The Role of the Physical Therapist in Cystic Fibrosis Care.

In looking back on 2020 and 2021, this Perspective reflects on the monumental impacts of the rollout of cystic fibrosis (CF) transmembrane conductance regulator highly effective modulator therapies and the COVID-19 pandemic on the management of CF. Advancements in the clinical management of people with CF have been both enormous and rapid, and physical therapists specializing in the care of people with CF have been at the forefront of driving this evolution in care. This year sees the thirtieth anniversary of the UK Association of Chartered Physiotherapists in Cystic Fibrosis and, as is inevitable in reaching such milestones, thoughts have turned to origins, role, impacts, and the future. With the changing demographics of the population of people with CF after the introduction of highly effective modulator therapies, potentially with fewer secondary complications, the future role of the physical therapist who specializes in CF is in question. This Perspective reflects upon and highlights the role of physical therapy within CF and provides insights into how physical therapists and respiratory therapists can evolve their roles to ensure relevance for the future.

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.

Implementation of digital health interventions in rehabilitation: A scoping review.

OBJECTIVE: Digital health interventions have potential to enhance rehabilitation services by increasing accessibility, affordability and scalability. However, implementation of digital interventions in rehabilitation is poorly understood. This scoping review aims to map current strategies, research designs, frameworks, outcomes and determinants used to support and evaluate the implementation of digital interventions in rehabilitation. DATA SOURCES: Comprehensive searches from inception until October 2022 of MEDLINE, CINAHL, PsycINFO, PEDro, SpeechBITE, NeuroBITE, REHABDATA, WHO International Clinical Trial Registry and the Cochrane Library. METHODS: Two reviewers screened studies against the eligibility criteria. Implementation science taxonomies and methods, including Powell et al.'s compilation of implementation strategies, were used to guide analysis and synthesis of findings. RESULTS: The search retrieved 13,833 papers and 23 studies were included. Only 4 studies were randomised controlled trials and 9 studies (39%) were feasibility studies. Thirty-seven discrete implementation strategies were reported across studies. Strategies related to training and educating clinicians (91%), providing interactive assistance (61%), and developing stakeholder interrelationships (43%) were most frequently reported. Few studies adequately described implementation strategies and methods for selecting strategies. Almost all studies measured implementation outcomes and determinants; most commonly, acceptability, compatibility and dose delivered of digital interventions. CONCLUSION: The rigour of implementation methods in the field is currently poor. Digital interventions require carefully planned and tailored implementation to facilitate successful adoption into rehabilitation practice. To keep pace with rapidly advancing technology, future rehabilitation research should prioritise using implementation science methods to explore and evaluate implementation while testing effectiveness of digital interventions.

Transformational leadership vs. proactive personality: Contributing factors to physiotherapists proactive behaviors and burnout during the SARS-COV-2 pandemic.

BACKGROUND: In May 2019, the World Health Organization (WHO) added burn out to the list of occupational phenomena in the 11th Revision of the International Classification of Diseases (ICD-11). Soon thereafter, in March 2020, a global pandemic of SARS-COV-2 was declared. OBJECTIVE: To investigate the interplay between transformational leadership, a proactive personality, employee proactive behaviors, and burn out in the field of physiotherapy during the SARS-COV-2 pandemic. METHODS: Physiotherapists working at the Meuhedet Health Maintenance Organization (HMO) were asked to fill an online cross-sectional survey, in which they were asked to evaluate the transformational behavior of their manager and to assess their own burn out rate, degree of self-efficacy, proactive personality, and proactive behaviors. Eighty-one physical therapists (average age of 37.3 years (SD = 9.0)) responded to the survey, most of whom were female (67.9%, n = 55). RESULTS: Transformational leadership and proactive personality were negatively associated with occupational burn out (ß = -0.231, p < 0.05, ß = -0.243, p < 0.05, respectively) among physiotherapists. The effect of the interaction between transformational leadership and proactive personality on proactive behaviors at work was not significant. However, a strong, significant positive relationship was found between proactive personality and proactive behaviors (ß = 0.425, p < 0.001), and between self-efficacy and proactive behaviors (ß = 0.479, p < 0.001). CONCLUSIONS: This up-to-date survey of transformational leadership and proactive personality among physiotherapists highlights these traits' important impact on burn out and proactive behaviors during the SARS-COV-2 pandemic. Furthermore, the transformational manager plays an important role in reducing burnout levels among physiotherapists, especially during a crisis such as the SARS-COV-2 pandemic.

