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Presents and discusses the findings of a study of the impact of the use of library services and information by physiotherapists on their decision making for patient care. A postal questionnaire was distributed to the staff of each physiotherapy department in 37 National Health Service Trust hospitals in the Northern and Yorkshire region. The methodology for the study was that used in previous studies undertaken in the USA. The “critical incident” technique was used in order to pinpoint a particular situation when a need for information, connected with patient care, had caused the respondent to seek help. The respondent was asked to pose the enquiry at their hospital library and information service point and complete a questionnaire to record the success and speed of their enquiry, and to evaluate the impact of the information on their decisions relating to patient care.

The purpose of this paper is to report findings from qualitative interviews with physiotherapists to demonstrate why even minor changes to clinical work resulting from the introduction of new interventions, are often difficult to implement. The paper seeks to illustrate how some of the obstacles to implementing change were managed by physiotherapists.

A total of 32 qualitative interviews with participating physiotherapists were conducted, 12 interviews prior to the introduction of the new system, and 20 afterwards. The interviews were coded and analysed thematically.

The findings reveal a number of perceived limitations of current management of low back pain and identify key themes around convergence with the new approach, such as willingness by physiotherapists to adopt the new approach, the perception of benefits to adopting the new approach, as well as some difficulty in adjusting to it. The authors refer to the positive and negative elements as “soft” and “hard” disruption. The adoption of the new approach is explored with reference to the “situated” dimensions of physiotherapy practice and normalisation process theory.

The study raises the need to conduct future observational research to support the interview findings.

The study describes the “situated” components of physiotherapy work, which have received limited research attention. The value of the study lies less in its ability to explain specifically why physiotherapists adopted or rejected the new system, but in describing the conditions and consequences of change that might be translated to other professions, contexts and interventions.

Physiotherapists throughout the UK have a professional obligation to keep up to date and practice effectively. The Scottish Physiotherapists Clinical Effectiveness Network (SPCEN) was established in 1999 with the aim of providing a mechanism through which physiotherapists could share and learn from experiences, avoid duplication of effort and undertake proactive activities. The purpose of this paper is to report on the experience of the SPCEN and provide an evaluation of the impact the network has made on the clinical effectiveness activities of physiotherapists throughout Scotland.

A questionnaire survey was distributed to 2,118 physiotherapists across Scotland (response rate of 54.5 per cent). It aimed to determine the level of clinical effectiveness activity, the confidence of physiotherapists in engaging in these activities and the extent of involvement with clinical guideline implementation.

Results were analysed in two groups. Group 1 consisted of those that reported that they did participate in network activities (40 per cent n=330) and Group 2, those who did not (60 per cent n=686). Participants were significantly more engaged in undertaking a range of clinical effectiveness activities than non‐participants (p<0.0001), had greater confidence in their own ability to engage and were involved in the implementation of clinical guidelines to a greater extent (p<0.0001).

Establishing the SPCEN has resulted in more confident physiotherapists who are engaging in greater levels of clinical effectiveness activity throughout Scotland.

This paper provides the reader with an indication of the value networks can achieve.

There is renewed interest in the professions as a range of occupations pursue professionalisation projects. The purpose of this paper is turn analysis to an important omission in current research – the skills deployed in the work of these professions. Such research is necessary because skills determine the formal classification of occupations as a profession.

Drawing on qualitative research, this paper explores the deployment of skills in work of one newly professionalised occupation in the UK’s National Health Service – physiotherapists.

The findings point to a disconnect between how this occupation has become a profession (the skills to get the job, and related political manoeuvring by representative bodies) and the mixed outcomes for their skills deployment (the skills to do the job) in work as a profession.

The paper provides missing empirical understanding of change for this new profession, and new conceptualisation of that change as both symbolic and substantive, with a “double hybridity” around occupational control and skill deployment for physiotherapists as a profession.

Using financial incentives has been criticised for putting too much focus on things that can be measured. Value-based reimbursement may better align professional values with financial incentives. However, professional values may differ between actor groups. In this article, the authors identify institutional logics within healthcare-providing organisations. Further, the authors analyse how the centrality and compatibility of the identified logics affect the institutionalisation of external demands.

41 semi-structured interviews were conducted with representatives from healthcare providers within spine surgery in Sweden, where a value-based reimbursement programme was introduced. Data were analysed using thematic content analysis with an abductive approach, and a conceptual framework based on neo-institutional theory.

