burnout experiences of outpatient physical therapists. The secondary aim was to identify the relationship between physical therapist burnout and the work setting.

METHODS

One-on-one interviews based on hermeneutics were used for qualitative analysis. Quantitative data was collected using the Maslach Burnout Inventory-Health Services Survey (MBI-HSS) and the Areas of Worklife Survey (AWS).

RESULTS

Qualitative analysis found participants interpreted an increased workload with no increase in wages, loss of control, and a mismatch between organizational culture and values as the main drivers of organizational stress. Professional issues such as high debt burden, low salaries, and declining reimbursement emerged as stressors. Participants showed moderate to high emotional exhaustion per the MBI-HSS. There was a statistically significant association between emotional exhaustion and workload and control (p < 0.001). For every one-point increase in workload, emotional exhaustion increased by 6.49 while for every one-point increase in control, emotional exhaustion decreased by 4.17.

CONCLUSION

Outpatient physical therapists in this study felt that increased workload with a lack of incentives and inequity, coupled with a loss of control, and a mismatch between personal and organizational values were significant job stressors. Creating awareness of outpatient physical therapist's perceived stressors may play an important role in developing strategies to diminish or prevent burnout.

Relationships Between Burnout and Resilience: Experiences of Physical Therapists and Occupational Therapists During the COVID-19 Pandemic

OBJECTIVE

Research on burnout among physical therapists and occupational therapists in the context of the coronavirus disease 2019 (COVID-19) pandemic is limited. Resilience may be important for reducing burnout and promoting well-being among rehabilitation specialists, especially during periods of elevated occupational demand and stress. The purpose of this study was to investigate experiences of burnout, COVID-19 pandemic-related distress, and resilience among physical therapists and occupational therapists during the first year of the COVID-19 pandemic.

METHODS

Physical therapists and occupational therapists working in a university-affiliated health system were invited to complete an online survey assessing burnout, COVID-19 pandemic-related distress, state- and trait-like resilience, physical activity, sleep disturbance, and financial concerns. Multiple linear regressions were used to examine variables associated with burnout as well as the contribution of specific aspects of resilience to burnout.

RESULTS

Greater COVID-19 pandemic-related distress was associated with greater emotional exhaustion and depersonalization, whereas state-like resilience at work was associated with lower emotional exhaustion, greater personal accomplishment, and lower depersonalization. Analyses examining the impact of specific components of resilience at work suggested that several components are associated with less burnout, with finding one's calling being particularly relevant for all 3 domains of burnout.

CONCLUSION

Symptoms of burnout were reported by many physical therapists and occupational therapists. COVID-19-related distress and state-like resilience at work, particularly the perception of finding one's calling, emerged as consistently being associated with burnout in the context of the COVID-19 pandemic.

IMPACT

These findings can inform the development of interventions to reduce burnout among physical therapists and occupational therapists amid the continuing COVID-19 pandemic.

Work-related musculoskeletal disorders among physical therapists in Taiwan

Work-related musculoskeletal disorders (WMSD) refer to musculoskeletal injuries caused by the occupation. Physical therapists (PTs) suffer from a high risk of WMSD despite their extensive knowledge in ergometrics and injury prevention. This study aims to discover the incidence and prevalence of WMSD among PTs using Taiwan's nationwide claims database. The trend of annual patients seeking rehabilitation and the prevalence of WMSD among PTs were presented. The age- and gender-specific incidence of WMSD were also calculated. The prevalence of WMSD in PTs varied from 6.1% to 75.2%, and the incidence ranged from 6.1 to 29.1 per 100 person-years during 1997 and 2012. For those aged ≤30 years, the incidence was higher in females than males (incidence rate ratio  = 1.08, 95% confidence interval [CI]: 1.02-1.14, P = .011), whereas for those aged from 31 to40 years, females had lower incidence of WMSD than males (incidence rate ratio  = 0.88, 95% CI: 0.80-0.96, P = .007). The patients/PTs ratio was higher (270.56-337.74) in 1998 and 2004 to 2007 and became stable (245.93-252.82) in 2008 to 2012, correlating with a rise in the WMSD prevalence in 1999 to 2007 and a steady prevalence after 2008 (63.5%-66.3%) in PTs. In conclusion, the risk of WMSD among PTs was positively correlated to the frequency of patients seeking rehabilitation service. In addition, age and gender were important risk factors for developing WMSD among PTs.

Burnout and intent-to-leave in physical therapists: a preliminary analysis of factors under organizational control

METHODS

Twelve hundred PTs were sent a survey packet including the 20-item Ethics Environment Questionnaire (EEQ) and additional items inquiring about contemporary practice factors. Returned packets (n = 340) were analyzed utilizing correlational and regression analyses to determine relationships between ethical environment, burnout, intent-to-leave, productivity standards, billing and coding requirements and ability to provide pro-bono services.

RESULTS

There was a strong correlation between PTs' view of organizational ethics and burnout (T_{b =} -0.55), and a moderate correlation between organizational ethics and intent-to-leave (T_b = -0.43). There was also a strong relationship between burnout/intent-to-leave and practice factors such as productivity standards, billing/coding policy, and organizational provision of pro-bono services (p ≤ 0.01). Finally, there was a moderate correlation between PTs' view of organizational ethics and practice factors such as productivity standards (T_b = 0.46) and billing and coding policy (T_b = -0.45).

CONCLUSIONS

Contemporary practice factors such as productivity standards and billing/coding practices are related PT's perception of ethical workplace environment and both are related to PT burnout and intent-to-leave. Factors identified in this study related to burnout are all under organizational control.

Assessment of Professional Quality of Life in the Alabama Physical Therapy Workforce

OBJECTIVE

The purposes of this study were to 1) determine the level of professional quality of life among physical therapists and physical therapist assistants in Alabama and 2) to identify personal or professional factors that may contribute to compassion satisfaction (CS), burnout, and secondary traumatic stress (STS).

METHODS

This study used a cross-sectional design and mixed-methods survey methodology to calculate odds ratios for factors affecting professional quality of life. Respondents completed a survey that included the Professional Quality of Life (ProQOL) scale, an open-ended question regarding their experience with professional burnout, and personal and professional demographics.

