Front-line Professionals Research Articles

Psychosocial support to medical teams in SAMUR-Protection Civile during COVID-19

The COVID-19 pandemic has had an exceptional impact on the health system. The lack of information and resources during the first stage of the outbreak COVID-19 has also meant a change in the way we work and in the way we relate to our relatives, colleagues and, of course, our patients. This traumatic situation, due to its characteristics of total uncertainty, novelty, frequency, and high intensity, made it necessary to develop a new approach to our work, a new psychological approach to the pandemic situation that leads to acute stress, insecurity, unknown consequences, uncertainty about its duration and a desolate future.During the first wave, it was necessary to respond to the new situation. In a first phase, an intervention protocol was created for front-line pre-hospital emergency professionals and a COVID-19 psychological unit was set up in a pandemic hospital in Madrid.In a second phase, emergency actions, their conditioning and possible change due to confinement are analysed; the emotional state of front-line intervention personnel is assessed, comparing the pre- and post-first wave period, and burnout syndrome is studied in the SAMUR-Civil Protection volunteer corps.

Causes of Stress among Healthcare Professionals and Successful Hospital Management Approaches to Mitigate It during the COVID-19 Pandemic: A Cross-Sectional Study.

The outbreak of the COVID-19 pandemic posed an immediate challenge to the management of hospitals in Germany and elsewhere. The risk of stress for front-line healthcare professionals forced occupational health and safety units to adopt a variety of protective measures, not all of which have been thoroughly validated. The main objective of the present analysis is to assess what the most important sources of stress were and which of the protective measures applied to counteract stress among healthcare staff had the greatest impact. A better understanding of these factors will improve hospital management and worker safety in a future health crisis situation and may also prove to be beneficial in non-crisis situations. For this purpose, in 2020, an exploratory, cross-sectional and quantitative study using a questionnaire created for this purpose was carried out on a total of 198 professionals—133 nurses and 65 physicians—at the Klinikum Mittelbaden Balg hospital in Baden-Baden, Germany, during the first wave of the pandemic. Statistical analyses showed that nurses suffer more stress than physicians and that stress is higher among professionals in critical care and emergency units than in units that are less exposed to infected patients. It was also found that measures such as salary incentives, encouragement of work in well-integrated teams, and perceived support from hospital management mitigate stress. These findings highlight the importance of support measures from management and superiors. Knowing the actual effectiveness of the measures applied by management and the factors mentioned above could help to protect healthcare professionals in the event of another pandemic or similar situations and may still be of value in dealing with the continuing COVID-19 pandemic.

Aggression, mini-aggression, and abuse against health care workers during the COVID-19 pandemic

Abstract Introduction COVID-19 pandemic brought multiple negative consequences that go beyond the direct damage caused by the disease and that affect health systems as well. Complaints of attacks against health care workers became frequent and concerning. The objective of this survey was to characterize the frequency and type of violent behavior against front-line professionals in Latin America. Material and methods A cross-sectional electronic survey was carried out between January 11th to February 28th, 2022. Different health care workers from Latin America who have been delivering care at least from March 2020, regardless of whether they assist or not patients with COVID-19 were included. A non-probabilistic snowball sampling was performed, and the survey was Results The survey was responded by 3,544 participants from 19 countries (Figure 1); 58.5% were women, and the mean age was 41.9±11 years. The 70.8% were doctors, 16% nurses, 3.4% physiotherapists, and the remaining 9.8% had other functions within the health team. About 85.1% of physicians were specialists: 33.9% were cardiologists, 14.4% were intensivists or emergency physicians, 10.9% had some surgical specialty, 7.7% were pediatricians or related subspecialties, and the remaining 33.1% had other specialties. The 36.3% and 28.8% worked in public and private practice respectively, the remaining worked in both. Direct and regular care to COVID-19 patients was provided by 74.7% of all contestants. Among the participants, 54.8% reported acts of violence: 95.6% suffered verbal violence, 11.1% physical violence, and 19.9% other types. 39.5% of respondents experienced it at least once a week. The acts of violence involved patients' relatives (32%), or patients together with their relatives (35.1%). The victims rated the stress level of these events with an average of 8.2±1.8 points (scale from 1 to 10). Approximately half of the health personnel who suffered an assault experienced psychosomatic symptoms after the traumatic event (Figure 2). Among the victims of violence, 56.2% considered changing their care tasks, and 33.6% abandoning their profession. However, only 23% of the health personnel attacked stated that they had made some type of legal action regarding these acts. In a logistic regression model, doctors (OR 1.95, p<0.01), nurses (OR 1.77, p=0.001), and administrative staff (OR 3.20, p<0.01) suffered more violence than other health workers. Women more frequently suffered violence (OR 1.56, p<0.01), as well as those who worked with patients with COVID-19 (OR 3.59, p<0.01). Conversely, a lower probability of violence was observed at older ages (OR 0.96, p<0.01). Conclusion We detected a high prevalence of violence against health personnel in Latin America during the current pandemic. Those caring for COVID-19 patients, younger staff, and women were found to be more vulnerable. It is imperative to develop strategies to mitigate these acts and their repercussions on the health team. Funding Acknowledgement Type of funding sources: None.

