Abstract
Background Physical therapists working in acute care hospitals require unique skills to adapt to the challenging environment and short patient length of stay. Previous literature has reported burnout of clinicians and difficulty with staff retention; however, no systematic reviews have investigated qualitative literature in the area.
Purpose The purpose of this study was to investigate the experiences of physical therapists working in acute hospitals.
Data Sources Six databases (MEDLINE, CINAHL Plus, EMBASE, AMED, PsycINFO, and Sociological Abstracts) were searched up to and including September 30, 2015, using relevant terms.
Study Selection Studies in English were selected if they included physical therapists working in an acute hospital setting, used qualitative methods, and contained themes or descriptive data relating to physical therapists' experiences.
Data Extraction and Data Synthesis Data extraction included the study authors and year, settings, participant characteristics, aims, and methods. Key themes, explanatory models/theories, and implications for policy and practice were extracted, and quality assessment was conducted. Thematic analysis was used to conduct qualitative synthesis.
Results Eight articles were included. Overall, study quality was high. Four main themes were identified describing factors that influence physical therapists' experience and clinical decision making: environmental/contextual factors, communication/relationships, the physical therapist as a person, and professional identity/role.
Limitations Qualitative synthesis may be difficult to replicate. The majority of articles were from North America and Australia, limiting transferability of the findings.
Conclusions The identified factors, which interact to influence the experiences of acute care physical therapists, should be considered by therapists and their managers to optimize the physical therapy role in acute care. Potential strategies include promotion of interprofessional and collegial relationships, clear delineation of the physical therapy role, multidisciplinary team member education, additional support staff, and innovative models of care to address funding and staff shortages.
Footnotes
All authors approved the final manuscript. Ms Lau was involved in study design; performed the searches, screening, data extraction, analysis, and interpretation; and completed the initial draft of the manuscript. Dr Skinner (guarantor) was involved in study conception and design, screening, data extraction, and interpretation and reviewed the manuscript for intellectually important content. Ms Lo was involved in study design, screening, data extraction, and interpretation and reviewed the manuscript for intellectually important content. Dr Bearman was involved in study conception and design, screening, data extraction, analysis and interpretation, and reviewed the manuscript for intellectually important content.
The study received in-kind support from the departments of physical therapy at Monash University and The University of Melbourne and from the HealthPEER Department of Monash University. No formal funding was received.
- Received May 4, 2015.
- Accepted March 10, 2016.
- © 2016 American Physical Therapy Association
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