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Kunstler, Breanne. "Physical activity promotion in physiotherapy practice." Thesis, Federation University Australia, 2018. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/165585.
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Australian physiotherapists promote non-treatment physical activity, which is physical activity used to improve or maintain general health, to patients with musculoskeletal conditions. However, it is unclear how physiotherapists promote non-treatment physical activity and the behaviour change techniques they use to do this. This thesis used four studies to: (i) review the efficacy of physiotherapist-led physical activity interventions; (ii) investigate the factors that influence physiotherapists’ choice to promote non-treatment physical activity; and (iii) identify the behaviour change techniques that private practice and outpatient physiotherapists use to promote non-treatment physical activity. Two systematic reviews identified that physiotherapist-led physical activity interventions are efficacious. However, effects were small and not maintained. Additionally, physiotherapists only used a small number of behaviour change techniques when promoting physical activity. National survey and interview studies were used to identify the factors that influence physiotherapists’ choice to promote non-treatment physical activity. The survey found that having poor knowledge of how to promote non-treatment physical activity, prioritising other patient problems before non-treatment physical activity and using promotion methods that were not compatible with daily practice significantly and independently reduced the odds of physiotherapists promoting non-treatment physical activity. Interpretative phenomenological analysis was used to design interviews that showed that having a perceived inability to motivate an unmotivated patient and believing that patients expect hands-on therapy instead of non-treatment physical activity promotion complicated treatment choices. The behaviour change techniques Australian physiotherapists used to promote non-treatment physical activity were compared to those used to encourage adherence to rehabilitation exercises in the survey too. The survey found that physiotherapists used similar behaviour change techniques to promote non-treatment physical activity and encourage adherence to rehabilitation exercises. This thesis provides clinicians and researchers with an understanding of the factors that influence Australian physiotherapists’ decision to promote non-treatment physical activity and the behaviour change techniques they use.Doctor of Philosophy
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Owen, Gwyneth. "Becoming a practice profession : a genealogy of physiotheraphy's moving/touching practices." Thesis, Cardiff University, 2014. http://orca.cf.ac.uk/68522/.
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This research responds to gaps in the literature about the evolution of physiotherapy practice and to uncertainties emerging from within physiotherapy about its professionalism and practice. It aimed to generate a theoretically informed understanding of the tensions present in contemporary physiotherapy practice by producing an embodied account of the process of becoming a practice profession. The research aim was achieved by a genealogical study of existing literature, documentary data from physiotherapy’s qualifying curricula and oral accounts of practice generated by depth interviews with physiotherapists who qualified during the 1940/60s. These data were subject to a Foucauldian discourse analysis and a phenomenological analysis to explore the events, discourses and actions shaping physiotherapy practice over time. Unlike existing historic accounts that trace the evolution of physiotherapy’s professional identity, this research prioritises the bodies doing physiotherapy over time so offers a fresh perspective on physiotherapy as a practice and as a profession. From a ‘doing’ perspective, professionalism ceases to be an acquisition that is externally bestowed and becomes a dynamic process of experiencing/producing autonomous problem-solving in practice. Physiotherapy’s professional practice can be traced back to the 1945 curriculum. It was enacted through the integration of physiotherapy movement/touch and by the discipline of movement, which generated autonomous problem-solving practices that cut across ward/disease boundaries established by medicine from the 1950s onwards. While still subject to medical supervision, physiotherapy’s movement/touch crossed the division of labour to develop capacity to produce diagnosis-inference-treatment once its technical autonomy was recognised in 1977. Once free of medicine, physiotherapy’s professional practices multiplied to provide moving/touching solutions for an increasing variety of movement disorders. My research complements the existing (disembodied) critical histories of physiotherapy as a profession and demonstrates the value of embodiment as a lens for tracing movement in physiotherapy’s professional identities and practices over time. It adds to sociological understanding of the organisation of healthcare occupations and practices by offering an account of a body that is a moving part of a division of labour organised around the dominant profession of medicine.
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Trede, Franziska Veronika. "A Critical Practice Model For Physiotherapy." University of Sydney, 2006. http://hdl.handle.net/2123/1430.
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Doctor of PhilosophyA perspective in critical social science is concerned with knowledge, power and critique. This thesis explores the question: What would physiotherapy practice look like if it were informed by critical social science? This question originated from four observations: (1) physiotherapists work with constantly changing health care demands, (2) traditional practice approaches underpinned by rational objectivity widen the gap between theory and practice, (3) professional judgments are based on more than objective, rational thinking, and (4) concluding from the first three observations clinical physiotherapists rely more and more on thinking for themselves. If physiotherapists were to adopt a critical social science perspective they would question their practice, identify taken-for-granted, unreflected assumptions and unnecessary system constraints and liberate themselves, their practice and patients, thereby enhancing both the quality of patient care and the practitioner’s professional work experience. Following the hermeneutic tradition I constructed texts from pertinent literature as well as transcripts from participants’ interviews, action plans and field notes. I developed an integrative design to interpret these texts drawing from philosophical and critical hermeneutics as well as action research. The question and answer dialogue methodology consisted of four cycles including deep, critical and transformative dimensions. These I labelled critical transformative dialogues. The first dialogue was with the critical social science literature and with the Gadamer-Habermas and Foucault- Habermas debates in particular. These debates addressed issues of rationality, knowledge and power. Further, I reviewed relevant education, nursing and health promotion literature that addressed these critical social science themes. This first dialogue crystallised my identification of key CSS dimensions relevant to physiotherapy practice. The second dialogue comprised physiotherapy literature that related to these identified critical social science dimensions, as well as transcripts from physiotherapists’ interviews. This dialogue critically interpreted current practice models in their historical, educational and practice contexts. It highlighted the finding that physiotherapy practice is currently dominated by instrumental thinking rather than critical thinking, and that there is a lack of engagement of physiotherapy practice with CSS. The third dialogue was with physiotherapists trialling CSS in practice. Physiotherapists of this trialling group designed action learning “contracts” where they set out to change their practice in the sense of adopting CSS principles and activities in their practice. I explored with these participants how CSS could work or fit in their practice and practice contexts and how this would be experienced. Through this action learning project of endeavouring to transform their practice towards a CSS model I explored participants’ capacity to learn about posing problems concerning their practice, recognise practice contradictions, experience practice challenges and recognise their motivations and interests. This exploration illuminated the viability of CSS in their practice. The fourth dialogue was with physiotherapists who operationalised CSS values or who could visualise a CSS framework for their practice whether they used this terminology or not. This dialogue brought critical understanding of the advantages and potential limitations of realising a CSS-centred physiotherapy practice. I conclude the thesis with twelve propositions arising from these four critical transformative dialogues. Based on the trialling, transforming and visioning of CSS as a model for physiotherapy practice, the relevance of these propositions for critical physiotherapy practice is asserted and implications for education and further research are discussed. The contribution that CSS can make to physiotherapy practice is to add critical transformative dialogues as a strategy to advance practice that is patient-centred and multidisciplinary in approach, inclusive of sociopolitical environments, mindful of professional power and open about professional values.
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Webster, Valerie Sneddon. "A study of open access physiotherapy practice." Thesis, Glasgow Caledonian University, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.387853.
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McNeill, Sheelagh C. "Acupuncture : clinical practice and effectiveness in physiotherapy." Thesis, University of Ulster, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.288826.
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Waterfield, Jacqueline. "Post-registration learning in physiotherapy : practice and policy." Thesis, Keele University, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.435153.
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The profession of physiotherapy is evolving in an era of evidence-based health C
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Ajjawi, Rola. "Learning to communicate clinical reasoning in physiotherapy practice." University of Sydney, 2006. http://hdl.handle.net/2123/1556.
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Doctor of Philosophy (PhD)Effective clinical reasoning and its communication are essential to health professional practice, especially in the current health care climate. Increasing litigation leading to legal requirements for comprehensive, relevant and appropriate information exchange between health professionals and patients (including their caregivers) and the drive for active consumer involvement are two key factors that underline the importance of clear communication and collaborative decision making. Health professionals are accountable for their decisions and service provision to various stakeholders, including patients, health sector managers, policy-makers and colleagues. An important aspect of this accountability is the ability to clearly articulate and justify management decisions. Considerable research across the health disciplines has investigated the nature of clinical reasoning and its relationship with knowledge and expertise. However, physiotherapy research literature to date has not specifically addressed the interaction between communication and clinical reasoning in practice, neither has it explored modes and patterns of learning that facilitate the acquisition of this complex skill. The purpose of this research was to contribute to the profession’s knowledge base a greater understanding of how experienced physiotherapists having learned to reason, then learn to communicate their clinical reasoning with patients and with novice physiotherapists. Informed by the interpretive paradigm, a hermeneutic phenomenological research study was conducted using multiple methods of data collection including observation, written reflective exercises and repeated semi-structured interviews. Data were analysed using phenomenological and hermeneutic strategies involving in-depth, iterative reading and interpretation to identify themes in the data. Twelve physiotherapists with clinical and supervisory experience were recruited from the areas of cardiopulmonary, musculoskeletal and neurological physiotherapy to participate in this study. Participants’ learning journeys were diverse, although certain factors and episodes of learning were common or similar. Participation with colleagues, peers and students, where the participants felt supported and guided in their learning, was a powerful way to learn to reason and to communicate reasoning. Experiential learning strategies, such as guidance, observation, discussion and feedback were found to be effective in enhancing learning of clinical reasoning and its communication. The cultural and environmental context created and supported by the practice community (which includes health professionals, patients and caregivers) was found to influence the participants’ learning of clinical reasoning and its communication. Participants reported various incidents that raised their awareness of their reasoning and communication abilities, such as teaching students on clinical placements, and informal discussions with peers about patients; these were linked with periods of steep learning of both abilities. Findings from this research present learning to reason and to communicate reasoning as journeys of professional socialisation that evolve through higher education and in the workplace. A key finding that supports this view is that clinical reasoning and its communication are embedded in the context of professional practice and therefore are best learned in this context of becoming, and developing as, a member of the profession. Communication of clinical reasoning was found to be both an inherent part of reasoning and an essential and complementary skill necessary for sound reasoning, that was embedded in the contextual demands of the task and situation. In this way clinical reasoning and its communication are intertwined and should be learned concurrently. The learning and teaching of clinical reasoning and its communication should be synergistic and integrated; contextual, meaningful and reflexive.
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Roberts, Penelope Anne. "The practice of physiotherapy : theoretical and contextual reflections." Thesis, Sheffield Hallam University, 2000. http://shura.shu.ac.uk/20795/.
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This thesis is an examination of the practice of physiotherapy, an exploration of the context within which the profession of physiotherapy developed and an identification of the theoretical frameworks within which it is practised. The experiences of physiotherapists and nurses working in particular settings at a specific point in the development of the profession provided a starting point for the study. Physiotherapy, a profession openly dependent for a significant part of its history on medicine for its practice and knowledge base, is contextualised with reference to the development of a medical hegemony, the changing role of women in society, and the development of specialisms within physiotherapy. A methodological framework was developed through the use of a naturalistic design which places the researcher within the study and legitimises personal perspectives. Knowledge of the field prior to the study, fieldwork observations, and findings from two sets of interviews generated the data which provided the framework for an exploration of the theoretical base for the practice of physiotherapy. The thesis concludes by examining the components of context and theory which are fundamental to the practice of theory, and places them within a new framework. This new framework or paradigm is based on a re-evaluation of the concept of holism and goes back to the origins of this model which developed amidst the chaos of post-Boer was South Africa. The meaning of holism has been changed to make it nearer the concept of summative dualism which fits well with key concepts of balance, harmony and homeostasis. True holism is about movement and change and this is proposed as an appropriate model on which to base a paradigm for physiotherapy.