1.24 Strengthening the Front Lines: A Child Welfare Program for Families and Multidisciplinary Professionals

Children in the child welfare system depend on a competent, comprehensive team to provide quality care. Oftentimes, team members have knowledge gaps related to attachment, developmental needs, mental health disorders, evidence-based treatments, and local resources. Innovative curation and dissemination of resources is paramount to bridging this gap. This program identifies knowledge gaps and then strengthens knowledge of families and frontline professionals involved in the child welfare system.

The effect of the online eye movement desensitization and reprocessing early intervention protocol (EMDR R-TEP) for the risk groups with post-traumatic stress symptoms during the COVID-19 pandemic.

The aim of the research is to investigate the effect of eye movement desensitization and reprocessing (EMDR) therapy on post-traumatic stress disorder (PTSD) levels of individuals who can be defined as high-risk groups during the pandemic. Therefore, the online EMDR R-TEP Protocol was applied to a total of 154 individuals working with coronavirus patients, frontline professionals (Doctors, Nurses, Paramedics, Polices, Red Crescent), relatives of coronavirus patients, coronavirus patients, and relatives of someone who died from coronavirus and the PTSD symptom level before, after, and 1 month after therapy was measured and examined. A personal information form and impact of events scale were used to collect data. Analyses showed that EMDR therapy was effective in reducing the PTSD level in all groups. The PTSD levels of frontline professionals continued to decrease until the follow-up test but remained the same in the other groups.

The Courage to Care: Teacher Compassion Predicts More Positive Attitudes Toward Trauma-Informed Practice

PurposeWith greater awareness of the prevalence and impact of childhood trauma and adversity, teachers are now assuming a more active role in creating emotionally healthy environments and responding to student distress. However, supporting trauma-affected students can be a source of amplified teacher stress. Compassion has been identified as a promising construct for frontline professionals in terms of promoting psychological wellbeing, and increasing the sensitivity to detect, tolerate and respond to distress in others. It has also been identified as an important aspect of trauma-informed practice. Nevertheless, the role of compassion in teachers’ attitudes towards, and readiness for implementing trauma-informed practices has not yet been explored. This study aimed to address this gap.MethodsA sample of 377 primary and post-primary teachers in Ireland completed the Attitudes Related to Trauma-Informed Care Scale, the Professional Quality of Life Scale, the Self-Compassion Scale, and a socio-demographic survey.ResultsTeachers were found to hold generally positive attitudes toward trauma-informed care. They exhibited low to moderate levels of secondary traumatic stress and burnout, and notably high levels of compassion satisfaction, indicating that they tend to embrace their caring role and find meaning and purpose in their work. Regression analyses showed that compassion satisfaction was the strongest predictor of positive attitudes toward trauma-informed care, followed by self-compassion. Older teachers were more likely to display positive attitudes toward trauma-informed care, whilst teachers in single-sex boys’ schools held attitudes that were less favorable.ConclusionThis study suggests potential benefits for both teachers and students of positioning compassion at the center of educational policy and practice. The results are contextualized within the Irish and international educational landscape.

The roles of primary care doctors in the COVID-19 pandemic: consistency and influencing factors of doctor's perception and actions and nominal definitions