Headache, Loss of Smell, and Visual Disturbances: Symptoms of SARS-CoV-2 Infection? A Case Report.

OBJECTIVE: The purpose of this case report is to describe the main components of the history and physical examination that led to idiopathic intracranial hypertension differential diagnosis, which initially was investigated as COVID-19. METHODS (CASE DESCRIPTION): A 28-year-old woman complaining of constant headache and loss of smell and taste was suspected as SARS-CoV-2 infection by her general practitioner. She underwent 3 molecular swab tests, all negative, then decided to seek her physical therapist for relieving headache. RESULTS: The full cranial nerve examination revealed impaired olfactory (CNI), abducens (CN VI), and facial (CN VII) nerves, leading the physical therapist to refer the patient to a neurosurgeon for a suspected central nervous system involvement. The neurosurgeon prescribed a detailed MRI and an ophthalmologic examination, which allowed for the final diagnosis of idiopathic intracranial hypertension. CONCLUSION: An urgent lumbo-peritoneal shunting surgery resolved the patient's symptoms and saved her sight. Despite the ongoing COVID-19 pandemic, health care professionals must pay attention to properly investigating patients' signs and symptoms using comprehensive clinical reasoning, considering the screening for referral to specialist medical attention. IMPACT: A thorough physical examination is required for every patient even if patients' signs and symptoms are in line with apparent common and widespread pathologies. Cranial nerve evaluation is an essential component of the physical therapist assessment and decision-making process. The ongoing pandemic highlighted the fundamental assistance of physical therapists toward physicians in the screening and management of musculoskeletal diseases.

The mental health of laboratory and rehabilitation specialists during COVID-19: A rapid review.

Backgrounds: Healthcare workers have experienced considerable stress and burnout during the COVID-19 pandemic. Among these healthcare workers are medical laboratory professionals and rehabilitation specialists, specifically, occupational therapists, and physical therapists, who all perform critical services for the functioning of a healthcare system. Purpose: This rapid review examined the impact of the pandemic on the mental health of medical laboratory professionals (MLPs), occupational therapists (OTs) and physical therapists (PTs) and identified gaps in the research necessary to understand the impact of the pandemic on these healthcare workers. Methods: We systematically searched "mental health" among MLPs, OTs and PTs using three databases (PsycINFO, MEDLINE, and CINAHL). Results: Our search yielded 8887 articles, 16 of which met our criteria. Our results revealed poor mental health among all occupational groups, including burnout, depression, and anxiety. Notably, MLPs reported feeling forgotten and unappreciated compared to other healthcare groups. In general, there is a dearth of literature on the mental health of these occupational groups before and during the pandemic; therefore, unique stressors are not yet uncovered. Conclusions: Our results highlight poor mental health outcomes for these occupational groups despite the dearth of research. In addition to more research among these groups, we recommend that policymakers focus on improving workplace cultures and embed more intrinsic incentives to improve job retention and reduce staff shortage. In future emergencies, providing timely and accurate health information to healthcare workers is imperative, which could also help reduce poor mental health outcomes.

Underused Physical Therapy Services in Primary Care Settings: An Overview

The combined effects of longer life, noncommunicable diseases, and injuries increase the need for rehabilitation services. Although physical therapists' unique skill set on movement-related dysfunction allows for broad contributions to health care, physical therapy (PT) remains underutilized. This article situates the problem within the broader primary care context, focusing on PT's ability to mitigate disability and dysfunction in complex syndromes including pelvic floor incontinence, vertigo, cancer, chronic neuromusculoskeletal pain, and long coronavirus disease (ie, lingering effects after acute coronavirus disease infection passes). The path from PT research to clinical implementation remains dependent on factors beyond research evidence. This overview underscores the need to address this evidence to practice gap.

The Beat Goes On: How PTs and PTAs Can Help Ease the Projected Increases in Cardiovascular Disease

The article discusses how physical therapists (PT) and PT assistants (PTA) can help avert projected cardiovascular disease (CVD) increases as of February 2023. Topics covered include CVD's higher incidence among minority groups, and PTs' primary task to assess risk, identify risk factors, and provide risk therapy, and their subsequent task to advise patients on how they can proactively address these risks factors. Also noted are PTs' possible education of underserved populations.

