Individual Professional Features of Physiotherapists Volume 52- Issue 4

Andrzej Lewandowski* and Zuzanna Piekorz

• Chair Department of Physiotherapy, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Poland

Received: August 25, 2023;   Published: August 30 2023

*Corresponding author: Andrzej Lewandowski, Chair Department of Physiotherapy, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Poland

DOI: 10.26717/BJSTR.2023.52.008272

Abstract PDF

The aim of the study is to prioritize the individual characteristics of the physiotherapist. It was assumed that gender and education influence their hierarchy. Material and Methods: 2,130 people were examined using the J. Herberger set of traits. Results: Patience (57-61%), willingness to help (51-66%) and respect for the patient (55-67%) turned out to be the most important. The overall hierarchy is similar to that presented more than two decades ago by the “Expert Group”. Differences in the preferences of women and men were found in 36.1% of the analyzed characteristics, with the dominance in the hybrid group and the highest percentage of respondents (39.2%). Education differentiated the individual preferences of a physiotherapist more than gender (50.0%). The preferences of people with vocational education differed significantly from those characterizing groups with different levels of education. However, the vast majority of respondents claim that the most desirable feature in this profession is the sense of recall (“calling”). This opinion was shared to a lesser extent by men and people with higher education. Conclusions: The most important individual features of a physical therapist are characterized by a high stability of social acceptance, while the level of education is important in both the current and future hierarchy / hierarchy, the latter being most likely hybrid features.

Keywords: Sex; Level of Education; Instrumental; Hybrid and Directional Characteristics Preferences; Differences

A permission to conduct this study was obtained from the Bioethics Committee of the Ludwik Rydygier Collegium Medicum of Nicolaus Copernicus University in Toruń (no. KB 525/2008). All men and women were informed about the purpose of the study, and the possibility to withdraw from the study without giving any reason. Each potential participant granted a voluntary consent for participation in the study.

The work of a physiotherapist is strongly related to the need of constant cooperation with the other people, which seems a crucial aspect during career selection process and the employment stage itself, but most of all, however, creates the need for knowledge about the usefulness of particular individual features which might contribute to the success of the profession [1,2]. They are just as important as physical traits and skills, the social perception and variability of which are determined by many factors [3-5]. Constant development of the therapy methods and the area of physiotherapists’ work aside with patients’ awareness of the so many various forms of therapy may influence the changes in the hierarchy of social expectations towards the therapists [6-9]. This issue is a rather rare subject of scientific research, yet seems of vital importance in developing countries, such as Poland, due to the medical and technological progress as well as the unlimited access to information.

Literature data indicate that many factors, particularly age, disease, and the health status of the patients, determine patient’s satisfaction with the therapy. The latter is also strongly related to the earlier expectations, the evaluation of its efficacy and finally personal and professional features of the therapist [10-14]. The results of previous own research prove relative stability in the most significant individual properties of the physiotherapist, whereas the differences expressed by different gender and education level groups concern the features hardly indicated by the respondents [15-18].

Therefore, the aim of the study was the attempt to update hierarchy of the individual features of a physiotherapist, significant for a larger social group, as well as the evaluation of their long-term changes. It was assumed that such variables as sex and educational background of the patients’ having had previous experience with therapies as well as the long-term development of the profession will impact the hierarchy. Additionally, it was assumed that directional characteristics which are strongly related to the feeling of vocation (‘calling’) for the profession will be expected of the therapist to a greater extent compared to the other features.

The data was collected by the administration of surveys conducted among people who had previous experience with physical therapy. 2130 respondents participated in the study, with 716 men (33.6%) and 1414 women (66.4%) from various family background from central and western Poland. Only 2120 questionnaires were analyzed since the remaining 28 were incomplete. The study group included patients from physiotherapy centers (34.9%); physiotherapists, university, and college students of physiotherapy (30.8%); medical personnel and university teachers (20.8%), and physical education students and regular fitness clubs’ clients (13.5%). The respondents were aged from 18 to 89 with the average age of 36.64 ± 14.63. Half of them was under 32 and the age range of men and women was similar. The highest percentage of the respondents admitted to having secondary education (53.4%), and the number of respondents with higher education (33.9%) significantly exceeded those with vocational education (12.7%). Men, more frequently than women, had higher and vocational education. The list of 36 individual properties of a physiotherapist proposed by J. Herberger [18] was adopted. The respondent was to choose only the 10 most significant in their opinion. Additionally, the author’s division into directional, instrumental and hybrid properties (possessing traces of both features) was applied. The data were analyzed by taking the gender and the level of education of the respondents into account. The success of the profession with the relation to the need of vocation (‘calling’) was also looked into. Statistical analysis of the gender preferences of the respondents was carried out using the Z statistical tool, while the correlation between the level of education and the percentage share of the response frequency, was determined using the Fisher-Snedecor test. When the percentage share of the responses in the three groups was below 0.2 or above 0.8 the statistical result was calculated using the F2 test, otherwise the F1 test was applied. The calculation of the percentage of all the differences was done at the level of 0.05.

