Physiotherapists’ perceptions of contributory and risk reduction factors for work-related spinal disorders in the profession in Wales

  • Philippa Coales

    Student thesis: Doctoral Thesis


    The prevalence rate of work-related spinal disorders in physiotherapists in a variety of clinical and geographical areas is approximately 35% and has not altered significantly over the last three decades. Previous evidence identifies physical and environmental factors which increase the risk of work-related spinal disorders and opportunities for risk reduction. There is a paucity of qualitative evidence from physiotherapists regarding their own perceptions of these issues. The purpose of this study was to explore the perceptions of practising physiotherapists in order to develop a theory regarding perceived contributory and risk reduction factors for work-related spinal disorders in the physiotherapy profession.

    The study used a constructivist grounded theory methodology using semi-structured interviews as the method. Participants, who met the inclusion criteria, were purposively recruited from physiotherapists in an NHS Health Board in South Wales. Two pilot interviews were conducted and were videoed for training purposes; fourteen further participants were recruited from the purposive sample, three were randomly selected and eleven were theoretical sampled directed by the data analysis. All interviews were audio-recorded, transcribed and thematically coded. The participants’ profile consisted of twelve females and four males with an age range between 24 to 57 years, representing NHS career bands 5 to 8b and varied over a number of clinical speciality areas. Data analysis commenced via line-by-line coding followed by initial coding. This coding directed further data requirements by focusing data collection and theoretical participant recruitment and was iterative in nature. Secondary coding and focused coding synthesised the initial codes by grouping them into themes. In total, three themes emerged regarding contributory and risk reduction factors for work-related spinal disorders – The Institution, The Job and The Individual. Each theme incorporated factors and sub-factors.

    Some of the key findings supported previous evidence especially around physiotherapy practice as a contributory factor. However, a number of factors emerged from the data which have not previously been reported and centred on the impact of the institution, the effect of team working, personal responsibility particularly with reference to personal fitness for the job and physiotherapists’ attitude towards and implementation of manual handling training and risk assessment.

    From the three key themes further abstraction resulted in the creation of a grounded theory identified as the Mixer Theory for Contributory and Risk Reduction Factors for Work-related Spinal Disorders in the Physiotherapy Profession involving four constructs - Knowledge, Loyalty, Infallibility and Responsibility.
    The recognition and understanding of the Mixer Theory developed from the findings will raise awareness to enhance the future safety of physiotherapists. Its validity could be tested for use in different NHS Trusts and other therapy professions.
    Date of AwardMar 2017
    Original languageEnglish
    Awarding Institution
    • University of Brighton
    SupervisorVirginia Jenkins (Supervisor), Angela Benson (Supervisor), Lucy Redhead (Supervisor) & Helen Fiddler (Supervisor)

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