RESULTS

Of the 742 physical therapists and physical therapist assistants in Alabama who completed the survey, the majority experienced moderate-high levels of CS and moderate-low levels of burnout and STS. Regression analyses indicated clinicians working 40 or more hours per week in patient care had greater odds for low-moderate CS and moderate-high burnout and STS subscale scores. Clinicians in our sample licensed between 6 to 15 or more than 30 years and those working in private outpatient settings had reduced odds of having moderate-high burnout, whereas those working 16 or more years had significantly increased odds for high CS scores. Responses to the open-ended question indicated workload demands and documentation as the top factors contributing to clinician burnout, while the connections with patients and coworkers help minimize such feelings.

CONCLUSION

Individuals later in their career may develop protective factors to mitigate feelings of burnout compared to those early in their career. Also, clinicians working 40 or more hours per week may be more vulnerable to experiencing low-moderate CS and moderate-high burnout. Thus, individual clinicians and employers must evaluate personal, occupational, and systemic factors that contribute to reduced professional quality of life to inform preventive strategies for mitigating burnout.

Job strain in German novice physical therapists / Psychische Beanspruchung am Arbeitsplatz von Berufsanfängern in der Physiotherapie

Introduction

International research shows high levels of job demands and psychological resources for physical therapists, and job strain is considered to be moderate. So far, publications are based on therapists with varying length of service. Little is known about job strain during the first year in the profession.

Aim

To investigate the level of job strain of German novice physical therapists and to identify common workplace stressors.

Methods

We conducted a web-based survey among physical therapists who had been working for 12 month or less. Using a self-administrated questionnaire, job strain was measured by its effects on work commitment, general health, job satisfaction, burnout and turnover intention. Subgroup analyses based on age, sex and rating of professional training were performed. Stressors at work were evaluated by priority and frequency of appearance.

Results

Data of 153 physical therapists was analysed. Low levels of job strain were reported. Novice physical therapists showed high levels of workplace commitment and general health, and low levels of turnover. Moderate ratings were recorded for job satisfaction and symptoms of burnout. Inadequate compensation for work, high caseload, time pressure and physical stress were the most common stressors mentioned. Therapists who rated their professional training as positive reported lower levels of job strain. No significant differences between women and men or between therapists of different age were found.

Conclusion

Although many workplace stressors are reported, novice physical therapists show low levels of job strain. Vocational training may be one important protective factor with regard to job strain.

Assessing the physiological strain of physical therapists according to work experience: A cross-sectional study

OBJECTIVES

This cross-sectional study aimed to assess the physiological response of physical therapists to compare the physiological workload within three groups of varying work experience and their comparative physiological responses during a 15-min recovery period.

METHODS

Thirty therapists participated in the present study. They were divided into three groups with varying levels of work experience based on the number of years they had been in active employment: 1) Early Career (EC) group = 2-6 years); 2) Mid-Career (MC) group = 7-11 years), and 3) Late career (LC) group = over 11 years). Each group included 10 subjects comprised of both males and females. To conduct the measurements, each therapist treated one hemiplegic patient for 20 min using a passive range of motion protocol and then rested for 15 min. The maximum voluntary contraction on trapezius and deltoid muscles were tested using electromyography before and after treatment. During treatment, the muscle workload, muscle fatigue, and cardiovascular load were measured. The perceived workload was assessed using a subjective workload index (SWI) questionnaire following treatment.

RESULTS

The three work experience groups of physical therapists performed a similar workload. The SWI corresponded well with physiological measurement. The muscle capacity after treatment of the EC group was significantly lower than that of the MC group (p < 0.05). Notably, the right deltoid of the LC group was significantly lower than that of the MC group.

CONCLUSIONS

The physical therapists worked with a moderate, objectified workload. A 15-min rest period brought the cardiovascular load below 30% and lowered fatigue in the right deltoids. This result may indicate a musculoskeletal disorder warning signal for the physical therapists.

Physiotherapists' Experiences Using the Ekso Bionic Exoskeleton with Patients in a Neurological Rehabilitation Hospital: A Qualitative Study

Use of bionic overground exoskeletons to assist with neurological rehabilitation is becoming increasingly prevalent and has important implications for physiotherapists and their patients. Yet, there is a paucity of research about the impact of integrating this technology on physiotherapists' work. The purpose of this study was to explore how the training and implementation of using the Ekso robotic exoskeleton with patients affects physiotherapists' work. An exploratory qualitative study of three physiotherapists working at a neurological rehabilitation centre in Eastern Canada was conducted using one-on-one semistructured interviews in July 2017. Audio recordings were transcribed verbatim, and data was coded and analyzed using thematic analysis. Six themes emerged from the data: developing organizational capacity; ethical use of technology; benefits of the equipment; challenges of the equipment; cognitive workload; and the technological environment. The results suggest that the adoption and integration of bionic exoskeletons into rehabilitation practice is not as simple as training physiotherapists and giving them the device. More research is needed to understand the increased cognitive demands of working with patients using technologically advanced exoskeletons within a dynamic, technology-rich healthcare environment, while managing patient expectations and ethical use.

A Quantitative Measurement of Physical Therapists' Empathy and Exploration of the Relationship With Practice Setting and Work Engagement

Clinical empathy has been studied in a number of health-care disciplines suggesting that higher practitioner empathy leads to improved patient health and wellness and improved patient outcomes. While some aspects of the physical therapist-patient relationship have been described, evidence of quantitative assessment of clinical empathy in physical therapists is scarce. To investigate the level of self-reported clinical empathy in physical therapists and its relationship to practice environment and workplace engagement, the Jefferson Scale of Empathy-Health Provider version (JSE-HP) and the Oldenburg Burnout Inventory (OLBI) were used. Study participants were 123 physical therapists working full time at either an acute care setting, a rehabilitation hospital, or an outpatient clinic. These physical therapists demonstrated a mean JSE-HP score of 118.5 (9.1) and a mean OLBI score of 15.63 (3.5). This mean empathy score was found to be higher than reported empathy level of some health disciplines such as nursing and pharmacy yet lower than others such as mental health workers, psychiatrists, and pediatricians. Practice setting was not found to be a significant factor regarding empathy levels in physical therapists. As reported in previous studies, there was a positive correlation between being female and having higher empathy levels. A positive correlation was found between age and work disengagement. Finally, our hypothesis regarding a negative correlation between empathy and work disengagement was confirmed, suggesting that workplace disengagement may diminish a physical therapist's empathy, which may then negatively affect patient clinical outcomes.