After the introduction of the value-based reimbursement programme, the centrality and compatibility of the institutional logics within healthcare-providing organisations changed. The logic of spine surgeons was dominating whereas physiotherapists struggled to motivate a higher cost for high quality physiotherapy. The institutional logic of nurses was aligned with spine surgeons, however as a peripheral logic facilitating spine surgery. To attain holistic and interdisciplinary healthcare, dominating institutional logics within healthcare-providing organisations need to allow peripheral institutional logics to attain a higher centrality for higher compatibility. Thus, allowing other occupations to take responsibility for quality and attain the feeling of professional pride.

Interviewing spine surgeons, physiotherapists, nurses, managers and administrators allows us to deepen the understanding of micro-level behaviour as a reaction (or lack thereof) to macro-level decisions.

This article summarises the recently published mental health physiotherapy strategy, Recovering Mind and Body: A framework for physiotherapy in mental health and wellbeing (Chartered Society of Physiotherapy, 2008a) and its companion document Commissioning Mental Health Services: The contribution of physiotherapy to integrated services for health and wellbeing (Chartered Society of Physiotherapy, 2008b), and discusses how the documents can be used to ensure that more mental health service users and carers can benefit from the skills of physiotherapists.

The role of the physiotherapist's services in the fracture clinic was audited to evaluate whether the number of treatments required by the patients was reduced, whether waiting time for an appointment was reduced, and patients' views of the physiotherapy services in the fracture clinic.

This paper aims to understand the clinical practice of physiotherapists and occupational therapists in the Republic of Ireland in the assessment and treatment of spasticity in adults, to inform and improve spasticity management practice. This study also aims to describe therapists’ knowledge, confidence and perceived barriers in the management of spasticity.

A cross sectional survey design study was completed, and respondents were recruited through an online survey.

In total, 92 respondents from a wide range of clinical settings revealed there is considerable variation in services available nationally for adults presenting with spasticity. There were significant inconsistencies across all areas of practice. The majority of respondents (94%) did provide intervention to patients with spasticity, yet three quarters did not have access to a specialist spasticity clinic, and the majority (82%) did not feel they were providing sufficient treatment intensity for spasticity.

These findings provide a unique insight into the assessment and treatment practices of Irish physiotherapists and occupational therapists. These results demonstrate the need for further upskilling and specialist high-quality spasticity services nationally.

Purpose – This chapter reflects on the importance of being reflexive as a socio-legal researcher whilst seeking to address the practicalities, challenges and methods of being reflexive during the research process. The chapter demonstrates ‘doing it’ by reporting on the use of an internal dialogue of the researcher’s feelings and choices during research encounters to reflect on the status of insider knowledge in the interview process. It also charts the unexpected emotional reactions of participants, and in doing so, highlights the challenges of reflection in and on everyday practice as a physiotherapist.

Methodology/Approach – The research reported here was an empirical ethics study using in-depth interviews and the voice-centred relational method as practical means of doing and being reflexive.

Findings – The chapter sheds light on the role of emotion in the research process, the author’s emotional position as researcher and the unexpected emotional reactions of participants.

Originality/Value – The chapter presents a practical method of reflexivity in qualitative research and considers the personal and ethical issues that arise during the research process from the competing perspectives of both insider and researcher. The key lesson learnt is the importance of reflecting on ethically important, and at times uncomfortable, moments in the research process so that other researchers can learn about the ‘how to’ of reflexivity and reflexive writing.

The purpose of this paper was to assess the knowledge on sport and exercise science held by a sample of Brazilian physiotherapists, nutritionists and physical educators.

A cross-sectional research design was used. The answers given by 1,147 professionals (300 physiotherapists, 705 physical educators and 142 nutritionists) who participated in a qualifying process for a specialization course on exercise physiology were analyzed. Questions were analyzed on maximal oxygen uptake (four questions), physical fitness assessment (three questions), physical training (two questions), bioenergetics (one question) and exercise in extreme environments (one question).

The results revealed misconceptions held by Brazilian health professionals on a number of concepts related to sport and exercise science, such as maximal oxygen uptake.

These results reinforce the need for continuing education programs to maximize the quality of the service provided by sport and exercise science professionals in Brazil. Improvements in the undergraduate courses curriculum are also recommended.

This is the first study to assess misconceptions about sport and exercise science among Brazilian health professionals.