Physiotherapists' perceptions of their role in the rehabilitation management of individuals with obesity.

PURPOSE: To examine physiotherapists' perceptions of their role in the rehabilitation management of individuals with obesity. METHODS: A Web-based survey was conducted in 2008. Participants were recruited through the Canadian Physiotherapy Association (CPA) via electronic communication and were eligible if they had entry level to practice qualifications and were residents of Canada. The online questionnaire consisted of 61 statements pertaining to potential PT roles, barriers, and learning needs, developed using the framework of CPA's position statement on obesity. Frequencies were computed for all Likert-scale response items on the questionnaire. RESULTS: A total of 851 physiotherapists, representative of CPA membership, participated in the study. There was strong agreement that physiotherapists have a role to play in the management of clients who are obese through exercise interventions (96%), mobility training (97%), and cardiorespiratory programmes for impairments associated with obesity (95%). Respondents were less clear about their role in the assessment of body fat or patients' weight loss. Lack of client motivation was identified as a barrier to treatment. CONCLUSION: Physiotherapists were clear that they see their role as largely focused on exercise and education to treat conditions associated with obesity. These are important components but do not by themselves constitute an overall management plan.Purpose: To examine physiotherapists' perceptions of their role in the rehabilitation management of individuals with obesity. Methods: A Web-based survey was conducted in 2008. Participants were recruited through the Canadian Physiotherapy Association (CPA) via electronic communication and were eligible if they had entry level to practice qualifications and were residents of Canada. The online questionnaire consisted of 61 statements pertaining to potential PT roles, barriers, and learning needs, developed using the framework of CPA's position statement on obesity. Frequencies were computed for all Likert-scale response items on the questionnaire. Results: A total of 851 physiotherapists, representative of CPA membership, participated in the study. There was strong agreement that physiotherapists have a role to play in the management of clients who are obese through exercise interventions (96%), mobility training (97%), and cardiorespiratory programmes for impairments associated with obesity (95%). Respondents were less clear about their role in the assessment of body fat or patients' weight loss. Lack of client motivation was identified as a barrier to treatment. Conclusion: Physiotherapists were clear that they see their role as largely focused on exercise and education to treat conditions associated with obesity. These are important components but do not by themselves constitute an overall management plan.

RÉSUMÉ Objectif : Examiner les perceptions qu'ont les physiothérapeutes de leur rôle dans la gestion de la réadaptation des personnes souffrant d'obésité. Méthode : Un sondage par Internet a été réalisé en 2008. Les participants ont été recrutés par l'intermédiaire de l'Association canadienne de physiothérapie (ACP) par communication électronique. Pour être admissibles, ils devaient posséder les compétences de base nécessaires à la pratique de la physiothérapie et être résidents du Canada. Le questionnaire en ligne qui leur a été soumis comportait 61 affirmations relatives au rôle potentiel des physiothérapeutes, aux obstacles et aux besoins de formation en pratique. Ces affirmations ont été préparées à partir des grandes lignes de l'énoncé de position de l'ACP en matière d'obésité. Les fréquences ont été calculées pour toutes les réponses du questionnaire recueillies à l'aide de l'échelle de Likert. Résultats : Au total, 851 physiothérapeutes représentatifs des membres de l'ACP ont participé à l'étude. Les répondants se sont dits fortement en accord avec le fait que les physiothérapeutes ont un rôle à jouer dans la gestion des clients obèses, par des interventions en matière d'exercices (96 %), par de l'entraînement à la mobilité (97 %) et par des programmes cardiorespiratoires pour faire face aux incapacités associées à l'obésité (95 %). Les répondants n'étaient pas aussi clairs quant à leur rôle dans l'évaluation du gras corporel ou de la perte de poids des patients. La motivation des clients a été citée comme un obstacle au traitement. Conclusion : Les physiothérapeutes perçoivent clairement leur rôle comme celui de professionnels centrés sur l'exercice et l'éducation pour le traitement de problèmes associés à l'obésité. Ces résultats semblent indiquer que leur rôle constitue une composante importante mais incomplète d'un plan de gestion global de l'obésité.