The results are presented in Tables 1-4. Tables 1 & 2 summarize numeral characteristics of the individual features of the physiotherapist by gender and level of education of the respondents. Tables 3 & 4 present the assessment of the expressed need of vocation (‘calling’) to the profession. On the basis of the above, it appears that patience (more frequently indicated by women), the need to help, respect for the patient and accuracy were among the most important properties. Women more often indicated emotional resistance, responsibility, professional self-improvement, feedback from patients, emotional balance, and kindness, while male respondents chose activation of the patient, professional authority, selflessness, honesty, experience, and professional independence. The percentages differences of these features were statistically significant. The percentage of directional features, prioritized by men and women alike (29.2%) was lower than instrumental properties (31.6%) and hybrid properties (39.2%) with slight differences between the sexes. They were found in 36.1% of all features used in the research (Table 1). The level of education of the respondents (50%) more than gender, influenced and differentiated the choice of the features. It was found that with the increase of the level of education of the respondents, certain parameters were chosen more often: theoretical knowledge, communicating skills, consistency, inspiring confidence, emotional resistance, emotional balance, professional self-improvement, individualization of treatment, patient’s activation, and the awareness of patient's expectations.

Table 1: Numerical characteristic of the preferences of a physiotherapist’s categorized qualities with regards to the respondents’ gender.

Note: Z - the result of the test of equality of two percentage structures based on the statistics “Z”

p - value used to determine statistical significance

*Statistically significant difference: p < 0.05.

The parameters which decreased were respect for the patient, knowledge of psychotherapy, professional experience, kindness, gentleness, scrupulousness, professional authority, and dedication. Differences of the particular parameters were statistically significant and turned out to appear more frequently in the hybrid and instrumental groups. The hybrid group appeared to have the largest percentage of the respondents (38.7-46.7%) and instrumental features group was the least numerous (24.2-33.9%) with the vast majority of the respondents with vocational education. Their preferences differed significantly compared to those with other levels of education (Table 2). Despite the observed differences, irrespective of the group, the vast majority of the respondents found “calling” a key aspect in the profession of a physiotherapist. Yet, men and people with higher education shared that opinion in a smaller share (the difference was statistically significant), while the number of respondents who did not have strong views on the topic was similar in both groups (Tables 3 & 4).

Table 2: Numerical characteristic of the preferences of a physiotherapist’s features with regard to the respondent’s level of education.

Note: F - multiple-ratio equality test result based on Fisher-Snedecor test statistics

p - value used to determine statistical significance

*Statistically significant difference: p < 0.05.

Table 3: Numerical characteristics of the vocation need in the physiotherapist’s profession with regards to the respondents’ gender.

Note: Z - the result of the test of equality of two percentage structures based on the statistics “Z”

p - value used to determine statistical significance

*Statistically significant difference: p < 0.05.

Table 4: Numerical characteristics of the vocation need in the physiotherapist’s profession with regards to the respondents’ level of education.

Note: Z - the result of the test of equality of two percentage structures based on the statistics “Z”

p - value used to determine statistical significance

*Statistically significant difference: p < 0.05.

The results enabled the authors to update the perception of a physiotherapist in accordance with the social expectations with regard to personality traits as well as professional training. These findings appear to be partly correlating with the studies carried out by J. Herberger [19], particularly in the aspect of the hierarchy of the most important features of a therapist, expressed by the so-called “expert group” (comprising of the most competent people with extensive knowledge about physiotherapy) but also the results of own studies on university teachers and physiotherapists [18-20]. This observation, however, does not change the overall research result, demonstrating progressing changes in social expectation towards the profession, especially over a long period of time. The consistency with the previous research, conducted over two decades ago, may result from the fact that the percentage of people with higher education made up the majority of the respondents. The results indicate a great stability of social hierarchy of the most important individual features of therapists, among which patience (57-61%), the will to help (51-66%) and respect for patient (55-67%) seem of key importance and need to be taken into consideration when educating new generations of physiotherapists. In this regard, we obtained similar results to the results obtained by Trylińska-Tekielska, et al. [21] in long-term studies of physiotherapy students. Interestingly the features strongly related to the therapist’s mental resistance were chosen less frequently than expected, i.e., determination (10-14%), emotional resistance (8-19%) and emotional balance (9-17%).