BackgroundAt the end of 2019, the Coronavirus Disease 2019 (COVID-19) pandemic broke out. As front-line health professionals, primary care doctors play a significant role in screening SARS-CoV-2 infection and transferring suspected cases. However, the performance of primary care doctors is influenced by their knowledge and role perception. A web-based cross-sectional survey was conducted to assess the consistency and influencing factors of primary care doctor's role perception and expert advice in the guidelines (regulatory definition).MethodsWe designed the questionnaire using “Wenjuanxing” platform, distributed and collected the questionnaire through WeChat social platform, and surveyed 1758 primary care doctors from 11 community health service stations, community health service centers and primary hospitals in Zhejiang Province, China. After the questionnaire was collected, descriptive statistics were made on the characteristics of participants, and univariate analysis and multivariate analysis were used to determine the relevant factors affecting their role cognition.ResultsIn the reporting and referral suspected cases and patients receiving treatment, most participants’ cognition of their roles were consistent with the requirements of guidelines. However, 49.54% and 61.43% of participant doctors were not in line with the government guidelines for diagnosing and classifying COVID-19 and treating suspected cases, respectively. Having a middle or senior professional title and participating in front-line COVID-19 prevention and control work is beneficial to the accurate role perception of diagnosis and classification of COVID-19, the reporting and transfer of suspected cases, and the treatment of suspected cases.ConclusionsPrimary care doctors’ role perceptions in the COVID-19 pandemic are not always consistent with government guidelines in some aspects, such as transferring and diagnosing suspected cases. Therefore, it is essential to guide primary care doctors in performing their duties, especially those with lower professional titles.

Exploring the ability of child and adolescent mental health services (CAMHS) to respond to new valuable knowledge: the influence of professionals and internal organisational processes

PurposeHealth policies in England highlight the need for child and adolescent mental health services (CAMHS) to embed new knowledge in practice, yet evidence remains scarce about the services’ ability to learn from the external environment. This paper aims to present a critical analysis of the CAMHS’ ability to implement new knowledge through the lens of absorptive capacity, an organisation’s ability to identify, assimilate and use new valuable knowledge.Design/methodology/approachSixteen semi-structured interviews were conducted with staff from the CAMHS department of a mental health organisation in England to explore the services’ absorptive capacity.FindingsProfessionals were identified having an impact on the main absorptive capacity components in the following ways: professional background and perceived reliability of knowledge sources appeared to affect knowledge identification; informal communication was found to facilitate knowledge assimilation and exploitation; trust was found to enable knowledge exploitation, particularly between senior management and frontline professionals. At an organisational level, team meetings and internal reporting were identified as enablers to knowledge assimilation and exploitation, while organisational hierarchy and patient data management systems were identified as barriers to knowledge assimilation. No organisational processes were found regarding knowledge identification, indicating an imbalanced investment in the main components of absorptive capacity.Practical implicationsInvesting in these underpinning factors of absorptive capacity can assist CAMHS with capitalising on new knowledge that is valuable to service provision.Originality/valueThis study offers novel insights into the learning ability of CAMHS through the lens of absorptive capacity.

O61 - Emotional and mental health challenges of expectant and new parents - what can midwives do to improve outcomes in pregnancy, birth and early parenthood

It is well established that expectant and new parents are most at risk of developing emotional and mental health conditions in pregnancy and the year following birth. Research was undertaken with 1,800 expectant and new parents to identify the key emotional and mental health challenges experienced, what were the compounding factors, and what could have prevented/alleviated the impact. 43% of respondents identified emotional and mental health challenges during their pregnancy and over a third (37%) experienced challenges at their birth. Expectant parents spoke of unmet expectations about what pregnancy was supposed to be like, the experience of anxiety, depression and hyperemesis – all of which were often not well understood by patients and/or health professionals. Body image, family violence, and the impacts of the pandemic were all seen to exacerbate mental health outcomes. Contrary to national guidelines, many parents came off their antidepressant medication, resulting in relapse at this already vulnerable life stage. Birth trauma featured prominently, exacerbated by poor treatment by front-line health professionals, lack of opportunity to debrief, and lack of continuity of care – all of which undermined new parents and further exacerbated their emotional and mental health vulnerability. The research emphasises the critical importance of education, prevention and early intervention approaches to support awareness and early detection and intervention. This presentation will equip midwives with insights, education and access to world-leading innovative solutions that are freely available to support best practice and reduce the significant levels of distress. All training and resources are freely available for practicing midwives and those in their care.

