title: The experience of thriving at work in rotational physiotherapists in Aotearoa New Zealand

authors: Stephens, Fiona

subjects: Thriving at work

abstract: Aim: This thesis aims to identify what contributes to thriving at work by rotational physiotherapists employed at national public hospitals in Aotearoa New Zealand. It will do this by exploring what enables individuals to thrive at work and what organisations can do to better support their rotational therapy staff to thrive, recommendations will be created to promote thriving at work to better support the retention and recruitment of staff in both a local and national workforce. 
Background: Workforce retention and attrition is a major concern for all health professions, including physiotherapy. A workforce analysis undertaken for the New Zealand physiotherapy workforce highlights that whilst there are no issues with the supply of physiotherapists for graduate positions, the supply of experienced physiotherapists, i.e. over five years work experience, is less than demand.  This study builds on the literature using the thriving at work model in the nursing workforce. Research has highlighted the lack of a perceived career pathway as a major concern for physiotherapists and a contributing factor to the number of physiotherapists who leave the profession before the seven-year mark. Recommendations to date have emphasised consideration be given to the implications regarding the quality of leadership support and positive workplace practices on job satisfaction and turnover intention in the profession. 
Design: An exploratory sequential mixed methods design.
Method: Data were collected in 2021 via face to face focus groups at one hospital location in Aotearoa New Zealand with rotational physiotherapists. The focus groups data was coded using Nvivo and then used to generate a nation-wide survey for rotational physiotherapists using Qualtrics. Survey data was analysed using thematic analysis. 
Results: The survey respondents had low intention to leave the profession, and agreed they found themselves learning often in their roles. Seven themes were generated from the qualitative data; 1) professional support; 2) culture of well-being; 3) supported learning activities; 4) workload; 5) engaged leaders; 6) rotations which align to career aspirations; 7) culture of Aotearoa. The recommendations include: 1) senior staff need to be available to provide regular clinical support and coaching; 2) mentorship by physiotherapists working outside of the hospital environment who also have previous experience within the environment; 3) provide access to cultural supervision for staff of Māori ethnicity; 4) explore the nationwide use of clinical coaches with rotational physiotherapists as they would be additional resource that would free-up current senior staff to provide workload support to the rotational staff;  5) replication for Allied Health of the funding models that exist for ongoing learning for other health professionals ; 6) increase connectivity by senior management in the organisation as well as line managers; 7) implement forums for rotational therapist nationwide to provide opportunity for two-way communication without senior clinicians present to provide safe space for  open discussion; 8) rotation allocation processes need to include regional and cross-district placements; 9) Develop an allied health specific wellness group to promote wellbeing in the workplace with provision to implement the Good4work model within Allied Health.
Conclusion: Professional support, culture of wellbeing and supported learning activities play an important role in supporting early career physiotherapists to thrive at work. Being engaged in work that aligns with career aspirations also help rotational physiotherapist to thrive. The unique culture of Aotearoa New Zealand should be reflected in future health workforce research to embody the spirit of Te Tiriti o Waitangi.

text: The experience of thriving at work in rotational physiotherapists in Aotearoa New Zealand Aim: This thesis aims to identify what contributes to thriving at work by rotational physiotherapists employed at national public hospitals in Aotearoa New Zealand. It will do this by exploring what enables individuals to thrive at work and what organisations can do to better support their rotational therapy staff to thrive, recommendations will be created to promote thriving at work to better support the retention and recruitment of staff in both a local and national workforce. 
Background: Workforce retention and attrition is a major concern for all health professions, including physiotherapy. A workforce analysis undertaken for the New Zealand physiotherapy workforce highlights that whilst there are no issues with the supply of physiotherapists for graduate positions, the supply of experienced physiotherapists, i.e. over five years work experience, is less than demand.  This study builds on the literature using the thriving at work model in the nursing workforce. Research has highlighted the lack of a perceived career pathway as a major concern for physiotherapists and a contributing factor to the number of physiotherapists who leave the profession before the seven-year mark. Recommendations to date have emphasised consideration be given to the implications regarding the quality of leadership support and positive workplace practices on job satisfaction and turnover intention in the profession. 
Design: An exploratory sequential mixed methods design.
Method: Data were collected in 2021 via face to face focus groups at one hospital location in Aotearoa New Zealand with rotational physiotherapists. The focus groups data was coded using Nvivo and then used to generate a nation-wide survey for rotational physiotherapists using Qualtrics. Survey data was analysed using thematic analysis. 
Results: The survey respondents had low intention to leave the profession, and agreed they found themselves learning often in their roles. Seven themes were generated from the qualitative data; 1) professional support; 2) culture of well-being; 3) supported learning activities; 4) workload; 5) engaged leaders; 6) rotations which align to career aspirations; 7) culture of Aotearoa. The recommendations include: 1) senior staff need to be available to provide regular clinical support and coaching; 2) mentorship by physiotherapists working outside of the hospital environment who also have previous experience within the environment; 3) provide access to cultural supervision for staff of Māori ethnicity; 4) explore the nationwide use of clinical coaches with rotational physiotherapists as they would be additional resource that would free-up current senior staff to provide workload support to the rotational staff;  5) replication for Allied Health of the funding models that exist for ongoing learning for other health professionals ; 6) increase connectivity by senior management in the organisation as well as line managers; 7) implement forums for rotational therapist nationwide to provide opportunity for two-way communication without senior clinicians present to provide safe space for  open discussion; 8) rotation allocation processes need to include regional and cross-district placements; 9) Develop an allied health specific wellness group to promote wellbeing in the workplace with provision to implement the Good4work model within Allied Health.
Conclusion: Professional support, culture of wellbeing and supported learning activities play an important role in supporting early career physiotherapists to thrive at work. Being engaged in work that aligns with career aspirations also help rotational physiotherapist to thrive. The unique culture of Aotearoa New Zealand should be reflected in future health workforce research to embody the spirit of Te Tiriti o Waitangi.

