South African Journal of Physiotherapy最新文献

Background: While attention has been drawn to the impact of the coronavirus disease 2019 (COVID-19) pandemic on the mental health of healthcare workers generally, little is known regarding mental health changes over time in frontline and non-frontline physiotherapists during this period.

Objectives: Our study aimed to investigate differences in mental health trends among frontline and non-frontline physiotherapists across three time periods during the pandemic.

Method: Survey-based data were collected from 366 practising physiotherapists across three time periods during the pandemic (Time 1: n = 171; Time 2: n = 101; Time 3: n = 94). Variations in reported mental health of frontline and non-frontline respondents generally and over time were analysed using comparative statistical techniques and trend analysis.

Results: Frontline physiotherapists reported significantly lower levels of general mental well-being and resilience, and significantly higher levels of burnout and maladaptive strategy use. Only frontline physiotherapists' general mental well-being and resilience decreased over time, whereas depression decreased over time for both groups. Anxiety decreased over time for non-frontline physiotherapists but initially decreased and then increased for frontline physiotherapists. Burnout increased initially and then decreased for non-frontline physiotherapists.

Conclusion: Varying mental health trends were found between frontline and non-frontline physiotherapists over time. Nuanced mental health interventions that consider the period of the pandemic and degree of exposure are needed.

Clinical implications: Understandings of the mental health trajectories experienced by physiotherapists across the pandemic can inform long-term, targeted interventions that effectively enhance well-being, retention, and sustainability of practitioners, and thus the care delivered, in the healthcare system.

Background: Health services are inaccessible in low-income countries. The National Health Insurance (NHI) bill, linked to primary health care (PHC), was introduced in South Africa to improve access to health services. Physiotherapists contribute to healthcare and improve individuals' health status across their lifespan. The South African healthcare system has many challenges: physiotherapists mostly practising at secondary and tertiary levels of care; a shortage of physiotherapists in the public health systems and rural areas; the omission of physiotherapy in health policies.

Objectives: To explore strategies to integrate physiotherapy services in PHC settings in South Africa.

Method: Our study used a qualitative, exploratory and descriptive approach to collect data from nine doctorate physiotherapists at South African universities. Data were thematically coded.

Results: The themes are to (1) improve societal knowledge of physiotherapy, (2) ensure policy representation of the profession, (3) transform physiotherapy education, (4) broaden the role of physiotherapy, (5) eradicate professional hierarchy and (6) increase the physiotherapy workforce.

Conclusion: Physiotherapy is not well known in South Africa. Physiotherapy is needed to feature in health policies to transform education focussing on disease prevention, health promotion and functioning in PHC. Broadening physiotherapy roles should consider the regulator's ethical rules. Physiotherapists should proactively collaborate with other health professionals to dismantle professional hierarchies. Without addressing the urban-rural, private-public divide, the physiotherapy workforce cannot improve, to the detriment of PHC.

Clinical implication: Implementing the suggested strategies may facilitate physiotherapy integration into PHC in South Africa.

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Background: With the ever-changing healthcare environment and impact of the coronavirus disease 2019 (COVID-19) pandemic on tertiary education, healthcare students need to constantly adapt their approach to learning, clinical practice and well-being. Adaptive performance is therefore vital.

Objectives: To investigate the adaptive performance of final year physiotherapy students at the University of the Free State.

Method: A quantitative descriptive study was performed. All consenting final year undergraduate physiotherapy students registered at the University of the Free State in 2021 were approached for inclusion. The short 55-item I-ADAPT measurement was distributed electronically to all possible participants.

Results: The response rate was 28.5% (n = 8). Descriptive statistics, namely frequencies and percentages for categorical data and medians and percentages for numerical data were calculated. The dimensions related to handling work stress (50%), uncertainty (62.2%) and creativity (64.0%) scored the lowest. Emotional response to stress (62.5%) and frustration in response to unpredictable situations (62.5%) was reported.

Conclusion: Uncertainty and unpredictability are inevitable for healthcare students. Stress management and emotional intelligence development are advised for inclusion in undergraduate physiotherapy programmes.

Clinical implications: A need for curricular evaluation to ensure students are equipped with stress management and emotional intelligence skills is proposed.

Background: Return to pre-stroke life is of great importance to stroke survivors, their families and communities as stroke affects their ability to perform activities of daily living. It is therefore important to understand the impact of stroke rehabilitation on the community life of stroke survivors in Ghana as there are limited data.

Objectives: Our study aimed to explore and describe the views of stroke survivors on the impact of stroke rehabilitation on their community life.

Method: A descriptive qualitative study was conducted among 15 stroke survivors recruited from three selected hospitals in the Greater Accra Region of Ghana. Individual in-depth interviews were conducted using a semi-structured interview guide. Interview transcripts were analysed using thematic analysis and this gave rise to several themes.

Results: The authors found that stroke left most of the survivors with functional limitations and they required various degrees of assistance to perform their activities of daily living. As the stroke survivors received rehabilitation, most of them mentioned improvements in function. However, most participants were still unable to return to work and enjoy social or leisure activities.

Conclusion: Our study shows that attention needs to be given to the occupational and social management in rehabilitation as much as it is given to the physical management, to improve community integration post-stroke.

Clinical implications: Our study highlights the need to take into consideration the occupational and social aspects of life as part of the rehabilitation process for stroke survivors.

Background: Physiotherapists are essential in the management of hospitalised patients. The way in which a physiotherapy service is offered in intensive care units (ICUs) can affect ICU patient outcomes.