Mental health and the effects on methylation of stress-related genes in front-line versus other health care professionals during the second wave of COVID-19 pandemic: an Italian pilot study

Healthcare workers experienced high degree of stress during COVID-19. Purpose of the present article is to compare mental health (depressive and Post-Traumatic-Stress-Disorders—PTSD—symptoms) and epigenetics aspects (degree of methylation of stress-related genes) in front-line healthcare professionals versus healthcare working in non-COVID-19 wards. Sixty-eight healthcare workers were included in the study: 39 were working in COVID-19 wards (cases) and 29 in non-COVID wards (controls). From all participants, demographic and clinical information were collected by an ad-hoc questionnaire. Depressive and PTSD symptoms were evaluated by the Patient Health Questionnaire-9 (PHQ-9) and the Impact of Event Scale—Revised (IES-R), respectively. Methylation analyses of 9 promoter/regulatory regions of genes known to be implicated in depression/PTSD (ADCYAP1, BDNF, CRHR1, DRD2, IGF2, LSD1/KDM1A, NR3C1, OXTR, SLC6A4) were performed on DNA from blood samples by the MassARRAY EpiTYPER platform, with MassCleave settings. Controls showed more frequent lifetime history of anxiety/depression with respect to cases (χ2 = 5.72, p = 0.03). On the contrary, cases versus controls presented higher PHQ-9 (t = 2.13, p = 0.04), PHQ-9 sleep item (t = 2.26, p = 0.03), IES-R total (t = 2.17, p = 0.03), IES-R intrusion (t = 2.46, p = 0.02), IES-R avoidance (t = 1.99, p = 0.05) mean total scores. Methylation levels at CRHR1, DRD2 and LSD1 genes was significantly higher in cases with respect to controls (p < 0.01, p = 0.03 and p = 0.03, respectively). Frontline health professionals experienced more negative effects on mental health during COVID-19 pandemic than non-frontline healthcare workers. Methylation levels were increased in genes regulating HPA axis (CRHR1) and dopamine neurotransmission (DRD2 and LSD1), thus supporting the involvement of these biological processes in depression/PTSD and indicating that methylation of these genes can be modulated by stress conditions, such as working as healthcare front-line during COVID-19 pandemic.

Mental Distress during the COVID-19 Pandemic: A Cross-Sectional Study of Women Receiving the Comprehensive Social Security Allowance in Hong Kong.

Welfare recipients were often considered the least deserving of COVID-related support. Despite the recent attention paid to the impact of COVID-19 pandemic on mental health, few studies have explored the mental distress experienced by welfare recipients. This cross-sectional study on female Comprehensive Social Security Allowance recipients in Hong Kong aimed to explore their level of mental distress and its association with a range of risk factors specific to welfare recipients. Hence, 316 valid cases from a local community center responded to our online survey. We found that 52.3%, 23.4%, and 78% of the participants showed moderate to extremely severe depression, anxiety, and stress symptoms, respectively. A higher level of mental distress was associated with having a psychiatric diagnosis, poorer social, and greater concerns over disciplining children, the living environment, daily expenses and being infected by COVID-19. Unexpectedly, being married, having a permanent residence, and having a job were not significant protective factors for this group. The models explained 45.5%, 44.6%, and 52.5% of the overall variance in the level of depression, anxiety, and stress (p < 0.01), respectively. Our findings have important implications for supporting female welfare recipients during a public health crisis and may help frontline staff and professionals provide prompt assistance to this group in need.

International education for the oppressed: A framework for international educators’ value-based practice

There has been a heightened awareness and intensified discussion of the ethical issue in global higher education among scholars of international education. There are also strong calls for actions from the governmental, organizational, and institutional perspectives. However, there seems to be little discussion on what frontline international educators can do in this regard. Motivated by Freire’s (1970) critical pedagogy, this paper aims to develop an actionable framework for frontline professionals’ value-based practice. It hopes to engage the large number of fellow practitioners in higher education internationalization to increase their awareness of the dire world situation of unbalanced development, to reaffirm the values they should uphold in their profession, and to implement actions within their scope of agency to make a change.

Moral Distress among Frontline Physicians and Nurses in the Early Phase of COVID-19 Pandemic in Italy.

During the COVID-19 health emergency, healthcare professionals faced several ethical demanding job stressors, becoming at particular risk of moral distress. To date, only a few scales have been developed to evaluate moral distress among frontline professionals working in contact with COVID-19 patients. Moreover, although many healthcare professionals from various disciplines were converted to COVID-19 patient care, no study has yet analyzed whether the resulting change in duties might represent a risk factor for moral distress. Thus, this study aimed to investigate how and when the change in duties during the emergency would be related to healthcare professionals’ psycho-physical malaise. To this aim, a first Italian adaptation of the Stress of Conscience Questionnaire (SCQ) was provided. In total, 272 Italian healthcare professionals participated in this cross-sectional study. Healthcare professionals who had to perform tasks outside their usual clinical duties were more likely to experience moral distress and then psycho-physical malaise. This was particularly likely for those who were extremely concerned about becoming infected with the virus. The results also indicated that the Italian adaptation of the SCQ had a one-factor solution composed of six items. This study provides the first Italian adaptation of SCQ and practical suggestions on how supporting professionals’ well-being during emergencies.

