Experiences and attitudes toward scientific research among physiotherapists in Austria: a cross-sectional online survey.

INTRODUCTION: Research is important for the development of physiotherapy practice, but several countries have a rather short history of physiotherapy as an academic profession. PURPOSE: This study investigated physiotherapists' experiences and attitudes toward scientific research in Austria, where physiotherapists have only been qualifying at bachelor level since 2009. METHODS: A convenience sample of 597 qualified physiotherapists completed an anonymous cross-sectional online survey. RESULTS: Most respondents were female (n = 467, 78.2%) and in age groups between: 26-35 years (n = 149, 25.0%); 36-45 years (n = 178, 29.8%); and 46-55 years (n = 173, 29.0%). Seventeen respondents (2.8%) held doctoral degrees, and 61 (10.2%) had substantial research experience beyond undergraduate or master-level student research. More positive research attitudes were observed in participants who were male, younger, without children, had completed their physiotherapy qualification since 2009, were engaged in teaching and education, and held postgraduate degrees. Most frequently reported barriers and/or enabling factors for physiotherapy research were time, training, finances and a "critical mass" of research activity. CONCLUSION: These findings highlight low levels of research activity among physiotherapists in Austria, despite general appreciation of the importance of research for the profession. The identified attitudinal profiles, barriers, and facilitators may inform initiatives for advancing physiotherapy research in the Austrian context.

Physiotherapists' job satisfaction according to employment situation: Findings from an online survey in Austria.

BACKGROUND AND PURPOSE: Physiotherapists are commonly working in self-employed, employed, or in combined employed and self-employed work arrangements. This study aimed at examining aspects of job satisfaction and predictors of physiotherapists' overall job satisfaction across those three types of work arrangements. METHODS: Austrian physiotherapists rated their overall job satisfaction as well as the importance and realisation of aspects of job satisfaction in a cross-sectional online survey. Multiple linear regression was used to identify predictors of overall job satisfaction, and (for employed therapists only) predictors for planning to change the employer. RESULTS: The sample consisted of 581 physiotherapists working in the public or private sector, of which, 342 were self-employed, 100 employed, and 139 both employed and self-employed. Physiotherapists generally indicated high job satisfaction with notable variations according to their work arrangements. Overall job satisfaction and the aspects of recognition and autonomy were higher in self-employed therapists, when compared to the other two groups. In contrast, self-employed therapists reported lower satisfaction with mentoring and peer support. Those who were both employed and self-employed reported the highest gap between the importance and realisation of their work-life balance (r = -0.50, p < 0.001). Recognition was identified as the most important predictor of job satisfaction (ß = 0.52, p < 0.001) and intention to leave (ß = -0.54, p < 0.001) in employed physiotherapists. DISCUSSION: The analysis of job satisfaction according to work arrangements suggests several approaches to increase or maintain a high level of job satisfaction, which may be addressed by employers and physiotherapy professional organisations. For employed physiotherapists, practices that increase their recognition and autonomy seem to be promising, whereas self-employed physiotherapists could benefit from enhanced opportunities for exchange and networking with colleagues. For those who are both employed and self-employed, more flexible work schedules may be helpful to integrate the demands of private patients and employer workloads.

Soft Factors, Smooth Transport? The role of safety climate and team processes in reducing adverse events during intrahospital transport in intensive care.

BACKGROUND: Intrahospital patient transports (IHTs) in intensive care involve an appreciable risk of adverse events (AEs). Research on determinants of AE occurrence during IHT has hitherto focused on patient, transport, and intensive care unit (ICU) characteristics. By contrast, the role of "soft" factors, although arguably relevant for IHTs and a topic of interest in general health care settings, has not yet been explored. PURPOSE: The study aims at examining the effect of safety climate and team processes on the occurrence of AE during IHT and whether team processes mediate the effect of safety climate. METHODOLOGY/APPROACH: Data stem from a noninterventional, observational multicenter study in 33 ICUs (from 12 European countries), with 858 transports overall recorded during 28 days. AEs include medication errors, dislodgments, equipment failures, and delays. Safety climate scales were taken from the "Patient Safety Climate in Healthcare Organizations" (short version), team processes scales from the "Leiden Operating Theatre and Intensive Care Safety" questionnaire. Patient condition was assessed with NEMS (Nine Equivalents of Nursing Manpower Use Score). All other variables could be directly observed. Hypothesis testing and assessment of effects rely on bivariate correlations and binomial logistic multilevel models (with ICU as random effect). FINDINGS: Both safety climate and team processes are comparatively important determinants of AE occurrence, also when controlling for transport-, staff-, and ICU-related variables. Team processes partially mediate the effect of safety climate. Patient condition and transport duration are consistently related with AE occurrence, too. PRACTICE IMPLICATIONS: Unlike most patient, transport, and ICU characteristics, safety climate and team processes are basically amenable to managerial interventions. Coupled with their considerable effect on AE occurrence, this makes pertinent endeavors a potentially promising approach for improving patient safety during IHT. Although literature suggests that safety climate is slow and hard to change (also compared to team processes), efforts to improve safety climate should not be forgone.

