(Almost) 50 shades of an ethical situation — international physiotherapists’ experiences of everyday ethics: a qualitative analysis

Sturm, Andrea; Edwards, Ian; Fryer, Caroline; Roth, Roswith

doi:10.1080/09593985.2021.2015812

Cited by 10 publications

(13 citation statements)

References 40 publications

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“…Discriminatory experiences reported by the front-line physiotherapists in relation to managing patients with COVID-19 as front-line healthcare workers is a novel finding in this study and has not been reported by other studies of patients with COVID-19. This finding aligns with a general lack of recognition of the role, scope and autonomy of physiotherapy by individuals, healthcare professionals especially physicians, government and the society globally, although this might be worse in low income settings 29–33. The front-line physiotherapists felt that they were not regarded as legitimate front-line members of the COVID-19 teams in Nigeria.…”

Section: Discussionmentioning

confidence: 56%

Experiences of physiotherapists involved in front-line management of patients with COVID-19 in Nigeria: a qualitative study

et al. 2022

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ObjectivesEvidence-based guidelines recommend physiotherapy for respiratory treatment and physical rehabilitation of patients with COVID-19. It is unclear to what extent physiotherapy services are used in the front-line management of COVID-19 in Nigeria. This study aimed to explore the experiences of front-line physiotherapists managing patients with COVID-19 in Nigeria.DesignQualitative interview-based study.SettingICU and hospital COVID-19 wards, COVID-isolation and treatment centres in Nigeria, between August 2020 and January 2021.ParticipantsEight out of 20 physiotherapists managing patients with COVID-19 in the front line were recruited using purposive and snowball sampling.MethodsQualitative in-depth semistructured telephone interviews of all consenting physiotherapists managing patients with COVID-19 in the front line in Nigeria were conducted and transcribed verbatim. Transcripts were thematically analysed.ResultsEight front-line physiotherapists (three neurological physiotherapists, two orthopaedic physiotherapists, one cardiopulmonary physiotherapist, one sports physiotherapist and one rotational physiotherapist) provided consent and data for this study. Four themes and 13 subthemes were generated illustrating discriminatory experiences of front-line physiotherapists, particularly from COVID-19 team leads; lack of multidisciplinary teamwork within COVID-19 teams; wide ranging stigmatisation from extended family members, colleagues, friends and the general public; material and psychosocial personal losses; lack of system support and suboptimal utilisation of physiotherapy in the management of COVID-19 in Nigeria. Personal agency, sense of professionalism, previous experience managing highly infectious diseases and being a cardiopulmonary physiotherapist were the factors that made the front-line physiotherapists to become involved in managing patients with COVID-19. However, discriminatory experiences made some of these physiotherapists to stop being involved in the management of patients with COVID-19 in the front line. Most front-line physiotherapists were not cardiopulmonary physiotherapists which may have influenced their level of expertise, multidisciplinary involvement and patient outcomes.ConclusionsThere is suboptimal involvement and support for physiotherapists, particularly cardiopulmonary physiotherapists treating patients with COVID-19 in the front line in Nigeria.

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Section: Discussionmentioning

confidence: 56%

Experiences of physiotherapists involved in front-line management of patients with COVID-19 in Nigeria: a qualitative study

et al. 2022

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“…This points to the commitment of physiotherapists to emancipation from influences of individual and organisational factors, and the confidence physiotherapists possess with professional ethical decision-making, despite unfavourable educational or working conditions. Developing and holding up individual moral integrity, especially in the light of organisational pressures, requires courage, as it could sometimes lead to diametrical consequences [ 1 , 62 ], burn-out or/and result in the decision to leave the job or the profession in general [ 1 , 41 , 64 , 65 ]. Participants clearly agreed with the statement that a recognisable organisational culture of ethical practice can help physiotherapists to make good ethical decisions.…”

Section: Discussionmentioning

confidence: 99%

“…Also, there is a plead for mandatory post-graduate ethics trainings [ 67 ], as already required in some countries for physiotherapists’ continuing professional development (CPD) and licensure renewal [ 70 , 71 ]. As ethical situations emerge on social, cultural, political and organisational levels, a decontextualized understanding of ethics and ethical decision-making must be avoided [ 1 , 54 ]. Therefore, reflections on and critical discussion of physiotherapists’ practices and experiences, their practice environments and (un)ethical cultures of their workplaces are necessary for professional development.…”