Objectives: To provide a clear picture of the organisation and structure of physiotherapy departments, the number and types of ICUs requiring physiotherapy services and the profile of physiotherapists working in South African public-sector central, regional and tertiary hospitals that house Level I-IV ICUs.

Method: Cross-sectional survey design using SurveyMonkey, analysed descriptively.

Results: One hundred and seventy units (the majority Level I, functioning as mixed [37%, n = 58] and neonatal [22%, n = 37] units) are serviced by 66 physiotherapy departments. The majority of physiotherapists (61.5%, n = 265) were younger than 30 years, had a bachelor's degree (95.1%, n = 408) and were employed in production Level I and community service posts (51%, n = 217) with a physiotherapy-to-hospital-bed ratio of 1:69.

Conclusion: Insight into the organisational structure of physiotherapy departments and physiotherapists working in public-sector hospitals with ICU facilities in South Africa was provided. It is evident that physiotherapists employed within this sector are young and early in their career development. The large number of ICUs functioning within these hospitals and high bed-to-physiotherapist ratio is concerning, highlighting the high burden of care within this sector and the possible effect on physiotherapy services in the ICUs.

Clinical implications: A high burden of care is placed on public-sector hospital-based physiotherapists. The number of senior-level posts within this sector raises concern. It is not clear how the current staffing levels, physiotherapist profile and structure of hospital-based physiotherapy departments affect patient outcomes.

Background: Patients with mental health disorders (MHDs) often present with chronic illness and complain of pain and poor physical health. They present with a high burden of disease and poor quality of life. Significant associations between MHDs and chronic illness have been found. Lifestyle interventions are cost-effective strategies, which seem to be effective in managing comorbid mental and physical health disorders. Therefore, a summary of the evidence and clinical practice guidelines is needed in South Africa.

Objectives: Our study will aim to determine the effectiveness of lifestyle interventions on health-related quality of life, in patients with comorbid mental and physical health disorders.

Method: The systematic review will be conducted using the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness. MEDLINE (Ovid), CINAHL (EBSCO), LiLACS, Scopus, Physiotherapy Evidence Data Base (PEDro) and Cochrane Central Register of Controlled Trials will be searched. A three-step search strategy will identify published literature in all languages from 2011 to 2022. Critical appraisal of all included studies will be performed, and the relevant data will then be extracted. Where possible, data will be pooled in a statistical meta-analysis.

Results: The results will provide the best available evidence regarding lifestyle interventions in the management of patients with comorbid mental and physical health disorders.

Conclusion: Our review will provide evidence on the effectiveness of lifestyle interventions in the management of patients with comorbid mental and physical health disorders.

Clinical implications: The results may assist in determining the best use of lifestyle interventions in the management of patients with MHDs and comorbidities.

Background: Cancer is one of the leading causes of death worldwide. Exercise is crucial for ameliorating the burden associated with cancer and its management. A broad review of exercise interventions for cancer patients is not available.

Objective: Our study aims to review the documented exercise interventions prescribed for adult cancer patients aimed at ameliorating cancer-related and cancer treatment-induced symptoms in patients along the continuum of care.

Methods: A three-step search strategy will be used, the research question was developed; the first step in the research process was identified and the search strategy was developed using the Participants-Concept-Context framework. English language publications from 15 electronic databases from 2011 to 2021 will be searched. The Joanna Briggs Institute methodology for scoping reviews will be to guide the review and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews will be used for the report. The search strategy incorporated terms relevant to the research question. The reference lists of articles included in the review will be screened for additional papers. Searched articles will be screened to determine their eligibility for inclusion and a pretested data extraction form will be used to chart the extracted evidence.

Results: This article presents a protocol for a scoping review on exercise interventions to affect symptoms in cancer patients from diagnosis to end-of-life care.

Conclusion: A broad review of exercise interventions for cancer management in adult patients will elucidate the characteristics and context of exercises used along the cancer care continuum.

Clinical implications: Exercise interventions used as part of cancer management will be mapped out to provide an overview of such exercise interventions. This could enhance knowledge among exercise oncology experts regarding exercise interventions for different cancer patient populations.

Background: People with chronic neck pain show decreased endurance and strength of cervical muscles with compromised respiratory function. There is little evidence that improvement in breathing function of people with neck pain can help in enhancing cervical muscle strength and pulmonary function. The objective of this our clinical trial was to examine the effects of breathing re-education combined with physiotherapy on endurance and strength of deep neck flexors, and pulmonary function in patients with chronic neck pain.

Methods/design: In this double blind randomised clinical trial, 30 patients with chronic neck pain (25-50 years old) were randomly allocated to two groups. Group A, physiotherapy (n = 15), and Group B, breathing re-education (n = 15). The duration of intervention was eight weeks with treatment five days a week. The endurance was measured with the craniocervical flexion test, strength with a handheld dynamometer (Baseline USA) and pulmonary functions with the Spiro lab 4 (USA) at baseline, at week four and at week eight of the intervention.

Discussion: There was a significant between group improvement in the strength of deep neck flexors and forced vital capacity (FVC) in Group B p = 0.0001 and p = 0.0200 (p ˂ 0.05) respectively. Intergroup comparisons showed no significant differences for endurance, cervical extensor strength, Forced Expiratory Volume in one second (FEV1), and FEV1/FVC percentage.

Conclusion: Our study concluded that breathing re-education combined with other physiotherapy management is effective for improving the strength of neck flexors and increasing FVC in people with chronic neck pain.

Clinical implication: Breathing re-education may be part of physiotherapy management in patients with chronic neck pain.

Trial registration: Iranian Registry of Clinical Trials, IRCT20200226046623N1, https://www.irct.ir/trial/46240.