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Dannapfel, Petra. "Evidence-Based Practice in Practice : Exploring Conditions for Using Research in Physiotherapy." Doctoral thesis, Linköpings universitet, Avdelningen för samhällsmedicin, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-122172.
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Research developments have led to increased opportunities for the use of improved diagnostic and treatment methods in physiotherapy and other areas of health care. The emergence of the evidence-based practice (EBP) movement has led to higher expectations for a more research-informed health care practice that integrates the best available research evidence with clinical experience and patient priorities and values. Physiotherapy research has grown exponentially, contributing to an increased interest in achieving a more evidence-based physiotherapy practice. However, implementation research has identified many individual and contextual barriers to research use. Strategies to achieve a more EBP tend to narrowly target individual practitioners to influence their knowledge, skills and attitudes concerning research use. However, there is an emerging recognition that contextual conditions such as leadership and culture are critical to successfully implementing EBP. Against this background, the overall aim of this thesis was to explore conditions at different levels, from the individual level to the organizational level and beyond, for the use of research and implementation of an evidence-based physiotherapy practice. The thesis consists of four interrelated papers that address various aspects of the aim. Individual and focus group interviews were conducted with physiotherapists and managers within physiotherapy in various county councils in Sweden between 2011 and 2014. Data were analysed using qualitative content analysis, direct content analysis and hermeneutics. It was found that many different types of motivation underlie physiotherapists’ use of research in their clinical practice, from amotivation (i.e. a lack of intention to engage in research use) to intrinsic motivation (research use is perceived as interesting and satisfying in itself). Most physiotherapists tend to view research use in favourable terms. Physiotherapists’ participation in a research project can yield many individual learning experiences that might contribute to a more research-informed physiotherapy practice. However, organizational learning was more limited. Numerous conditions at different levels (individual, workplace and extra-organizational levels) provide support for physiotherapists’ use of research in their clinical practice. However, physiotherapy leaders appear to contribute to a modest degree to establishing a culture that is conducive to implementing EBP in physiotherapy practice. Instead, EBP issues largely seem to depend on committed individual physiotherapists who keep to up to date with research in physiotherapy and inform colleagues about the latest research findings.
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Thomson, Diane. "An ethnography of physiotherapy practice : a contextual exploration into the social construction of practice." Thesis, University of East Anglia, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.426841.
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Background Unpredictability, time constraints and having to constantly adapt to new situations characterise modem physiotherapy practice such that everyday clinical situations can be seen to have no easy and unambiguous solutions. Physiotherapists' practice has not yet been explored in the U.K. and their voices not yet heard, as they cope with increasing workloads in the day to day realities of busy hospital departments and their continuing professional development needs. Methodology and Design An eight months in-depth investigation into a team of NHS physiotherapists' construction of their day to day practice, viewed from a social constructionist stance, was carried out. The chosen paradigm for this study was ethnography as it embraces the importance of context related to time and the person. Analysis and Findings A systematic analysis of coding, categorising and identification of themes was carried out. All observations with the participants were followed up from a reflexive stance in the quest for a co-constituted account. Four main building blocks were identified as major contributors to the construction of the team's practice: the team's relationships with their patients, their negotiation and meaning of their food activities, their use of humour and their response to the visit from the inspectors from the Commission for Health Improvement. The institutional hierarchy and the demand for leadership skills in the senior therapist were the most potent parameters of the team's practice arena. Conclusions Contrasting themes have been presented as a way to explain the everyday world of this team's practice. The senior therapists had to manage the differing requirements of training the juniors alongside their own expectation of excellence. Propositional and craft knowledge have to complement each other more and critical reflexive dialogues are a powerful vehicle to achieve this, but the bi-annual rotations put this potential at risk. Hierarchical stances within a department can 'blur' issues by deflecting the juniors' expertise.
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Lee, Hongting Claudia. "Mental practice with physiotherapy in gait rehabilitation in Chinese elderly /." View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36434541.
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Lee, Hongting Claudia, and 李康婷. "Mental practice with physiotherapy in gait rehabilitation in Chinese elderly." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B4501081X.
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Stephenson, Richard Christopher. "Paradigm challenges to physiotherapy practice taking a complexity theory approach." Thesis, University of East Anglia, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.405908.
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Concannon, Michael. "An exploration of how ethics informs physiotherapy and podiatry practice." Thesis, University of Huddersfield, 2016. http://eprints.hud.ac.uk/id/eprint/30242/.
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Introduction: Moral complexities exist in every day health care practice creating conflicting responsibilities in providing care. Health care ethics (HCE) enable an applied practical linkage of theory and practice to create professional behaviour that focuses on service user benefit. This thesis explored how physiotherapists and podiatrists embodied health care ethics in their practice. Methods: Interpretative Phenomenological Analysis (IPA) as a hermeneutical approach was utilised in order to explore how HCE informs physiotherapy and podiatry practice. Whilst always involving interpretation, this method has the ability to describe the human experience as it is lived. Using a framework embedded in hermeneutic IPA facilitated an inquiry that promotes the participant’s own reflections of experiential practice (phenomenology) and then interpreting them (hermeneutical) in the relevant and wider context. Purposively sampled individual interviews were carried out (n=21) in an attempt to interpret the participants’ lifeworld of embodied HCE. The preliminary findings were taken to one purposively sampled group interview for discussion which contributed to further interpretation. Findings: Five themes emerged from the data. The themes indicated that there is a desire by participants to extol ethical practice, but acknowledged various limitations in the reality of achieving this. The place of empathy has a key role in HCE for clinical reasoning and decision making which may prevent HCPs from passively following performance guidelines and checklists. If empathy and virtue ethics can be taught and utilised by HCPs then guidelines may be considered for individual implementation as an outcome, rather than a prerequisite, of ethical decision making. Conclusion: Ethical decision making may be enhanced by reconsidering the education of character virtues including empathy. Empathy is a basic condition and source of morality. As a central component of phronesis, empathy may enable understanding of a service user’s needs and increase motivation for HCPs to act in a caring way, thus making the service user the bearer of an ethical interaction.
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Morris, Dinah Jane. "Physiotherapy students' lived experience of formative assessment during practice education." Thesis, University of Brighton, 2011. https://research.brighton.ac.uk/en/studentTheses/b649fcfb-b0bd-46d6-bc5f-c57972dbc82b.
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The purpose of this study was to gain insight into physiotherapy students' experience of formative assessment on placements. A purposive sample of nine physiotherapy students was selected from a pre-registration problem-based learning programme. Four postgraduate practice educators were interviewed to explore emergent themes. A qualitative phenomenological approach was adopted using semi-structured interviews. Reflective logs and theme boards were used to promote participants' reflection prior to interview. An interpretative phenomenological analysis (IPA) approach was used.
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Bernhardsson, Susanne. "Advancing evidence-based practice in primary care physiotherapy : Guideline implementation, clinical practice, and patient preferences." Doctoral thesis, Linköpings universitet, Avdelningen för fysioterapi, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-122558.
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Research on physiotherapy treatment interventions has increased dramatically in the past 25 years and it is a challenge to transfer research findings into clinical practice, so that patients benefit from effective treatment. Development of clinical practice guidelines is a potentially useful strategy to implement research evidence into practice. However, the impact of guideline implementation in Swedish primary care physiotherapy is unknown. To achieve evidence-based practice (EBP), research evidence should be integrated with clinical expertise and patient preferences, but knowledge is limited about these factors in Swedish primary care physiotherapy. The overall aim of this thesis was to increase understanding of factors of importance for the implementation of EBP in Swedish primary care physiotherapy. Specific aims were: to translate and adapt a questionnaire for the measurement of EBP and guidelines; to investigate physiotherapists’ attitudes, knowledge and behaviour related to EBP and guidelines; to examine clinical practice patterns; to evaluate the effects of a tailored guideline implementation strategy; and to explore patients’ preferences for physiotherapy. The thesis comprises four studies (A-D), reported in five papers. In Study A, a questionnaire for the measurement of EBP and guidelines was translated, cross-culturally adapted, and tested for validity (n=10) and reliability (n=42). Study B was a cross-sectional study in which this questionnaire was used to survey primary care physiotherapists in the county council Region Västra Götaland (n=271). In Study C, a strategy for the implementation of guidelines was developed and evaluated, using the same questionnaire (n=271 at baseline, n=256 at follow-up), in a prospective controlled trial. The strategy was based on an implementation model, was tailored to address the determinants of guideline use identified in Study B, and comprised several components including an educational seminar. Study D was an exploratory qualitative study of patients with musculoskeletal disorders (n=20), using qualitative content analysis. The validity and reliability of the questionnaire was found to be satisfactory. Most physiotherapists have a positive regard for EBP and guidelines, although these attitudes are not fully reflected in the reported use of guidelines. The most important determinants of guideline use were considering guidelines important to facilitate practice and knowing how to integrate patient preferences with guidelines. The tailored, multi-component guideline implementation significantly affected awareness of, knowledge of, and access to guidelines. Use of guidelines was significantly affected among those who attended an implementation seminar. Clinical practice for common musculoskeletal conditions included interventions supported by evidence of various strengths as well as interventions with insufficient research evidence. The most frequently reported interventions were advice and exercise therapy. The interviewed patients expressed trust and confidence in the professionalism of physiotherapists and in the therapists’ ability to choose appropriate treatment, rendering treatment preferences subordinate. This trust seemed to foster active engagement in their physiotherapy. In conclusion: The adapted questionnaire can be used to reliably measure EBP in physiotherapy. The positive attitudes found do not necessarily translate to guideline use, due to several perceived barriers. The tailored guideline implementation strategy used can be effective to reduce barriers and contribute to increased use of guidelines. The clinical practice patterns identified suggest that physiotherapists rely both on research evidence and their clinical expertise when choosing treatment methods. Patients’ trust in their physiotherapist’s competence and preference for active engagement in their therapy need to be embraced by the clinician and, together with the therapist’s clinical expertise, integrated with guideline use in the clinical decision making. Further research is needed on how the EBP components and different knowledge sources can be integrated in physiotherapy practice, as well as on implementation effects on patient outcomes.
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Bennett, Rosalie. "Maintaining the quality of clinical education in physiotherapy." Thesis, University of Birmingham, 2008. http://etheses.bham.ac.uk//id/eprint/204/.
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Government demands to increase the number of physiotherapy students have led to problems in acquiring extra placements in which these students can experience their clinical education. This problem has been accentuated by difficulties with recruitment and retention of physiotherapy staff that might take on the role of clinical educator. This study uses empirical data to explore how further placements could be found without compromising the quality of the learning experiences. Action research is used to identify current practice and areas where change may be advantageous. Perceptions are drawn from professionals and students - physiotherapy managers, clinical educators and physiotherapy students. Data collecting techniques include interviews (13 physiotherapy managers) and five questionnaires – with clinical educators (n=67 and 42) and students (n= 73, 76 and 62) as samples. All data are triangulated to justify the study findings. The findings are framed around concepts of management and learning within clinical education. Evidence that emerged during the action research process led to two main changes. Firstly more junior grades of physiotherapy staff were included within the pool of clinical educators. Secondly a new ‘model’ of facilitating learning was established through the creation of ‘learning teams’ where both students and clinical educators worked together to share and develop knowledge. Changes meant that increased student numbers were accommodated without compromising quality. This was demonstrated through positive student evaluation of clinical placements at the end of their degree course. The impact of accommodating students within physiotherapy settings is discussed in relation to departmental, personal and professional management. Priority could be given to improving how student learning might influence not only personal but also professional development.