Section: Discussionmentioning

confidence: 99%

“…Societal and cultural systems have been identified as key influences on physiotherapists’ ethical practice internationally [ 1 , 2 ]. Ethical practice is a domain of physiotherapist practice competence, which the World Physiotherapy Association expects graduates to have after completion of the entry-level programme [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…There is also great variability in the understanding of the body, health, illness and healing [ 35 , 36 ] and work conditions [ 6 , 27 , 37 ] around the world. Moral, professional, religious or political theories held by individual clinicians can conflict with particular ethical principles [ 38 ], as well as the values and goals of physiotherapists with those of other professionals [ 29 ], their work systems [ 1 ] and their patients [ 39 ]. Physiotherapists’ values – both personal and professional – can dictate behaviours, influence actions, and reflect their attitudes [ 40 ].…”

Section: Introductionmentioning

confidence: 99%

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Views of physiotherapists on factors that play a role in ethical decision-making: an international online survey study

Sturm¹,

Roth

Ager

2023

Arch Physiother

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Background There is a lack of knowledge about the ways physiotherapists around the world learn about professional code of ethics and ethical decision-making frameworks. The profession has a gap in the understanding about physiotherapists’ views on factors that play a role in ethical decision-making and whether these views differ between World Physiotherapy regions. Methods An online survey study in English was conducted from October 2018 to October 2019. Participants included 559 physiotherapists located in 72 countries. The self-designed survey questionnaire contained 13 items asking about demographic information and means of learning about ethical codes and decision-making frameworks. A further 30 items were presented which included statements underpinned with individual, organisational, situational and societal factors influencing ethical decision-making. Participants were asked to express their level of agreement or disagreement using a 5-point-Likert-scale. Results Participants’ highest rated responses endorsed that the professional role of physiotherapists is linked to social expectations of ethical behaviour and that ethical decision-making requires more skills than simply following a code of ethics. A recognisable organisational ethical culture was rated as supporting good ethical decisions. Comparing responses by World Physiotherapy regions showed significant differences in factors such as culture, religion, emotions, organisational values, significant others, consequences of professional misconduct and professional obligations. Entry level education was not perceived to provide a solid base for ethical decision-making in every World Physiotherapy region. Participants reported multiple sources for learning about a professional code of ethics and ethical decision-making frameworks. What’s more, the number of sources differed between World Physiotherapy regions. Conclusions Multiple factors play a role in physiotherapists’ ethical decision-making internationally. Physiotherapists’ ethical knowledge is informed by, and acquired from, several learning sources, which differ in both quality and quantity amongst World Physiotherapy regions. Easily accessible knowledge and education about professional codes of ethics and ethical decision-making can foster continuing professional development for physiotherapists. The establishment of constructive ethical cultures in workplaces can improve ethical decision-making, and should acknowledge the influence of individual, organisational, situational and societal factors. The establishment of collaborative learning environments can support knowledge translation which acknowledges practice-based methods of knowing and learning.

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Anstand und Berufsstand – Berufsethik im internationalen Vergleich

Sturm¹

2023

physiopraxis

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Für ihre Promotion beschäftigte sich Andrea Sturm mit berufsethischen Herausforderungen in der internationalen Physiotherapie. In physiopraxis berichtet die Bildungs- und Erziehungswissenschaftlerin über die Entwicklung der Berufsethik und die Ergebnisse ihrer fünfjährigen Forschungsarbeit. Fazit: Weltweit am häufigsten beklagen Physiotherapeut*innen knappe Ressourcen und Zeitmangel, welche die Qualität ihrer Behandlung beeinträchtigen. Im deutschsprachigen Raum besteht zudem Reformbedarf beim Ethikunterricht in der Grundausbildung.

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(Almost) 50 shades of an ethical situation — international physiotherapists’ experiences of everyday ethics: a qualitative analysis

Cited by 10 publications

References 40 publications

Experiences of physiotherapists involved in front-line management of patients with COVID-19 in Nigeria: a qualitative study

Experiences of physiotherapists involved in front-line management of patients with COVID-19 in Nigeria: a qualitative study

Views of physiotherapists on factors that play a role in ethical decision-making: an international online survey study

Anstand und Berufsstand – Berufsethik im internationalen Vergleich

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