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Objective: To conduct a business case analysis for Department of Veterans Affairs (VA) program STRIDE (ASsisTed EaRly MobIlization for hospitalizeD older VEterans), which was designed to address immobility for hospitalized older adults. Data Sources and Study Setting: This was a secondary analysis of primary data from a VA 8‐hospital implementation trial conducted by the Function and Independence Quality Enhancement Research Initiative (QUERI). In partnership with VA operational partners, we estimated resources needed for program delivery in and out of the VA as well as national implementation facilitation in the VA. A scenario analysis using wage data from the Bureau of Labor Statistics informs implementation decisions outside the VA. Study Design: This budget impact analysis compared delivery and implementation costs for two implementation strategies (Replicating Effective Programs [REP]+CONNECT and REP‐only). To simulate national budget scenarios for implementation, we estimated the number of eligible hospitalizations nationally and varied key parameters (e.g., enrollment rates) to evaluate the impact of uncertainty. Data Collection: Personnel time and implementation outcomes were collected from hospitals (2017–2019). Hospital average daily census and wage data were estimated as of 2022 to improve relevance to future implementation. Principal Findings: Average implementation costs were $9450 for REP+CONNECT and $5622 for REP‐only; average program delivery costs were less than $30 per participant in both VA and non‐VA hospital settings. Number of walks had the most impact on delivery costs and ranged from 1 to 5 walks per participant. In sensitivity analyses, cost increased to $35 per participant if a physical therapist assistant conducts the walks. Among study hospitals, mean enrollment rates were higher among the REP+CONNECT hospitals (12%) than the REP‐only hospitals (4%) and VA implementation costs ranged from $66 to $100 per enrolled. Conclusions: STRIDE is a low‐cost intervention, and program participation has the biggest impact on the resources needed for delivering STRIDE. Trial Registration: ClinicalsTrials.gov NCT03300336. Prospectively registered on 3 October 2017. [ABSTRACT FROM AUTHOR]

Introduction/Objective: The purposes of this study were to determine the presence of burnout in physical therapists and physical therapist assistants, examine differences in burnout between demographic groups, and explore circumstances that contribute to and alleviate burnout. Methods: A cross-sectional survey consisting of demographic questions, the Maslach Burnout Inventory, and open-ended questions was conducted within two health systems. Descriptive statistics and nonparametric tests were used to analyze responses to close-ended questions and to examine differences between groups. Thematic analysis was used to analyze open-ended questions. Results: In total, 202 individuals participated in the study; 146 participants responded to at least one open-ended question (72.3%). Participants, regardless of demographic characteristic, demonstrated at least some degree of burnout on each subscale. Ten major themes emerged from analysis of circumstances that contribute to and alleviate burnout: 1) workload; 2) schedule; 3) work-life balance; 4) care continuum; 5) coping/morale; 6) team dynamics and resources; 7) psychological or emotional burden; 8) compensation and recognition; 9) physical therapy as a profession; and 10) COVID-19. Conclusion: Burnout is present within physical therapists regardless of demographic group. Understanding circumstances that contribute to and alleviate burnout is an important first step to develop and research strategies to address these circumstances to positively impact the provider, patient, and the healthcare system. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol use disorder (AUD) is a psychiatric disease that affects approximately 10% of the population. Individuals suffer from a myriad of causes and consequences of AUD, and team-based management of patients is often required for given the chronic and complex nature of the disease. Interprofessional education (IPE) for biomedical science and health professional students that incorporates patient-centered cases focused on AUD and adjacent stress-related disorders may improve future collaboration in managing these conditions and community outcomes related to wellbeing. Methods: This study assessed the impact of a single, 90-minute IPE exercise on improving confidence in possessing the knowledge and skills required for screening and management of patients at risk for AUD, the role of social determinants in health and stress-related diseases, and the importance of supporting the mental health of professionals to improve patient care. The exercise was provided to three groups of post-baccalaureate students (physician assistant [PA], physical therapy [PT], and biomedical sciences [BMS] graduate programs) within a human physiology course. Pre- and post-test surveys were administered via web-based platform before and after the session. Results: We found significant improvements in responses to seven of the eight assessment questions, including improved knowledge of one's role in biomedical research or brief interventions for alcohol misuse, increased confidence in advising patients and community members about responsible alcohol drinking, and improved understanding of the role of all three professions (PA, PT, and BMS) in managing, treating, or researching stress-related disorders. Discussion: These findings suggest that a single focused IPE session is impactful for improving student knowledge and understanding of stress-related disorders. IPE may represent an important educational strategy to bring together future scientists and health professionals to reflect upon unique and shared knowledge bases as well as integrative care principles for both patient and professional wellbeing. [ABSTRACT FROM AUTHOR]