Predictors for Nonspecific Low Back Pain in Rubber Farmers: A 1-Year Prospective Cohort Study

High prevalence of low back pain (LBP) has been reported among farmers. A number of contributing factors have been associated with LBP. However, predictors for LBP in this population are unknown. This longitudinally designed study aimed to identify the predictors of LBP in a sample of rubber farmers whose work involves heavy manual labor. Three hundred and twenty-seven rubber farmers, aged 18 to 70 years who reported no LBP in the previous year, were face-to-face interviewed and examined physically. The incidence of LBP was assessed monthly. The 12-month incidence of LBP in the cohort was 35%. Having a history of LBP (hazard ratio = 1.55, 95% confidence interval = 1.05-2.30) and an active job (hazard ratio = 1.98, 95% confidence interval = 1.16-3.40) were the predictors for the new onset of LBP in this sample. These 2 factors could therefore potentially be targeted to prevent or reduce the incidence of LBP in rubber farmers.

Beyond supervised learning: A multi-perspective approach to outpatient physical therapy mentoring

Background: Novice physical therapists face multiple challenges as they transition to autonomous, efficient, and seasoned therapists. Mentoring is known to facilitate growth among novice therapists; however, formalized mentoring programs within the outpatient setting are scarce or management-centered. This study sought to explore the most desired components of a formal mentoring program from multiple perspectives. Methods: An inductive qualitative inquiry explored perceptions of participants (n = 35) from four populations. Interviews were conducted with students (n = 5) and novice therapists (n = 5), and survey data was collected from faculty (n = 7) and expert therapists (n = 18). Thematic content analysis was used for data analysis. Results: Three primary themes emerged as program emphasis: 1) Program function; 2) novice therapists' needs; and 3) the making of a mentorship (including mentor/mentee characteristics and matching strategy). Conclusions: This study captured multiple perspectives as to the components of interest in development of a formalized mentoring program for novice therapists in the outpatient setting. As the profession continues to emphasize standards for guided learning, steps must be taken by individual employers to promote and facilitate the most effective practices. Findings provide depth and suggestions for developing an outpatient-mentoring program.

Role Strain, Part 1: Experiences of Athletic Trainers Employed in the Professional Sports Setting

CONTEXT

  The demands and expectations of athletic trainers employed in professional sports settings (ATPSSs) have increased over the years. Meeting these demands and expectations may predispose the athletic trainer to workplace stress and ultimately role strain.

OBJECTIVE

  To investigate the concept of role strain among ATPSSs.

DESIGN

  Sequential, explanatory mixed-methods study consisting of 2 phases: (1) population role-strain survey and (2) personal interviews.

PATIENTS OR OTHER PARTICIPANTS

  From a purposeful sampling of 389 athletic trainers employed in the 5 major sports leagues (Major League Baseball, Major League Soccer, National Basketball Association, National Football League, and National Hockey League), 152 individuals provided usable data (39% response rate).

MAIN OUTCOME MEASURE(S)

  A previously validated and reliable role-strain survey using a 5-point Likert scale (1 = never, 5 = nearly all the time) was administered. Measures of central tendency were used to identify the presence and degree of role strain; inferential statistics were calculated using analysis of variance to determine group differences in overall role strain and its subcomponents.

RESULTS

  More than half of the participants (53.9%) experienced a moderate to high degree of role strain. Interrole conflict (2.99 ± 0.77) and role overload (2.91 ± 0.75) represented the most prominent components of role strain. Differences existed by sport leagues and employment.

CONCLUSIONS

  Role strain existed at moderate to high levels (mean Role Strain Score > 2.70) among ATPSSs. Interrole conflict and role overload contributed the most to overall role strain. The ATPSSs experienced role strain to a higher degree than reported in other settings.

Identifying the factors that affect the job satisfaction of early career Notre Dame graduate physiotherapists

Objective Previous studies have highlighted the short career intentions and high attrition rates of physiotherapists from the profession. The aim of the present study was to examine the job satisfaction and attrition rates of early career physiotherapists graduating from one Western Australian university. Methods A self-administered online survey was conducted of 157 Notre Dame physiotherapy graduates (2006-2012), incorporating a job satisfaction rating scale. Results Results showed that lowered job satisfaction was related to working in the cardiorespiratory area of physiotherapy and working in multiple jobs since graduation. The majority of graduates did not predict a long-term career in physiotherapy, highlighting a lack of career progression and limited scope of practice as influential factors. Conclusions Job satisfaction in early career physiotherapists varies across different clinical areas of practice related to several factors, including challenge and flexibility. New roles in the profession, including extended scope roles, may impact on the future job satisfaction of physiotherapists. Further studies are needed to explore the effect of these roles on workforce trends, including attrition rates. What is known about the topic? Physiotherapists predict careers of 10 years or less on entry into the profession. No previous studies have explored the individual factors influencing job satisfaction in early career physiotherapists across different clinical settings. What does this paper add? This study highlights specific factors influencing the job satisfaction of early career physiotherapists, including clinical area of practice. Physiotherapists working in the cardiorespiratory area were less satisfied, as were physiotherapists undertaking multiple positions since graduation. What are the implications for practitioners? This study informs employers and workforce planners on the factors affecting job satisfaction in early career physiotherapists. In addition, knowledge of issues affecting job satisfaction in the early career stage may assist educational institutions in their preparation of graduates for the future health workforce.

Job stress dimension and work-related musculoskeletal disorders among southeast Nigerian physiotherapists

BACKGROUND

Although publications describe physical demands of the job in the physiotherapy profession, there is a dearth of literature on job stress dimensions (JSDs), and their relationship to work-related musculoskeletal disorders (WMSDs).

OBJECTIVE

To investigate JSDs and their relationship to WMSDs among physiotherapists currently practicing in southeast Nigeria.

METHOD

A cross-sectional study using items related to the Job Content Questionnaire and the Nordic musculoskeletal questionnaire. Data were summarized with descriptive statistics, and the relationship between WMSDs and JSDs was analyzed with the Mann-Whitney U test.