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Richardson, Barbara. "Paradigms of practice in physiotherapy and the implications for professional development." Thesis, University of East Anglia, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309097.
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Higgins, Jull Roberta. "Educating for autonomy in practice : the experiences of undergraduate physiotherapy students." Thesis, University of Sheffield, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.395131.
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Duthie, Jennifer. "Physiotherapy student practice education : students' perspectives through cultural-historical activity theory." Thesis, University of Stirling, 2017. http://hdl.handle.net/1893/25656.
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Physiotherapy student practice education, the focus of this thesis, is a highly valued, yet scarcely researched component of pre-registration physiotherapy education. Moreover, the student voice is largely absent from existing research. In this study, 14 physiotherapy students’ perspectives of practice education were gained through email communications (n=13) and face-to-face interviews (n=12). To provide an in-depth and provocative view, physiotherapy student practice education was analysed as a type of activity system, employing concepts borrowed from cultural-historical activity theory (CHAT). Interacting activity systems, objects, players, rules, norms, divisions of labour, mediating artefacts, intra- and inter-systemic contradictions were explored and identified. The findings show that assessment skewed students’ object motives. Practice educators were positioned as powerful gatekeeper/assessor gift-holders. Physiotherapy students enacted ‘learning practice’ norms, such as extensive reading, and adopted the position of practice educator-pleaser. Students sometimes refrained from speaking when they wanted to, for example, to challenge unprofessional staff behaviour. Students were reluctant to show themselves as learners, feeling instead that they needed to present themselves as knowledgeable, able practitioners. However, students did not easily recognise themselves as able contributors to practice. For students, knowledge for practice was focussed on patient assessment and treatment, but the level, depth and volume of knowledge required was perceived differently across distinctive practice areas. Intra- and inter-systemic contradictions, such as the skewing of student object motives towards assessment, and away from whole-patient-centred care, are highlighted. The study findings therefore have implications for patient care as well as for the object of physiotherapy student practice education, student learning and assessment and workplace learning. A cross-profession review of the object of physiotherapy student practice education, to include the voice of service users, students, practice educators, HEIs and service providers, is recommended. A review of physiotherapy student practice-placement assessment, which seemed to be at the core of PSPE dynamics and conditions, is recommended, to take account of the extent to which assessment can influence students’ PSPE object motives, PE/student dynamics and student/patient interactions. Developmental Work Research is proposed as a way forward for future research in this area.
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Ramaswamy, Bhanu. "Reconceptualising Parkinson's from illness to wellness : advancing physiotherapy practice through Action Research." Thesis, Sheffield Hallam University, 2016. http://shura.shu.ac.uk/20715/.
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‘Staying well’ is a reason people attend exercise classes run by the Sheffield Branch of the charity Parkinson’s UK. ‘Wellness’ is a social construct given meaning by the context in which it is used, and by whom. It is hard to define, yet is an aim of physiotherapy professional practice, and a main goal of health policy in the United Kingdom. The Doctoral Research Project was undertaken to explore the role of physiotherapy for people affected by Parkinson’s undertaking activities to attain wellness through the use of Participatory Action Research (PAR) methodology. PAR is a transformative method, and the project evolved through three successive cycles of interaction with recruited co-researchers (the MontyZoomers). The scope developed from action research (a listening and responding role), through participatory action (advising, social involvement and knowledge generation), broadening into emancipation action (regaining a political stance after group and individual identity had been [re]established). Exchanging stories of altering health experiences (even pre-diagnosis) enabled a review of how negatively communicated beliefs and information from health professionals had formed peoples’ understanding of Parkinson’s (epistemology). The qualitative and quantitative projects chosen and analysed by the MontyZoomers allowed them to develop a new way of seeing their journey (ontology), one they wanted communicated to the wider health and social care professionals. The MontyZoomers utilised their new knowledge to construct a socially-driven consensus model. The message of interdependence and hope that enables people affected by Parkinson’s to remain well is what the thesis contributes to physiotherapy practice and knowledge. In the current political climate pushing self-management and empowerment agenda for people with long-term conditions, physiotherapy education and practice can facilitate the process of self-determination for people with Parkinson’s to achieve control over their own health, decided by their own actions to support one another, and be supported by all involved others through interdependent relationships within the broader community.
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Kingau, Naomi Wanjiru. "Contextualization of a physiotherapy clinical practice guideline for stroke rehabilitation in Kenya." University of the Western Cape, 2018. http://hdl.handle.net/11394/6272.
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Philosophiae Doctor - PhD (Physiotherapy)Stroke is the third leading cause of death and disability worldwide. Eighty five per cent of strokes occur in developing countries, and it is estimated that the prevalence will increase in future. Evidence based rehabilitation programs inherent in clinical practice guidelines has the potential to improves functional activities, and participation. However Kenya does not have this guideline. Most clinical guidelines are developed in the western world, and reflect developed world healthcare systems and resources that are not always appropriate to developing nations. Likewise, guidelines are costly to produce. Kenya lacks the resources and the expertise for de novo guideline development. It is therefore appropriate and cost effective to contextualise the available high quality recommendations.
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Cross, Vinette. "Professional education in transition : the implications for clinical competence assessment of physiotherapy undergraduates." Thesis, University of Birmingham, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.365387.
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Bradbury, Katherine. "How do experiences of physiotherapy and osteopathy vary between NHS and private practice?" Thesis, University of Southampton, 2013. https://eprints.soton.ac.uk/362602/.
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Previous research had shown that experiences of treatments vary between NHS and private practice. It was unclear whether different treatments might vary in the same or in different ways between healthcare sectors. This thesis explored how experiences of physiotherapy and osteopathy vary between NHS and private settings. Study 1: A systematic review of the literature identified psychosocial factors which are likely to be important within physiotherapy for lower back pain. Study 2: A qualitative interview study explored the experiences and appraisals of 35 patients who had received NHS or private physiotherapy or osteopathy for lower back pain. This study indicated that physiotherapy and osteopathy do not vary in the same ways between healthcare sectors. Study 3 and 4: Mixed methods were used to develop and establish the face validity, internal consistency and structural validity of a new measure of treatment appraisal, the Appraisals of Physical Treatments Questionnaire (APTQ). Study 5: The APTQ and other measures of treatment appraisal were then examined in a cross-sectional questionnaire study (n=91) which explored how and to what extent aspects of treatment appraisal vary between healthcare sectors and treatment types. There were ceiling effects in many of the measures, although some aspects of treatment appraisal varied in ways which were consistent, or partially consistent, with the hypotheses. Study 6: Finally, study 6 looked at practitioners’ (physiotherapists’ and osteopaths’) experiences of treating lower back pain in the NHS and private practice. Practitioners’ reports largely confirmed those of patients, indicating that physiotherapy and osteopathy do not vary in the same ways between healthcare sectors. Factors that might be responsible for the differences in patients’ experiences of NHS and private physiotherapy and osteopathy were also identified and organised into a model. Physiotherapy and osteopathy did not appear to vary in the same ways between healthcare sectors, indicating that the healthcare sector might not have a uniform influence on treatments.
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Jones, Diana. "Mapping self-management strategies in Parkinson's disease : implications for physiotherapy practice and research." Thesis, Northumbria University, 2001. http://nrl.northumbria.ac.uk/472/.
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The overarching purpose of this research was to find out about life with Parkinson's disease and to use that knowledge to inform physiotherapy management. The project aimed to explore current and alternative ways in which professionals could seek to understand the experience of life with Parkinson's disease; to explore the implications of resultant new knowledge; and to investigate how physiotherapy relationships should take account of new ways of understanding and new knowledge. A spiral of research activity was undertaken comprising three successive cycles. The first two cycles were undertaken using case study methodology, focusing on the experience of life with Parkinson's disease from a group and an individual perspective. A wide range of qualitative and quantitative methods for both data collection (including interviews, disability and quality of life scales and activity monitoring) and data analysis were employed. The level and complexity of personal work undertaken by individuals to manage their condition was the principal theme to emerge from initial cycles. This insight led to the development of a tool — strategy mapping — to enable professionals to capture and use information about self- management in their interactions with individuals. The third cycle employed action research methodology to develop and evaluate the strategy mapping framework - centred on identifying strategies related to Self, Routines, Support and Involvement - in physiotherapy practice. A number of perspectives were developed in relation to the project's aims. The methodological perspective highlighted the need for commitment to listening to the experiential narrative and hearing the story of self-management. The ontological perspective offered the potential for practice and research to build on existing self- management solutions. The epistemological perspective pointed to addressing power differentials between knowledge bases to promote collaborative therapy relationships. The full potential of a paradigm shift which attempts to increase the degree of alignment between the everyday lives of individuals with Parkinson's disease and physiotherapy practice, education and research remains to be uncovered.
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Krantz, Rasmus. "Translation and Cross-cultural Adaptation of the Lumbar Spine Instability Questionnaire into Swedish : Validation and Reliability testing of the questionnaire in patients with low back pain." Thesis, Luleå tekniska universitet, Institutionen för hälsovetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-69364.
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Objective. To translate and cross-cultural adapt the Lumbar Spine Instability Questionnaire (LSIQ) into Swedish and to test its validity and reliability on patients with non-specific lowback pain in primary health care. Methods. The LSIQ was translated and cross-culturally adapted into Swedish language according to accepted guidelines. Data from 15 patients were collected through a ”thinkaloud” process to test the face validity of the instrument. Together with an additional 35 patients, data from a total of 50 participants (27 men and 23 women) were thereafter subsequently collected to assess test-retest reliability and construct validity. Data were collected through the Lumbar Spine Instability Questionnaire, and the Roland Morris Disability Questionnaire. Results. The Lumbar Spine Instability Questionnaire was successfully adapted into Swedish language according to recommended guidelines. The result demonstrated high test-retest reliability, and the analysis of construct validity showed consistency with the hypothesis, proving a moderate positive correlation with the Roland Morris Disability Questionnaire. No floor or ceiling effects were detected. Conclusion. The Swedish version of the Lumbar Spine Instability Questionnaire (LSIQ-S) shows good psychometric properties regarding reliability and validity. To further study the usefulness of the instrument, the dimensionality also need to be investigated.
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Hanekom, Susan. "The implementation and evaluation of a best practice physiotherapy protocol in a surgical ICU." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5328.
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BibliographyThesis (PhD ( Interdisciplinary Health))--University of Stellenbosch, 2010.
