资源稀缺和获取不公平经常被报道为国际物理治疗师的伦理问题：一项观察性研究。
Scarcity of resources and inequity in access are frequently reported ethical issues for physiotherapists internationally: an observational study.
机构信息
UniSA Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia.
Interuniversity College for Health and Development Graz, Castle of Seggau, Seggauberg, Austria.
出版信息
BMC Med Ethics. 2021 Jul 20;22(1):97. doi: 10.1186/s12910-021-00663-x.
BACKGROUND
Little is known about the ethical situations which physiotherapists encounter internationally. This lack of knowledge impedes the ability of the profession to prepare and support physiotherapists in all world regions in their ethical practice. The purpose of the study was to answer the following research questions: What types of ethical issues are experienced by physiotherapists internationally? How frequently are ethical issues experienced by physiotherapists internationally? Can the frequency and type of ethical issue experienced by physiotherapists be predicted by sociodemographic, educational or vocational variables?
METHODS
An observational study was conducted in English using an online survey from October 2018 to May 2019. Participants were 1212 physiotherapists and physiotherapy students located internationally which represented less than 1% of estimated number of physiotherapists worldwide at that time. The survey questionnaire contained 13 items requesting demographic detail and knowledge of ethical codes and decision-making, and 46 items asking what frequency participants experienced specific ethical issues in four categories: (A) Physiotherapist and patient interaction (19 items), (B) Physiotherapist and other health professionals including other physiotherapists (10 items), (C) Physiotherapists and the system (5 items) and (D) Professional and economic ethical situations (12 items).
RESULTS
The two most frequently experienced ethical issues were 'Scarce resources and time affecting quality of physiotherapy treatment' and 'Physiotherapy not accessible to all people in society who need it'. These items were experienced, on average, more often than monthly. Interprofessional practice also presented frequent ethical issues for participants. Ethical issues related to the context of 'Physiotherapists and the system' were most frequently experienced for all world regions. Working longer years in physiotherapy and learning about ethics in basic physiotherapy education was associated with participants reporting lower frequencies of ethical issues across all contexts.
CONCLUSION
This study provides the first global profile of ethical issues experienced by physiotherapists. Societal and cultural systems are key influences on physiotherapists' ethical practice. Physiotherapists globally need support from their work organisations, academic institutions and professional associations, and robust ethical training, to assist them to be active moral agents in their practice.
背景
目前对于国际物理治疗师所面临的伦理情况知之甚少。这种知识的缺乏阻碍了该专业在全球各个地区为物理治疗师做好准备并为其伦理实践提供支持的能力。本研究的目的是回答以下研究问题：国际物理治疗师面临哪些类型的伦理问题？国际物理治疗师经历伦理问题的频率是多少？物理治疗师经历的伦理问题的频率和类型是否可以通过社会人口统计学、教育或职业变量来预测？
方法
这是一项使用在线问卷调查于 2018 年 10 月至 2019 年 5 月期间开展的观察性研究。参与者为来自世界各地的 1212 名物理治疗师和物理治疗学生，这不到当时全球物理治疗师估计人数的 1%。调查问卷包含 13 项内容，要求提供人口统计信息和对伦理准则和决策的了解，以及 46 项内容，询问参与者在以下四个类别中经历特定伦理问题的频率：（A）物理治疗师与患者的互动（19 项）、（B）物理治疗师与其他卫生专业人员（包括其他物理治疗师）（10 项）、（C）物理治疗师与系统（5 项）和（D）专业和经济伦理情况（12 项）。
结果
经历频率最高的两个伦理问题是“稀缺的资源和时间影响物理治疗的质量”和“社会中并非所有需要物理治疗的人都能获得物理治疗”。这些问题的平均经历频率每月超过一次。参与者也经历了与跨专业实践相关的频繁伦理问题。与“物理治疗师与系统”背景相关的伦理问题在所有地区最常被提及。在物理治疗领域工作的年限更长，以及在基础物理治疗教育中学习伦理学，与参与者报告在所有背景下经历伦理问题的频率较低有关。
结论
本研究提供了国际物理治疗师所面临的伦理问题的首份全球概况。社会和文化系统是影响物理治疗师伦理实践的关键因素。全球的物理治疗师需要得到工作组织、学术机构和专业协会的支持，并需要接受强有力的伦理培训，以帮助他们在实践中成为积极的道德主体。
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