Nurses' perceptions of supporting a 'good death' in intensive care units.

Death in the intensive care unit (ICU) is an unavoidable aspect of nursing practice. Nurses are the primary front-line healthcare professionals (HCPs) which care for dying patients in this setting. Facilitating 'good deaths' in the ICU has become increasingly debated due to the challenges involved, especially during the COVID-19 pandemic. Aim: To explore how nurses perceive a 'good death' for patients in the ICU. Literature published in English between 2005 and 2020 was rigorously searched and recorded using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data sources were: CINAHL Complete, MEDLINE complete, APA PsycInfo, ScienceDirect, SocINDEX, SwePub, SciELO, Complementary Index, Academic Search Ultimate, Supplemental Index, Education Source and Directory of Open Access Journals. Search terms included: nurses' perceptions, ICUs, 'good deaths', quality of death and dignified deaths. Seven articles met the search criteria, five used qualitative methods, one used a quantitative method and one used a mixed method design. Each of these were critically analysed. A process of thematic analysis identified three prevalent themes: ensuring physical comfort, providing an appropriate physical environment and the importance of relatives. The review revealed that creating a less technical environment within the ICU can influence a 'good death', but further research is needed to establish how this can be enacted. More effective management of physical symptoms such as pain and dyspnoea are also recommended. Including care of relatives in care plans was also found to contribute toward a 'good death' and that this could be facilitated through improved staff education. Providing a private area for grieving relatives within the ICU has also had an impact in enabling a 'good death'.

Complying Resistant and Resistant Complying Frontline Professionals: An Identity Work Perspective

Professionals are caught between two competing identity demands of being autonomous actors or turning into conformist organizational members. Professionalism has been mainly viewed as a discursive resource on which professionals draw in their identity talks to either fully or partially resist managerialism that intends to discipline their identities. Based on a study conducted in a public social welfare organization, we found that the frontline professionals’ identities are disciplined in their talks about two routine practices of daily paperwork and regular supervisory meetings (both introduced by the organization) when performing in congruence with the rules. However, when discussing the instances of intentional deviation from the organizational policies, their seemingly resistant identities are disciplined by their aspiration of presenting their selves as caregivers which is rooted in the most dominant professional discourse in this field. We, therefore, argue that control is not the sole property of organizations, but pervasive professional discourses may also introduce disciplinary effects that account for the responsible autonomy demonstrated by professionals. By pairing discursive practices with different types of action, our analysis also suggests that both discursive conformity and resistance cut across the boundaries between acting in alignment with and against the organizational policies.

Relationship between COVID-19-specific occupational stressors and mental distress in frontline and non-frontline staff

This study investigated the difference in the severity of mental distress and factors contributing to mental distress in frontline and non-frontline healthcare professionals during the coronavirus disease (COVID-19) pandemic. A cross-sectional web-based survey of medical staff collected by snow-ball sampling was performed in Japan in October 2020 using the Kessler Psychological Distress Scale (K6) as an outcome measure for mental distress. Originally developed items asking about the degree of change in psychological and physical burdens, COVID-19-related fear, and experience of discrimination were obtained. The median score of the K6 was 7 in the frontline staff group (n = 86) and 6 in the non-frontline staff group (n = 504), without a statistically significant difference. Multiple regression analyses showed that among the participants, an increase in psychological burden and COVID-19-related fear was significantly associated with mental distress in both groups. Experience of discrimination was significantly associated with mental distress only in the frontline staff group. However, an increase in physical burden was significantly associated with mental distress only in the non-frontline staff group. The results indicate that the factors contributing to mental distress between frontline and non-frontline staff can be different, although the severity of mental distress is comparable between them.