Bibliography
ENGLISH ABSTRACT: Introduction: It is increasingly being recognized that how intensive care services are delivered may have a greater impact on patient outcome than the individual therapies. Uncertainty regarding the optimal physiotherapy service provision model in a surgical intensive care unit (ICU) exists. Methodology: The aims of this study were to 1) develop an evidence-based physiotherapy protocol; 2) validate the content of the protocol; and 3) conduct an explorative intervention trial to compare usual care to the estimated effects of providing a physiotherapy service guided by an evidence-based physiotherapy protocol by a dedicated physiotherapist. A systematic review process was used to synthesize the evidence in eight subject areas. The GRADE system was used to formulate best practice recommendations and algorithm statements. Forty-two experts from a variety of disciplines were invited to participate in a Delphi process. Finally, the evidence-based physiotherapy protocol was implemented in a surgical ICU over four three-week intervention periods by a group of research therapists. The outcomes measured included ventilator time, ventilation proportions, failed extubation proportions, length of ICU and hospital stay, mortality, functional capacity, functional ability and cost (using nursing workload as proxy). Results: Fifty-three research reports in eight subject areas were identified, 23 draft best-practice recommendations and 198 algorithm statements were formulated. The draft protocol consisted of five clinical management algorithms. Fifteen international research experts and twelve national academics in the field of critical care agreed to participate in the Delphi process. Consensus was reached on the formulation of 87% (20/23) recommendations and the rating of 66% (130/198) statements. The risk of an adverse event during the protocol care intervention period was 6:1000 treatment sessions (p=0.34). Patients admitted to the unit during the protocol care intervention period were less likely to be intubated (RR 0.16 95%CI 0.07 – 0.71; RRR 0.84 NNT 5.02; p=0.005) or fail extubation (RR 0.23 95%CI 0.05 – 0.98; RRR =0.77 NNT 6.95; p=0.04). The mean difference in the daily unit TISS-28 score between the two condition periods was 1.99 95%CI 0.65 – 3.35 (p=0.04). Patients managed by the protocol tended to remain in the hospital for a shorter time after unit discharge (p=0.05). There was no difference in the time spent on the ventilator (p=0.50), mortality (p=0.52) or in the six minute walk distance (p=0.65). In addition there was no difference in the proportion of patients who reached independence in any of the Barthel Index activities measured within 48 hours of discharge from the unit. Conclusions: The use of an evidence-based physiotherapy protocol for the comprehensive physiotherapeutic management of patients in a surgical ICU was feasible and safe. The preliminary results of this study suggest that a physiotherapy service, which is guided by an evidence-based protocol and offered by a dedicated unit therapist, has the potential to lower the cost of ICU care and facilitate the functional recovery of patients after unit discharge. This information can now be considered by administrators to optimize the physiotherapy service provided in ICU.
AFRIKAANSE OPSOMMING: Inleiding: Daar word toenemend erken dat die wyse waarop dienste gelewer word, ‘n groter impak mag hê op die uitkoms van pasiënte as die spesifieke modaliteite in gebruik. Onsekerheid heers tans oor die optimale fisioterapie diens model om te volg in ‘n chirurgiese intensiewe sorg eenheid (ISE). Metodologie: The doel van hierdie projek was om 1) ‘n bewysgesteunde protokol te ontwikkel; 2) die geldigheid van die protokol te bevestig; en 3) om deur middel van ‘n eksploratiewe studie die uitkoms van pasiënte te vergelyk wanneer die fisioterapie diens gelewer word aan die hand van die bewysgesteunde protokol deur ‘n toegewyde fisioterapeut, teenoor wanneer die gewone fisioterapie diens gelewer word. Die empiriese bewyse in agt onderwerp areas is gesintetiseer na afloop van ‘n sistematiese literatuur oorsig proses. Die GRADE sisteem is gebruik om beste praktyk aanbevelings en algoritme stellings te formuleer. Twee en veertig kundige persone van verskeie disiplines is genooi om deel te neem aan die Delphi proses om die geldigheid van die protokol te bevestig. Uiteindelik is die geldige bewysgesteunde protokol oor ‘n tydperk van vier drie weke intervensie periodes deur ‘n groep navorsings terapeute in ‘n chirurgiese ISE geïmplementeer. Die tyd wat pasiënte geventileer is, die proporsie pasiënte wat geïntubeer en geherintubeer is in die tydperk, die lengte van ISE en hospitaal verblyf, mortaliteit, funksionele kapasiteit asook funksionele vaardigheid en koste (deur die verpleeg werkslading te gebruik as ‘n indikasie van koste) is gemeet. Resultate: Drie en vyftig navorsings verslae in agt onderwerp areas is geïdentifiseer, 23 konsep aanbevelings en 198 algoritme stellings is geformuleer. Die konsep protokol het uit vyf algoritmes bestaan. Vyftien internasionale en twaalf nasionale kundiges het die uitnodiging aanvaar om aan die delphi proses deel te neem. Konsensus is bereik vir die formulering van 87% (20/23) van die aanbevelings en die gradering van 66% (130/198) van die algoritme stellings. Die risiko vir ‘n ongunstige episode tydens die protokol intervensie periode was 6:1000 sessies (p=0.34). Pasiënte wat tydens die protokol intervensie periode tot die eenheid toegelaat is was minder geneig om geïntubeer te word (RR 0.16 95%CI 0.07 – 0.71; RRR 0.84 NNT 5.02; p=0.005) of om ‘n ekstubasie te faal (RR 0.23 95%CI 0.05 – 0.98; RRR =0.77 NNT 6.95; p=0.04). Die gemiddelde verskil in die daaglikse eenheid TISS-28 telling tussen die twee intervensie periodes was 1.99 95%CI 0.65 – 3.35 (p=0.04). Patiente wat tydens die protokol intervensie periode behandel is was geneig om vinniger uit die hospitaal ontslaan te word nadat hul uit die eenheid ontslaan is (p=0.05). Daar was geen verskil in die ventilasie tyd, (p=0.50) die mortaliteit (p=0.52) of die afstand wat pasiente in ses minute kon aflê binne 48 uur na ontslag uit die eenheid (p=0.65) nie. Daar was ook geen verskil in die proporsie pasiente wat onafhanklikheid bereik het in enige van die kategorieë van die Barthell Index instrument nie. Gevolgtrekking: Die gebruik van die protokol vir die omvattende hantering van pasiënte in ‘n chirurgiese eenheid is haalbaar en veilig. Die voorlopige resultate van hierdie studie dui daarop dat wanneer ‘n fisioterapie diens in ‘n chirurgiese ISE gelewer word aan die hand van ‘n bewysgesteunde protokol deur ‘n toegewyde fisioterapeut dit die potensiaal het om ISE koste te verminder en die funksionele herstel van pasiente na ontslag uit die eenheid te fasiliteer. Hierdie inligting kan nou deur administrateurs oorweeg word om ‘n optimale fisioterapie diens in ‘n chirurgiese ISE te verseker.
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Alenezi, Majid. "Motor imagery as a potential tool for improvement of musculoskeletal function in physiotherapy practice." Thesis, Bangor University, 2018. https://research.bangor.ac.uk/portal/en/theses/motor-imagery-as-a-potential-tool-for-improvement-of-musculoskeletal-function-in-physiotherapy-practice(2daf1dd3-2404-45aa-9626-cb05013a012a).html.
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Motor imagery (MI) is a cognitive simulation technique with increasing importance in psychology, sport psychology and applied therapeutic domains (Dickstein & Deutsch, 2007; Guillot & Collet, 2008; Moran, Guillot, MacIntyre, & Collet, 2012). MI can be described as executing specific actions/tasks mentally, without any bodily movement, by adopting different sensory modalities (e.g. Collet & Guillot, 2010; Cumming & Ramsey, 2008; Jackson, Lafleur, Malouin, Richards, & Doyon, 2001). In the last two decades, a considerable amount of work has been performed to introduce MI as an effective rehabilitation tool for motor function, especially in the neurorehabilitation setting (Braun et al., 2006; Dickstein & Deutsch, 2007; Malouin & Richards, 2013; Mulder, 2007; Schuster, Butler, Andrews, Kischka, & Ettlin, 2012; Zimmermann-Schlatter et al., 2008). Despite the accumulating evidence supporting the benefits of cognitive techniques (e.g. MI) for patients with various neurological conditions, relatively little attention has been paid to the effects of imagery applications on the musculoskeletal system (Pelletier, Higgins, & Bourbonnais, 2015a, 2015b; Snodgrass et al., 2014). Consequently, the general objective of this thesis is to explore the potential role of MI as a therapeutic tool to be used as an alternative or adjunct to the traditional physiotherapeutic exercise for musculoskeletal parameters. The thesis is written as a collection of research studies committed to the objective described above. Chapter 1 represents a review of the literature exploring the potential role of imagery in musculoskeletal rehabilitation. Although the review chapter shows encouraging findings from the recent literature, it reveals the need to improve and develop the existing imagery intervention protocols for muscle strength outcomes to be used as a physiotherapeutic tool. Based on this need, our thesis comprises two experimental studies examining imagery’s efficacy on maximal force production in larger muscle groups, which is relevant in physiotherapy practice. In addition, this thesis builds on the potential expansion of research activities using imagery in Arabic countries by translating the vividness movement imagery questionnaire (VMIQ-2) to the Arabic language. Chapter 2 describes outcomes of a randomised control study examining the efficacy of cognitive imagery training on hip abductor strength in healthy individuals. In the study, two newly developed imagery protocols with specific imagery modalities, namely kinaesthetic with visual (KIN+VI) and kinesthetic only (KIN), were used and compared with a control group (no practice). The results demonstrated the efficacy of the imagery intervention for increasing strength in the hip abductor muscles and emphasised superior outcomes for the combined protocol (KIN+VI) for strength gains. In addition, the study revealed the efficacy of the KIN+VI imagery intervention for improving imagery ability (vividness). Chapter 3 reports the results of the second experimental study, which examines the efficacy of imagery practice (using the KIN+VI protocol from study 1) on the maximal isometric strength and electrical activity (EMG) of hip abductors (i.e. the efficacy of the ipsilateral training effect and bilateral transfer effects) compared with exercise in healthy individuals. In this study, the results showed a significant ipsilateral increase in strength and EMG amplitude in the trained hip abductor muscles of the imagery group (KIN+VI), while the exercise group did not show considerable gains. In addition, this chapter reports a novel finding concerning a bilateral transfer effect occurring after unilateral imagery training of the tested muscle group, with no strength gains occurring following exercise training. Finally, this study shows a clear indication that the home-imagery intervention protocol should be favoured over the home-exercise training due to the higher level of commitment in the imagery group; this illustrates the possibility of using imagery practice as a self-management intervention. Chapter 4 reports on the translation and validation of the VMIQ-2 to Arabic among Arabic native speakers living in the United Kingdom and Saudi Arabia. The chapter provides information about the translation process, cognitive debriefing test and initial reliability of the VMIQ-2 Arabic version. The study used an advanced analytical procedure to evaluate factorial validity by employing Bayesian structural equation modelling (BSEM) for each country’s dataset. The findings of this study provide initial support for the newly translated VMIQ-2-A with adequate psychometric properties; hence, it represents the first imagery ability questionnaire that has been translated into Arabic. Chapter 5 provides a summary of the thesis findings and clarifies the novelty of the current thesis. In addition, it outlines the future implications of the findings from the application and research perspectives. Furthermore, this chapter addresses the strengths and limitations of the thesis. Finally, it presents the conclusion of the current work.
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Pringle, Eve. "Research and practice : an empirical study of the 'therapy' occupations." Thesis, University of Kent, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.324661.
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Jakobsson, Albin, and Joel Ekblad. "Fysioterapeuters upplevelser av möjligheter och utmaningar med att implementera evidens : En kvalitativ intervjustudie." Thesis, Uppsala universitet, Åsenlöf: Fysioterapi, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-431985.
