Date of Award

Summer 7-31-2025

Degree Type

Dissertation

Degree Name

PhD Health Sciences

Department

Health and Medical Sciences

Advisor

Genevieve Zipp, PT, EdD, FNAP

Committee Member

Gavin Williams, PhD, FACP

Committee Member

Courtney Spiteri, DPsych

Keywords

traumatic brain injury, agitation, physical therapist, burnout, resilience, mentorship

Abstract

The purpose of this study was to investigate the impact patient agitation post traumatic brain injury (TBI) has on physical therapist burnout and the factors that contribute to its presence. Therefore, the following research questions were posed: 1) What is the prevalence of burnout among physical therapists (PTs) providing direct patient care for patients with post-TBI agitation? 2) Is there a relationship between clinical setting and 3) percentage of direct patient care and PT burnout? 4) How do scores of resilience differ between those that do and do not have burnout? And 5) What work system factors do PTs working with the post-TBI agitated patient population identify as contributing to burnout? Participants/Methods: An embedded mixed methods design was used in which 97 participants agreed to participate in a cross-sectional Qualtrics survey that included both quantitative (OLdenburg Burnout Inventory (OLBI) and the Medical Professionals Resilience Scale (MeRS)) and qualitative (five-researcher developed open-ended questions) measures. Demographic data was collected and included years of experience, specialty certifications, practice setting, whether or not mentorship had been provided, and the percent caseload dedicated to direct patient care with the specified population. Results/Data Analysis: Quantitative and qualitative analyses were completed post data collection. Descriptive and inferential statistics were used to analyze the quantitative findings via SPSS whereas the qualitative data was coded via Atlas.ti using an in-vivo coding process classifying data from categories to a thematic analysis statement. Using the OLBI and its two domains of Exhaustion and Disengagement to indicate burnout, 25% of the participants met the cut-off score for Exhaustion and 22% for Disengagement. Combined, 13% met the cut-off score for both Exhaustion and Disengagement. No relationship was found between clinical setting or percent caseload and burnout using the OLBI cut-off scores however there was a relationship between viii resilience and burnout when examining the MeRS Global score and Exhaustion (p =< .001), Disengagement (p =< .001), and combined Exhaustion/Disengagement (p =< .001) subscales. Specifically, the MeRS domain of Control was identified as having an association with Exhaustion (p =.009) and the combined Exhaustion/Disengagement (p =.009) subscales. Additional findings include an association between mentorship and the MeRS Global score (p = .005). Qualitative findings revealed that one’s external stressors, the dynamic nature between the PT and the patient, and the job demands of a challenging caseload, increasing productivity, lack of support, and the physical and psychological burden all contribute to burnout whereas the job resources of available continuing education, mentorship, multidisciplinary support and collaboration, and the positive influence of the relationship between the patient and PT mitigate burnout. Conclusion: Prevalence of burnout in PT’s providing direct patient care for patients with post-TBI range from 22-25%. Practice setting and percent caseload were not found to be correlated to burnout, but specific personal factors and job demands of working with this population were identified. Resilience was found to be associated with burnout with a relationship between resilience and mentorship identified. Additionally, job resources and the relationship between the PT and the patient were also found to positively impact burnout.

Download

Share

COinS