Physiotherapy Under Pressure: A Cross-Sectional Study on The Interplay Between Perfectionism, Moral Injury, and Burnout

Abstract

Background: Given the escalating challenges for UK-based physiotherapists in workload pressures, budget constraints, staff shortages and patient wait times, the profession (of 65,000 registered physiotherapists) requires immediate care and review of therapist health. This pioneering study aims to examine perfectionism, moral injury, and burnout among UK-based physiotherapists across the NHS, private practice, sports, and academia. Method: This cross-sectional study utilised an online survey and implementation of Structure Equation Modelling (SEM) to assess the interplay of Perfectionism (Multidimension Perfectionism Scale-Short Form), Moral Injury (Moral Injury Symptoms Scale-Healthcare Professionals) and Burnout (Shirom-Melamed Burnout Questionnaire). Our sample size calculation shows representation of the UK physiotherapy profession via utilisation of 95% confidence interval with a 5% margin of error. Findings: Our analysis conducted on (n=402) UK-based physiotherapists reveals significant burnout levels – 96% are categorised as moderate to high. Furthermore, associations and SEM of Perfectionism and Moral Injury collectively account for a substantial proportion of burnout variability (r2.62), highlighting their sequential impact on burnout manifestation. Interpretation: With such high levels of burnout, urgent intervention is paramount. Elevated burnout presents challenges for the physiotherapy profession as staff retention, accurate and effective patient care, and overall health are severely impacted due to burnout. Recognising and addressing perfectionism and moral injury becomes pivotal to mitigate its impact on individual and collective health.