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Background: It has been proven to be a challenge for physiotherapists to utilize evidence within their practice. Conducting evidence-based care is a requirement for providing good care and a requirement in the legitimation for Swedish physiotherapists. Aim: To explore physiotherapists experiences of their possibilities and challenges in implementing prevailing evidence in their practice. Method: A qualitative method was applied with a semi-structured interview guide. A choice of convenience sampling was made with 5 physiotherapists from a region in Sweden with the aim of getting as wide a sample as possible. The analysis of the data was done through a qualitative content analysis. Results: Physiotherapists felt that the challenges were based on their work environment and that the Swedish care structure measures quantity over quality. Other contributing challenging factors mentioned where lack of time, low interest from managers, lack of training and difficulties in understanding and evaluating the different parts of the evidence model. Opportunities that were raised were the mutual learning among colleagues in the workplace and that research is easily accessible with today's technology. Conclusion: This study shows that in order for physiotherapists to feel that they have good opportunities to implement evidence, one needs to try to eliminate the various challenges that arise within their work environment. This can enable organizations in which physiotherapists work to gain an understanding of what needs to be focused on and improved in order for physiotherapists to be able to implement evidence-based care and therefore increase the quality of care for patients.Bakgrund: Det har visat sig vara en utmaning för fysioterapeuter att använda sig av evidens inom sitt verksamhetsområde. Att bedriva en evidensbaserad vård är en nödvändighet för att bedriva en god vård och ett krav i legitimationen för svenska fysioterapeuter. Syfte: Att utforska fysioterapeuters upplevelser av sina möjligheter och utmaningar med att implementera rådande evidens inom sitt verksamhetsområde. Metod: En kvalitativ metod tillämpades med en semistrukturerad intervjuguide. Ett bekvämlighetsval användes där 5 fysioterapeuter valdes från en region i Sverige och med syfte att få så brett urval som möjligt. Analysen av data gjordes genom en kvalitativ innehållsanalys. Resultat: Fysioterapeuterna upplevde att utmaningarna främst grundade sig i deras arbetsmiljö och att den svenska vårdstrukturen är mer uppbyggd för att mäta kvantitet och inte kvalité. Andra nämnda bidragande utmanande faktorer var tidsbrist, lågt intresse från chefer, brist på utbildning och svårigheter med att förstå och värdera evidensmodellens olika delar. Möjligheter som togs upp var det gemensamma lärandet bland kollegor på arbetsplatsen och att forskningen är lättillgänglig med dagens teknik. Konklusion: Den här studien visar att om fysioterapeuter ska uppleva att de har goda möjligheter att implementera evidens så behöver man försöka eliminera de olika utmaningar som finns inom deras arbetsmiljö. Detta kan möjliggöra att organisationer som fysioterapeuter jobbar inom kan få en förståelse för vad man behöver fokusera på och förbättra för att fysioterapeuter ska kunna implementera en evidensbaserad vård och därmed öka vårdkvalitén för patienter.
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Barnitt, Rosemary E. "An investigation of ethical dilemmas in occupational therapy and physiotherapy : issues of methodology and practice." Thesis, King's College London (University of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.360509.
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Alexanders, Jenny. "Physiotherapy goal setting in anterior cruciate ligament rehabilitation : an exploration of training, practice and beliefs." Thesis, University of Hull, 2018. http://hydra.hull.ac.uk/resources/hull:16888.
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Despite the growing interest into the role of physiotherapists providing psychological interventions within anterior cruciate ligament (ACL), literature surrounding goal setting practices within this field is minimal. The main purpose of this research was to explore physiotherapists' approaches, training and beliefs into goal setting practices used within ACL rehabilitation. The thesis consisted of seven chapters, two of which were empirical studies. The empirical chapters aimed to gain further insight into physiotherapists understanding on the psychological aspects of patients following ACL surgery, theoretical knowledge of goal setting, experiences of implementing goals, training received on goal setting and future training needs. Study four involved a UK cross sectional online survey of one hundred and twenty four physiotherapists (N=124). The survey provided an insight of perceptions and goal setting approaches used within ACL rehabilitation. These findings were further explored in study five which involved a UK semi-structured interview study including twenty four physiotherapists (N=24), using an inductive approach. Study five provided a much deeper understanding in to physiotherapist's goal setting practices, training and experiences within ACL rehabilitation and also revealed issues surrounding the initial consultation process. The research findings were conceptualised into a theoretical, innovative goal setting model. The goal of this model is to outline a multi-phase conceptual model of an appropriate ACL rehabilitation goal setting strategy for physiotherapists in an attempt to guide both practice, teaching and research.
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Wasiu, Awotidebe Adedapo. "Knowledge and attitudes of physiotherapy students at The University of the Western Cape towards obesity." Thesis, University of the Western Cape, 2008. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_4154_1275428729.
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The increasing prevalence of obesity in both developed and developing countries and its associated health risks have brought the issue of obesity prevention and management a public health debate. Health care professionals have been identified to have a role to play in directing the future of obesity management. However, among the numerous barriers for effective management of obesity is lack of knowledge of causes of obesity and negative attitudes towards obese patients by health care professionals. With limited or no studies available for the physiotherapy setting, the aim of the study was to determine the knowledge and attitudes of students of Physiotherapy at the University of the Western Cape, South Africa towards obese individual. A descriptive quantitative research design using a cross-sectional survey was used. One hundred and seventy five (175) students of Physiotherapy took part in the study using a convenience sampling technique. Data was collected by means of a structured, self-administered questionnaire adopted from the Obesity Risk Knowledge-10 scale, Beliefs About Obese Person scale and the Fat Phobia Scale. A response rate of 77.3% was obtained. Descriptive and inferential statistics were employed to describe the relationship and association between variables. Alpha level was set at 0.05. The mean age of the sample was 21.54 (SD = 4.903). Females constituted 73.5% and males 26.5% of the sample. The results showed that majority of the students of Physiotherapy (85%) reported having received no formal education regarding obesity.
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Gustafsson, Estelle, and Oskar Jansson. "Fysioterapeuters erfarenheter av tillämpning av beteendemedicin i praktiken : En kvalitativ intervjustudie." Thesis, Uppsala universitet, Åsenlöf: Fysioterapi, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-443619.
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Beteendemedicin är ett paraplybegrepp där den fysioterapeutiska tillämpningen i praktik kan se ut på många olika sätt. Hur fysioterapeuter tillämpar beteendemedicin i praktiken och hur det avspeglas i den individanpassade behandlingsplanen råder det oklarheter kring. Syftet med denna studie var att undersöka fem fysioterapeuters upplevelser och erfarenheter av tillämpning av beteendemedicin inom sina respektive verksamheter i Uppsala län. Studien var av kvalitativ design. Enskilda semistrukturerade intervjuer avfem fysioterapeuter inom olika verksamheter utfördes. Databearbetning genomfördes i form av en kvalitativ innehållsanalys. Deltagarna tillämpade flertalet olika tekniker inom beteendemedicin. De upplevde även att det finns utmaningar som att det är tidskrävande, att patienten inte förstår konceptet och att teorin är lättare än tillämpningen i praktik. Alla deltagare var överens om att det finns en nytta med beteendemedicinsk tillämpning, som att bli en bättre fysioterapeut, att det ger vinst i långa loppet samt att teorin fyller en viktig funktion för praktisk tillämpning. Det föreföll sig som att fysioterapeuterna tillämpar beteendemedicin på ett annat sätt än vad de lärt sig från den teoretiska utbildningen. Fyra huvudkategorier identifierades under databearbetningen; Olika tekniker inom beteendemedicin, Utmaningar med att arbeta beteendemedicinskt, Förståelse av nyttan med beteendemedicin, Blivit en “tyst” kunskap. Deltagarna upplevde att beteendemedicin fyller en viktig funktion i den individualiserade behandlingsplanen för patienten, men upplevde även många utmaningar. Trots utmaningarna så var deltagarna överens om att beteendemedicin är ett vinnande behandlingskoncept inom fysioterapi. Detta examensarbete kan bidra till utvecklingsmöjligheter för grundutbildningen i fysioterapi.Behavioral medicine is an umbrella concept where the physiotherapeutic application in practice can differ in many ways. There are uncertainties about how physiotherapists apply it in practice and how this is reflected in the individualized treatment plan. The aim of this study was to investigate five physiotherapists' experiences of applying behavioral medicine in clinical practice within each of their workplaces in Uppsala. This study is of a qualitative design. Individual semi-structured interviews offive physiotherapists were performed. Data processing was carried out in the form of a qualitative content analysis. The participants applied several different behavioral medicine techniques. They also experienced challenges; it is time consuming, the patient does not understand the concept and the theory is easier than the application in practice. All participants agreed that there are benefits to behavioral medicine application; becoming a better physiotherapist, it provides benefits in the long run and the theory fulfills an important function for practical application. It seemed that the physiotherapists apply behavioral medicine in a different way than what they have learned. Four main categories were identified; Different techniques in behavioral medicine, Challenges when working with behavioral medicine, Understanding the benefits of behavioral medicine, Has become a “silent” knowledge. The participants experienced that behavioral medicine fulfills an important function in individualized treatment plans for patients, but they also experienced many challenges. Despite the challenges, the participants agreed that behavioral medicine is a winning concept in physiotherapy. This degree project can contribute to development opportunities for the undergraduate education in physiotherapy.
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Zarezadeh, Yadolah. "The teaching and learning of reflective practice in medicine, nursing and physiotherapy : a grounded theory study." Thesis, University of Newcastle upon Tyne, 2009. http://hdl.handle.net/10443/3605.
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The purpose of this study is to develop a comparative understanding of the teaching and learning of reflection in medical and healthcare education in two UK universities. Reflection is claimed to fill the gap between theory and practice (Schon, 1987), encourage a deeper level of learning (Entwistle, 1997), and promote lifelong learning (Moon, 1999). Using symbolic interactionism as an interpretivist theoretical perspective, this study adopted the grounded theory methodology. A hermeneutic approach informed both the theoretical perspective and the methodology of the study. The methods of data collection used in the study included semi-structured interviews (n=38), non-participant observation, students' reflective assignments, and students' reflective diaries. Data were analysed by theoretical coding to identify concepts and categories. A constant comparison method (Glaser, 2004) of data analysis enabled the generation of theory. This was supported by the understanding and insight gained through a movement between the parts and the whole of the data in a hermeneutic circle. This study revealed that teaching and learning reflection in different courses is based on the perceived image of the reflective practitioner and the personal and professional benefits of reflection. Different professions use reflection for different purposes. This is influenced by their socio-political stance, social position, and ambitions of the profession. These, in tum affect methods, strategies, and outcomes of reflection. This research contributes to a growing recognition of the sensitivity of assessing students' reflective works, supports the idea that it is problematic and suggests that there are ethical and delicate educational issues to be considered in terms of assessing students' reflective works. This thesis concludes with an acknowledgement of the complexity of teaching and learning reflection in medical and healthcare education. It calls for considering teaching and learning reflection as a "whole" when dealing with its different features (parts) in order to understand and work with the phenomenon. This study has some implications for lecturers, students, and educationalists.
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Ma, Man-fong. "An audit of physiotherapy evidence-based practice in management of acute non-specific low back pain." View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36886877.
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Ma, Man-fong, and 馬曼芳. "An audit of physiotherapy evidence-based practice in management of acute non-specific low back pain." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B39724876.
