A Cross-Sectional Survey of Practice Patterns and Selected Demographics of Respiratory Therapists in India

Psychometric properties and development of a structured questionnaire to assess the perception, attitude, and job satisfaction among respiratory therapists

Background

Over the past ten years, significant transformations have occurred in the healthcare landscape, presenting respiratory therapists (RTs) with a mix of challenges and opportunities. Hence, their perceptions about career progression and job satisfaction will be critical factor in determining the recruitment and retention of RTs. However, there are no studies in the literature that comprehensively assessed these aspects using a reliable and valid measure specific to RTs. Our objective was to develop and psychometrically test a Standardized Questionnaire (SQ) for evaluating RT's overall job satisfaction.

Methods

Following consultations with experts and interviews conducted with RTs, a preliminary questionnaire was devised for the purpose of exploratory factor analysis (EFA). The 49 items of the Structured Questionnaire (SQ) were used for verification of the theorized factor structure and content validity using a confirmatory factor analysis (CFA). Principal Component Analysis (PCA), Structural Equation Modeling (SEM), and Confirmatory Factor Analysis (CFA) for the global fit were done. Cronbach's alpha was performed to estimate the internal consistency. The samples of RTs were collected from India between August 2021 and January 2022.

Results

A convenience sample comprising 409 respiratory therapists (RTs) employed in India participated in the survey conducted from June 2021 to January 2022. The exploratory factor analysis revealed three factors that explained 61.2 % of the total variance. The confirmatory factor analysis yielded a 3-factor structure (X2/df = 4.4, p < 0.02, standardized root-mean-square residual = 0.05, goodness of fit index = 0.94, comparative fit index = 0.98). The Cronbach's alpha was 0.94 for the total scale.

Conclusions

Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) are becoming more prevalent, especially in the development and psychometric evaluation of instruments. This Structured Questionnaire is a reliable and valid tool that has utility for assessing perceptions, satisfaction, and attitude among Respiratory Therapists and for making comparisons of similar psychometric measures.

Gaps in asthma diagnosis and treatment in low- and middle-income countries

Low- and middle-income countries (LMICs) contribute to a major proportion of asthma morbidity and mortality globally, even though the prevalence is higher in high income countries. Mortality due to asthma is avoidable and patients should be able to live a near normal life. There are factors that influence overall disease prevalence and poor health outcomes due to asthma in LMICs. This article summarizes the gaps in asthma diagnosis and management in LMICs. The gaps are diverse. Each challenge needs to be addressed through policy decisions, upgrade of infrastructure, knowledge and skills for early diagnosis and correct management among health care providers, both clinicians and paramedics. Healthcare accessibility and affordability are genuine challenges, and the public healthcare system needs to be geared up to address these at primary and tertiary levels. Mass education of the population through national level government initiatives is needed to help bridge the sociocultural gaps.

Validation of a structured questionnaire to assess the perception and satisfaction of respiratory therapy students toward career prospects and learning resources

BACKGROUND

Respiratory therapy is an emerging profession that has existed in India since 1995. Respiratory therapy students will play a significant role in strengthening various aspects of healthcare in the future. There are no validated instruments to evaluate students' perceptions of their careers and satisfaction with the learning resources. The primary objective of the current study is to develop and validate a structured questionnaire (SQ) for respiratory therapy students in India, encompassing all the components of their career development and satisfaction.

METHODS

Based on the literature review and content validity from respiratory therapy experts through multiple focused group discussions, a reliable SQ was generated with 40 items based on the Likert scale. After getting institutional ethics clearance and informed consent, the SQ was administered to 904 respiratory therapy students across the country. We performed principal component analysis (PCA), structural equation modeling, and confirmatory factor analysis (CFA) for the global fit. Cronbach's alpha was performed to estimate the internal consistency.

RESULTS

The PCA generated a 4-factor model, and internal consistency for the total scale exceeded the standard criterion of >0.70. Satisfactory goodness of fit data were yielded from CFA. Average variances extracted were higher than the correlation coefficients of the factors, which show sufficient discriminant validity.

CONCLUSION

This study shows a clinically acceptable model, it fits and suggests the possibility of applying a SQ to a respiratory therapy student with relatively good construct validity and internal consistency, based on the results of CFA.

A survey on the attitudinal differences between acute and community settings

INTRODUCTION

While challenges facing community and acute care practitioners have been studied elsewhere, this is not the case for respiratory therapists (RTs). This study aimed to examine attitudinal differences amongst RTs in British Columbia regarding challenges faced by acute and community settings.

METHODS

A 40-item anonymous online survey was sent to members of the British Columbia Society or Respiratory Therapists. Of the 40 questions, 11 were relevant to the study's aim.

RESULTS

Of 1024 invitations, 197 (19.2%) responded. One-hundred and seventeen (59.4%) self-identified as working in acute care settings, 53 (26.9%) in community settings, and 27 (13.7%) as "other". Stress- and interpersonal-related challenges showed statistically significant differences (P ≤ 0.05) based on work setting. Acute care had the highest percentage of responses for challenges related to technology, stress, inter-professional collaboration, and training. Community settings had the highest percentage in challenges related to independence and education. Both being equal received the highest percentage in challenges related to problem-solving, interpersonal, communication, and resource management.

DISCUSSION

While attitudinal differences exist, they are not extreme. It did not appear that respondents' primary motivation was to vote along "party lines".

CONCLUSIONS

The setting an RT works in can influence attitudes related to stress and interpersonal challenges. Despite this, one setting is not universally more challenging. Acute care settings can have greater technological, inter-professional, and training-related challenges. Community settings can have greater independence and education-related challenges. Both settings can provide similar challenges with problem-solving, communication, and resource management.

Exploring the professionalization of respiratory therapy in Canada

Introduction

A recurrent challenge facing respiratory therapists (RTs) is their legitimacy as professionals. RTs are often referred to as technologists, vocationalists, or technicians and must often justify their status as full professionals rather than "professional technicians". There is currently little exploration of what it means to be a profession and the process of professionalization in respiratory therapy.

Approach

Drawing from sociological theory, the purpose of this paper is to discuss the professionalization of respiratory therapy in Canada using Andrew Abbott's theory, the "system of professions". We will use this theory as a lens to propose areas of consideration for professional development regarding two pervasive themes in the respiratory therapy community, RTs' specialized body of knowledge and professional autonomy.

Findings

Abstract knowledge is believed to be essential in the evolution from occupation to profession and is valuable to a profession in three ways: it can influence the profession's legitimacy, it can be used for conducting research, and it promotes higher education. RTs possess jurisdictional professional autonomy within Canada. The privilege of self-regulation allows RTs to act according to their knowledge and judgement without direct oversight from other professions.

Conclusion

Based on Abbott's theoretical position, RTs can rightly justify their position as professionals. However, RTs need to acknowledge that professionalization is a dynamic and continuous process that requires creative changes to innovate within the profession and support future efforts to reinforce their position as professionals. Throughout this paper, we offer suggestions for how RTs can contribute to the ongoing professionalization of respiratory therapy.