RESULTS

A total of 126 physiotherapists responded. There were high levels of stress in most of the job dimensions investigated: 82.1% and 22.8% of the physiotherapists had WMSDs in at least one body region in the last 12 months and the last 7 days respectively. The lower back was the most commonly affected in both periods. No specific domain was related to development of WMSDs.

CONCLUSION

Over 80% of physiotherapists in southeast Nigeria have WMSDs. However, despite high levels of physical demands on the job, physiotherapists have job control and good social support. Intervention programs aimed at reducing WMSDs in physiotherapists should focus on risk factors that target the physical demands of the job.

Strategies to overcome size and mechanical disadvantages in manual therapy

The practice of manual therapy (MT) is often difficult when providing care for large patients and for practitioners small in stature or with other physical limitations. Many MT techniques can be modified using simple principles to require less exertion, permitting consistency with standards of practice even in the presence of physical challenges. Commonly used MT techniques are herein described and demonstrated with alternative preparatory and movement methods, which can also be adopted for use in other techniques. These alternative techniques and the procedures used to adapt them warrant discussion among practitioners and educators in order to implement care, consistent with the best treatment evidence for many common musculoskeletal (MSK) conditions. The inclusion in educational curricula and MT training programs is recommended to enrich skill development in physical therapists (PTs), spanning entry-level practitioners to those pursuing advanced manual skills.

Wellbeing and occupational risk perception among health care workers: a multicenter study in Morocco and France

Background

The study analyzes health care workers’ (HCWs) occupational risk perception and compares exposure to occupational risk factors in Moroccan and French hospitals.

Method

Across nine public hospitals from three Moroccan regions (north, center and south), a 49 item French questionnaire, based on the Job Content Questionnaire, and 4 occupational risks subscales, was distributed to 4746 HCWs. Internal consistency of the study was determined for each subscale. Confirmatory factor analysis was conducted on the Moroccan questionnaire. Psychosocial job demand, job decision latitude and social support scores analysis was used to isolate high strain jobs. Occupational risks and high strain perception correlation were analyzed by univariate and multivariate logistic regression. A comparative analysis between Moroccan and French (Nantes Hospitals) investigations data was performed.

Results

In Morocco, 2863 HCWs (60 %) answered the questionnaire (54 % women; mean age 40 years; mean work seniority 11 years; 24 % physicians; 45 % nurses). 44 % Moroccan HCWs are at high strain. Casablanca region (1.75 OR; CI: 1.34–2.28), north Morocco (1.66 OR; CI: 1.27–2.17), midwives (2.35 OR; 95 % CI 1.51–3.68), nursing aides (1.80 OR; 95 % CI: 1.09–2.95), full-time employment (1.34 OR; 95 % CI 1.06–1.68); hypnotics, sedatives use (1.48 OR; 95 % CI 1.19–1.83), analgesics use (1.40 OR; 95 % CI 1.18–1.65) were statistically associated to high strain. 44% Moroccan HCWs are at high strain versus 37 % French (Nantes) HCWs (p < 0.001).

Conclusion

Moroccan HCWs have high strain activity. Moroccan HCWs and more Moroccan physicians are at high strain than Nantes HCWs. Moroccan and French’s results showed that full time workers, midwives, workers using hypnotics, and analgesics are at high strain. Our findings underscore out the importance of implementing a risk prevention plan and even a hospital reform. Further research, with an enlarged study pool will provide more information on psychosocial risks (PSR) and HCWs’ health.

Allied Health Professionals and Work-Related Musculoskeletal Disorders: A Systematic Review

Work-related musculoskeletal injuries and disorders (WMSD) are a significant issue in the health care sector. Allied Health professionals (AHP) in this sector are exposed to physical and psychosocial factors associated with increased risk of developing a WMSD. Clarification of relevant hazard and risk factors for AHP is needed to improve understanding and inform WMSD risk management. A systematic analysis of the literature was undertaken to determine prevalence and risk factors for WMSD in AHP. Databases of Ovid MEDLINE, CINAHL (EBSCO), EMBASE and the Cochrane Database of Systematic Reviews were reviewed. This quality of articles was low. Outcome measures were varied, with prevalence rates of WMSD reported from 28% to 96% over a one-year time period. The lower back was the most commonly affected body part. Relevant factors identified with the development of WMSD included inexperience in the role and area of employment. Future research needs to focus on undertaking high quality prospective studies to determine the factors associated with WMSD development in AHP.

Psychosocial and occupational risk perception among health care workers: a Moroccan multicenter study

BACKGROUND

International studies on occupational risks in public hospitals are infrequent and only few researchers have focused on psychosocial stress in Moroccan Health Care Workers (HCWs). The aim of this study was to present and analyze Moroccan HCWs occupational risk perception. Across nine public hospitals from three Moroccan regions (northern, central and southern), a 49 item French questionnaire with 4 occupational risks subscales, was distributed to 4746 HCWs. This questionnaire was based on the Job Content Questionnaire. Psychosocial job demand, job decision latitude and social support scores analysis were used to isolate high strain jobs. Occupational risks and high strain perception correlation were analyzed by univariate and multivariate logistic regression.

RESULTS

2863 HCWs (60%) answered the questionnaire (54% women; mean age 40 years; mean work seniority 11 years; 24% physicians; 45% nurses). 44% of Moroccan HCWs were at high strain. High strain was strongly associated with two occupational categories: midwives (2.33 OR; CI 1.41-3.85), full-time employment (1.65 OR; CI 1.24-2.19), hypnotics and sedatives use (1.41 OR; CI 1.11-1.79), analgesics use (1.37 OR; CI 1.13-1.66).

CONCLUSION

Moroccan HCWs, physicians included, perceive their job as high strain. Moroccan HCWs use of hypnotics, sedatives and analgesics is high. Risk prevention plan implementation is highly recommended.

Prevalence of Musculoskeletal Disorders for Nurses in Hospitals, Long-Term Care Facilities, and Home Health Care: A Comprehensive Review

OBJECTIVE

The aim of this study was to determine the prevalence of musculoskeletal pain and reported injuries for nurses and nursing aides.

BACKGROUND

Nurses and nursing aides suffer from work-related pain and musculoskeletal disorders (MSDs). Although there have been a plethora of studies on MSDs, an overall understanding of the prevalence of MSDs and pain can lead to better prioritization of research needs with respect to the health care industry.

