Several studies have looked at home-based physiotherapy, which has advantages over out-patient hospital services for selected groups of survivors: for example, issues relating to travel are eliminated if there are no travel costs or waiting time in out-patient clinics (Gladman, Lincoln and Barer 1993; Young and Forster 1992). However, there is relatively little information on the content of community physiotherapy treatment. Forster and Young (1990) found that survivors who received treatment at home had advantages such as the elimination of problems related to transport including travel costs, out-patient waiting time, and travel time. Lang (1996) examined the distribution of work time for community physiotherapists and showed that they spent 29 to 30 per cent of their time on direct treatment, 23 to 30 per cent in consultation and the rest travelling. However, it is not easy to decide if this time is well-spent when the data is not compared with other settings. Conversely, Burnard (1988) found that community therapists spent only 8 per cent of their time travelling, although this may have been because of the distance patients lived from the physiotherapy department.
Collins et al (1998) examined community physiotherapy services by studying 737 home visits to 279 patients aged 64.3 years on average. Their findings revealed that direct patient treatment was the most time-consuming and exercises were the most frequent modality used. Possible explanations for these differences in the findings may be related to methods of data collection and differences in work patterns and environments. In the United Kingdom, community physiotherapy was established in 1943 and became widely established by 1984 (Partridge and Barnitt 1986) but there is very little research about the role of community physiotherapy in general and stroke rehabilitation in particular. In Jordan and the Middle East, only a few studies have attempted to investigate the role of physiotherapists and no work has specifically looked at stroke rehabilitation.
The satisfaction of stroke survivors with their therapy, including physiotherapy, is of some importance. In a well-designed study to explore the opinions of stroke survivors and their carers of the physiotherapy received or being received, Partridge (1993) interviewed 16 stroke survivors and six family carers in different parts of England. The survivors were three men and 13 women whose stroke had occurred between two months and three years earlier and their ages ranged from 29 and 70. Focus group interviews were used to collect data from the participants. The survivors identified several themes related to physiotherapy services. These included: Timing of physiotherapy: Most of the participants reported the importance of early physiotherapy intervention after stroke onset. Other participants felt that there should be a delay before the start of intensive physiotherapy. However, early intervention proved to be better than late intervention.
Amount of physiotherapy: The actual time spent with physiotherapists was seen as important in building a one-to-one relationship. Participants were not satisfied with the amount of physiotherapy given in acute and later stages. One-third of the survivors had sought help from private physiotherapists when they were no longer receiving NHS physiotherapy and they believed that they deteriorated when physiotherapy stopped.
Communication: Participants reported unhappiness and dissatisfaction with therapists who appeared not to listen to them and who failed to provide written information about stroke and recovery from stroke.
Therapists' personal and professional characteristics: Participants reported that they were able to identify the experienced from the inexperienced therapists within the first week of treatment and that this was not necessarily related to the age of the physiotherapists. Therapists who were interested in stroke, had a strong sense of humour and who talked and listened to survivors and their carers were highly appreciated. These results indicate that therapists' therapeutic skill and knowledge alone are not enough for survivors but that the attitude and the communication skills of therapists contribute significantly to survivors' satisfaction with therapy and therefore produce a better potential outcome. As in previous studies, survivors were not happy with short-term physiotherapy and found it difficult to understand the time constraints on therapy which led to termination of physiotherapy when survivors felt it was still needed (Kelson, Ford and Rigge 1998).
Retrieved from "http://www.articlesbase.com/disabilities-articles/community-physiotherapy-for-people-with-disbailiteis-2857403.html"
No comments:
Post a Comment