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Bowman, Winifred Edna. "The evaluation of an accreditation programme for quality improvement in private physiotherapy practice in South Africa." Thesis, Stellenbosch : Stellenbosch University, 2001. http://hdl.handle.net/10019.1/52525.
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Thesis (PhD)--University of Stellenbosch, 2001.ENGLISH ABSTRACT: "Quality" has different meanings to different people. Even quality experts do not agree on a single definition: Juran's definition of quality revolves around his concept of "fitness for use", Crosby defines quality in terms of performance that produces "zero defects" and Deming defines quality as a "never ending cycle of continuous improvement". One element, however, that is common to all three approaches is that management must accept and demonstrate leadership if quality is to be achieved. Quality is rarely thought of as others perceive it. What is apparent is that if providers of care wish to maintain leadership in defining quality, they need to - Actively participate in the public debate about quality. Review the way in which they have been defining quality. Question whether their definitions are aligned with what the purchasers of health care define as being important. Develop meaningful measures of quality and data collection systems that will allow them to demonstrate quality and value. - Willingly share data not only on outcomes, and also measures that are specific to individual procedures and service providers. The PhysioFocus practice accreditation programme attempted to achieve the above factors. By realising the goal of the research this was determined. The goal of the research was to evaluate the PhysioFocus practice accreditation programme and to make recommendations on the educational programme for accreditation in private physiotherapy practices. This goal was realised by means of an exploratory and descriptive research design with a qualitative orientation. The evaluation of the PhysioFocus practice accreditation programme was performed by means of a validated evaluation instrument. The group interview revealed components of the PhysioFocus practice accreditation programme that require remediation. Recommendations included professional-ethical issues, business management and legislative issues. The recommendations will be implemented by the PhysioFocus practice accreditation committee. The PhysioFocus practice accreditation learning programme was evaluated by means of a semi-structured questionnaire, containing eleven questions and a section for comments. The general consensus was that the PhysioFocus practice accreditation programme is essential in private physiotherapy practice in South Africa. The implementation of the PhysioFocus practice accreditation programme resulted in the facilitation of quality physiotherapy; professional and personal development; monitoring of quality improvement processes; and the evaluation and remediation of these processes. This supported the central theoretical assumption of the research. Concerns were voiced about the lack of standards, lack of quality improvement skills, the public image of the physiotherapy profession and the lack of basic business management training. The researcher concluded that the implementation of the PhysioFocus practice accreditation programme is essential in private physiotherapy practice in South Africa. At present the current PhysioFocus practice accreditation programme does not address all the needs of private physiotherapy practices. Recommendations based on the research included remediation of the current PhysioFocus practice accreditation programme, formal education included business management, professional-ethical-Iegal issues, standards and scientific methods to analyse process variation and the development of improvement strategies in quality improvement. Other recommendations include informal education, physiotherapy management and structured quality improvement activities. The issue of the image of the professional physiotherapist was also addressed. Topics for future research were identified. The uniqueness of the research lies in the fact that this is the only physiotherapy practice accreditation programme implemented in South Africa. It is also the only physiotherapy practice accreditation programme in South Africa that has been evaluated.
AFRIKAANSE OPSOMMING: "Gehalte" het verskillende betekenisse vir verskillende mense. Selfs kenners op die gebied van gehalte stem nie saam met 'n enkele definisie nie. Juran se omvattende definisie is "gebruikswaarde", terwyl Crosby gehalte in terme van produksie, naamlik "zero defek", definieer. Deming definieer gehalte as "'n nimmereindigende siklus van voortdurende verbetering". Die een aspek wat al drie die kenners egter gemeen het, is dat bestuur leierskap moet aanvaar en demonstreer indien gehalte bereik wil word. Geen twee persone ervaar gehalte eenders nie. Indien diensverskaffers leiding wil behou ten opsigte van gehalte-definiëring, sal hulle verplig wees om: aktief deel te neem aan openbare debat oor gehalte; die aanvaarde definisie van gehalte te herevalueer; die aanvaarde definisie van gehalte op te weeg teenoor dié van die mediese hulpfonds-administrasie; gehalte- en data insamelingsisteme te ontwikkel om gehalte en waarde te bewys; en gewillig alle data te deel - nie net uitkomsdata nie, maar ook data wat spesifiek op individuele prosedures en diensverskaffers van toepassing is. Die PhysioFocus praktyk-akkreditasieprogram het gepoog om bogenoemde te bereik. Die navorsing het gerealiseer deurdat die doelstelling bereik is. Die doelstelling van die navorsing was om die PhysioFocus praktykakkreditasieprogram te evalueer en aanbevelings te maak vir 'n leerprogram vir die akkreditasieprogram. Die doelstelling het gerealiseer deur "n verkennende en beskrywende navorsingsontwerp vanuit 'n kwalitatiewe oriëntasie. Die evaluering van die PhysioFocus praktyk-akkreditasieprogram het deur middel van 'n gevalideerde evalueringsinstrument geskied. Die groepsonderhoud het areas van die PhysioFocus praktyk- akkreditasieprogram wat remediëring benodig, geïdentifiseer. Aanbevelings het professionele-etiese aspekte, besigheidsbestuur en wetlike aspekte ingesluit. Die aanbevelings sal deur die PhysioFocus praktykakkreditasiekommitee geïmplementeer word. Die evaluering van die PhysioFocus praktyk-akkreditasieleerprogram het deur middel van 'n semi-gestruktureerde vraelys met 11 oop vrae, tesame met 'n afdeling vir opmerkings, geskied. Die algemene aanname was dat die PhysioFocus praktyk-akkreditasieprogram noodsaaklik is in privaat fisioterapiepraktyk in Suid-Afrika. Die implementering van die PhysioFocus praktyk-akkreditasieprogram het gehalte fisioterapie, professionele en persoonlike ontwikkeling, die monitering van gehalteverbeteringsprosesse, asook evaluering en remediëring van hierdie prosesse, tot gevolg gehad. Dit het die sentraalteoretiese aanname van die navorsing ondersteun. Daar was egter kommer oor die gebrek aan standaarde, die beeld van die fisioterapieprofessie, asook die gebrek aan besigheidsbestuuropleiding. Die navorser het tot die gevolgtrekking gekom dat die implementering van die PhysioFocus praktyk-akkreditasieprogram noodsaaklik is in privaat fisioterapiepraktyk in Suid-Afrika. Die huidige PhysioFocus praktykakkreditasieprogram voldoen nie aan al die vereistes van privaat fisioterapiepraktyk in Suid Afrika nie. Aanbevelings vanuit die navorsing sluit die volgende in: remediëring van die huidige PhysioFocus praktyk-akkreditasieprogram; formele opleiding, insluitende profesionele-etiese-wetlike aspekte; standaarde; wetenskaplike metodes om die praktykprosesveranderinge te analiseer; en die ontwikkeling van 'n gestruktureerde gehalteverbeteringstrategie. Die beeld van die fisioterapieprofessie is ook aangespreek. Onderwerpe vir toekomstige navorsing is geïdentifiseer. Die navorsing is uniek omdat die PhysioFocus praktyk-akkreditasieprogram die enigste akkreditasieprogram vir fisioterapie in Suid Afrika is. Dit is ook die enigste fisioterapie-akkreditasieprogram wat in Suid Afrika geëvalueer is.
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Stoikov, Susan. "Physiotherapy student contribution to the delivery of health services and the transition from student to new graduate." Phd thesis, Australian Catholic University, 2021. https://acuresearchbank.acu.edu.au/download/35a00eeb8c8af13d59489ef5951f5f2ecdc5437fd96dac3c17f65689c7ea3135/4181611/Stoikov_2021_Physiotherapy_student_contribution_to_the_delivery_REDACTED.pdf.
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Clinical education in physiotherapy is arguably the most important contributor to developing safe and competent new graduate physiotherapists and supporting the transition from student to new graduate. However, with increasing demand for clinical placements and a fiscal health environment, there is a growing need to identify how physiotherapy students contribute to the delivery of health services. This also raises the need to investigate how clinical placements impact the transition from student to new graduate. This thesis, comprising of five studies, examines the student contribution to the delivery of health services and how physiotherapy students transition to new graduates.
The first study investigated the direct patient care activity of individual physiotherapy students during 5-week clinical placements in three clinical areas: cardiorespiratory, musculoskeletal and neurorehabilitation. Clinical activity data, measured by occasions of service (OOS) and length of occasion of service (LOOS), was obtained from five Queensland public health sector hospitals totalling 300 weeks of clinical activity data. The clinical educator to student (CE:student) ratio, which describes the clinical educator full time equivalent supervising the number of students participating in the same clinical placement were also collected. The average OOS completed by an individual student during a cardiorespiratory placement was 98.3 OOS, 74.0 OOS for a musculoskeletal placement and 72.4 OOS in a neurorehabilitation placement. In the three clinical areas, the total number of OOS provided by students in each week increased from week 1 to week 4 and plateaued in week 5. A main effect existed between LOOS and weeks (F = 402.1, p < 0.001) and LOOS and clinical area (F = 1331.5, p < 0.001). In each clinical area the average LOOS reduced each week. There were differences between hospitals in each clinical area in the average OOS completed per student during a clinical placement. The average OOS per student per 5-week clinical placement block was not different between CE:student ratios in each of the three clinical areas.
The second study investigated the direct patient care activity of a group-of-students and how this compared to the direct patient care activity of a junior and senior physiotherapist. Study 2 also examined the impact of clinical area and CE:student ratio on the student contribution to the delivery of health services. Clinical activity data were obtained from physiotherapy students and physiotherapists working at five Queensland public health sector hospitals in the clinical areas of cardiorespiratory, musculoskeletal, neurorehabilitation and orthopaedics. Data were collected from 135 groups of physiotherapy students (408 individual student clinical placements) representing 2040 weeks of clinical activity data. The average OOS/day a group-of-students participating in a collaborative clinical placement was 10.6 OOS/day. A higher CE:student ratio produced more OOS/day in three of the four clinical areas. Clinical area and CE:student ratio accounted for 39% of the variance in average OOS/day a group-of-students completed. On average a group-of-students were able to meet the direct patient care activity of a junior and senior physiotherapist by week 2 of a 5-week clinical placement.
The third study was a qualitative exploration of the perspectives of new graduate and experienced physiotherapists on the student contribution to the delivery of health services. Focus groups with a semi-structured interview guide were conducted at five Queensland public health sector hospitals with new graduates and experienced physiotherapists. Focus group interviews were transcribed verbatim and a thematic analysis conducted. Three main themes were identified: tangible student contribution, non-tangible student contribution and factors that influence the student contribution. Factors that influenced the student contribution included meaningfulness of activities, autonomy, efficiency, students struggling with clinical practice and the CE:student ratio.
The fourth study investigated the change in direct patient care activity from student to new graduate. The clinical activity data of 412 student clinical placements representing 2060 weeks of clinical activity and 445 weeks of new graduate clinical activity data were obtained from five Queensland public health sector hospitals. Data were obtained from students on clinical placement across four clinical areas: cardiorespiratory, musculoskeletal, neurorehabilitation and orthopaedics. OOS and LOOS data were collected in weeks 4 and 5 of a 5-week clinical placement to determine the change in percentage of direct patient care, average OOS and average LOOS from physiotherapy student to new graduate. Students spent on average 56% of their time in direct patient care activities compared to 80% for new graduates (p < 0.001). In each clinical area students completed significantly less OOS than new graduates (p < 0.001) completing approximately half as many OOS. Students LOOS was greater than new graduate in all clinical areas with an approximate difference of 30%.