The Impact of Moral Injury on Patients and Colleagues

The article discusses the concept of moral injury that refers to a provider's inability to provide care due to the conflict of a clinician's task and their calling to help people. It cites a case where two physical therapists (PT) faced an ethical issue on whether to accept the organization's lower care standard mindset or make independent decisions in the patient's best interest. Also noted are these developments' consequences on the PTs' mental health and their effective delivery of care.

Experiences of physical therapists during the COVID-19 pandemic: an interpretive phenomenological analysis.

INTRODUCTION: The COVID-19 pandemic is the most fundamental challenge to the healthcare system in current generations. Physical therapists (PTs), as essential members of the healthcare team, were impacted substantially. Understanding their experiences during this unique and challenging time would help PTs manage the pandemic and future crises in healthcare. It may also reveal professional changes that may persist through the pandemic and beyond. PURPOSE: To describe the experiences of PTs in the New York metropolitan area during the initial wave of the pandemic. METHODS: This was an interpretive phenomenological study. Data were collected during 8 focus groups of 2-3 PTs each in August and September 2020 via videoconference. Audio recordings of the groups were transcribed, and data were coded in 3 rounds. RESULTS: Twenty-two PTs from a range of settings participated. Four themes were identified: (1) Everything was disrupted; (2) It was not safe; (3) It was overwhelming; and (4) There was a professional transformation. In hospitals, participants described chaos, poor communication, and unsafe working environments. In outpatient settings, participants described job instability and challenges adapting to telehealth. As the pandemic progressed inpatient PTs felt safer, gained confidence, and became critical members of interdisciplinary care teams. Outpatient therapists adapted to telehealth and experienced rising caseloads as patients returned to therapy. CONCLUSION: Physical therapists experienced a variety of challenges during the initial phases of the pandemic. As the pandemic progressed, they redefined practice.

Who You Gonna Call?

MSMA has successfully spearheaded additional reforms to reduce lawsuit abuse: expert witness reforms that require testimony to be based on evidence widely accepted by the scientific community, updates to the collateral source rule so plaintiffs can only recover actual monetary damages instead of billed charges and increasing the standard of proof for punitive damage claims. There are many groups, including the state's trial attorneys, the hospitals, integrated healthcare systems, pharmacy benefit managers, pharmacy chains, health insurers, and many others that are in Jefferson City every day often pushing positions that are at odds with what is best for our patients. Select Legislation important for Physicians and Patients that MSMA Passed or Blocked 2010 * Insurance company prompt pay (signed into law) * Naturopath licensure and scope expansion (blocked) * Private Medicaid fraud lawsuits (blocked) * Statute of limitations expansion for medical malpractice cases and weakening of the collateral source rule (blocked) * Tiering of physicians (blocked) * Autism insurance coverage (signed into law) 2011 * Drug testing of surgeons (blocked) * Chiropractors Medicaid payment (blocked) * Allowing professional counselors to diagnose (blocked) * Board of Healing Arts civil penalties (blocked) * Implementation of concussion protocols for student athletes (signed into law) * Preemption of local tobacco laws (blocked) 2012 * Increased use of ignition interlock devices (signed into law) * Regulations on the creation and operation of HIEs (signed into law) * Lay midwife licensure (blocked) * CRNA scope expansion (blocked) * Co-pay equity between primary care physicians and physical therapists (blocked) 2013 * Prompt credentialing improvements (signed into law) * Telehealth reimbursement parity (signed into law) * Repeal of collaborative practice act (blocked) * Volunteer physician malpractice immunity (signed into law) * Updating of newborn screening requirements (signed into law) * Mandatory arbitration for claims over 30 days unpaid (blocked) 2014 * Non-physician clinicians scope expansion (blocked) * Tanning bed parental permission (signed into law) * Establishment of ECHO telehealth distance learning program (signed into law) * Statewide Medicaid managed care implementation (blocked) 2015 * Tort reform (signed into law) * Establishment of direct primary care services (blocked) * Expansion of APRN scope-of-practice (blocked) * Parental notification of immunization exemptions (signed into law) 2016 * Telehealth expansion (signed into law) * Prohibit MOC/MOL for licensure (signed into law) * Licensure not conditioned on participating in any health insurance plan (signed into law) * Step therapy reform (signed into law) * Insurance contracts gag clauses banned (signed into law) * APRN, athletic trainers, physical therapists, radiology technicians scope expansion (blocked) 2017 * Expert witness reform (signed into law) * Collateral source rule updated (signed into law) * Tort reform fix for hospital non-employees (signed into law) * Requirements for medical student mental health and wellbeing (signed into law) * APRN opioid prescriptive authority expansion (blocked) * Implementation of statewide naloxone protocol (signed into law) 2018 * Protection of prudent layperson standard in the ER (signed into law) * Prohibit pharmacy gag clauses (signed into law) * Non-physician clinicians, physical therapists, radiology technicians scope expansion (blocked) * Implementation of workers compensation fee schedule (blocked) * Increased Medicaid post-partum benefits (signed into law) 2019 * Prior authorization reform (signed into law) * Prohibit use of virtual credit cards by insurers (signed into law) * Establishment of pregnancy-associated mortality review board (signed into law) * Implementation of statewide MAT insurance coverage for opioid disorders (blocked) * Defeat of various anti-vaccination requirements for physicians (blocked) * Independent pharmacist prescribing (blocked) 2020 * Punitive damages only for intentional or malicious act (signed into law) * Prompt credentialing to pay from the date of application (signed into law) * Overpayment transparency (signed into law) * Vaping prohibitions (signed into law) * Criminal penalties for gender dysmorphia treatments (blocked)