METHOD

A total of 132 articles on prevalence of MSD pain and injuries were included in the review. All articles were published in peer-reviewed English-speaking journals and subjected to a quality review.

RESULTS

Reported prevalence of MSD pain for nurses and nursing aides was highest in the low back, followed by shoulders and neck. However, the majority of the studies have been concentrated on 12-month pain in the low back and predominantly in hospitals. Few researchers have investigated pain in the upper and lower extremities (less than 27% of the studies). Even fewer researchers have evaluated reported injuries or even subjective lost-time injuries (less than 15% of the studies).

CONCLUSION

MSD pain in the nursing profession has been widely investigated worldwide, with a major focus on low-back pain. Given new directions in health care, such as patients who live longer with more chronic diseases, bariatric patients, early mobility requirements, and those who want to be at home during sickness, higher prevalence levels may shift to different populations--home health care workers, long-term care workers, and physical therapists--as well as shift to different body regions, such as shoulders and upper extremities.

Prevalence of low back pain and associated factors among farmers during the rice transplanting process

[Purpose] The aim of this study was to investigate the prevalence of low back pain and associated factors in Thai rice farmers during the rice transplanting process. [Subjects and Methods] Three hundred and forty-four farmers, aged 20–59 years old, were asked to answer a questionnaire modified from the Standard Nordic Questionnaire (Thai version). The questionnaire sought demographic, back-related, and psychosocial data. [Results] The results showed that the prevalence of low back pain was 83.1%. Farmers younger than 45 years old who worked in the field fewer than six days were more likely to experience low back pain than those who worked for at least six days. Farmers with high stress levels were more likely to have low back pain. [Conclusion] In the rice transplanting process, the low back pain experienced by the farmers was associated with the weekly work duration and stress.

The Interrelationships of Coping Styles and Professional Burnout Among Physiotherapists: A Cross-Sectional Study

Burnout is a pathological syndrome in which emotional exhaustion (EE), depersonalization (DEP), and a reduced sense of personal accomplishment (PA) develop in response to prolonged occupational stress. Those working in the physiotherapy profession appear to be at risk for professional burnout brought on by the specific character of the medical professions, involving continuous contact with patients and associated stress, as well as poor working conditions. However, literature data concerning the scale of professional burnout and its psychosocial correlates remain scarce. The aim of the present study was to assess the scale of professional burnout among physiotherapists and to determine the interrelationships between coping styles and burnout symptoms. The sample consisted of 117 professionally active physiotherapists (90 women and 27 men) aged 21 to 55 years (mean [M] 31.88, standard deviation [SD] = 9.14, responsiveness rate of 80.6%) from randomly selected medical institutions of the Lodz Region. The study was conducted using the Maslach Burnout Inventory (MBI) and Coping Inventory for Stressful Situations (CISS) by Endler and Parker. Demographic and job-related data on the respondents were also collected. Task-oriented coping correlated negatively with DEP, EE, and low PA, in contrast to emotion-oriented coping. No correlation was found between avoidance-oriented coping and burnout symptoms. Similarly, no interactive correlations between coping styles and particular burnout symptoms were confirmed. Coping styles correlate independently with professional burnout, without any mutual correlations. Physiotherapists employing a wider spectrum of task-oriented strategies are slightly more satisfied with their job. The incidence of burnout syndrome in the analyzed group is similar to that observed in other medical professions and requires the adoption of preventive measures.

Predictors of global job satisfaction among Saudi physiotherapists: a descriptive study

BACKGROUND AND OBJECTIVE

Job satisfaction is an important consideration in the recruitment and retention of physiotherapists (PTs). To date, the job satisfaction of PTs working in Saudi Arabia has not been investigated. The aim of this study was to measure the level of job satisfaction of PTs working in Saudi Arabia and evaluate predictors of job satisfaction.

DESIGN AND SETTINGS

This was a cross-sectional observational study among licensed physical therapists working across 11 health care centers and university hospitals in Riyadh between 2013 and 2014.

SUBJECTS AND METHODS

A total of 183 physical therapists participated in the survey. Level of job satisfaction and factors influencing satisfaction were explored using a purpose-designed job satisfaction questionnaire. It consisted of 8 survey domains, and the scores were normalized to allow between-domain comparison.

RESULTS

Global job satisfaction was 37%. The highest levels of job satisfaction were seen in the domains of professional development and teamwork and the lowest levels of job satisfaction in the domains of supervisory/ management relationship (75%) and working environment (60%). Predictors of job satisfaction were gender (OR [odds ratio] 1.4, 95% CI 1.1-2.3), age (OR 0.7, 95% CI 0.5-0.9), relationships with supervisors and managers (OR 1.3, 95% CI 1.2-1.9), working environment (OR 1.2, 95% CI 1.0-2.3), and opportunities for professional development (OR 1.4, 95% CI 1.2-3.7).

CONCLUSION

Saudi PTs were moderately satisfied with their job; strategies should be designed in such a way that they experience a high level of job satisfaction and retention thus resulting in improved rehabilitation services in Saudi Arabia.

Occupational accident and disease claims, work-related stress and job satisfaction of physiotherapists

INTRODUCTION

Physiotherapists are exposed to diverse occupational demands. Until now, little has been known about the interaction between occupational stress and the job satisfaction of physiotherapists. This paper aims to examine their work-related stress and job satisfaction. It will analyse accidents at work and occupational diseases of physiotherapists along with work-related physical and psychosocial stress and job satisfaction.

METHOD

We analysed routine data of the German Institute for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW) on accidents at work and occurring en route to/from work as well as occupational diseases of physiotherapists. Work-related stress and job satisfaction were examined in a cross-sectional survey using a standard questionnaire to be completed by subjects themselves.

RESULTS

Between 2007 and 2011, 1,229 cases of occupational disease were reported to the BGW. The majority of reports involved skin diseases (73%). Stumbles and falls were the most frequent causes of accidents at work (42.9%). Eighty-five physiotherapists all over Germany took part in the survey. They experience high quantitative demands at work. The main physical demands consist of a torso posture between 45° and 90° and high hand activity. Of the 85 subjects, 51% suffer from complaints of the musculoskeletal system in the neck and thoracic spine area and 24% have skin diseases. Most physiotherapists (88%) are satisfied with their work overall. This is aided by a high degree of influence on their work and breaks, by practical application of skills and expert knowledge, high regard for their profession, varied work and a good atmosphere at work. Reservations tend to be about statutory regulations and the social benefits provided by the German healthcare system.

