Rehabilitation healthcare professionals’ perceptions of professional responsibility: a focus group study in Italy

Main Article Content

Alessandra Da Ros
Pamela Tozzo
Luciana Caenazzo

Keywords

Professional Responsibility, Rehabilitation Research, Focus Group, Qualitative research, Law no. 24/17, Health Professions

Abstract

BACKGROUND AND AIM OF THE WORK: Law no. 24/17 has updated the Italian legislation regarding healthcare professional responsibility. In practice, all eight groups of healthcare professionals have well defined areas of activity and responsibility.


The aim of this research is to investigate how rehabilitation healthcare professionals perceive responsibility in the professional life.


METHODS: a qualitative pilot study was conducted using a focus group consisting of rehabilitation professionals enrolled in the Master’s Degree program in Rehabilitation Sciences at the University of Padova.


RESULTS: the analysis (performed at micro, meso and macro-level) highlighted that respondents perceived professional responsibility as a dilemma, because it is identified as a continuous balancing between external and internal pressures regarding professional competence, professional autonomy, teamwork, and social matters.


CONCLUSIONS: rehabilitation professionals seem to experience a great deal of dilemmas because they felt that their responsibility was a constant challenge of weighing pros and cons. Rehabilitation professionals need a genuine autonomy recognition at every level of their practice to better cope with the professional responsibility on a daily basis.


Responsibility has to be continuously and effectively implemented in all its aspects throughout the care pathway as to allow rehabilitation professionals to provide quality care to all patients. This analysis was useful for highlighting the emerging issues that need to be addressed in everyday practice.