Relationship between physical activity levels of Portuguese physical therapists and mental health during a COVID-19 pandemic: Being active is the key.

Introduction: Physical activity is essential for a healthy life and quality of life, representing a fundamental role in individuals' physical and mental health. Concomitantly, the physical therapist, through the promotion of physical activity and exercise, can improve mental health, an essential factor in the current pandemic, triggering anxiety, fear, and depression crisis. Objective: To verify physical activity among Portuguese physical therapists and its association with mental health during pandemic times. Methods: An online questionnaire was applied through social media to all Portuguese physical therapists between October 21, 2021, and January 14, 2022. It contained general characterization questions of the sample, the IPAQ-SF questionnaire to assess physical activity levels, the Goldberg General Health Questionnaire (GHQ-28), which assesses the levels of mental health and the WHO Well-Being Index (WHO-5) to assess the subjective wellbeing. Results: The sample totaled 286 respondents (82% female), with a mean age of 33. Of the total answers, 82% practiced physical activity, 45% had moderate levels of physical activity, and 19% vigorous. Physical therapists in these categories had lower values in the GHQ-28 and higher in the WHO-5. Those with better mental health also showed better subjective wellbeing (r = -0.571, p = 0.000). Conclusion: The data obtained showed that physical therapists mostly have moderate and vigorous levels of physical activity and that physical activity positively influences individuals' mental health and wellbeing, which proved to be a key factor due to the pandemic situation.

The impact of COVID-19 pandemic on anxiety and depression among physical therapists in Saudi Arabia: a cross-sectional study.

BACKGROUNDS: A physical therapist may become infected while treating a patient since they are in direct contact with them or within a two-meter radius. In addition, physical therapists may feel that they are more susceptible to COVID-19 infection when applying rehabilitation practices, which often involve direct contact with patients. The physical therapist were surveyed on their level of anxiety and depression due to the Coronavirus disease pandemic (COVID-19). METHODS: The physical therapists were asked to complete two reliable and validated scales, the Generalized Anxiety Disorder scale (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), to identify the presence of anxiety and depression in the participants. In addition, logistic regression models were used to determine the general characteristics of anxiety or depression. RESULTS: Among the 117 physical therapists who completed and participated in the study, 74 (63%) and 65 (55.5%) physical therapists reported having symptoms of anxiety and depression, respectively. The prevalence of overall anxiety levels was higher; mild (OR = 2.09; P = 0.08), moderate (OR = 2.26; P = 0.15), and severe levels six times as high (OR = 6.28; P = 0.1) in females compared to male physical therapists. Females, younger age, unmarried individuals, not having children, and not living with family showed a higher prevalence of anxiety and depression. Binary logistic regression analysis also revealed that the female gender, a single individual, and having no children were associated with anxiety and depression. CONCLUSIONS: A significant percentage of physical therapists reported symptoms of anxiety and depression, especially among females, younger age, single individuals, not having children, and not living with family. Thus, the mental health of physical therapists is suggested to be constantly and cautiously monitored, especially for those at high risk of developing psychological symptoms.