 These results are contradictory to the opinions expressed by the physiotherapists and others related to the profession [17-22]. The research conducted has shown that hybrid properties are of great importance and were preferred by the respondents with higher education. Thereby, the hypothesis claiming that the directional properties are the most important in the profession of a physiotherapist has been verified negatively, contrary to the thesis on strong correlation between the level of education and the particular preferences of the said features. Thus, it can be concluded that nowadays the therapists are expected to possess professional knowledge and skills, rather than “calling”. Directional properties which are closer to “calling”, were mainly advocated by people with low level of education, and their perception of the profession differed greatly to that expressed by more educated groups [15]. The results also contradict the widespread belief found in previous research claiming that “calling” is one of the essential features of the therapist [15-20]. The “calling” or vocation understood as kindness, warm-heartedness, or the concept of selfless, noble act - “caritas” or compassion, is commonly expected from the representatives of many professions such as: doctors, nurses, teachers, or priests. This opinion is confirmed in numerous literature data [23], yet it seems that it remains more in a declarative area and the factual social expectations focus on hybrid and instrumental features. This claim seems to be further confirmed by a small percentage of the respondents choosing dedication (3-7%) and gentleness (7-17%) as important features of the therapist.

Possibly, “calling” being one of the features well-grounded in social hierarchy, affiliating many virtues, was indicated in the questionnaire by almost 90% of both men and women and did not require, in their opinion, additional confirmation of its validity. It is worth noticing; however, it was hardly chosen by the respondents with higher education (statistically significant difference). Thus, it can be assumed, that perhaps in the future, due to the civilization progress and increase of the level of education of the society, “calling” or vocation to the profession of a physiotherapist as well as many other directional properties will lose their significance in favor of the hybrid and instrumental properties. In both hybrid and instrumental group, low percentage of organizational skills indication (8-10%) being very useful during working with patients, as well as the awareness of patient’s expectations (5-9%) and psycho-pedagogical knowledge (16-19%) came as a surprise and turned out to be contrary to the literature data [24-26]. Also in the current research, this view was confirmed by almost 50% of the respondents, however, at a significantly lower rate among the people with basic education. Therapist-patient communication of both educational and socio-affective nature takes place non-stop, supporting their mutual understanding, cooperation and creating emotional bonds [24]. Its main elements comprise of instructions, explanations, manual demonstrations, or support [25] and come as a key element of the therapy for all patients, also post-stroke patients who, despite the obvious difficulties, are its participants and recipients [26]. With regard to the above, it can be concluded, that soft competences in the said profession, previously underestimated in other professions, are more important and more acknowledged by people with higher education.

The results, being an attempt to update social expectations as for individual properties of a physiotherapist, indicate a high stability of those most important, among which patience, the will to help and respect for the patient prevail and also allow forecasting of expectation in the attitudes and competence of therapists. Therefore, with high probability, it can be presumed, that in the near future, competence attitude of a physiotherapist, manifested in paramedical nature of work, seems to be more expected than humanistic attitude, in which representatives of the profession prefer para-pedagogical nature of work and therefore, pay more attention to the contact with the patient and the effect on his or her personality [19]. This view also allows us to assume that in a wider social scope, the so-called hard competences of a physiotherapist are still more important than soft competences, which were not given proper attention when it comes to the success of many professions.

The perception of the most important individual properties of a physiotherapist has remained stable for many years. Directional features have received slightly lower acknowledgment and the level of education of the society is a significant factor in both the present and future hierarchy of the analyzed features. It can be assumed that hybrid and instrumental features will most likely prevail as the properties being subjected to a process of development in the course of job progress and strongly related to the character of a future therapist. In this light the process of selection of university candidates and their proper education seems of key importance.

The research was carried out as part of its statutory activities of the Department of Basic of Physical Culture, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University.

The authors declare that there are no conflicts of interest.