Physical therapists' experiences updating the clinical management of walking rehabilitation after stroke: a qualitative study.

BACKGROUND: Little is known about physical therapists' experiences using research evidence to improve the delivery of stroke rehabilitation. OBJECTIVES: The purpose of this study was to explore how physical therapists use research evidence to update the clinical management of walking rehabilitation after stroke. Specific objectives were to identify physical therapists' clinical questions related to walking rehabilitation, sources of information sought to address these questions, and factors influencing the incorporation of research evidence into practice. DESIGN AND METHODS: Two authors conducted in-depth telephone interviews with 23 physical therapists who treat people with stroke and who had participated in a previous survey on evidence-based practice. Data were analyzed with a constant comparative approach to identify emerging themes. RESULTS: Therapists commonly raised questions about the selection of treatments or outcome measures. Therapists relied foremost on peers for information because of their availability, ease of access, and minimal cost. Participants sought information from research literature themselves or with the help of librarians or students. Research syntheses (eg, systematic reviews) enabled access to a body of research. Older therapists described insufficient computer and search skills. Most participants considered appraisal and application of research findings challenging and identified insufficient time and peer isolation as organizational barriers to the use of research. CONCLUSIONS: Physical therapists require efficient access to research syntheses primarily to inform the measurement and treatment of walking limitation after stroke. Continuing education is needed to enhance skills in appraising research findings and applying them to practice. Older therapists require additional training to develop computer and search skills. Peer networks and student internships may optimize the exchange of new knowledge for therapists working in isolation.

Identification of recruitment and retention strategies for rehabilitation professionals in Ontario, Canada: results from expert panels.

BACKGROUND: Demand for rehabilitation services is expected to increase due to factors such as an aging population, workforce pressures, rise in chronic and complex multi-system disorders, advances in technology, and changes in interprofessional health service delivery models. However, health human resource (HHR) strategies for Canadian rehabilitation professionals are lagging behind other professional groups such as physicians and nurses. The objectives of this study were: 1) to identify recruitment and retention strategies of rehabilitation professionals including occupational therapists, physical therapists and speech language pathologists from the literature; and 2) to investigate both the importance and feasibility of the identified strategies using expert panels amongst HHR and education experts. METHODS: A review of the literature was conducted to identify recruitment and retention strategies for rehabilitation professionals. Two expert panels, one on Recruitment and Retention and the other on Education were convened to determine the importance and feasibility of the identified strategies. A modified-delphi process was used to gain consensus and to rate the identified strategies along these two dimensions. RESULTS: A total of 34 strategies were identified by the Recruitment and Retention and Education expert panels as being important and feasible for the development of a HHR plan for recruitment and retention of rehabilitation professionals. Seven were categorized under the Quality of Worklife and Work Environment theme, another seven in Financial Incentives and Marketing, two in Workload and Skill Mix, thirteen in Professional Development and five in Education and Training. CONCLUSION: Based on the results from the expert panels, the three major areas of focus for HHR planning in the rehabilitation sector should include strategies addressing Quality of Worklife and Work Environment, Financial Incentives and Marketing and Professional Development.

A personality trait-based interactionist model of job performance.

Evidence for situational specificity of personality-job performance relations calls for better understanding of how personality is expressed as valued work behavior. On the basis of an interactionist principle of trait activation (R. P. Tett & H. A. Guterman, 2000), a model is proposed that distinguishes among 5 situational features relevant to trait expression (job demands, distracters, constraints, releasers, and facilitators), operating at task, social, and organizational levels. Trait-expressive work behavior is distinguished from (valued) job performance in clarifying the conditions favoring personality use in selection efforts. The model frames linkages between situational taxonomies (e.g., J. L. Holland's [1985] RIASEC model) and the Big Five and promotes useful discussion of critical issues, including situational specificity, personality-oriented job analysis, team building, and work motivation.