Innovation: It's in Our DNA.

Colleen M. Kigin, PT, DPT, MS, MPA, FAPTA, the 52nd Mary McMillan Lecturer, is a consultant focused on innovation. She is a visiting clinical professor at the University of Colorado physical therapy program, University of Colorado School of Medicine, and an adjunct associate professor at the MGH Institute of Health Professions (MGH IHP). From 1998-2014, she held the positions of chief of staff and program manager for the Center of Integration of Medicine and Innovative Technology, a 12-institution consortium based in Boston, Massachusetts, developing innovative solutions to health care problems. She subsequently has served as a consultant to such efforts as the University of Manchester, Manchester Academic Health Science Centre, United Kingdom, to develop an innovation culture. In 1994, she joined the newly formed Partners HealthCare System in Boston, coordinating the system's cost reduction efforts through 1998. Kigin previously served as director of physical therapy services at Massachusetts General Hospital (MGH) (1977-1984) and as assistant professor at MGH IHP (1980-1994). While at MGH, she was responsible for the merger of 2 separate physical therapy departments, the establishment of the first nonphysician specialist position, and practice without referral for the physical therapy services. Kigin has held numerous positions within the American Physical Therapy Association (APTA), serving on the Board of Directors from 1988-1997, including as vice president; co-chair of The Physical Therapy Summit in 2007; and co-chair of FiRST, the Frontiers in Rehabilitation, Science and Technology Council. She also served as prior chair of the APTA Committee on Clinical Residencies and served on the American Board of Physical Therapy Specialties. Kigin earned a bachelor of science degree in physical therapy at the University of Colorado, a master of science degree at Boston University, a master's degree in public administration from the Harvard Kennedy School of Government, and a doctor in physical therapy degree from the MGH IHP.

Performance of Subnational Governments in the COVID-19 Pandemic: An Analysis of the Public and Private Health Services in Brazil

This article analyzes the differences between public and private health services regarding infrastructure and human resources at the state (subnational) and macro-regional levels in Brazil. The research collected monthly data on inpatient beds and the number of nurses, physiotherapists, and doctors from Brazilian states for 2020. Indicators were created following quarterly changes and comparing the actions of public and private healthcare entities. Variations were analyzed using temporal graphs based on means and standard deviation. The findings suggest: (1) exponential growth in health care infrastructure and human resources led by public sector investment in the second quarter, followed by a slowdown;(2) a more significant variation in the acceleration and deceleration of the public sector response in the North of Brazil and the states of Maranhäo, Rio Grande do Norte, and the Federal District;(3) the public sector was the primary response mechanism to the pandemic considering the variations throughout the year. The study concludes that the government was the leading actor in response to the COVID-19 pandemic in Brazil in 2020, pointing out that responses were uneven in the states.

Protocol for the development of a 'trustworthy' living systematic review and meta analyses of manual therapy interventions to treat neuromusculoskeletal impairments.

BACKGROUND: Preprocessed research resources are believed to be highly 'trustworthy' when translating research to clinical practice. However, the overall 'trustworthiness' is unknown if this evidence contains randomized clinical trials (RCTs) where prospective has not been/cannot be verified, has low confidence in estimated effects, and if they are not up to date. OBJECTIVES: This protocol will be used to create a baseline benchmark for a series of trustworthy living systematic reviews (SRs) regarding manual therapy interventions. METHODS: Data will originate from RCTs related to manual therapy neuromusculoskeletal interventions, indexed in 6 search engines in English from 1 January 2010, to the present. Two blinded reviewers will identify the RCTs and extract data using Covidence. The data will be synthesized based on consensus and analyzed using the Cochrane collaboration's Review Manager. EXPECTED OUTCOMES: It is expected that there will be a shortage of RCTs with at least a moderate confidence in estimated effects that will allow for strong practice recommendations. DISCUSSION: Identifying evidence that can be translated into strong practice recommendations is essential to identify beneficial and harmful interventions, decrease practice variability, and identify neuromusculoskeletal manual therapy interventions that require further disciplined methodological focus.