CONCLUSION

Overall, despite high demands and stress relating to the adequacy of resources, the majority of physiotherapists surveyed seem to be satisfied with their job. The main focus of action to promote the health of physiotherapists should be on preventing skin disease, problems of the musculoskeletal system and accidents caused by stumbles and falls.

The mental vitality @ work study: effectiveness of a mental module for workers' health surveillance for nurses and allied health care professionals on their help-seeking behavior

OBJECTIVES

To study the effectiveness of a mental module for workers' health surveillance for health care workers.

METHODS

Nurses and allied health care professionals from one organization were cluster-randomized at ward level to an intervention or control group. The intervention included screening for work functioning impairments and mental health complaints. Positively screened workers were invited to visit their occupational physician. Outcome measures, including help-seeking behavior, work functioning, and mental health, were assessed at baseline, 3-month follow-up, and 6-month follow-up.

RESULTS

An effect of study-group × time interaction on help-seeking behavior was found (P = 0.02). Workers in the intervention group showed less work functioning impairments over time than the control group (P = 0.04).

CONCLUSION

The module can be used to stimulate help seeking from the occupational physician and to improve functioning in workers with mild to moderate work functioning, mental health complaints, or both.

TRIAL NUMBER

NTR2786.

Comparative cost-effectiveness of two interventions to promote work functioning by targeting mental health complaints among nurses: pragmatic cluster randomised trial

BACKGROUND

The specific job demands of working in a hospital may place nurses at elevated risk for developing distress, anxiety and depression. Screening followed by referral to early interventions may reduce the incidence of these health problems and promote work functioning.

OBJECTIVE

To evaluate the comparative cost-effectiveness of two strategies to promote work functioning among nurses by reducing symptoms of mental health complaints. Three conditions were compared: the control condition consisted of online screening for mental health problems without feedback about the screening results. The occupational physician condition consisted of screening, feedback and referral to the occupational physician for screen-positive nurses. The third condition included screening, feedback, and referral to e-mental health.

DESIGN

The study was designed as an economic evaluation alongside a pragmatic cluster randomised controlled trial with randomisation at hospital-ward level.

SETTING AND PARTICIPANTS

The study included 617 nurses in one academic medical centre in the Netherlands.

METHODS

Treatment response was defined as an improvement on the Nurses Work Functioning Questionnaire of at least 40% between baseline and follow-up. Total per-participant costs encompassed intervention costs, direct medical and non-medical costs, and indirect costs stemming from lost productivity due to absenteeism and presenteeism. All costs were indexed for the year 2011.

RESULTS

At 6 months follow-up, significant improvement in work functioning occurred in 20%, 24% and 16% of the participating nurses in the control condition, the occupational physician condition and the e-mental health condition, respectively. In these conditions the total average annualised costs were €1752, €1266 and €1375 per nurse. The median incremental cost-effectiveness ratio for the occupational physician condition versus the control condition was dominant, suggesting cost savings of €5049 per treatment responder. The incremental cost-effectiveness ratio for the e-mental health condition versus the control condition was estimated at €4054 (added costs) per treatment responder. Sensitivity analyses attested to the robustness of these findings.

CONCLUSIONS

The occupational physician condition resulted in greater treatment responses for less costs relative to the control condition and can therefore be recommended. The e-mental health condition produced less treatment response than the control condition and cannot be recommended as an intervention to improve work functioning among nurses.

Are workers who leave a job exposed to similar physical demands as workers who develop clinically meaningful declines in low-back function?

OBJECTIVE

The objective is to quantify differences in physical exposures for those who stayed on a job (survivor) versus those who left the job (turnover).

BACKGROUND

It has been suggested that high physical job demands lead to greater turnover and that turnover rates may supplement low-back disorder incidence rates in passive surveillance systems.

METHOD

A prospective study with 811 participants was conducted. The physical exposure of distribution center work was quantified using a moment monitor. A total of 68 quantitative physical exposure measures in three categories (load, position, and timing) were examined. Low-back health function was quantified using the lumbar motion monitor at baseline and 6-month follow-up.

RESULTS

There were 365 turnover employees within the 6-month follow-up period and 446 "survivors" who remained on the same job, of which 126 survivors had a clinically meaningful decline in low-back functional performance (cases) and 320 survivors did not have a meaningful decline in low-back functional performance (noncases). Of the job exposure measures, 6% were significantly different between turnover and cases compared to 69% between turnover and noncases. Turnover employees had significantly greater exposure compared to noncases.

CONCLUSION

Turnover employees had similar physical job exposures to workers who remained on the job and had a clinically meaningful decline in low-back functional performance. Thus, ergonomists and HR should be aware that high turnover jobs appear to have similar physical exposure as those jobs that put workers at risk for a decline in low-back functional performance.

Physical therapists versus nurses in a rehabilitation hospital: comparing prevalence of work-related musculoskeletal complaints and working conditions

The objective of this study was to investigate the prevalence and work avoidance of work-related musculoskeletal complaints and to compare patient handling tasks and psychosocial factors of physical therapists (PTs) and nurses in a rehabilitation hospital. Cross-sectional observational study was carried out using questionnaires relating to basic demographics, prevalence of musculoskeletal morbidity, workload, and job satisfaction. Comparing 26 PTs and 54 nurses, all females, lower back pain was significantly more prevalent in PTs, even after adjusting for the confounding demographic factors; PTs performed full and partial manual patient transfer, as well as trunk bending and walking assistance more frequently than the nurses and were significantly more satisfied. Unique physical load could be the main factor for the high prevalence of lower back pain in PTs. They should urgently initiate a "no-lift policy" in treatment.