Professionals in Public: Challenges to Professional and Frontline Work in Public Organizations

This symposium aims to present research that analyzes some of the current challenges professionals and frontline workers face in public organizations. Public organizations, from large organizations to small agencies, perform key tasks for the functioning of government and society. To do so, they employ workers with specialized skills and knowledge that face challenges on the way their work is understood, managed, and assessed. Some of these challenges involve interacting with different audiences; managing conflicting expectations, criteria, expertise, and mandates; interacting with citizens; and conducting expert work in bureaucratic settings. This symposium aims to identify common concerns and insights across this research and to provide avenues for future scholarship in this area. Presenters have conducted research on professional identity, expert work, accountability, and conflicting mandates in police departments, public hospitals, emergency management services, and regulatory agencies in different countries. From Brave Enforcer to Trusted Protector: Role Evolution and Procedural Justice Training in Mexico Presenter: Rodrigo Canales; Yale U. Presenter: Jessica Zarkin; Cornell U. Presenter: Lluvia Gonzalez; Innovations for Poverty Action Routinization of Expertise: Experts and the Entry of Less-Credentialed Workers into Organizations Presenter: Jillian Chown; Northwestern Kellogg School of Management Presenter: Carlos Inoue; U. of Illinois at Urbana-Champaign Social Media Scrutiny of Front-line Professionals in Emergency Management Organizations Presenter: Arvind Karunakaran; Stanford U. Managing Conflicting Mandates: Wielding Procedural Expertise in a Government Agency Presenter: Samantha Orlena Ortiz Casillas; EMLYON Business School

Oncology provider experiences during the COVID-19 pandemic.

PurposeThe COVID-19 pandemic upended nearly all aspects of daily life and of medical care, placing a double burden of professional and personal concerns on those who provide medical care. We set out to assess the burden of the pandemic on provider outlook and understand how cancer survivorship providers experienced rapid changes to practice.MethodsWe distributed a survey through the American College of Surgeons Commission on Cancer (CoC) to its accredited organizations in mid-October 2020. We included questions on provider characteristics, changes in patient care practices resulting from the pandemic, worry about COVID-19, and concern about impact on cancer survivors.ResultsOf the n = 607 participants, three-quarters were female and three-quarters were White. Only 2.1% of participants reported having had COVID-19, but 43% reported anxiety about getting COVID-19 and over a quarter experienced sadness or depression, anxiety about the future, changes to sleep, difficulty concentrating, or social isolation. Approximately half of providers also expressed significant concern about progression of cancer in patients who experienced care delays or were afraid of accessing in-person care. In terms of changes to survivorship care, respondents reported changes to visitor policies, delays or cancellations, and efforts to reduce in-person visits.ConclusionsCOVID-19 has taken a significant toll on front-line healthcare professionals, including oncologists and cancer care allied health professionals. Findings support proactive mental health support of healthcare professionals as well as emergency preparedness to manage delays to care for cancer patients in the event of future unexpected pandemics.

Workplace Perceptions and Experiences Related to COVID-19 Response Efforts Among Public Health Workers - Public Health Workforce Interests and Needs Survey, United States, September 2021-January 2022.

The COVID-19 pandemic has strained many essential frontline professionals, including public health workers*; however, few studies have evaluated the specific challenges facing public health workers during this period. Data from the 2021 Public Health Workforce Interests and Needs Survey (PH WINS), a nationally representative survey of individual state and local governmental public health agency workers, provide insight into public health workers' demographic characteristics and experiences during the COVID-19 pandemic, tenure, and intention to leave their organization† (1). Surveyed governmental public health workers identified predominantly as non-Hispanic White (White), women, and aged >40 years; however, workforce characteristics differed by agency type. Overall, 72% of respondents reported working fully or partially in a COVID-19 response role at any point during March 2020-January 2022. An estimated 44% of workers reported that they were considering leaving their jobs within the next 5 years for retirement or other reasons. Of those considering leaving, 76% began thinking about leaving since the start of the COVID-19 pandemic. When asked what was needed, besides funding, to respond to the COVID-19 pandemic, 51% selected additional staff capacity. Survey findings highlight the importance of focused attention on recruitment and retention that promotes diversity (2) and workers with public health experience, which will be critical as the workforce rebuilds as the COVID-19 pandemic evolves.

Importance of Establishing Expectations in Physical Therapy World During Evaluation with Patients

Physical therapists play a crucial role as frontline professionals managing orthopedic pathologies resulting from chronic or acute injuries. Despite undergoing extensive education, including six to seven years of professional training and passing national and state examinations, therapists often lack formal training in patient communication. This gap in education is typically addressed only through practical experience. As the field of physical therapy has evolved due to regulatory and insurance reimbursement changes, effective communication during patient evaluations has become increasingly vital. Establishing clear expectations, understanding patient’s emotions and social styles, and building trust through reliability, credibility, and intimacy are essential. Failure to accurately communicate or follow up can lead to recurring symptoms, increased reliance on medications or surgeries, and undue stress and financial hardship for patients. By improving communication skills and understanding different social styles, therapists can enhance patient education, trust, and overall treatment outcomes.