Background Compassionate care is an important component of quality healthcare. Compassion fatigue (CF) is common among healthcare providers. However, there are limited studies investigating components of compassion fatigue among physical therapists and physical therapist assistants. This study investigates the prevalence of compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) among physical therapists and physical therapist assistants in the state of Mississippi during the COVID-19 pandemic. Methods A cross-sectional descriptive survey approach was used to collect data from 187 licensed physical therapists and physical therapy assistants in Mississippi. The survey utilized the Professional Quality of Life (ProQOL) questionnaire to assess the participants' well-being and job satisfaction. Results The results showed that the mean scores of the ProQOL subscales indicated a majority of individuals experienced medium (55%) to high (44%) compassion satisfaction. Burnout scores were low (41%) to medium (59%) with no response recording a high burnout rating. A majority (99%) of participants reported medium (37%) to low (62%) secondary traumatic stress. There were some significant differences in the mean scores in relation to the participants' demographic characteristics. Age showed a significant positive association with compassion satisfaction (β=2.724, p=0.011) but not burnout (β=-1.471, p=0.149) or secondary traumatic stress (β=-0.454, p=0.633). The results of the study showed that respondents 55 years old or older reported the highest mean compassion satisfaction score, the lowest burnout score, and the lowest secondary traumatic stress score. Being a male is negatively associated with secondary traumatic stress (β=-4.063, p<0.001) but not compassion satisfaction (β=-0.779, p=0.483) or burnout (β=-1.222, p=0.252). Neither education nor care type were significant predictors for compassion satisfaction, burnout, and secondary traumatic stress. Whether respondents worked overtime appeared to be a significant predictor for secondary traumatic stress (β=3.520, p<0.001) but not for compassion satisfaction (β=1.043, p=0.321) or burnout (β=1.167, p=0.247). Conclusions The findings of this study suggest that physical therapists in Mississippi experienced both compassion satisfaction as well as burnout and secondary traumatic stress during the COVID-19 pandemic. However, the degree to which each individual experienced these were dependent on various factors and not all were statistically significant. Age, sex, and corresponding experience level of the practitioner seemed to play the biggest role. The results of this study highlight individual factors that could increase a physical therapist's or physical therapist assistant's likelihood of developing compassion fatigue. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Individuals with advanced Parkinson's Disease (PD) and Parkinson-related disorders (PRD) are frequently referred for home allied therapies and nursing care, yet home healthcare professionals have limited training in PD/PRD. While recognizing the need for such care, patients and families report home healthcare professionals are unfamiliar with these conditions, which may be driven by neurophobia and may contribute to suboptimal care and early termination of services. We sought to determine the feasibility and effects of a virtual, multimodal educational intervention on PD knowledge, confidence, and empathy among home health professionals. Methods: Home health nurses, occupational therapists, physical therapists and physical therapy assistants, and speech-language pathologists participated in a daylong, virtual symposium on advanced PD/PRD, combining focused lectures, discipline-specific breakout sessions, immersive virtual reality vignettes, and interactive panels with both patients and families, and movement disorders and home healthcare experts. Participants completed online pre- and post-symposium surveys including: demographics; PD/PRD knowledge (0–10 points possible); empathy (Interpersonal Reactivity Index); and 10-point scales of confidence with and attitudes towards individuals with PD/PRD, respectively. Pre-post intervention changes and effect sizes were evaluated with paired t-tests and Cohen's d. We performed qualitative analyses of post-symposium free-text feedback using a grounded theory approach to identify participants' intentions to change their practice. Results: Participants had a mean improvement of 3.1 points on the PD/PRD knowledge test (p < 0.001, d = 1.97), and improvement in confidence managing individuals with PD/PRD (p = 0.0003, d =.36), and no change in empathy. The interactive, virtual format was rated as effective by 95%. Common themes regarding symposium-motivated practice change included: interdisciplinary collaboration; greater involvement and weighting of the patient and caregiver voice in care plans; attention to visit scheduling in relation to patient function; recognition and practical management of the causes of sudden change in PD/PRD, including infections and orthostatic hypotension. Conclusions: A virtual, multimodal, brief educational pilot intervention improved PD/PRD-specific knowledge and confidence among home healthcare nurses and allied health professionals. Future studies are necessary to test the short- and long-term effects of this intervention more broadly and to investigate the impact of this education on patient and caregiver outcomes. [ABSTRACT FROM AUTHOR]

Background: Integrating psychosocial resources into orthopaedic clinics can reduce psychological distress and opioid use after injury, enhance functional outcomes, and increase patient satisfaction with care. Establishing referral pathways for connecting orthopaedic patients with psychosocial resources requires the active collaboration and buy-in of orthopaedic healthcare professionals. Designing and disseminating psychosocial training materials for orthopaedic healthcare professionals requires a nuanced understanding of orthopaedic healthcare professionals' current attitudes toward addressing psychosocial factors, including any stigma and misconceptions about mental health that exist.Questions/purposes: (1) What are orthopaedic healthcare professionals' attitudes toward addressing patient psychosocial factors, and how are they related? (2) How do orthopaedic healthcare professionals' beliefs, reasonings, and experiences help to explain these attitudes? (3) How do attitudes differ between physicians and nonphysician healthcare professionals?Methods: In this multisite, mixed-methods study (that is, a study collecting both quantitative and qualitative data), our team of psychology researchers conducted qualitative focus groups over secure live video with 79 orthopaedic healthcare professionals at three geographically diverse Level I trauma centers. We approached all orthopaedic healthcare professionals within the three trauma centers to participate in the study to collect as many diverse perspectives as possible. Eighty-four percent (79 of 94) of the professionals we approached participated in qualitative data collection (the group of professionals comprised 20 attending surgeons; 28 residents; 10 nurse practitioners, registered nurses, and physician assistants; 13 medical assistants; five physical therapists and social workers; and three research fellows). We also asked participants to complete self-report items that assessed their attitudes toward addressing patients' psychosocial factors (research question 1). The different attitudes identified through the quantitative measurement served as a priori defined themes within which our two independent coders organized the qualitative data and identified beliefs and experiences that explained attitudes (research question 2). We used both quantitative and qualitative data to assess differences between surgeons and residents and nonphysician healthcare professionals (research question 3).Results: We quantitatively identified six underlying attitudes toward addressing psychosocial factors: professional confidence, perceived resource availability, fear of offending patients, fear of negative patient reactions, blame toward patients, and professional role resistance. We observed a strong quantitative correlation between the attitudes of professional confidence and perceived resource availability, and qualitative data revealed how healthcare professionals' willingness to discuss psychosocial issues with patients is shaped by their perception of psychosocial resources available for orthopaedic patients, as well as their perception of their own skills and tools to navigate these conversations. Quantitative data suggested that surgeons and residents endorse higher blame toward patients for psychosocial factors (medium effect size; p = 0.04), which is a stigmatizing attitude that serves as a barrier to integrating psychosocial resources into orthopaedic settings.Conclusion: The varying levels of confidence orthopaedic healthcare professionals reported with respect to the topic of discussing psychosocial factors and the misconceptions they endorse regarding psychosocial factors (such as blame toward patients) highlight the need for more specific education for orthopaedic healthcare professionals to help equip them with skills to raise and discuss psychosocial factors with patients in an empathic and destigmatizing manner.Clinical Relevance: The strong relationship observed between the attitudes of professional confidence and perceived resource availability suggests that expanding the provision of psychosocial resources in orthopaedic settings and establishing specific, efficient referral processes to connect patients with psychosocial resources will in turn increase orthopaedic healthcare professionals' confidence discussing psychosocial issues with patients. [ABSTRACT FROM AUTHOR]

Objective The purposes of this study were to 1) determine the level of professional quality of life among physical therapists and physical therapist assistants in Alabama and 2) to identify personal or professional factors that may contribute to compassion satisfaction (CS), burnout, and secondary traumatic stress (STS). Methods This study used a cross-sectional design and mixed-methods survey methodology to calculate odds ratios for factors affecting professional quality of life. Respondents completed a survey that included the Professional Quality of Life (ProQOL) scale, an open-ended question regarding their experience with professional burnout, and personal and professional demographics. Results Of the 742 physical therapists and physical therapist assistants in Alabama who completed the survey, the majority experienced moderate-high levels of CS and moderate-low levels of burnout and STS. Regression analyses indicated clinicians working 40 or more hours per week in patient care had greater odds for low-moderate CS and moderate-high burnout and STS subscale scores. Clinicians in our sample licensed between 6 to 15 or more than 30 years and those working in private outpatient settings had reduced odds of having moderate-high burnout, whereas those working 16 or more years had significantly increased odds for high CS scores. Responses to the open-ended question indicated workload demands and documentation as the top factors contributing to clinician burnout, while the connections with patients and coworkers help minimize such feelings. Conclusion Individuals later in their career may develop protective factors to mitigate feelings of burnout compared to those early in their career. Also, clinicians working 40 or more hours per week may be more vulnerable to experiencing low-moderate CS and moderate-high burnout. Thus, individual clinicians and employers must evaluate personal, occupational, and systemic factors that contribute to reduced professional quality of life to inform preventive strategies for mitigating burnout. [ABSTRACT FROM AUTHOR]

PURPOSE: We evaluated the attitudes of nurses compared to physiotherapy assistants and medical masseurs (PAMs) regarding various treatment modalities used in the treatment of low-back pain (LBP) as their opinions might influence the patients' attitudes to therapy. DESIGN: Cross sectional self-reported questionnaire survey. METHODS: 175 Hungarian health care providers completed questionnaires evaluating their opinions on the importance of various therapeutic interventions and the need for initiation of LBP treatment. Their personal LBP history and fear-avoidance beliefs (FABQ) were also investigated. FINDINGS: The importance of exercise therapy (p = 0.024) and massage (p < 0.01) was evaluated higher by the PAMs, while medication (p = 0.04) was scored higher by the nurses. Those who experienced moderate or severe LBP were more positive about pain medication than to those with mild pain (p = 0.048). Years in health care work had only a weak association with opinions. The nurses reported more fear-avoidance beliefs than the PAMs about both physical activity (p = 0.024) and work (p = 0.021). Those who experienced moderate or severe LBP had higher FABQ scores (p = 0,076), however the difference was significant only for FABQ activity (p = 0.035). CONCLUSIONS: Our study confirmed that professional background and years of experience can influence the attitudes towards the importance of certain therapies, although these differences were small. Experiencing moderate or severe LBP increased the fear-avoidance beliefs about work and physical activity independently of the professional background. CLINICAL RELEVANCE: Our study draws the attention to the importance of standardization of the information to be passed to the patients and to the need of discussing personal experiences and beliefs during professional training. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to investigate the physical therapy process of care, clinical practices, and the self-reported psychosocial impact of working during the 2020 pandemic on physical therapists and physical therapist assistants. Methods An electronic survey including closed and open-ended questions was distributed to physical therapists employed in a range of health care settings across the United States. Results Physical therapy use and process of care varied across settings. Feasibility of performing an assessment was the main driver for selection of outcome measures. Interventions were mainly geared toward improving respiratory function and deconditioning. Prone patient positioning, now commonplace, was used infrequently by therapists in acute care prior to coronavirus disease 2019 (COVID-19). Similarly, outpatient and home care settings noted an increase in the use of respiratory-driven interventions such as incentive spirometry and breathing exercises. Qualitative data analysis revealed both physical barriers (personal protective equipment [PPE]) and social barriers to care. Therapists noted challenges in discharge planning and patient/family education due to the impact of social isolation. They also noted difficulty maintaining productivity standards because of additional time spent in changing PPE and following safety measures. Participants dealt with rapid changes in their role, changing productivity standards, and needing to increase their knowledge in a short amount of time. Conclusion Physical therapy use varied widely across settings. Despite some concern for personal health, respondents felt that the COVID-19 pandemic increased a sense of togetherness among team members and promoted greater appreciation for life and work. Impact This exploration of the process of care and current clinical practices across settings provides important knowledge about the role of physical therapists and physical therapist assistants in the care of patients with COVID-19. Gaining an understanding of the psychosocial impact of the pandemic among therapists could assist in creating solutions to better support clinicians' well-being. [ABSTRACT FROM AUTHOR]