The fifth study examined the perspectives of new graduate and experienced physiotherapists on the transition from student to new graduate in five Queensland public health sector hospitals. Focus groups with a semi-structured interview guide were conducted, transcribed verbatim and thematically analysed. Four themes emerged: preparedness for practice, protected practice, independence and affirmation of practice and performance expectations. Furthermore, three key strategies to enhance the transition from student to new graduate were identified. These were organisational, clinical placement experiences and self-efficacy.
This research program demonstrated that physiotherapy students contribute to the delivery of health services by primarily providing direct patient care but also in supporting the health service and staff development. The clinical area and CE:student ratio are important considerations when planning for student clinical placements and maximising the student contribution. There is a gap between student and new graduate practice, and transition to independent clinician poses many challenges which necessitates the need for stakeholders to work together to support the transition from student to new graduate.
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Scopes, Judy. "Outcome measures of physical function in adult unilateral lower limb amputees during prosthetic rehabilitation : use in clinical practice and psychometric properties." Thesis, Queen Margaret University, 2016. https://eresearch.qmu.ac.uk/handle/20.500.12289/7422.
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The aim of this thesis is to inform clinicians and researchers of the reliability and responsiveness of the most commonly used outcome measures in prosthetic rehabilitation in the UK. In addition, this thesis supports the call for more studies of high methodological quality to provide evidence of the psychometric properties of outcome measures of physical function in lower limb amputees. A survey (study I) of Allied Health Professionals established that the outcome measures used most often during prosthetic rehabilitation in the UK were: the Timed Up and Go (TUG), a timed walk test, the Locomotor Capability Index (LCI) and its modified version (LCI-5), the Socket Comfort Score (SCS) and the Special Interest Group in Amputee Medicine (SIGAM) Mobility Grades. A standardised quality checklist (COSMIN) was used in a systematic review (study II) to measure the methodological quality and strength of evidence of the published literature that reported on the psychometric properties of outcome measures used to measure physical function during prosthetic rehabilitation. The review found mixed methodological quality ratings and many studies with small sample sizes rendering the strength of the evidence indeterminate. A limited number of studies commented on limits of agreement and measurement error when reporting on reliability. Even fewer studies reported on responsiveness with only one reporting minimally clinically important difference (MCID) values. Values for consistency, agreement and measurement error, were calculated for the top five commonly used outcome measures as identified from the survey, using a test-retest study design with a period of 7 days between tests (study III). Minimum detectable change (MDC) values were calculated for the SIGAM, LCI-5, TUG and 2MWT. The EQ-5D-5LTM, a measure of the global health of the respondent, was also included as knowledge of its psychometric properties in a population of pwLLA is unknown. However, reliability could not be confirmed for the EQ-5D-5L or the SCS in this population. A longitudinal study (study IV), based during the early rehabilitation period (mean 84 days) following provision of a primary prosthesis, gathered data to calculate indices of responsiveness for the same six outcome measures. Effect sizes were presented for five measures: SIGAM, LCI-5, TUG, 2MWT, SCS and EQ-5D-5L. Minimal clinically important difference values were also presented for the first time for all the outcome measures in this population. A patient reported change questionnaire was used as the anchor in a Receiver Operator Characteristic (ROC) curve analysis to establish the MCID values.
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Kunda, Richard. "The Outcomes and Impact of a Postgraduate Physiotherapy Master's Programme on Research and Clinical Practice in Africa." Thesis, University of the Western Cape, 2016. http://hdl.handle.net/11394/5526.
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Philosophiae Doctor - PhDThe past decade has seen a growth in Physiotherapy schools offering postgraduate programmes in South Africa. The Republic of South Africa assists other African countries like Kenya, Malawi, Rwanda, Tanzania and Zambia in upgrading the education of diploma-trained physiotherapists (DTPs) to Bacherlor of Science (Honours) (BSc (Hons) and Master's Degrees respectively. The three institutions offering Physiotherapy training in Cape Town make it the largest training locality for Physiotherapy in South Africa. The University of Cape Town (UCT), University of the Western Cape (UWC) and Stellenbosch University are situated within a twenty kilometre radius from each other. These schools have taken a leading role in the postgraduate training of their own PTs, and those from other developing countries. In 2007, for example, about 20% of postgraduate students in Cape Town Physiotherapy schools were from other African countries. The Department of Physiotherapy at UWC in particular has been upgrading DTPs from other African countries to BSc (Hons) and Master's degrees for the last twenty years. However, compared to the wealth of educational literature on other healthcare professions, literature on the evaluation of postgraduate Physiotherapy programmes is scarce. Thus, the aim of this study was to evaluate the outcomes and impact of the UWC postgraduate Physiotherapy BSc (Hons) and Master's programme on clinical practice and research in East and Southern Africa. The dissertation used an explorative and descriptive theory-based evaluation approach using qualitative research methodology. The steps involved in the research process determined the choice and use of the qualitative methodology. The use of qualitative methods was undertaken to provide a comprehensive analysis of the research problem. The study had three main phases. Initially, administrative document reviews and in-depth interviews with UWC postgraduate Master's programme designers (PDs) were conducted to help develop and test the programme theory and measuring instruments (interview guides). Secondly, postgraduates were interviewed to establish and test the implementation process theory, as well as investigate perceived programme outcomes. Then focus group discussions with postgraduate students of UWC, and individual interviews with workplace supervisors of the UWC postgraduates were undertaken to investigate the perceived outcomes and impact of the UWC Master's programme. A variety of methods appropriate for the different steps or stages of the programme were employed, to ensure this evaluation exercise becomes an integrated function in which data are continuously collected and used for decision-making and programme improvement. Multiple types of data were collected to inform each phase. The researcher used purposive sampling technique to constitute the sample. The sampling technique yielded three official documents, three (3) PDs and two (2) implementers, 27 UWC postgraduates, seven (7) workplace supervisors and 30 students of UWC postgraduates. Data was collected via document analyses, in-depth interviews, telephonic in-depth interviews and focus group discussions. Qualitative data analysis occurred concurrently with data collection. Atlas Ti software version 10 was used to assist with data management. The UWC postgraduates reported acquiring knowledge of manual therapy, better management of musculo-skeletal conditions and enhanced clinical reasoning. Participants also reported career growth, pursuit of higher degrees such as PhDs, promotions, job changes from physiotherapy clinicians to educators, involvement in research and the introduction of BSc programmes in their respective countries. The current study demonstrates that the primary objective of the UWC BSc (Hons) and Master's programmes such as increasing access to physiotherapy training in Africa and empowering DTPs with research skills and knowledge of community-based rehabilitation was being realised. However, many postgraduate participants in all countries emphasised the need to include basic sciences, clinical practice and specialisation in the UWC BSc (Hons) and Master's programmes respectively. Furthermore, the participants reported that the programmes did not have much impact on management of conditions other than musculo-skeletal. On the other hand, the employers that participated in the current study identified that the UWC programmes had a positive impact on Physiotherapy education in their respective countries, producing a total of five Physiotherapy degree programmes between the year 2000 and 2014. Kenya, Rwanda, Tanzania and Zambia reported introducing two, one, one and two BSc Physiotherapy programmes respectively. The study also revealed moderate research activity among UWC postgraduates, a challenge most employers attributed to institutional research agendas, high patient work-load and personal strengths of postgraduate students. The students of UWC graduates who participated in the current study reported acquiring new assessment skills for musculo-skeletal conditions, enhanced treatment techniques for musculoskeletal conditions and use of evidence to guide their clinical practice. The participants also reported reduced hospital visits among patients with musculo-skeletal conditions and relatively short treatment durations. However, in all universities but one, students indicated that most lecturers had difficulty applying basic sciences during lectures. The participants also reported a lack of specialist lecturers in areas other than musculo-skeletal. This thesis focused on evaluation of the outcomes and impact of postgraduate BSc (Hons) and Master's programmes in Physiotherapy for DTPs in SADC and East Africa. While the thesis has highlighted many achievements, it has also identified training needs of DTPs that require attention. First, we recommend that the curriculum be reviewed to incorporate clinical practice and more theoretical content in the BSc (Hons) programme and that the UWC special BSc (Hons) programme be considered an RPL project to ensure the visible (documented) and nonvisible (undocumented) knowledge claimed by applicants are subjected to a form of assessment through the UWC RPL process, thus enabling the university to identify the knowledge gap that requires bridging among DTPs seeking admission to the degree programme. Second, we recommend a review of the Master's degree by coursework programme to include more theoretical and clinical practice components that would allow for specialisation.
National Research Foundation (NRF)
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Chetty, Laran. "A study to determine the occupational health and safety knowledge, practices and injury patterns of workers at a specific beverage manufacturing company." Master's thesis, University of Cape Town, 2006. http://hdl.handle.net/11427/3006.
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Includes bibliographical references (leaves 129-164).The aim of this study was to determine the occupational health and safety knowledge, practices and injury pattern of workers at a specific beverage manufacturing company.
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Kerr, Daniel Paul. "The use of acupuncture in physiotherapy practice and its efficacy in the management of low back pain." Thesis, University of Ulster, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.342533.
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Pollock, Alexandra Susan. "An investigation into independent practice as an addition to physiotherapy intervention for patients with recently acquired stroke." Thesis, Open University, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.265350.
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Smith, Patricia. "A cultural approach to community based rehabilitation and it's implications for physiotherapy practice : a Jamaican case study." Thesis, University of East London, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.532591.
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This study explores how health beliefs and socio-cultural factors impact on the practice and delivery of Community Based Rehabilitation (CBR) and examines the implications for the theory and practice of physiotherapy. The World Health Organisation has promoted CBR for disabled people in developing countries (WHO, 1981) as an alternative to institutionalised rehabilitation. This study examines the practice of CBR in post-colonial Jamaica. The researcher, a trained physiotherapist who qualified in Jamaica and then worked in the UK conducted ethnographic fieldwork with eight rural families who took part in the 3D Projects programme in Jamaica. She spent a year participating in the life experiences of these participants, observing and conducting contextual interviews. Set against the legacy of imperialism, Jamaica presents the challenge of economic hardship, unemployment, crime and violence and class divide. However, it also offers community resistance and this thesis explores the experiences of families living within rural communities who are caring for children with disability. The study looks at CBR and analyses the role of women and their families caring for children with disability and the implications of community capacity building and the notion of community. Some of the tensions that exist between western ideologies of disability and traditional Jamaican explanations for the causation of disability and then the implications for care are explored. The key role of the Community Rehabilitation Workers (CRW) was recognised. It is suggested that CBR should take into account the cultural and social context of the client, the family and the community. The implications call for the physiotherapist is the need to develop skills of networking, management and negotiation, in order to facilitate the optimal function of the disabled child, the child's family and community. In conclusion, the researcher suggests that there is no one single model of CBR. Physiotherapists are increasingly working in countries other than their own (Noorderhaven, 200 I) and as such, there is a need to develop models of practice which reflect cultural sensitivity in the assessment, planning, implementation and evaluation necessary for the practice of physiotherapy in a CBR programme within a post-colonial society.
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Stenner, R. "Exercise prescription for patients with non-specific chronic low back pain : a qualitative exploration of physiotherapy practice." Thesis, University of the West of England, Bristol, 2014. http://eprints.uwe.ac.uk/22930/.
