Dataset Information

Physiotherapists' views on the Australian Physiotherapy Association's Choosing Wisely recommendations: a content analysis.

ABSTRACT: OBJECTIVES:Choosing Wisely holds promise for increasing awareness of low-value care in physiotherapy. However, it is unclear how physiotherapists' view Choosing Wisely recommendations. The aim of this study was to evaluate physiotherapists' feedback on Choosing Wisely recommendations and investigate agreement with each recommendation. SETTING:The Australian Physiotherapy Association emailed a survey to all 20 029 physiotherapist members in 2015 seeking feedback on a list of Choosing Wisely recommendations. PARTICIPANTS:A total of 9764 physiotherapists opened the email invitation (49%) and 543 completed the survey (response rate 5.6%). Participants were asked about the acceptability of the wording of recommendations using a closed (Yes/No) and free-text response option (section 1). Then using a similar response format, participants were asked whether they agreed with each Choosing Wisely recommendation (sections 2-6). PRIMARY AND SECONDARY OUTCOMES:We performed a content analysis of free-text responses (primary outcome) and used descriptive statistics to report agreement and disagreement with each recommendation (secondary outcome). RESULTS:There were 872 free-text responses across the six sections. A total of 347 physiotherapists (63.9%) agreed with the 'don't' style of wording. Agreement with recommendations ranged from 52.3% (electrotherapy for back pain) to 76.6% (validated decision rules for imaging). The content analysis revealed that physiotherapists felt that blanket rules were inappropriate (range across recommendations: 13.9%-30.1% of responses), clinical experience is more valuable than evidence (11.7%-28.3%) and recommendations would benefit from further refining or better defining key terms (7.3%-22.4%). CONCLUSIONS:Although most physiotherapists agreed with both the style of wording for Choosing Wisely recommendations and with the recommendations, their feedback highlighted a number of areas of disagreement and suggestions for improvement. These findings will support the development of future recommendations and are the first step towards increasing the impact Choosing Wisely has on physiotherapy practice.

SUBMITTER: Zadro J

PROVIDER: S-EPMC6756333 | biostudies-other | 2019 Sep

REPOSITORIES: biostudies-other

ACCESS DATA

Publications

Physiotherapists' views on the Australian Physiotherapy Association's Choosing Wisely recommendations: a content analysis.

Zadro Joshua J Peek Aimie L AL Dodd Rachael H RH McCaffery Kirsten K Maher Christopher C

BMJ open 20190920 9

<h4>Objectives</h4>Choosing Wisely holds promise for increasing awareness of low-value care in physiotherapy. However, it is unclear how physiotherapists' view Choosing Wisely recommendations. The aim of this study was to evaluate physiotherapists' feedback on Choosing Wisely recommendations and investigate agreement with each recommendation.<h4>Setting</h4>The Australian Physiotherapy Association emailed a survey to all 20 029 physiotherapist members in 2015 seeking feedback on a list of Choosi ...[more]

PMID: 31542762

Similar Datasets

Project description:BACKGROUND:It is unknown to what extent Choosing Wisely recommendations about income-generating treatments apply to members of the society generating the recommendations. The primary aim of this study is to determine the proportion of Choosing Wisely recommendations targeting income-generating treatments, and whether recommendations from professional societies on income-generating treatments are more likely to target members or non-members. The secondary aim is to determine the prevalence of qualified statements, and whether qualified statements are more likely to appear in recommendations targeting income-generating or non-income-generating treatments that apply to members. METHODS:We performed a content analysis of all Choosing Wisely recommendations, with data extracted from Choosing Wisely websites. Two researchers coded recommendations as test or treatment-based, for or against a procedure, containing qualified statements, income-generating and applying to members. Disagreements were resolved by discussion or consultation with a third researcher. A Chi-squared test evaluated whether society recommendations on income-generating treatments were more likely to target members or non-members; and whether qualified statements were more likely to appear in recommendations targeting income-generating or non-income-generating treatments that apply to members. RESULTS:We found 1293 Choosing Wisely recommendations (48.3% tests and 48.6% treatments). Ninety-eight treatment recommendations targeted income-generating treatments (17.8%), and recommendations on income-generating treatments were less likely to target members compared to non-members (15.6% vs. 40.4%, p?<?0.001). Nearly half of all recommendations were qualified (41.9%), with a similar proportion of recommendations targeting income-generating and non-income-generating treatments that apply to members containing qualified statements (49.4% vs. 42.0%, p?=?0.23). CONCLUSIONS:Many societies provide Choosing Wisely recommendations that minimise impact on their own members. Only 20% of treatment recommendations target income-generating treatments, and of these recommendations mostly target non-members. Many recommendations are also qualified. Increasing the number of recommendations from societies that are unqualified and target member clinicians responsible for de-implementation of low-value and costly treatments should be a priority.