Comparison of physical therapy with energy healing for improving range of motion in subjects with restricted shoulder mobility

Two forms of energy healing, Reconnective Healing (RH) and Reiki, which involve light or no touch, were tested for efficacy against physical therapy (PT) for increasing limited range of motion (ROM) of arm elevation in the scapular plane. Participants were assigned to one of 5 groups: PT, Reiki, RH, Sham Healing, or no treatment. Except for no treatment, participants were blinded as to grouping. Range of Motion, self-reported pain, and heart rate variability (HRV) were assessed before and after a 10-minute session. On average, for PT, Reiki, RH, Sham Healing, and no treatment, respectively, ROM increased by 12°, 20°, 26°, 0.6°, and 3° and pain score decreased by 11.5%, 10.1%, 23.9%, 15.4%, and 0%. Physical therapy, Reiki, and RH were more effective than Sham Healing for increasing ROM (PT: F = 8.05, P = 0.008; Reiki: F = 10.48, P = 0.003; RH: F = 30.19, P < 0.001). It is possible that this improvement was not mediated by myofascial release because the subjects' HRV did not change, suggesting no significant increase in vagal activity. Sham treatment significantly reduced pain compared to no treatment (F = 8.4, P = 0.007) and was just as effective as PT, Reiki, and RH. It is the authors' opinion that the accompanying pain relief is a placebo effect.

Development of an instrument to measure attitudes of physical therapy providers working with people with dementia

BACKGROUND AND PURPOSE

This study investigated the factor structure of an instrument to measure attitudes and beliefs of how physical therapist (PT) practitioners perceive working with people with a dementia disorder.

METHODS

A survey was mailed to every skilled nursing facility in Indiana (n = 495) for completion by a PT or physical therapist assistant. The survey was developed and included whether the severity of Alzheimer's disease (AD) impacts the attitudes of physical therapy practitioners.

RESULTS

Of the 12 attitudinal questions, 11 were significant (P < .001) concerning how the severity of a diagnosis of AD (early, middle, and late) impacts attitudes of people in physical therapy practice. Principal component analysis identified 3 factors with Eigen values of 3.3 or higher accounting for 43% of the cumulative variance. These factors include professional competence, resources, and conscientiousness.

CONCLUSION

This brief instrument could serve as an assessment tool to determine whether PT practitioners exhibit therapeutic nihilism when working with people with a dementia disorder.

Speech-Language Pathologist Job Satisfaction in School Versus Medical Settings

Purpose

The goal of this study was to determine if job satisfaction differs between speech-language pathologists (SLPs) working in school settings and SLPs working in medical settings.

Method

The Job Satisfaction Survey (JSS) by Spector (1997) was sent via electronic mail to 250 SLPs in each of the 2 settings. Job satisfaction scores were computed from subscale category ratings and were compared between the 2 settings. Subscale category ratings for pay, promotion, supervision, benefits, contingent rewards, operating conditions, coworkers, nature of work, and communication were analyzed for differences between and within settings. Age, caseload size, and years-at-position were analyzed by linear regression to determine whether these factors might predict SLPs' job satisfaction.

Results

The survey had a response rate of 19.6% ( N = 98 participants). Although SLPs in both settings were generally satisfied with their jobs, SLPs in medical settings had significantly higher total job satisfaction scores. Respondents from both settings had similar satisfaction ratings for subscale categories, with nature of work receiving the highest rating and operating conditions and promotion the lowest. Results of the linear regression analysis for age, caseload size, and years-at-position were not significant.

Conclusion

Further research should evaluate important aspects of job satisfaction in both settings, especially nature of work operating conditions, and promotion.

Recent experiences and challenges of military physiotherapists deployed to afghanistan: a qualitative study

PURPOSE

Military physiotherapists in the Canadian Forces meet the unique rehabilitation needs of military personnel. Recently, the physiotherapy officer role has evolved in response to the Canadian Forces' involvement in the combat theatre of operations of Afghanistan, and this has created new and unique challenges and demands. The purpose of this study was to describe the experiences and challenges of military physiotherapists deployed to Afghanistan.

METHODS

A qualitative research design guided by descriptive phenomenology involved recruitment of key informants and in-depth interviews as the data collection method. The interviews were transcribed verbatim and the data analyzed using a foundational thematic analysis approach. Strategies of peer review and member checking were incorporated into the study design.

RESULTS

Six military physiotherapists were interviewed. They described rewarding experiences that were stressful yet highly career-satisfying. Main challenges revolved around heavy workloads, an expanded scope of practice as sole-charge practitioners, and the consequences and criticality of their clinical decisions.

CONCLUSIONS

Our findings suggest that enhanced pre-deployment training and the implementation of a stronger support network will improve the capabilities of military physiotherapists deployed to difficult theatres of operations. This type of systematic and comprehensive research is needed to assist the Canadian Forces in proactively preparing and supporting physiotherapists deployed on future missions.

A survey study of musculoskeletal disorders among eye care physicians compared with family medicine physicians

PURPOSE

To evaluate the prevalence of musculoskeletal disorders among eye care physicians compared with family medicine physicians.

DESIGN

Case control study.

PARTICIPANTS AND CONTROLS

Ophthalmologists and optometrists at the University of Iowa and Mayo Clinic (participants) and family medicine physicians at the University of Iowa and Mayo Clinic (controls).

METHODS

An electronic survey was e-mailed to all subjects.

MAIN OUTCOME MEASURES

The prevalence of musculoskeletal symptoms between eye care providers and family medicine physicians (control group).

RESULTS

One hundred eight-six surveys were completed by 94 eye care physicians and 92 family medicine physicians with a response rate of 99% and 80%, respectively. There were no significant differences between the 2 groups with regard to mean age, gender, body mass index, years with current employer, or years in practice. Eye care providers, compared with their family medicine colleagues, reported a higher prevalence of neck (46% vs 21%; P<0.01), hand/wrist pain (17% vs 7%; P = 0.03), and lower back pain (26% vs 9%; P<0.01). A greater proportion of eye care physicians classified their job as a high-strain job (high demand, low control; 31% vs 20%) and a lower proportion classified their job as an active job (high demand, high control; 24% vs 47%; p = 0.01). Several job factors reported by eye care providers to contribute to musculoskeletal symptoms included performing the same task repeatedly, working in awkward/cramped positions, working in the same position for long periods, and bending/twisting the back (all P<0.01).

