The South African Journal of Physiotherapy最新文献

Background: Service centres for older persons were set up in South Africa to implement programmes relating to the six determinants of the World Health Organization's (WHO) active ageing framework. The framework highlights the value of being physically active to prevent functional decline.

Objective: Our aim was to explore the characteristics of these centres and their members in the Eastern Cape province.

Method: An exploratory, descriptive, cross-sectional design was utilised to explore the characteristics of 25 centres and the profiles of their managers and 275 members of these centres.

Results: The managers had no formal training. Health and social care system requirements were important in the province, but access to healthcare services was minimal, and managers were concerned about the physical environment. Over 50% of the centres provided meals (72%), social support services (60%), dance and aerobics (56%), blood glucose testing (52%) and guardianship for members without families (52%). The members reported multiple morbidities, including hypertension (59%), diabetes (16%) and arthritis (10.5%). Few members used tobacco (n = 20) and alcohol (n = 27), but most (n = 213) were afraid of falling although they went about their daily activities with minimal difficulties. Members were satisfied with their lives (n = 231).

Conclusion: The centres provided platforms to enable the fulfilment of some of the goals of the WHO's active-ageing framework, but a comprehensive exploration of the centres and the members is needed.

Clinical implications: Physiotherapy, as part of interdisciplinary intervention, will promote the physical health of the members of the centres.

Background: The coronavirus disease 2019 (COVID-19) pandemic has exposed physiotherapists to unique work-related challenges. However, there is a lack of research regarding the mental health and lived experiences of South African physiotherapists during the COVID-19 pandemic.

Objectives: To determine levels of mental and physical health, burnout, depression, anxiety and resilience and coping strategies used by a sample of South African physiotherapists with and without exposure to patients with COVID-19. Lived work experience, perceived health and sources of support were also explored.

Method: A non-experimental, cross-sectional, mixed-method design was used. Physiotherapists completed an online survey comprising: a demographic questionnaire; scales assessing mental and physical health, burnout, depression, anxiety and coping strategies and six open-ended questions. A total of 171 physiotherapists participated in our study, 43.3% of whom were exposed to patients with COVID-19.

Results: The exposure group scored significantly higher on self-reported mental health, anxiety, depression and burnout than the non-exposure group. No significant differences were reported for physical health and resilience. Significantly more maladaptive coping strategies were employed by the exposure group. Participants' lived experiences highlighted similar experiences, as well as work-related challenges. Both groups reported that primary sources of support were significant others, but highlighted the lack of organisational support.

Conclusion: Irrespective of the degree of exposure to COVID-19, the mental health and lived experiences of physiotherapists working in South Africa has been negatively impacted by COVID-19.

Clinical implications: Understanding physiotherapists' well-being and lived experiences during the pandemic may guide workplace interventions. Our findings suggest the need for psycho-educational intervention programmes to be implemented at an organisational level.

Background: Patients with major burns suffer with pain, which impacts their physical function during hospitalisation.

Objectives: To describe the demographics, burn characteristics, clinical course, physical function, complications developed after major burns and to establish predictors of non-independent physical function at hospital discharge.

Method: Records of all consecutive adult burn admissions to a Level 1 Trauma Centre between 2015 and 2017 were screened retrospectively against our study criteria, using the Trauma Bank Data Registry. Anonymised data from included records were captured on specifically designed data extraction forms. Descriptive statistics were used to summarise findings. A regression analysis was undertaken to establish predictors of non-independent function at discharge.

Results: Males represented 87.7% (n = 64) of included records (n = 73). Median age was 38 (interquartile range [IQR]: 22). Thermal burns were most reported (n = 47, 64.4%), followed by median total body surface area (TBSA) 31% and head and arms were most affected (60.3% and 71.2%). Injury severity was high with median intensive care unit (ICU) length of stay (LOS) of 17 (IQR: 34) and hospital LOS 44 (IQR: 31) days. Wound debridement was mostly performed (n = 27, 36.9%) with limb oedema as a common complication (n = 15, 21.7%). Muscle strength and functional performance improved throughout LOS. None of the variables identified were predictors of non-independent function at hospital discharge.

Conclusion: Adults with major burns were predominantly male, in mid-life and sustained thermal injury with a high injury severity. Decreased range of motion (ROM) of affected areas, 'fair' muscle strength and independent function were recorded for most patients at hospital discharge.

Clinical implications: These findings contribute to the limited body of evidence on the profile, clinical course and outcomes of South African adult burn patients.