Attitudes of physiotherapists towards the use of performance-based measures and questionnaires

Background The use of outcome assessments in physiotherapy is widely recommended to support clinical decision-making, document patient progress and ensure therapeutic quality. Despite these recommendations, outcome assessments are underutilised in practice. One factor that might influence their usage is physiotherapists’ attitudes towards them. However, informative value from existing research is limited due to the use of non-standardised instruments to measure these attitudes. The aim of this study was to develop a standardised instrument for measuring the attitudes of physiotherapists towards the use of outcome assessments in clinical practice and to examine the instrument’s validity and reliability. Methods A set of preliminary items was generated and tested within a two-phase validation study conducted as an online survey. Licenced physiotherapists were invited to participate. Phase one included a 10-day-retest, whereas the survey was completed only once in the second phase. Correlation analyses were performed to explore the relationships between items and identify clusters potentially measuring the same construct. Factor analysis was performed to assess structural validity. Test-retest reliability (ICC) and internal consistency reliability (Cronbach’s alpha) were determined, as well as floor and ceiling effects. Results Data were collected from 144 physiotherapists, and 30 participants completed the retest assessment. The final instrument consists of a subscale of 9 items for the attitude towards the use of performance-based measures (PBM) and one with 10 towards the use of questionnaires, with factor loadings between 0.6 and 0.9. The instrument significantly differentiates between therapists who use/do not use PBM or questionnaires in practice. Cronbach’s alpha for the subscales was 0.90/0.93 and ICC was 0.84. No floor or ceiling effects were given. Conclusion The developed instrument might provide a better understanding of the impact of attitudes on the use of clinical outcome assessments in physiotherapy practice. First evidence of the instrument’s psychometric properties indicate it as a valuable tool for research and education, supporting analysis of the gap between the recommended and actual use of outcome assessments. Trial registration: German Clinical Trials Register (DRKS00029360). Registered 01 July 2022.