1. Kiebzdak W, Rusin M, Śliwiński Z, Dwornik M, Kiljański M, et al. (2013) Professional culture versus phisiotherapit’s culture. Fizjoter Pol 13(4): 44-50.
2. Rusin M, Kiebzdak W, Kiliański M (2013) Shaping ethical attitude of physiotherapist. Fizjoter Pol 13(4): 51-57.
3. Bishop F, Smith R, Lewith GT (2013) Patient preferences for technical skills versus interpersonal skills in chiropractor’s physiotherapist treating low back pain. Family Practice 30(2): 197-203.
4. Buining EM, Margit K Kooijman, Ilse C S Swinkels, Martijn F Pisters, Cindy Veenhof, et al. (2015) Exploring physiotherapist personality traits that influence treatment outcome in patients with chronic diseases: A cohort study 2012. Faculty of Medicine Theses, Utrecht University Repository.
5. Lewandowski A, Sarwińska J, Siedlaczek M, Zuzanna Piekorz (2020) 10-Year Longitudinal Changes in Fitness Parameters in Physiotherapy Students. BioMed Research International, 7154797: 8p.
6. Biniakiewicz B (1994) Kształcenie, zawód i praca magistrów rehabilitacji ruchowej (Education, profession and work of masters of physical rehabilitation). Poznań
7. Pawelec R (1998) The role of a physiotherapeutist in a sports club. Medycyna Sportowa 14(5): 4-6.
8. Piątkowski W (2010) Badania socjologiczne nad inną medycyną (Sociological research on other medicine). Warszawa, IFiS PAN.
9. Starczyńska M, Błaszkiewicz E, Kiebzak W, Śliwiński Z (2011) The profession of physiotherapist in the opinion of the professional group. Fizjoter Pol 11(3): 227-239.
10. Casserley-Feeney S, Phelan M, Duffy F, Susan Roush, Melinda C Cairns, et al. (2008) Patient satisfaction with private physiotherapy for musculoskeletal pain. Musculoskelet Disord 9: 50.
11. Hills R, Kitchen S (2007) Satisfaction with outpatient physiotherapy: a survey comparing the views of patients with acute and chronic musculoskeletal conditions. Physiotherapy Theory and Practice 23(1): 21-36.
12. Hills R, Kitchen S (2007) Satisfaction with outpatient physiotherapy: focus groups to explore the views of patients with acute and chronic musculoskeletal conditions. Physiotherapy Theory and Practice 23(1): 1-20.
13. George S, Hirsh A (2005) Distinguishing patient satisfaction with treatment delivery from treatment effect: A preliminary investigation of patient satisfaction with symptoms after physical therapy treatment of low back pain. Archives of Physical Medicine and Rehabilitation 86(7): 1338-1344.
14. Lewandowski A, Sarwińska J, Piekorz Z (2023) Physiotherapists’ work in public perception. Baltic Journal of Health and Physical Activity 15(1): Article 8.
15. Lewandowski A, Śmiglewska M, Smeja JM (2010) Individual characteristics of a physiotherapist in the successful realization in the profession–a study done on the women physiotherapy students. Postępy Rehabilitacji 24(1): 13-19.
16. Marosz A, Lewandowski A (205) The model of a professional physiotherapist based on an opinion of patients – derived from the research carried out on patients of urban rehabilitation health centres in the kujawsko-pomorskie district. Medical and Biological Sciences 19(3): 69-75.
17. Lewandowski A, Sobolewski M (2007) The opinions of physiotherapy’s female students in Ludwik Rydygier Collegium Medicum in Bydgoszcz concerning the importance of individual characteristics on the realization of the future profession. Medical and Biological Sciences 21(1): 55-62.
18. Lewandowski A, Isbrandt K, Smeja B (2007) Physiotherapist’s occupation and work in the opinion of academic teachers. Medical and Biological Sciences 21(48): 9-97.
19. Herberger J (1990) Psychospołeczne uwarunkowania przydatności magistrów rehabilitacji ruchowej do pracy zawodowej (Psychosocial determinants of suitability of masters of motor rehabilitation for professional work). Zeszyty Naukowe AWF Wrocław 51: 152-182.
20. Lewandowski A, Zaremba A, Śmiglewska M (2012) Profession and individual characteristics of a physiotherapist – a study based on research among employees of health resort centres. Acta Balneologica Polska 1: 28-36.
21. Trylińska-Tekielska E, Drewnik M, Włostowska K, (2020) Predictors for choosing the profession of physiotherapist. A longitudinal study 2011-2016. Fizjoter Pol 20(2): 58-68.
22. Lewandowski A, Gronowska I, Grucza R (2008) Self–estimated workload in physiotherapy. Medical and Biological Sciences 22(2): 65-68.
23. Frankl VE (1992) Man’s search for meaning. Beacon Press Boston.
24. Gyllensten L, Gard G, Salford E (1999) Interaction between patient and physiotherapist: A qualitative study reflecting the physiotherapist’s perspective. Physiotherapy Research International 4(2): 89-109.
25. Thornguist E (1994) Profession and life: Separate worlds. Social Science and Medicine 39(5): 701-713.
26. Talvitie U (1996) Guidance strategies and motor modelling in physiotherapy. Physiotherapy Theory and Practice 12(1): 49-60.