Two sides of the safety coin?: How patient engagement and safety climate jointly affect error occurrence in hospital units.

BACKGROUND: Safety climate (SC) and more recently patient engagement (PE) have been identified as potential determinants of patient safety, but conceptual and empirical studies combining both are lacking. PURPOSES: On the basis of extant theories and concepts in safety research, this study investigates the effect of PE in conjunction with SC on perceived error occurrence (pEO) in hospitals, controlling for various staff-, patient-, and hospital-related variables as well as the amount of stress and (lack of) organizational support experienced by staff. Besides the main effects of PE and SC on error occurrence, their interaction is examined, too. METHODOLOGY/APPROACH: In 66 hospital units, 4,345 patients assessed the degree of PE, and 811 staff assessed SC and pEO. PE was measured with a new instrument, capturing its core elements according to a recent literature review: Information Provision (both active and passive) and Activation and Collaboration. SC and pEO were measured with validated German-language questionnaires. Besides standard regression and correlational analyses, partial least squares analysis was employed to model the main and interaction effects of PE and SC on pEO, also controlling for stress and (lack of) support perceived by staff, various staff and patient attributes, and potential single-source bias. FINDINGS: Both PE and SC are associated with lower pEO, to a similar extent. The joint effect of these predictors suggests a substitution rather than mutually reinforcing interaction. Accounting for control variables and/or potential single-source bias slightly attenuates some effects without altering the results. PRACTICE IMPLICATIONS: Ignoring PE potentially amounts to forgoing a potential source of additional safety. On the other hand, despite the abovementioned substitution effect and conjectures of SC being inert, PE should not be considered as a replacement for SC.

A quarter of a century of job transitions in Germany.

By examining trends in intra-organizational and inter-organizational job transition probabilities among professional and managerial employees in Germany, we test the applicability of mainstream career theory to a specific context and challenge its implied change assumption. Drawing on data from the German Socio-Economic Panel (GSOEP), we apply linear probability models to show the influence of time, economic cycle and age on the probability of job transitions between 1984 and 2010. Results indicate a slight negative trend in the frequency of job transitions during the analyzed time span, owing to a pronounced decrease in intra-organizational transitions, which is only partly offset by a comparatively weaker positive trend towards increased inter-organizational transitions. The latter is strongly influenced by fluctuations in the economic cycle. Finally, the probability of job transitions keeps declining steadily through the course of one's working life. In contrast to inter-organizational transitions, however, this age effect for intra-organizational transitions has decreased over time.

Development and validation of a patient safety culture questionnaire in acute geriatric units.

BACKGROUND: Older patients (≥65 years) are exposed to more harm resulting from adverse events in hospitals than younger patients. Theoretical considerations and empirical findings suggest that safety culture is the key to improving the quality of health care. OBJECTIVE: To describe the development of a German-language instrument for assessing patient safety culture (PSC) and its reliability and validity; to verify criterion validity by means of a cross-sectional analysis of the impact of PSC on clinical quality that compares acute geriatric units with a sample from intensive care, surgery and trauma surgery departments, and to report variations in the PSC profile between these groups. METHODOLOGY: Using a review of existing safety culture surveys, multidimensional scaling procedures and expert interviews, we tested the content and convergent validity of a 158-item questionnaire completed by 508 physicians and nurses from 31 acute geriatric units and 7 comparison departments. Criterion validity was verified by various regression models with a self-reported measure of adverse events. Differences in PSC profiles were analyzed using a one-factorial ANOVA and regression models. RESULTS: We identified 7 constructs of PSC and demonstrated substantial convergent and criterion validity. In the acute geriatric units, higher levels of 'management commitment to patient safety' and lower levels of 'error fatalism' were associated with a reduced incidence of medical errors. In the comparison group, only the variable 'active learning from mistakes' was relevant for safety performance. Our results also indicate that acute geriatric units display higher standards than the comparison group in all the aspects of patient safety examined. CONCLUSION: It is possible to measure salient features of PSC using a valid and reliable survey. Some aspects of PSC are more closely related to safety events than others. In acute geriatric units, patient safety appears to be influenced mainly by management's determination of how things are done whereas improvement of the system itself in a more incremental manner is required in the other high-risk ward types.