Project description:BackgroundWith an increasingly ageing population in Australia, more older adults who are frail are living in residential aged care facilities (RACFs). The aim of this study was to detail the type, scope, and funding of physiotherapy utilised in Australian RACFs.MethodsRegistered physiotherapists (n = 219, 72% female, mean age (SD) = 38.6 (12.9) years) working in Australian RACFs participated in a nationwide, cross-sectional online survey. The survey was developed iteratively through a review of the literature and clinical guidelines, consensus of final survey items by an expert panel of five senior physiotherapists and aged care managers. Survey questions related to the characteristics of the physiotherapists (e.g., age, gender, employment status), characteristics of the RACFs (e.g., state, remoteness, sector), the type and scope of physiotherapy provided by respondents, and the availability of equipment and certain spaces (e.g., gyms) in the RACFs that respondents worked in. Survey responses were analysed and presented descriptively. Correlation using Spearman's rho (ρ) and the associated 95% confidence intervals (CI) were used to determine whether the availability of equipment or space at the RACF was associated with the time dedicated to performing non-Aged Care Funding Instrument (ACFI) tasks.ResultsCommon reasons for physiotherapy referral were chronic pain management as per the ACFI framework (89.7%), falls (69.2%), and reduced mobility (35.9%). Rehabilitation or short-term restorative care was provided in only 22.2% of the facilities. The ACFI funded 91.4% of all participants, which limited physiotherapists to low-value chronic pain management including massage and electrical stimulation. Respondents spent 64.5% of their time on ACFI tasks, which equated to 19 h per week. More time was spent on non-ACFI tasks particularly when resistance bands (ρ = 0.28, 95%CI 0.14-0.41) and a dedicated therapy space or gym (ρ = 0.19, 95%CI 0.04-0.33) were available.ConclusionsThe expertise of physiotherapists is currently being under-utilised in Australian RACFs, which may be related to the availability of public funding, equipment, and space for therapy. Therefore, public health policy should address the urgent need for high-value, evidence-based physiotherapy that supports the reablement and independence of older adults living in RACFs.

Project description:BackgroundNo documented standard or core competencies exist for paediatric curriculum in entry-level physiotherapy programs in Australia. Consequently, extensive variability is thought to exist amongst Australian entry-level physiotherapy programs for preparing physiotherapists to work safely and effectively with children. The purpose of this study was to explore the landscape of paediatric curriculum in Australian entry-level physiotherapy programs and identify the paediatric content being covered, its perceived importance according to university academics who teach paediatrics, the mode of delivery and assessment, and the strengths, weaknesses, barriers and facilitators to implementing paediatric curriculum.MethodsA web-based desktop audit and an online cross-sectional survey using closed and open-ended questions was administered to all Australian universities offering entry-level physiotherapy programs in November 2017. Content coverage and perceived level of importance for paediatric content areas were determined using Likert scale responses. Open-ended responses were thematically analysed to identify key themes for strengths, weaknesses and facilitators to implementation of paediatric curriculum.ResultsAll (n = 20, 100%) entry-level programs used the terms lifespan, child and/or paediatrics somewhere in at least one subject descriptor. Forty-five percent (n = 9) of universities did not use the terms lifespan, child or paediatric in their published learning objectives. Eight (40%) universities offered a paediatric stand-alone course. Sixty-five (13/20) percent of universities invited, responded to the survey. For paediatric conditions the perceived level of importance was predominately higher than its course content coverage for 19 of the 31 conditions surveyed. Key barriers to implementating paediatric curriculum were: crowded curriculum, limited financial resources resulting in a lack of qualified staff, lack of prioritisation of paediatric curriculum and inadequate paediatric placement availability. Facilitators for effective implementation of paediatric content were stand-alone paediatric subjects, demonstrated dedication to paediatric curriculum and having suitably qualified faculty members.ConclusionThe results of this survey provide the physiotherapy community with the views of paediatric physiotherapy academic educators regarding the content, perceived need to expand content delivery in identified clinical areas, and the barriers and facilitators to implementing paediatric content in Australian entry-level physiotherapy programs. Further research exploring similar questions with paediatric physiotherapy clinicians would complement the findings of this study.

Project description:The phenomenon of professional migrations in the healthcare sector may exacerbate the problem of health workforce shortages. The scale of migration of medical personnel in Poland is estimated mainly on the certificates issued by the regional chambers confirming qualifications that grant the legal right to practice in other EU countries. Migrations concern also physiotherapists, who are the third largest group of health professionals. However, the problem of this phenomenon has not been assessed, and there is a lack of research in this area. The aim of the study was to compare the intention of migration among practicing physiotherapists and students in the last two years of master's studies in physiotherapy, as well as to identify the factors affecting their intentions to migrate. The study covered practicing physiotherapists and students in the last two years of master's studies in the field of physiotherapy in Poland. A total of 236 respondents took part in the study, including 119 physiotherapists and 117 students of physiotherapy. The tool used for the study was an online questionnaire. The scale of the intention to migrate was estimated at 45.3% among students and 47.1% in the group of practicing physiotherapists. The most frequently indicated destination countries for the migration of physiotherapy students and practicing physiotherapists were Germany, Norway, Switzerland, France and the United Kingdom. In both studied groups, the pull factors with the greatest impact on the intention to migrate were the possibility of obtaining higher earnings and working in better infrastructural conditions. In turn, the most important push factors turned out to be the low prestige of the profession in Poland, limited prospects for professional advancement and the stressful work environment. The respondents most often indicated separation from loved ones and poor command of foreign languages as significant barriers to professional migration. Both students of physiotherapy and practicing physiotherapists show great interest in the intention of professional migration, and the decisive determinant is economic factors.

Dataset Information

Physiotherapists' views on the Australian Physiotherapy Association's Choosing Wisely recommendations: a content analysis.

Publications

Physiotherapists' views on the Australian Physiotherapy Association's Choosing Wisely recommendations: a content analysis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets