Score: 17.6, Published: 2024-02-11
DOI: 10.1101/2024.02.09.24302501
BackgroundGiven the escalating challenges for UK-based physiotherapists in workload pressures, budget constraints, staff shortages and patient wait times, the profession (of 65,000 registered physiotherapists) requires immediate care and review of therapist health. This pioneering study aims to examine perfectionism, moral injury, and burnout among UK-based physiotherapists across the NHS, private practice, sports, and academia. MethodThis cross-sectional study utilised an online survey and implementation of Structure Equation Modelling (SEM) to assess the interplay of Perfectionism (Multidimension Perfectionism Scale-Short Form), Moral Injury (Moral Injury Symptoms Scale-Healthcare Professionals) and Burnout (Shirom-Melamed Burnout Questionnaire). Our sample size calculation shows representation of the UK physiotherapy profession via utilisation of 95% confidence interval with a 5% margin of error. FindingsOur analysis conducted on (n=402) UK-based physiotherapists reveals significant burnout levels - 96% are categorised as moderate to high. Furthermore, associations and SEM of Perfectionism and Moral Injury collectively account for a substantial proportion of burnout variability (r2.62), highlighting their sequential impact on burnout manifestation. InterpretationWith such high levels of burnout, urgent intervention is paramount. Elevated burnout presents challenges for the physiotherapy profession as staff retention, accurate and effective patient care, and overall health are severely impacted due to burnout. Recognising and addressing perfectionism and moral injury becomes pivotal to mitigate its impact on individual and collective health. FundingNo funding was acquired for this research project.
Score: 3.9, Published: 2024-02-12
DOI: 10.1101/2024.02.09.24302483
ObjectivesThe evidence supports early and intensive mobilization and physical activity for hospitalized patients following a hip fracture. Since bedrest and inactivity during acute care are potentially fatal, we need updated knowledge of levels of physical activity in a diverse clinical population. Therefore, the objective was to determine levels of physical activity among a broad representation of patients hospitalized following hip fracture, and secondly to explore the association with 30-day post-discharge readmission, and mortality. DesignProspective cohort study SettingData were collected at two university hospitals in the Capital Region of Denmark from March to June 2023. ParticipantsPatients hospitalized following hip fracture. Main outcome measures24-hr upright time (time standing and walking) was measured from inclusion (post-operative day (POD) 1-3) to discharge using a thigh-worn accelerometer. Readmission and mortality were verified by electronic patient records. Results101 patients (62 women) with a mean (SD) age of 79.9 (8.4) years were included. The median (IQR) 24-hr upright time on POD2-6 ranged from 15 (6.9:31.0) to a maximum of 34 (16:67) mins. Patients with cognitive impairment had less upright time than patients without. Post-surgery length of stay was a median of 7 (5:8) days. 25% of the patients were readmitted or had emergency ward referrals and 3% died within 30 days of discharge (no clear association with upright time). ConclusionsPhysical activity seems extremely low among a broad representation of patients within the first week following a hip fracture but was not found to influence readmissions. Considering the strong evidence supporting physical activity during acute hospitalization, the low activity level in these patients calls for action. Clinicaltrials.gov-identifier: NCT05756517