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The profile and reach of physiotherapy has expanded in areas of extended scope of practice, and broader engagement with population needs beyond the individual treatment encounter. These changes raise increasingly complex ethical challenges evidenced by growth in physiotherapy-based ethics studies and discussions. This paper examines how a broad cross section of Australian physiotherapists perceive, interpret, and respond to ethical challenges in their work contexts and how professional codes of conduct are used in their practice. Using an interpretive qualitative methodology, purposive sampling of 88 members of national clinical special interest groups were recruited for focus group discussions. Narrative-based and thematic data analysis identified ethical challenges as emerging from specific clinical contexts, and influenced by health organizations, funding policies, workplace relationships, and individually held perspectives. Five themes were developed to represent these findings: (1) the working environment, (2) balancing diverse needs and expectation, (3) defining ethics, (4) striving to act ethically, and (5) talking about ethics. The results portray a diverse and complex ethical landscape where therapists encounter and grapple with ethical questions emerging from the impact of funding models and policies affecting clinical work, expanding boundaries and scope of practice and changing professional roles and relationships. Codes of conduct were described as foundational ethical knowledge but not always helpful for "in the moment" ethical decision-making. Based on this research, we suggest how codes of conduct, educators, and professional associations could cultivate and nurture ethics capability in physiotherapy practitioners for these contemporary challenges. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this case report is to explore the active engagement model as a tool to illuminate the ethical reflections of student physical therapists in the context of service learning in a developing country.Methods: The study participants were a convenience sample of six students. The study design is a case report using a phenomenological perspective. Data were collected from students’ narrative writing and semi-structured interviews. The steps of the active engagement model provided the structural framework for student responses. The analysis process included open coding, selective coding, and member checking.Results: Results showed the emergence of two main themes: 1) gathering rich detail and 2) developing independent moral identity. Students’ descriptions of their relationships were detailed and included explanations about the complexities of the sociocultural context. Independent and deliberate agency was evident by the students’ preparedness to be collaborative, to raise ethical questions, to identify ethically important aspects of their practice and to describe their professional roles. The students noted that the use of the model increased their engagement in the ethical decision-making process and their recognition of ethical questions.Conclusions: This case report illustrates attributes of the active engagement model which have implications for teaching ethical reflection: scaffolding for ethical reflection, use of narrative for reflection, reflection in action, and illumination of relevant themes. Each of these attributes leads to the development of meaningful ethical reflection. The attributes of this model shown by this case report have potential applications to teaching ethical reflection. [ABSTRACT FROM PUBLISHER]

While the prevalence of patients presenting to hospitals with mental health conditions is growing, allied health professionals often poorly understand the needs and overall different presentation of people with mental health concerns.This research examined, via validated pre- and post questionnaires, how a clinical placement of up to 6 weeks at a metropolitan inpatient mental health facility impacted exercise physiology, speech- language pathology and dietetic students' familiarity with and beliefs and attitudes towards mental health, and perception of their role in working with patients with mental health problems. Results indicated that students' beliefs and attitudes towards and understanding of mental health conditions positively changed following this clinical placement experience. All students (n = 26) demonstrated a statistically significant change (p = 0.03) in their familiarity with mental illness, and showed a decrease in negative, stigmatising beliefs and attitudes. Such placement experiences may assist in: (a) improving students' familiarity with and understanding of mental health, (b) shaping initially fearful or dismissive attitudes towards more positive, person-centred views, and (c) facilitating awareness of potential professional roles in caring for patients with a mental illness and supporting their needs as individuals and members of the community. [ABSTRACT FROM AUTHOR]

With the globalisation of university education, national frameworks are commonly used to prescribe standardised learning outcomes and achieve accountability. However, these frameworks are generally not accompanied by guiding pedagogy to support academics in adjusting their teaching practices to achieve the set outcomes. This paper reports the results of a scoping review of health science literature aimed at identifying pedagogy and teaching strategies relevant to achieve the learning outcomes specified by the Australian Qualifications Framework at a master's degree level. Eight practical teaching messages emerged from the review and three broad pedagogical trends were identified: the need to use authentic disciplinary-based learning activities; ensure that students are able to discover different perspectives about future practice and bring student reflection about their own knowledge into curricula. More critically, the review highlights that academics attempting to translate national learning outcome frameworks into their teaching practices face a complex and time-consuming task which may involve searching beyond their own disciplinary focus to identify practical teaching strategies to meet prescribed learning outcomes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Mechanical insufflation-exsufflation (MI-E) is increasingly used in the home management of children with neuromuscular disease. Research to date has focused on the effect of MI-E on physical health. The aim of this study was to qualitatively investigate the impact of home MI-E on the child and family's lifestyle. METHODS: Eight parents and 3 children participated in semistructured interviews. RESULTS: Five themes emerged from parent interviews demonstrating: (1) lifestyle implications, (2) parents becoming experts, (3) parents developing a sense of control over their child's condition, (4) an element of extra care, and (5) impacts on the parent-child relationship. Developing themes from the child interviews showed them adjusting to and then relying on the device. Home MI-E medicalized the home, but the overall lifestyle impact was positive. CONCLUSIONS: Although involving a small number of subjects, this study demonstrated a mixture of opposing impacts of home MI-E on lifestyle, both enabling and disabling, which need to be considered when introducing home MI-E. The positive impacts included greater ability to manage the child's health, including avoidance of hospital admissions. Negative impacts were greatest for those parents who were sole operators of the device, including a frequently disrupted lifestyle. [ABSTRACT FROM AUTHOR]

Background: Despite improvements in pain and physical capacity experienced by patients following total hip arthroplasty (THA) and total knee arthroplasty (TKA), recent studies suggest that levels of physical activity may not change. This study aimed to qualitatively explore people's beliefs and perspectives about physical activity at 6 months following THA or TKA for the treatment of osteoarthritis (OA) . Methods: Semi-structured interviews were conducted with 10 participants (age range 51-78 years) at 6 months post-arthroplasty surgery. Participants were recruited from a concurrent larger quantitative study examining quantitative physical activity levels via accelerometers. Interviews were transcribed, coded and analysed using a thematic approach. Results: Participants described greater capacity to be physically active post-surgery despite no increase in objective measures. Three themes emerged from the interviews relating to the participants perspective of physical activity after surgery: (1) physical activity is for enjoying living; (2) new limitations on physical activity: age and comorbidities; and (3) personal beliefs about physical activity: it is enough to know you can. Conclusion: Individual beliefs and perceptions are important in understanding factors influencing physical activity following THA and TKA. Health practitioners should examine this when developing management plans aimed at optimizing physical activity. [ABSTRACT FROM AUTHOR]

Background: Sharing information and decisions with children and their parents is critical in pediatric rehabilitation. Although the ethical significance and clinical benefits of sharing decisions are established, approaches for implementing shared decision-making in clinical practice are still developing. Aim: To explore the ethical challenges of sharing information and decisions with one family in pediatric occupational therapy. Method: We used a single qualitative in-depth interview with an occupational therapist to examine the ethical dimensions of sharing decisions. Results: We found that asking what was ethically at stake in the information-sharing process, highlighted how timing and style of information sharing impacts on understanding and collaboration within the therapeutic relationship. Using ethics-based questions assisted in drawing out the complexity of implementing the ideals of sharing information and decisions in pediatric practice. Conclusion: Reflecting on ethical dimensions of communication with families assists to identify approaches to shared decision-making in clinical practice. [ABSTRACT FROM AUTHOR]