Death and resistance: Professionals on the front line against COVID-19

The COVID-19 pandemic has intensely affected the quality of life and labor conditions of healthcare workers (HCWs). This study sought to understand the experiences of 16 professionals in medicine, nursing and physical therapy who work on the "frontline" of the new Coronavirus. A phenomenological design was used. Results were organized into four axes: (a) the impact of the arrival of the pandemic;(b) participants' progressive exhaustion;(c) fear and coping;and (d) rethinking life and death. Experiences of anguish, anxiety, depression, and physical and psychological health problems stand out. It was possible to observe that the lack of national coordination, in addition to unscientific political positions, were felt as an aggravating factor for work demands, and that impotence in the face of the disease implicated in rethinking the meaning of life and death. According to the JD-R model, the need to expand resources and emotional support so HCWs can properly manage psychosocial risk factors at work is evident. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Portuguese) A pandemia vem afetando intensamente a qualidade de vida e condicoes laborais dos trabalhadores da saude (TS). Este estudo teve por objetivo compreender as vivencias de 16 profissionais da medicina, enfermagem e fisioterapia que atuam na "linha de frente" do novo coronavirus. Empregou-se desenho fenomenologico. Os resultados foram organizados em quatro eixos: (a) o impacto da chegada;(b) desgaste progressivo;(c) medo e enfrentamento e (d) repensando a morte e a vida. Destacam-se vivencias de angustia, ansiedade, depressao, agravos a saude fisica e psicologica. Foi possivel observar que a falta de coordenacao nacional somada a posicionamentos politicos anticientificos foi sentida como agravante das demandas laborais e que a impotencia diante da doenca implicou repensar o sentido da vida e da morte. Com base no modelo JD-R, fica evidente a necessidade de ampliar recursos e suporte emocional aos TS a fim de administrar adequadamente os Fatores Psicossociais de Risco no Trabalho. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Spanish) La pandemia ha afectado intensamente la calidad de vida y condiciones laborales de los trabajadores de la salud (TS). Este estudio busco conocer experiencias de 16 profesionales de medicina, enfermeria y fisioterapia que trabajan en la "primera linea" del nuevo coronavirus. Se utilizo diseno fenomenologico. Los resultados se organizaron en: (a) el impacto de la llegada;(b) desgaste progresivo;(c) miedo y confrontacion;y (d) repensar la muerte y la vida. Se destacan experiencias de angustia, ansiedad, depresion, problemas de salud fisica y psicologica. Se observo que la falta de coordinacion nacional, sumada a posiciones politicas acientificas, fue un agravante de demandas laborales y que la impotencia frente a la enfermedad implicaba repensar el sentido de la vida y la muerte. Desde el modelo JD-R, es evidente la necesidad de ampliar recursos y apoyo emocional a los TS para gestionar adecuadamente los Factores de Riesgo Psicosoc ial en el Trabajo. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Impact of the COVID-19 Pandemic on the Work Activity of Spanish Physical Therapists and Their Response to Vaccination.

Due to the COVID-19 pandemic, physical therapists have had to adopt a set of specific protection measures, which have had an impact on their clinical activity and economy. The objective was to evaluate the impact of the COVID-19 pandemic on the work of Spanish physical therapists, as well as their attitudes and predisposition to vaccination. An online questionnaire was divided into five sections: (1) demographic and professional data; (2) labor impact; (3) precautions and infection-control measures; (4) economic impact; and (5) vaccine acceptance and adverse effects. Of the 666 participants, 62.1% showed a reduction in their working hours motivated by: fear of infection (p = 0.007), financial issues (p = 0.002) and being in quarantine or isolation (p < 0.001). Of these, 36.4% were forced to close the clinic, 62.7% requested help from the government, but only 12.04% mentioned that it was adequate. The main prevention measures adopted were the use of gels and masks and, in the private sector, disinfection with ozone or ultraviolet light (p < 0.05). The acceptance of the vaccine was high, 87.5%, being lower among the group over 40 years of age, self-employed, widowed or separated. More adverse effects were mentioned after receiving the AstraZeneca-Oxford vaccine, compared to Pfizer-BioNTech or Moderna. In conclusion, this study assessed for the first time that the COVID-19 pandemic in Spain had a negative impact on work and finances of physical therapists. The vaccine was widely accepted, in part by the economic impact that an infection in the work setting could signify.