CONCLUSIONS

In this survey, the study group, composed of ophthalmologists and optometrists, had a higher prevalence of neck, hand/wrist, and lower back pain compared with family medicine physicians; repetitive tasks, prolonged or awkward/cramped positions, and bending/twisting were contributory factors. Given the ramifications of these findings, future efforts should concentrate on modifications to the eye care providers' work environment to prevent or alleviate musculoskeletal disorders and their personal and socioeconomic burden.

Retention and attrition factors for female certified athletic trainers in the National Collegiate Athletic Association Division I Football Bowl Subdivision setting

CONTEXT

Organizational effectiveness and the continuity of patient care can be affected by certain levels of attrition. However, little is known about the retention and attrition of female certified athletic trainers (ATs) in certain settings.

OBJECTIVE

To gain insight and understanding into the factors and circumstances affecting female ATs' decisions to persist in or leave the National Collegiate Athletic Association Division I Football Bowl Subdivision (NCAA D-I FBS) setting.

DESIGN

Qualitative study.

SETTING

The 12 NCAA D-I FBS institutions within the Southeastern Conference.

PATIENTS OR OTHER PARTICIPANTS

A total of 23 women who were current full-time ATs (n = 12) or former full-time ATs (n = 11) at Southeastern Conference institutions participated.

DATA COLLECTION AND ANALYSIS

Data were collected via in-depth, semistructured interviews, transcribed verbatim, and analyzed via a grounded theory approach. Peer review and member checking methods were performed to establish trustworthiness.

RESULTS

The decision to persist involved 4 main factors: (1) increased autonomy, (2) increased social support, (3) enjoyment of job/fitting the NCAA D-I mold, and (4) kinship responsibility. Two subfactors of persistence, the NCAA D-I atmosphere and positive athlete dynamics, emerged under the main factor of enjoyment of job/fitting the NCAA D-I mold. The decision to leave included 3 main factors: (1) life balance issues, (2) role conflict and role overload, and (3) kinship responsibility. Two subfactors of leaving, supervisory/coach conflict and decreased autonomy, emerged under the main factor of role conflict and role overload.

CONCLUSIONS

A female AT's decision to persist in or leave the NCAA D-I FBS setting can involve several factors. In order to retain capable ATs long term in the NCAA D-I setting, an individual's attributes and obligations, the setting's cultural issues, and an organization's social support paradigm should be considered.

The first year of practice: an investigation of the professional learning and development of promising novice physical therapists

BACKGROUND

The goal in studying expertise is not merely to describe ways in which experts excel but also to understand how experts develop in order to better facilitate the development of novices. The study of novice progression helps us to understand what successful versus unsuccessful learning looks like. This understanding is critical, as autonomous practice places increased demands for advanced clinical judgments and the ability to assume professional responsibilities.

OBJECTIVES

The purpose of this study was to explore the experiences, learning, and development of promising novice therapists throughout their first year of practice in the United States.

DESIGN AND METHODS

A longitudinal, multiple-site qualitative case study method was used for within-case and across-case analysis. A purposive sample of 11 promising new graduates from 4 physical therapist education programs participated. Investigators followed the graduates throughout their first year of practice. Data sources included: (1) semistructured interviews conducted at baseline and every 3 months thereafter for 1 year, (2) reflective journals completed at regular intervals, and (3) review of academic and clinical education records and résumés.

RESULTS

Four themes emerged: (1) the clinical environment influenced the novice physical therapists' performance, (2) participants learned through experience and social interaction and learning was primarily directed toward self, (3) growing confidence was directly related to developing communication skills, and (4) therapists were engaged in professional identity formation and role transitions.

CONCLUSIONS

The findings suggest there are common experiences and themes that emerge as novice physical therapists develop. Although research has been conducted on expertise in physical therapy, few longitudinal investigations have explored the development of therapists across transitions from graduate to novice to expert practitioner. This study explored and described the learning and development of graduates during their first year of practice.

Impact of work-related pain on physical therapists and occupational therapists

BACKGROUND

Physical therapists and occupational therapists experience high rates of work-related pain. Although most therapists continue to work through this pain, it interferes with work and alters therapists' work habits. However, the effects on productivity, quality of patient care, and therapists' quality of life and long-term career plans are unknown.

OBJECTIVES

The purpose of this study was to determine the impact of working with work-related pain on physical therapists and occupational therapists.

DESIGN

Multiple methods were used in this study. It was primarily a phenomenological study.

METHODS

A phenomenological approach was used to explore the meaning of work-related pain in therapists. Focus group interviews were used as the method of data collection. A questionnaire was used to supplement the qualitative analysis.

RESULTS

Nineteen therapists participated in 4 focus groups ranging from 2 to 7 participants each. The participants noted substantial effects of work-related pain at work, at home, and in their career plans. All of the therapists were concerned about their potential clinical longevity. The professional culture complicated these effects by forcing therapists into a professional ideal.

CONCLUSIONS

Work-related pain affects therapists in several personal and professional domains. It also may affect career plans. Strategies to reduce the risk of injury and physical loading of jobs are needed.

Associação entre características pessoais, organização do trabalho e presença de dor em funcionários de uma indústria moveleira

Os distúrbios osteomusculares relacionados ao trabalho são afecções que atingem os tecidos moles. Têm um nexo causal com fatores de risco ergonômicos e um caráter insidioso e multifatorial, apresentando como sintoma comum dores musculoesqueléticas. O objetivo deste estudo foi investigar possível associação entre características pessoais, organização do trabalho e presença de dor em funcionários de uma indústria moveleira no município de Araçatuba, SP. Foi aplicado um questionário a uma amostra de 158 funcionários de diversos setores da empresa, com questões de caráter sociodemográfico (sexo, idade), trabalhista (setor, tempo de serviço, função desempenhada e jornada de trabalho semanal), bem como sobre sintomas dolorosos musculoesqueléticos. Dor foi relatada por 58,9% dos funcionários e relacionada de maneira significativa com o sexo (p=0,0001), setor de trabalho (p=0,0021), função desempenhada (p=0,0135) e jornada de trabalho semanal (p=0,0123). A dor predominou em mulheres, dependendo do setor, da função desempenhada e da jornada de trabalho semanal. Para tentar saná-la, a maioria dos trabalhadores usa medicamentos ou adota a atitude de ignorá-la. Os resultados sugerem a necessidade de intervenção fisioterapêutica preventiva.