The knowledge, attitudes and perceptions of physiotherapists in KwaZulu-Natal, South Africa, towards mental health

Physiotherapists Lack Knowledge in Mental Health: A Survey of Knowledge and Attitudes of Physical Therapists About Their Role in Mental Health

Purpose

As the number of mental illnesses increases, there is a need to manage it holistically within a multidisciplinary team. The majority of patients with physical disabilities suffer from mental health problems, and physiotherapy can play a role in improving their lifestyle. This study aimed to determine physiotherapists' self-reported knowledge and attitudes regarding their role in treating patients with mental health disorders.

Methods

This study adopted a descriptive, cross-sectional, and prospective observational survey design. The sample consisted of 208 physical therapists.

Results

The majority of the participants, (48%) had a positive attitude score, with (40%) having a neutral attitude and (12%) having a negative attitude toward treating patients with mental health issues. Most respondents (86%) reported that they need more information regarding patients with mental health disorders and physiotherapists' management of their physical health issues.

Conclusion

Many physiotherapists lack knowledge and hold a neutral to negative attitude towards treating patients with mental disorders. This highlights the need for more training to fill the gap in knowledge and guide physiotherapists to build upon their positive attitude towards treating patients with mental disorders.

Physiotherapists' perceptions of their role in treating and managing people with depression and anxiety disorders: A systematic review

BACKGROUND

Despite the prevalence of mental health disorders rising worldwide, physio-therapists' perceptions of their role and ability to holistically treat people with anxiety and depression remain unclear.

PURPOSE

This research aimed to understand the physiotherapists' perception of their role in treating and managing people with anxiety and depression while revealing barriers and facilitators in practice.

METHODS

PubMed, PsycInfo, CINAHL, EMBASE, Web of Science, and Google Scholar were searched systematically for mixed-method, quantitative, or qualitative designs. Using the Joanna Briggs Institute (JBI) Methodology for Systematic Reviews, data was extracted, critically appraised, assigned quality grades, and synthesized through meta-aggregation.

RESULTS

A total of 2991 records were initially sourced, with eleven studies included in the systematic review. The studies were published worldwide between 2016 and 2021, with the majority (n = 8) published in 2020-2021. Participating physiotherapists most frequently had a Bachelor's degree (35.7-62.6%), followed by a Master's degree (28.4-37.4%). Meta-aggregation revealed the synthesized finding that physiotherapists perceived their role to include treating people with anxiety and depression despite feeling underprepared. Physiotherapists perceive many barriers and facilitators, such as education, when treating people with anxiety and depression.

CONCLUSION

Physiotherapists have positive perceptions toward anxiety and depression, despite feeling underprepared in their ability to implement psychosocial strategies.

The Approach of Physiotherapists in the Management of Patients with Persistent Pain and Comorbid Anxiety/Depression: Are There Any Differences between Male and Female Professionals?

Background and Objectives: Chronic pain is a prevalent condition that is frequently complicated by mood and anxiety disorders. The purpose of the present article is to identify differences in the management of patients with chronic pain and anxiety/mood disorders depending on the physiotherapists' gender. Materials and Methods: An ad hoc questionnaire was developed and sent to 327 physiotherapists by e-mail. The two groups identified by gender were compared by unpaired-sample t tests for continuous variables and χ2 tests for qualitative ones. A binary logistic regression was then performed with factors resulting as statistically significant in univariate analyses as independent variables and gender as a dependent one. Results: Female physiotherapists exhibited a higher level of confidence than male physiotherapists in administering continued physiotherapy for patients affected by Generalized Anxiety Disorder (GAD) (p = 0.01), as well as for individuals who had previously engaged with a mental health professional (p = 0.01). Furthermore, female physiotherapists believed that pharmacotherapy was less associated with motor side effects (p < 0.01) and more frequently recognized the importance of training to identify affective disorders (p = 0.01) and the need for more education in mental health (p = 0.01). The binary logistic regression model confirmed that female professionals were less likely to work = freelance (p = 0.015) and were more confident in the receival of physiotherapy by patients with GAD (p = 0.05). Conclusions: Female physiotherapists compared to male ones seem to be more comfortable with patients affected by mental conditions and to be more aware of the need for training on mental health. Further studies are needed to confirm the results of the present study.

Mental health education for physiotherapists: A scoping review

Background

Physiotherapists play an integral role in the management of people living with a mental illness, yet little is known about their knowledge, attitudes and perceptions about mental health globally and particularly in South Africa.

Aim

The purpose of the study is to map global evidence on mental health education for physiotherapists, including their knowledge, attitude and perceptions, with the goal of using this information to design an improved undergraduate curriculum for physiotherapy in South Africa.

Setting

The search was focused on the South African and global context, with the participants as physiotherapists and physiotherapy students.

Methods

The methodical framework proposed by Arksey and O'Malleys guided the scoping review. The online search used five electronic databases. An expert librarian assisted in the search strategy. English language, primary research articles that investigated physiotherapist or physiotherapy students' knowledge, attitude and perceptions towards mental health were sought.

Results

The search strategy extracted 226 published studies and 15 studies were included in the analysis. The results indicated that globally physiotherapists and physiotherapy students had limited knowledge about mental health. Improved attitudes were noted with a mental health training intervention. Negative perceptions were associated with limited knowledge.

Conclusion

There was limited literature on the influence of education on mental health in physiotherapy on attitudes and perceptions. Physiotherapists desired more knowledge about mental health because of the prevalence of mental health disorders.

