This project examines the current and the future physiotherapist and occupational therapists attitudes towards the patient’s employment status and professional background throughout the rehabilitation procedure during and after discharge from secondary to primary sector. Data from the project has been derived from a factorial quantitative survey by the use of vignette technique carried out by physiotherapist and occupational therapists in somatic hospitals. In addition, the study was carried out by physiotherapist and occupational therapist students at the Metropolitan University College in Copenhagen. All in all, the factorial survey included 589 participants’ of both current and future physiotherapist and occupational therapists.
The point of departure for the project are the negative attitudes towards unemployed and the establishment of a “workfare line”, as a solution for social problems that, - which can be seen in society. Thus, this project seeks to uncover, whether or not negative attitudes associated with citizens whom lack or have no work, likewise can be identified throughout therapeutic attitudinal approaches to patients in the health care system. The government’s stance on the health care system based upon a New Public Management approach leaves the patients with very complex issues. In this approach, the government allows for greater freedom of choice but thereby forces the patient to have a greater insight into these pertaining choices. Therefore, this freedom from the government can induce some patients, due to their educational background, to seek more insight pertaining to the system than others. Thus, patients with a long education and or professional background can possibly influence the therapist to make an extra effort in their rehabilitation, compared to patients who do not have this background. The project thereby seeks to highlight whether or not these patients, without even having a real interaction with the therapists, nevertheless are being attitudinal favoured due to their educational and professional background.
The backbone of this project lies in the factorial vignette survey, where current and future physiotherapist and occupational therapists relate to a vignette about a fictitious patient who suffers from stroke. There are 4 different versions of the study, in which the fictitious patient is either described as janitor, an unemployed janitor, lawyer or an unemployed lawyer. The study consist of an indirect and or concealed part, were respondents were not aware of the projects objective and a direct part were the respondent are aware of the study’s aim through more direct questions. The study’s indirect part could not elucidate any correlation between the fictitious patients employment status and professional background and the therapist attitudes towards him. The therapist was seemingly concentrating on the patient’s rehabilitation and pathological picture. The study’s indirect part therefore indicates that the therapist’s attitude deflects an inclusive recognition approach, where the therapist is not influenced by the patient’s employment status and professional background. Opposite the study’s direct part, concluded that therapists differentiate more based on the patient’s background. The tendency to differentiate is presumably based upon personal attitudes of physiotherapist and occupational therapists, which seem to be either positive or negative. These attitudes can change, depending on the fictitious patients employment status and professional background. The finding seems to illustrate that there are both positive and negative attitudes towards patients who are unemployment in the health care system. The majority of the therapists seems to be mixed, where some are less in agreement and more in disagreement, while others seems to be more in agreement and less in disagreement with regard to the patients employment status. If the fictitious patient is unemployed and previously holding a high status job, the therapist seems to be less in agreement to differentiate such a patient over other patients. Some therapists seems to be more in agreement and less in disagreement to differentiate, if the fictitious patient is instead unemployed and previously holding a lower status job. This result therefore draws attention to the detail that therapists seem to be aware of their preferential treatment to patients with a higher job status. Overall, the patient’s employment status does come into play in the therapists’ treatment according to the study’s direct path. The study’s direct part seems to illustrate that therapists are influenced by the patient’s employment status and professional background and some of them are thereby may create an exclusionary approach to these patients. The therapist attitudes found in this study, may originate from prior influences, based on the fact that these students who were used in the study, have already opinions towards differentiating these patient groups. Thus, it appears that organisational settings for the therapeutic work prompt an attitudinal impact. Furthermore these settings will take its point of origin in organisational goals, encouraging accelerated continuity of care and a faster rehabilitation assessment instead of a patient specific recognition client-centred approach as therapist have acquired through there education.