Downloads

Download data is not yet available.
Abstract 56 | PDF Downloads 31

References

1. Benci L., Bernardi A., Fiore A., Frittelli T., Gasparrini V., Hazan, M., et al. (2017). Sicurezza delle cure e responsabilità sanitaria. Commentario alla legge 24; 2017.
2. Heavey E., Waring J., De Brún A., Dawson P., Scott J. Patients’ conceptualizations of responsibility for healthcare: a typology for understanding differing attributions in the context of patient safety. Journal of health and social behavior 2019; 60(2), 188-203.
3. Gastmans C. Dignity-enhancing nursing care: a foundational ethical framework. Nursing Ethics 2013; 20(2): 142-149.
4. Mackenzie C., Stoljar N. Introduction: autonomy refigured. In Relational autonomy: Feminist perspectives on autonomy, agency, and the social self. Oxford University Press, 2000, 3-31.
5. Glaser B.G., Strauss A.L. Discovery of grounded theory: Strategies for qualitative research. Routledge; 2017.
6. Charmaz K., Belgrave L.L. Grounded theory. The Blackwell encyclopedia of sociology 2007.
7. Rieger, K.L. Discriminating among grounded theory approaches. Nursing inquiry 2019; 26(1), e12261.
8. Malterud K. Qualitative research: standards, challenges, and guidelines. The lancet 2001; 358(9280): 483-488.
9. Tong A., Sainsbury P., Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International journal for quality in health care 2007; 19(6): 349-357.
10. Shamdasani P., Stewart D., Rook D. Focus groups: Theory and practice. Group Dynamics and Focus Group Research. Newbury Park, Calif: Sage Publications, Inc 1990.
11. Krueger R.A. Focus groups: A practical guide for applied research. Sage publications 2014.
12. Vandemeulebroucke T., Dierckx de Casterlé B., Welbergen L., Massart M., Gastmans, C. The Ethics of Socially Assistive Robots in Aged Care. A Focus Group Study With Older Adults in Flanders, Belgium. The Journals of Gerontology 2019.
13. Eisenhardt, K. M. (1989). Building theories from case study research. Academy of management review 1989; 14(4): 532-550.
14. Doody O., Slevin E., Taggart L. Focus group interviews part 3: Analysis. British Journal of Nursing 2013; 22(5): 266-269.
15. Cho J.Y., Lee E.H.. Reducing confusion about grounded theory and qualitative content analysis: Similarities and differences. The qualitative report 2014; 19(32): 1-20.
16. Koplan J.P., Bond T.C., Merson M.H., Reddy K.S., Rodriguez M.H., Sewankambo N.K., Wasserheit J.N. Towards a common definition of global health. The Lancet 2009; 373(9679): 1993-1995.
17. Presidenza del Consiglio dei Ministri, Comitato Nazionale per la Bioetica, Bioetica e riabilitazione, 2006 .
18. 42. 45. Walker M.U. Moral understandings: A feminist study in ethics. Oxford University Press 2007.
19. Drolet M.J., Hudon A. Theoretical frameworks used to discuss ethical issues in private physiotherapy practice and proposal of a new ethical tool. Medicine, health care and philosophy 2015; 18(1): 51-62.
20. Praestegaard J., Gard G. Ethical issues in physiotherapy–Reflected from the perspective of physiotherapists in private practice. Physiotherapy theory and practice 2013; 29(2): 96-112.
21. Kappel K. Medicinsk Etik En Filosofisk Diskussion Af Bioetiske Grundproblemer 1996.
22. Denier Y., Dhaene L., Gastmans C. ‘You can give them wings to fly’: a qualitative study on values-based leadership in health care. BMC medical ethics 2019; 20(1).
23. Casserley-Feeney S.N., Bury G., Daly L., Hurley D.A. Physiotherapy for low back pain: Differences between public and private healthcare sectors in Ireland—A retrospective survey. Manual Therapy 2008; 13(5): 441-449.
24. Sackett D.L., Rosenberg W.M., Gray J.M., Haynes R.B., Richardson W.S. Evidence based medicine: what it is and what it isn't, Clinical orthopaedics and related research, 1996; 455, 3.
25. Graber D.R., Kilpatrick A.O. Establishing values-based leadership and value systems in healthcare organizations. Journal of health and human services administration 2008; 179-197.
26. Erlingsson C., Brysiewicz P. A hands-on guide to doing content analysis. African Journal of Emergency Medicine 2017; 7(3): 93-99.
27. Albarqouni L., Hoffmann T., Straus S., Olsen N.R., Young T., Ilic D., et al. Core competencies in evidence-based practice for health professionals: consensus statement based on a systematic review and Delphi survey. JAMA network 2018.
28. Ter Maten-Speksnijder A., Grypdonck M., Pool A., Meurs P., Van Staa, A. Learning to attain an advanced level of professional responsibility. Nurse education today 2015; 35(8): 954-959.
29. Müller C., Zimmermann L., Körner M. Förderfaktoren und Barrieren interprofessioneller Kooperation in Rehabilitationskliniken–Eine Befragung von Führungskräften. Die Rehabilitation 2014; 53(06): 390-395.
30. Lentza V., Montgomery A.J., Georganta K., Panagopoulou E. Constructing the health care system in G reece: responsibility and powerlessness. British journal of health psychology 2014; 19(1): 219-230.
31. Stratil J.M., Rieger M.A., Voelter-Mahlknecht S. Image and perception of physicians as barriers to inter-disciplinary cooperation?–the example of German occupational health physicians in the rehabilitation process: a qualitative study. BMC 2018.
32. Bryon E., Dierckx De Casterlé B., Gastmans C. Because we see them naked'–nurses’experiences in caring for hospitalized patients with dementia: considering artificial nutrition or hydration (ANH). Bioethics 2012; 26(6). 285-295.
33. Supper I., Catala O., Lustman M., Chemla C., Bourgueil Y., Letrilliart L. Interprofessional collaboration in primary health care: a review of facilitators and barriers perceived by involved actors. Journal of Public Health 2015; 37(4): 716-727.
34. DiazGranados D., Dow A.W., Appelbaum N., Mazmanian P.E., Retchin, S.M. Interprofessional practice in different patient care settings: A qualitative exploration. Journal of interprofessional care 2018; 32(2): 151-159.
35. Singh R., Küçükdeveci A.A., Grabljevec K., Gray, A. The Role of Interdisciplinary Teams in Physical and Rehabilitation Medicine. Journal of Rehabilitation Medicine 2018; 50(8): 673-678.
36. Stratil J.M., Rieger M.A., Völter-Mahlknecht S. Cooperation between general practitioners, occupational health physicians, and rehabilitation physicians in Germany: what are problems and barriers to cooperation? A qualitative study. Interna 2017.
37. Stratil J., Rieger M.A., Voelter-Mahlknecht S. Optimizing cooperation between general practitioners, occupational health and rehabilitation physicians in Germany: a qualitative study. International archives of occupational and environmental 2017.
38. Körner M., Becker S., Dinius J., Müller C., Zimmermann L., Rundel, M.. A patient-centred team-coaching concept for medical rehabilitation. Journal of interprofessional care 2018; 32(1): 123-126.
39. Strasser D.C., Falconer J.A., Martino-Saltzmann D. The rehabilitation team: staff perceptions of the hospital environment, the interdisciplinary team environment, and interprofessional relations. Archives of Physical Medicine and Rehabilita 1994.
40. Bugnoli G. Infermieristica e Lean Thinking: metodologie e strumenti per una moderna assistenza: Esperienze a confronto all'Azienda Ospedaliera Universitaria Senese. FrancoAngeli 2017.
41. Radnor Z.J., Holweg M., Waring J. Lean in healthcare: the unfilled promise?. Social science & medicine 2012; 74(3): 364-371.
42. Mazzocato P., Savage C., Brommels M., Aronsson H., Thor J.. Lean thinking in healthcare: a realist review of the literature. BMJ Quality & Safety 2010; 19(5): 376-382.
43. Joynes V.C. Defining and understanding the relationship between professional identity and interprofessional responsibility: implications for educating health and social care students. Advances in Health Sciences Education 2018; 23(1): 133-149.
44. Gray J.A.M. Evidence-based healthcare and public health: how to make decisions about health services and public health. Elsevier Health Sciences 2009.