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Background: Providing an effective exercise prescription process for a patient with non-specific chronic low back pain (NSCLBP) within the limits of time that a busy clinician faces is a challenging task. Emerging research has indicated that partnership in care and shared decision making are important for people with NSCLBP, and calls for further investigation into the approaches used to prescribe exercise. Objective: To explore the characteristics and processes of physiotherapy exercise prescription for patients with NSCLBP, and investigate how shared decision making and patient partnership are addressed by physiotherapists in this process. Design: A qualitative study using a philosophical hermeneutic approach. In phase one of the study eight physiotherapists were each observed on three occasions undertaking their usual clinical activities. They participated in brief interviews after each observation and a later in depth semi-structured interview. In phase two semi-structured interviews with eight patients including use of some brief patient vignettes was undertaken to provide a rich descriptive text of their personal experiences of receiving exercise as part of the management of their NSCLBP, and their involvement in decisions regarding their treatment plans. In depth iterative hermeneutic strategies were used to interpret the texts and identify the characteristics and processes of exercise prescription for patients with NSCLBP. . Analysis: Thematic analysis (Braun and Clarke, 1996) was employed to search for themes and patterns from the observations and interviews with physiotherapists and patients. Findings: The findings provide a complex understanding of how physiotherapists regard and utilise exercise based management strategies for patients with NSCLBP. Patient partnership and shared decision making were rarely evident and were linked to the physiotherapists’ clinical orientations, cognitive and decision making processes, and assumptions about patients. The overall feeling of the patients was that the role they played in the therapeutic interaction was a marginal one, such that the therapist was dominant in structuring the interactions, leaving the patients feeling disempowered to question and contribute. Conclusions: This research, by focusing on a patient-centred approach, makes an important contribution to the body of evidence relating to the management of NSCLBP. It challenges physiotherapists to critically appraise their approaches to the prescription of exercise therapy in order to improve outcomes in these patients.
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Gow, Audrey Helen. "An investigation of service quality in the healthcare sector : a study of an independnet private physiotherapy practice." Thesis, Edinburgh Napier University, 2014. http://researchrepository.napier.ac.uk/Output/6910.
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This study was concerned with an investigation into the service quality of an independent private physiotherapy practice using a mixed method approach. The Directors of the private physiotherapy practice (the practice) required an understanding of their customer services; however, this did not include the services of the treatment. It was anticipated that the findings of the study would enhance the service quality of the practice in order that it may remain competitive. A review of the literature revealed a gap for the independent private practice and, in particular, a gap in service quality. The two main debates in the literature pertained to the instrument of measurement for service quality and the appropriate conceptual model. The literature review suggested that the SERVQUAL Instrument was the most suitable method to meet one of the objectives of this study. It also revealed that there were two main models of service quality (American and Nordic) and that the American model was the conceptual model most related to services and therefore suited to the objectives of this study. The study comprised of two phases, phase one was the more dominant phase and was accomplished utilising the SERVQUAL Instrument with a sample of 62 practice customers. The analysis in phase one informed the basis for the semi-structured interviews for the second phase. Phase two specifically investigated areas of the service quality where customers had rated their perceptions lower than their expectations. Nine interviews were conducted for phase two. The key findings for phase one identified, that overall, the service quality of the practice was positive. This was in contrast to other healthcare studies that were in the UK public healthcare sector. On further analysis it was revealed that there were areas of service quality that the customers had rated with a negative perception, in particular the reliability factor. Further, phase one identified that previous experience of physiotherapy services significantly influenced the customers' expectations of services. In addition the study was in accord with previous literature that suggested that expectations were also culture and socio economic dependent. The key findings for phase two identified that an investigation into negative perceived service quality was crucial to understanding the ‘why' of the customers' perception of the service quality of the practice. Phase two revealed that not only were customers' expectations formed through experiences, but also that perceptions were formed through other people's experiences i.e. relatives. Another key finding in phase two was, that despite the customers being informed on several occasions that the study was in relation to service quality and not the treatment, they could not distinguish between the two constructs. Finally, the study concluded that the SERVQUAL Instrument was suitable for the independent private practice and should be slightly amended to fit the context and culture of the study. In addition, it was concluded that it was of academic and managerial benefit to measure both the expectations and the perceptions of service quality. The core service (service quality and treatment) is required to be taken into consideration in any future healthcare study. Face to face interviews sequentially following the analysis of the SERVQUAL questionnaire provided deeper and perhaps more meaningful information. The data and information gathered could be translated into staff training to maintain the competiveness of the service quality of the practice.
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Faure, Mary. "Investigating strategies to enhance clinical education in an undergraduate physiotherapy programme: An action research study." University of the Western Cape, 1997. http://hdl.handle.net/11394/8398.
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Magister Philosophiae - MPhilThe traditional approach to physiotherapy education is that of an applied science, in which scientific theory and therapeutic skills are taught in a classroom, and then implemented in a clinical setting. Many difficulties were demonstrated by students during the clinical practice component of the undergraduate course at the University of the Western Cape (UWC). This raised the question of whether current strategies of clinical education were effective in facilitating the development of the clinical skills deemed necessary for professional practice. Furthermore, it appeared to me that the teaching strategies which I employed did little to integrate classroom teaching with clinical practice. During 1993 and 1994 I initiated two cycles of workshops as an action research project, in collaboration with students and colleagues at UWC. The purpose of the workshops was for me to investigate my practice as a clinical educator, whereby I hoped to understand more fully, and therefore enhance, my teaching practice. The study revealed that clinical education is a complex and dynamic process strongly influenced by many factors. Personal perceptions of the educator's role in clinical teaching and learning, as well as the interaction with, and expections of those participating in clinical education, shape teaching practice. The concept of a positive learning environment was explored, and it was found that collaboration_with students and classroom democracy has a significant impact on student motivation. The effect of a variety of reading and writing tasks, co-operative learning and structured group discussion are some of the teaching strategies that were implemented, and positively evaluated by students and colleagues. Ethical considerations relating to the role of the patient during clinical practice and clinical education developed as an important aspect of the workshops. The conflict which can arise between the related roles of clinical educator and clinician, evolved as a professional dilemma. It is suggested that the process of clinical education requires further investigation. Educational change and innovation proved to be a difficult personal, and co-operative, process. Unique responses by different groups of individuals to similar situations or strategies make this issue more complex. In order to practice more competently, it would be appropriate that the clinical education process be thoroughly investigated in order to be more fully understood by physiotherapy educators, rather than be taken for granted. Action research proved to be an effective and flexible vehicle for investigating, and responding to, the dynamic teaching process. The action research study documented in this thesis, being similar in effect to the therapeutic process, would serve the physiotherapy clinician as effectively as it would the physiotherapy lecturer.
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Simpson, Helene. "Physiotherapeutic management of acute ankle sprains : a survey of clinical practice in the Western Cape and comparison thereof to evidence based guidelines." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/85818.
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Thesis (MScPhysio)--Stellenbosch University, 2013.ENGLISH ABSTRACT: Ankle sprains are reportedly the most common lower limb injury amongst active individuals. Aim: The aim of this study was to investigate whether treatment interventions employed by physiotherapists during the first week of functional rehabilitation of an ankle sprain, at primary care level, were aligned with evidence-based guidelines for acute ankle sprains. Design: A descriptive cross-sectional study was conducted. Participants: A total of 91 physiotherapists from the Western Cape Metropole (WCM) completed questionnaires. Method: Physiotherapists' treatment interventions were recorded based on a case study of a typical moderately sprained ankle. According to classification of the West Point Ankle Grading System, a moderate sprain is a partial macroscopic tear of the ligaments with moderate pain, swelling and tenderness with some loss of motion and mild to moderate instability of the joint. Anticipated return to sport is two to six weeks. Relative occurrence of selected interventions during the first week of rehabilitation was calculated. Chi-square tests were used to compare differences between physiotherapists' responses and the recommendations of the practice guidelines. Results: Physiotherapists' overall selections of treatment interventions were in alignment with the "Koninklijk Nederlands Genootschap voor Fysiotherapie" (KNGF) guidelines and correlated positively to the recommendations stipulated by KNGF therein. Physiotherapists indicated many interventions for which good evidence exists: compression, cryotherapy, early mobilisation, and neuromuscular exercises. It is of concern that 49% – 91% (n = 91) physiotherapists indicated some form of manual mobilisations for which there is a lack of evidence, and more than two-thirds indicated the application of an electrotherapy intervention, which is not recommended in the guidelines. Conclusion: Physiotherapists should reconsider interventions for which there is no evidence as this may reduce cost of care, without compromising patient outcomes.
AFRIKAANSE OPSOMMING: Verslae dui daarop dat verstuite enkels die mees algemene besering van die onderste ledemaat van aktiewe persone is. Doelwit: Die doel van hierdie ondersoek was om vas te stel of fisioterapeute in primere gesondheidsorg se keuse van rehabilitasie tegnieke gedurende die eerste week van funksionele rehabilitasie na 'n enkel besering, op koers is met bewysgebaseerde kliniese riglyne in die hantering van akute enkel beserings. Ontwerp: 'n Beskrywende deursnit ondersoek is geloods. Deelnemers: 'n Vooraf opgestelde vraelys is deur 91 fisioterapeute in die Weskaapse metropool voltooi. Metodiek: 'n Gevalle studie is aangebied van 'n tipiese matige verstuite enkel. Die respondent moes hulle tegnieke in die hantering van die geval aandui. Volgens die klassifikasie van die “West Point Grading System” word so 'n verstuiting gekenmerk deur makroskopiese gedeeltelike skeur van die enkel ligamente, matige pyn, swelsel en tasteerheid van die area. Dit gaan gepaard met 'n effense verlies van beweging en stabiliteit van die gewrig. Die prognose vir so 'n besering om na sport terug te keer is om en by twee tot ses weke. Die insidensie van aanwending van geselekteerde metodes van behandeling gedurende die eerste week en die verhouding met die vooraf geselekteerde behandelings riglyne opgestel deur die “Koninklijk Nederlands Genootschap voor Fysiotherapie” (KNGF) is bereken en ontleed. Die “Chi-square” toets is gebruik om die verskil te bereken tussen die respons van die Fisioterapeute en die aanbevelings van die kliniese riglyne. Resultate: Oorkoepelend is die keuses van behandelings tegnieke deur die fisioterapeute in lyn met die riglyne van die 'Koninklijk Nederlands Genootschap voor Fysiotherapie' (KNGF). Verskeie sinvolle behandelings is gekies waarvoor daar positiewe aanduidings was, byvoorbeeld: lokale kompressie, ys terapie, en oefeninge. Dit is egter kommerwekkend dat 49 – 91% (n=91) van die deelnemers 'n manuele tegniek ingesluit het waar daar tans gebrekkige aanduidings voor bestaan. Verder, het meer as twee derdes van die fisioterapeute aangedui dat hulle elektroterapie sou gebruik wat nie in riglyne aanbeveel word nie. Gevolgtrekking: Fisioterapeute moet die gebruik van tegnieke waarvoor daar nie duidelike bewyse in die literatuur bestaan nie, heroorweeg, want dit mag die koste van behandeling verminder, sonder om die positiewe resultate van herstel, negatief te beinvloed.
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Wright, Grahame G. D. "Health promotion in undergraduate programmes of dietetics, occupational therapy, physiotherapy and how this is applied in professional practice." Thesis, Robert Gordon University, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.442685.
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