year: 2022

title: Eccentric Force-Velocity Characteristics during a Novel Squat Protocol in Trained Rugby Union Athletes-Pilot Study

authors: McNeill, Conor

subjects: energy absorption

abstract: Eccentric strength characteristics have been shown to be important factors in physical performance. Many eccentric tests have been performed in isolation or with supramaximal loading. The purpose of this study was to investigate within- and between- session reliability of an incremental eccentric back squat protocol. Force plates and a linear position transducer captured force-time-displacement data across six loading conditions, separated by at least seven days. The reliability of eccentric specific measurements was assessed using coefficient of variation (CV), change in mean, and intraclass correlation coefficient (ICC). Eccentric peak force demonstrated good ICC (≥0.82) and TE (≤7.3%) for each load. Variables based on mean data were generally less reliable (e.g., mean rate of force development, mean force, mean velocity). This novel protocol meets acceptable levels of reliability for different eccentric-specific measurements although the extent to which these variables affect dynamic performance requires further research.

text: Eccentric Force-Velocity Characteristics during a Novel Squat Protocol in Trained Rugby Union Athletes-Pilot Study Eccentric strength characteristics have been shown to be important factors in physical performance. Many eccentric tests have been performed in isolation or with supramaximal loading. The purpose of this study was to investigate within- and between- session reliability of an incremental eccentric back squat protocol. Force plates and a linear position transducer captured force-time-displacement data across six loading conditions, separated by at least seven days. The reliability of eccentric specific measurements was assessed using coefficient of variation (CV), change in mean, and intraclass correlation coefficient (ICC). Eccentric peak force demonstrated good ICC (≥0.82) and TE (≤7.3%) for each load. Variables based on mean data were generally less reliable (e.g., mean rate of force development, mean force, mean velocity). This novel protocol meets acceptable levels of reliability for different eccentric-specific measurements although the extent to which these variables affect dynamic performance requires further research.

year: 2021-03-30

title: He Pikinga Waiora Kimi Ora lifestyle programme: Case study of a successful community-based indigenous diabetes intervention

authors: Masters-Awatere, Bridgette

subjects: adult

abstract: AIM: To co-design and implement a whānau-centred, community-based lifestyle programme (Kimi Ora) intended to ensure no worsening of HbA1c and to improve wellbeing for Māori whānau and communities with diabetes or pre-diabetes. 

METHODS: Māori healthcare providers, community members, research advisors and wider stakeholders used a co-design process underpinned by He Pikinga Waiora to collaboratively develop and implement Kimi Ora Control group comparisons and participants were recruited from Te Kōhao Health. Multi-method monitoring and collection captured individual, whānau and community data. 

RESULTS: Kimi Ora was run in two communities in Aotearoa New Zealand. In total, there were 35 participants who took part in an eight-week programme offered five times alongside a comparison group comprising 21 participants. Kimi Ora resulted in significant improvements on all biomedical measures compared to baseline, and participants had gains relative to the comparison group for variables including weight, BMI, blood pressure and waist measurement. Of particular note was the 100% retention rate and sustained community support for Kimi Ora.

CONCLUSIONS: Outcomes from Kimi Ora demonstrate this programme, which was actively tailored for and worked with Māori communities in a responsive and flexible manner, resulted in successful biomedical outcomes, high engagement and high retention.

text: He Pikinga Waiora Kimi Ora lifestyle programme: Case study of a successful community-based indigenous diabetes intervention AIM: To co-design and implement a whānau-centred, community-based lifestyle programme (Kimi Ora) intended to ensure no worsening of HbA1c and to improve wellbeing for Māori whānau and communities with diabetes or pre-diabetes. 

METHODS: Māori healthcare providers, community members, research advisors and wider stakeholders used a co-design process underpinned by He Pikinga Waiora to collaboratively develop and implement Kimi Ora Control group comparisons and participants were recruited from Te Kōhao Health. Multi-method monitoring and collection captured individual, whānau and community data. 

RESULTS: Kimi Ora was run in two communities in Aotearoa New Zealand. In total, there were 35 participants who took part in an eight-week programme offered five times alongside a comparison group comprising 21 participants. Kimi Ora resulted in significant improvements on all biomedical measures compared to baseline, and participants had gains relative to the comparison group for variables including weight, BMI, blood pressure and waist measurement. Of particular note was the 100% retention rate and sustained community support for Kimi Ora.

CONCLUSIONS: Outcomes from Kimi Ora demonstrate this programme, which was actively tailored for and worked with Māori communities in a responsive and flexible manner, resulted in successful biomedical outcomes, high engagement and high retention.

year: 2021