The Quiet Quitting Phenomenon Among Physiotherapists

Health workers are essential to the functioning of health systems; expanding health care coverage and attaining the right to the highest possible level of health are based on the availability, accessibility, acceptance, and quality of health care. Policymakers must take the necessary steps to improve health care quality by considering gender, family, profession, and age group differences in line with technological, scientific, and social developments. Additionally, the investigators need to remember the factors that reduce organizational commitment, job satisfaction, productivity, and motivation. Acting in the international cooperation framework will contribute to greater harmony between societies.

The identified study design is an observational study without the use of drugs or medical devices. The study involved the use of a questionnaire specifically structured for this research, divided into three distinct sections. The first section is aimed at collecting demographic and professional data from participants, as well as verifying compliance with the inclusion criteria. The second section includes the 36 items of the Job Satisfaction Survey (JSS), translated into Italian. Finally, the third section consists of the 9 items of the Quiet Quitting Scale, also translated into Italian. Sampling will follow a non-probability approach, using convenience sampling. Participants will be recruited through the dissemination of a questionnaire created with Google Forms. Recruitment will occur via the institutional channels (newsletter/website) of the Professional Board of Physiotherapists of Belluno- Treviso-Vicenza-Verona and the Italian Association of Physiotherapists (AIFI) - Veneto section, subject to prior authorization, along with a request for voluntary participation. Individuals who respond to the questionnaire, provide informed consent, and meet the inclusion criteria will be enrolled in the study. All participants will be included and the questionnaire will be administered at a single time point (T0); no follow-up is planned. Reading and accepting the study information sheet-after reviewing the data processing information and providing informed consent-will be considered an essential condition for questionnaire administration, as outlined in the information notice. The consent form and information sheet will be integrated into the Google Forms format, and only after selecting "Yes, I Consent" for both fields (data processing and informed consent) on the first page will the respondent be granted access to the actual questionnaire. It will not be possible to trace the participant's email address or IP address. To achieve the targeted sample size, the questionnaire will be disseminated through the institutional channels of the Professional Board of Physiotherapists of Belluno-Treviso-Vicenza-Verona and the Italian Association of Physiotherapists (AIFI) - Veneto section, subject to prior authorization. Participation by physiotherapists will be voluntary. The communication will include the purpose of the survey, instructions for completing and submitting the questionnaire, and will consist of:

• A brief description of the study
• The information and informed consent form
• The information form regarding personal data processing
• Contact details of the study promoter for any additional information or clarifications
• A link to access the questionnaire Upon completion, by clicking "submit," respondents will send their responses to the electronic platform managed by the three project investigators. Thanks to a specific feature of Google Forms, each submission will be identified solely by the date and time of submission; it will not be possible to trace the participant's email address or IP address. In the absence of a randomized sample, the estimation of sample size is not considered binding. The study size will therefore be determined by the total number of participants who complete the questionnaire. However, although not binding, the following statistical guidelines are provided: with a 95% confidence level and an acceptable margin of error of 0.20, the goal is to estimate the mean score of the outcomes in the target population. The literature reports a standard deviation of 0.987, which will be adopted as a preliminary estimate of the standard deviation in this sample. Based on this information, a sample size of 94 participants is recommended to estimate the mean score of the outcomes. Means and standard deviations (medians and percentiles) will be calculated for continuous variables. For categorical variables, frequencies and proportions will be calculated. The association between the outcome and the variables of interest will be analyzed within each stratum of potential confounding factors (age, gender, years of experience). Scale scores between groups of interest (e.g., hospital vs. primary care) may be compared using appropriate statistical tests. The extent and nature of missing data will be assessed. In cases where a respondent has omitted a high number of responses, the entire questionnaire will be excluded. For small amounts of missing data, the missing values will be replaced by the median of the corresponding variable. Due to the use of convenience sampling, it is acknowledged that the sample may not be representative. Respondents with incomplete data will be excluded, and potential exclusion of outliers will also be considered.