RESUMO
CONTEXT: Professionalism has been discussed and defined in a variety of ways, including attire and other forms of self-expression. OBJECTIVES: To determine athletic trainer (AT), physical therapist (PT), and athletic training or PT students' perceptions of appearance-based professionalism in the workplace and, secondly, to ascertain how perceptions differed across professions. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: Athletic trainers, PTs, and athletic training and PT students who were predominantly White, non-Hispanic, female, aged 30 ± 9 years, and recruited via listservs and social media. DATA COLLECTION AND ANALYSIS: The independent variables were participant demographics. The dependent variables were self-reported perceptions of professionalism for each photo. The survey consisted of 3 sections: demographics, 8 photos of ATs or PTs with depictions of patient-provider interactions, and open-ended responses. For each photo, participants selected yes, no, or unsure regarding the photo. An open-ended response was prompted with a no or unsure selection. The participant further described the reason for that choice. RESULTS: Most participants determined the health care provider depicted in 7 photos appeared professional. Only 1 photo was deemed unprofessional by the professional majority. Significant differences existed between students and professionals for 5 photos. The proportion of participants who reported the photos were unprofessional differed among professions for 2 photos. From our qualitative analysis, we found 6 domains: (1) unprofessional attire and hair, (2) situation-dependent attire, (3) role confusion and health care employer or employee identification, (4) nonappearance related, (5) tattoo-related bias, and (6) rethinking after question is displayed. CONCLUSION: What is considered appropriate and professional is not concrete. Differing concepts of professionalism generated biased judgments and criticisms. CLINICAL RELEVANCE: Our findings should lead providers to reexamine the definition of professionalism. The past should not dictate the future, and today's social mores can help shape the definition as it should be considered in today's settings.
Assuntos
Fisioterapeutas , Profissionalismo , Humanos , Feminino , Estudos Transversais , Adulto , Masculino , Fisioterapeutas/psicologia , Inquéritos e Questionários , Atitude do Pessoal de Saúde , Pessoal de Saúde/psicologia , Local de Trabalho/psicologia , PercepçãoRESUMO
CONTEXT: Limited research exists regarding athletic trainers' (ATs') perceptions of professionalism. OBJECTIVE: To explore the lived experiences of ATs and their perceptions of professionalism. DESIGN: Qualitative study. SETTING: Participants were ATs who completed a semistructured interview protocol via audio-only recording conferencing. PATIENTS OR OTHER PARTICIPANTS: Seventeen participants (age = 33 ± 8 years; range = 25-56 years) who were certified ATs with an average of 10 years of experience (SD = ±8; range = 1-33 years) were interviewed. DATA COLLECTION AND ANALYSIS: Individuals self-identified their interest in participating in a follow-up interview recruitment located within a survey. Interviews occurred until saturation was met and included a variety of participants. Demographic information was gathered from the survey for each person. All transcripts were audio recorded, transcribed verbatim, and coded using a 3-person coding team following the consensual qualitative research protocol. Member checking, auditing, and triangulation established trustworthiness and credibility in the data-analysis process. RESULTS: A total of 4 domains with supporting categories were identified. Athletic trainers spoke of the employee environment that affected perceptions of what was determined to be professional, specifically in various settings or situations. They shared their personal determination of outward appearance and expression when differentiating what was deemed professional, including references to cleanliness, judgment of self-expression, and implicit bias. Whether intentional or unintentional, participants made comments that demonstrated a bias toward sex or race and ethnicity when determining outward appearance appropriateness. They noted various cultural awareness situations, including progression of perceptions over time, external pressure, and internal dialog. Respondents shared discourse regarding an internal struggle of what was right and wrong in their responses. They discussed professionalism based on the provider's conduct, mainly in terms of communication and patient care. Participants shared that communication occurring through both verbal and nonverbal means is vital to the perceptions of professionalism for ATs. CONCLUSIONS: Current views of professionalism in athletic training were shaped by various lived experiences. With the movement toward athletic training becoming more diverse, equitable, and inclusive, antiquated professionalism ideals need to shift to provide a better work environment for all.
Assuntos
Profissionalismo , Pesquisa Qualitativa , Humanos , Adulto , Masculino , Feminino , Pessoa de Meia-Idade , Inquéritos e Questionários , Esportes , Educação Física e TreinamentoRESUMO
OBJECTIVES: The main research aims were to investigate whether physical therapists are examining the hip(s) in individuals with a primary complaint of low back pain (LBP) and if so, the interventions being provided that target the hip(s). METHODS: An anonymous electronic survey was distributed to the membership of the American Physical Therapy Association Orthopaedic and Sports Sections, as well as that of the American Academy of Orthopaedic Manual Physical Therapists. Participant demographics and survey responses were analyzed using descriptive statistics. Associations between variables were examined using chi-square analysis. RESULTS: The estimated response rate was 18.4% (n=1163, mean age 40.5±11.4 years). The majority of respondents (91%, n=1059) reported they always or most of the time examined the hip(s) in individuals with LBP. The most common examination items utilized were hip strength testing (94%, n=948), passive range of motion (91%, n=921) and muscle flexibility testing (90%, n=906). The most common interventions included hip strengthening (94%, n=866) and hip flexibility exercises (90%, n=814). Respondents enrolled in or having completed a post-professional fellowship were more likely to utilize hip joint manual therapy techniques (x2=25.3, p=<0.001) and less likely to prescribe hip flexibility exercises (x2=7.9, p=0.005) or use electrophysical modalities (x2=4.3, p=0.039). CONCLUSIONS: Physical therapists commonly examine and provide interventions directed at the hip(s) for individuals with LBP. Post-professional fellowship training appears to influence the intervention selection of the physical therapist, with an increase in usage of hip joint manual therapy and a decrease in hip muscle flexibility and modality usage.
Assuntos
Quadril/fisiologia , Dor Lombar/terapia , Fisioterapeutas/estatística & dados numéricos , Terapia por Exercício , Humanos , Dor Lombar/fisiopatologia , Esportes , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Recent evidence suggests that physical therapy interventions targeting the hips may improve outcomes, including pain and disability, for patients with low back pain (LBP). Currently, there is conflicting data in regard to whether an individual with LBP needs to have a concurrent hip impairment in order to respond to this approach. The purpose of this clinical trial will be to determine the short and long-term effectiveness of physical therapy interventions directed at the lumbar spine only, versus lumbar spine and hip(s), in individuals with a primary complaint of LBP with a concurrent hip impairment. METHODS: A multi-center, randomized controlled trial of 76 adult individuals with a primary complaint of LBP, who also have at least one concurrent hip impairment. Participants will be randomized into the 'LBP only' or 'LBP+Hip' group. Treatment to the low back in both groups will be a pragmatic approach consisting of interventions targeting the low back without targeting the hip(s). Participants randomized to the LBP+Hip group will also receive a semi-prescriptive set of manual therapy and exercise techniques that target the hips. The primary outcome measures will be the modified Oswestry Disability Index and the Numeric Pain Rating Scale at discharge. DISCUSSION: These two treatment strategies are commonly utilized in physical therapy practice, but there is uncertainty which is superior. This trial will also help to provide a better understanding of the role of concurrent hip impairments in LBP. TRIAL REGISTRATION: This trial has been prospectively registered at clinicaltrials.gov (ID# NCT03550014, https://clinicaltrials.gov/ct2/show/NCT03550014) on June 7, 2018.