File
Ellwanger-Morales T1,2, Sizer PS3, Mauri-Stecca MV1,4
1Facultad de Medicina, Clínica Alemana - Universidad del Desarrollo, School of Physical Therapy, Santiago, Chile, 2Equipo de Salud Rural. Depto. de Salud I. Municipalidad Osorno, Osorno, Chile, 3Texas Tech University Health Sciences Center, Center for Rehabilitation Research, School of Health Professions, Lubbock, United States, 4Advanced Physical Therapy, Physical Therapy, Anchorage, United States
Background: Self-efficacy (SE) is defined as the belief in one´s ability to succeed or produce designated levels of performance in specific situations. It also includes how subjects will organize and execute their actions to achieve desired performance. Higher SE levels lead health-related professionals to better clinical decision-making that positively impacts patient's treatment and education associated outcomes. SE becomes relevant in preventing risky behaviors and promoting actions that benefit people and patients.
Purpose: SE can positively or negatively be influenced by different factors. For instance, health-related professionals' attitudes and beliefs about health and illness play an important role in selected therapeutic approaches and their clinical outcomes. The purpose of this study is to identify, in reported scientific and grey literature, key factors that influence SE in musculoskeletal physiotherapy. By identifying such factors, efforts can be oriented to successfully create, or maintain, optimal patient care.
Methods: A scoping review of scientific and grey literature was conducted. Authors followed the guidelines proposed by the Joanna Bringgs Institute, which includes: i)identification of research question; ii)identification of relevant studies through search strategies; iii)selection of articles using an iterative team approach; iv)data extraction; and v)description of findings and results. MEDLINE/PubMed, SUMsearch, Tripdatabase, Scielo and Google Scholar databases were used to identify potentially relevant studies available until December 31st, 2017. Two independent reviewers identified and selected relevant articles following specific inclusion and exclusion criteria. Bibliometric and specific data, such as academic degree level, years-of-experience, and SE key factors, among others, were extracted and analyzed.
Results: Seven out of 1,344 potentially relevant articles were included for final analysis. Eighty-six percent of the articles were published after 2010, with equal number of experimental and observational studies (42.8%). PT sample, included in the articles, ranged from 11 to 517, and “years-of-experience” ranged from 7.7 to 20.3. Key factors that positively influence SE included: a) promote evidence-based-practice (43%), b) practice based on functional results (29%), c) pursue continuous learning (29%), d) advocacy activities (14%), e) development of emerging markets (14%), f) use of innovative approaches to achieve organizational objectives (14%), and g) improve non-clinical work skills such as oral expression (29%). Two (29%) articles agreed on the biopsychosocial model of care for clinical practice and recognize that psychosocial factors in patients with pain are key factors to increase the SE. Lack of “professional-career-development or clinical-specialty,” and little autonomy in decision-making can contribute to diminish SE. Also, a stressful environment, lack of personnel, excessive workload, limited time to attend patients and family members, excessive paperwork or administrative work added to the work group and work environment can contribute to the decrease SE.
Conclusion(s): Three types of key factors that influence SE in musculoskeletal PTs were identified: a) specific factors related to the clinician, b) PT-patient relationship, and c) work context and environment. Improvement in clinical skills, evidence-based practice and use of biopsychosocial model are recommended to increase SE.
Implications: Higher SE levels lead to better clinical decisions and positive impact on patient´s health condition.
Keywords: Physical Therapy, Self-Efficacy, Scoping Review
Funding acknowledgements: No funding were granted for this project
Purpose: SE can positively or negatively be influenced by different factors. For instance, health-related professionals' attitudes and beliefs about health and illness play an important role in selected therapeutic approaches and their clinical outcomes. The purpose of this study is to identify, in reported scientific and grey literature, key factors that influence SE in musculoskeletal physiotherapy. By identifying such factors, efforts can be oriented to successfully create, or maintain, optimal patient care.
Methods: A scoping review of scientific and grey literature was conducted. Authors followed the guidelines proposed by the Joanna Bringgs Institute, which includes: i)identification of research question; ii)identification of relevant studies through search strategies; iii)selection of articles using an iterative team approach; iv)data extraction; and v)description of findings and results. MEDLINE/PubMed, SUMsearch, Tripdatabase, Scielo and Google Scholar databases were used to identify potentially relevant studies available until December 31st, 2017. Two independent reviewers identified and selected relevant articles following specific inclusion and exclusion criteria. Bibliometric and specific data, such as academic degree level, years-of-experience, and SE key factors, among others, were extracted and analyzed.
Results: Seven out of 1,344 potentially relevant articles were included for final analysis. Eighty-six percent of the articles were published after 2010, with equal number of experimental and observational studies (42.8%). PT sample, included in the articles, ranged from 11 to 517, and “years-of-experience” ranged from 7.7 to 20.3. Key factors that positively influence SE included: a) promote evidence-based-practice (43%), b) practice based on functional results (29%), c) pursue continuous learning (29%), d) advocacy activities (14%), e) development of emerging markets (14%), f) use of innovative approaches to achieve organizational objectives (14%), and g) improve non-clinical work skills such as oral expression (29%). Two (29%) articles agreed on the biopsychosocial model of care for clinical practice and recognize that psychosocial factors in patients with pain are key factors to increase the SE. Lack of “professional-career-development or clinical-specialty,” and little autonomy in decision-making can contribute to diminish SE. Also, a stressful environment, lack of personnel, excessive workload, limited time to attend patients and family members, excessive paperwork or administrative work added to the work group and work environment can contribute to the decrease SE.
Conclusion(s): Three types of key factors that influence SE in musculoskeletal PTs were identified: a) specific factors related to the clinician, b) PT-patient relationship, and c) work context and environment. Improvement in clinical skills, evidence-based practice and use of biopsychosocial model are recommended to increase SE.
Implications: Higher SE levels lead to better clinical decisions and positive impact on patient´s health condition.
Keywords: Physical Therapy, Self-Efficacy, Scoping Review
Funding acknowledgements: No funding were granted for this project
Topic: Education; Education: continuing professional development; Professional issues
Ethics approval required: No
Institution: Universidad del Desarrollo - Facultad de Medicina CAS-UDD
Ethics committee: Comité Ético Científico
Reason not required: Exploratory - Scoping review of scientific and grey literature
All authors, affiliations and abstracts have been published as submitted.