Contribution

Because of the increasing prevalence of mental illness globally, the findings of this review suggest the necessity of integrating mental health content in the physiotherapists' undergraduate programme to provide high-quality care physiotherapy management for people with mental illnesses.

Physiotherapy students' knowledge and attitudes about their role in mental health

Background

As the prevalence of mental health disorders (MHD) increases, physiotherapy students will be increasingly exposed to patients with MHD in their undergraduate studies. International research has shown that students who have mental health included in their curriculum have more knowledge and positive attitudes towards patients with MHD. In South Africa, little is known about physiotherapy students' attitudes towards and knowledge of mental health.

Objectives

To establish the knowledge of and attitudes towards the role of physiotherapy in determining the mental health attitudes.

Method

In our cross-sectional, descriptive study, third- and fourth-year physiotherapy students at the University of the Witwatersrand were purposefully sampled. Online questionnaires, based on the Mental Health Knowledge Schedule (MAKS) and Mental Illness Clinicians' Attitudes (MICA) scales were completed.

Results

Thirty-four students participated in our study. Overall, all students indicated a moderate level of knowledge and a positive attitude towards mental health with mean MAKS score: 26.94 (standard deviation [s.d.]: 3.57) and MICA-4 score: 39.12 (s.d.: 16.12). Fourth-year students had more knowledge and a better attitude towards mental health when compared to the third-year students.

Conclusion

Third- and fourth-year University of the Witwatersrand physiotherapy students have moderate knowledge and a positive attitude towards the role of physiotherapy in mental health.

Clinical implications

The inclusion of mental health in the physiotherapy curriculum may improve students' knowledge and attitudes towards mental health and prepare them for managing these complex patients in the future.

Current knowledge and practice of post-stroke unilateral spatial neglect rehabilitation: A cross-sectional survey of South African neurorehabilitation physiotherapists

Background

Unilateral spatial neglect (USN) affects the rehabilitation process leading to poor functional outcomes after stroke. South African physiotherapists’ level of uptake of available evidence in USN rehabilitation and the barriers they encounter are not known.

Objectives

To evaluate knowledge, current practice enablers and barriers to USN management in stroke survivors amongst physiotherapists in South Africa.

Methods

Our cross-sectional survey used a total sampling technique. Questionnaires were sent to neurorehabilitation physiotherapists in South Africa. Descriptive and inferential statistics analysed the data.

Results

The overall knowledge score of USN was 14.11 ± 5.23 of a total of 25. The knowledge was good for definitions of USN; moderate for incidences, causes, screening, diagnosis and prognosis of USN and poor for pharmacological approaches to the management of USN. A significant low positive correlation between respondents’ age (r = 0.46; p = 0.016) and years of practice as a physiotherapist (r = 0.43; p = 0.026) and knowledge of USN was found. The most frequently utilised intervention was constraint-induced movement therapy; the commonly utilised assessment tool was the comb and razor test. ‘Inadequate therapy time’ (55.56%) and ‘lack of relevant equipment for rehabilitation of USN’ (38.89%) were identified as major barriers to USN rehabilitation. Major enablers to USN rehabilitation were the ‘presence of multidisciplinary stroke team in clinical practice’ (83.35%) and ‘availability of adequate staff’ (76.47%).

Conclusion

Physiotherapists demonstrated a fair knowledge of USN although knowledge about pharmacological management of USN was modest. Current practice in post-stroke USN by South African neuro-physiotherapists follows current evidence and practice guidelines.

Clinical implication

Our study shows the level of knowledge and current practice of post-stroke USN rehabilitation. The demonstrated fair knowledge of USN may be improved through training, curriculum modifications or continuing professional development. Identified barriers to the rehabilitation of post-stroke USN can assist health policy, managers and clinicians to improve stroke-specific care.

Attitudes of medical students toward psychiatry in Eastern Mediterranean Region: A systematic review

BACKGROUND

Psychiatry is facing one of the highest levels of shortages among medical specialties. Stigma toward psychiatry plays an influential role in medical students' decision to choose psychiatry as a career and has been reported to be prevalent in different parts of the world, particularly in low/middle-income countries.

OBJECTIVE

To systematically review the Eastern Mediterranean Region (EMR) medical students' attitudes toward psychiatry, to assess whether their attitudes are stigmatized or not, and the factors affecting their attitudes.

METHOD

PubMed, Scopus, Web of Science, and PsychInfo (PsycARTICLES) were searched using a combination of main terms "stigma," "psychiatry," "medical students," and the name of Eastern Mediterranean countries. Cross-sectional studies assessing the attitudes of EMR medical students toward psychiatry were included in this review.

RESULTS

Ten studies were eligible to be included in the result synthesis. These were from Pakistan (n = 3), Iran (n = 2), Saudi Arabia (n = 1), Lebanon (n = 1), Egypt (n = 1), Bahrain (n = 1), and Oman (n = 1). Most studies reported a combination of both positive and negative attitudes among medical students; however, the overall attitude was positive. Factors affecting medical students' attitude toward psychiatry included poor psychological well-being, having a friend with a psychiatric illness, involving in a romantic relationship with someone suffering from mental illness, young age, frequency of exposure to psychiatry clerkship/teaching, and quality of psychiatry clerkship. Nevertheless, the final positive or negative outcome of these factors on students' attitudes remained controversial.

CONCLUSION

Considering the lack of sufficient data from most EMR countries, we need to exercise caution in interpreting the results of this review. Nevertheless, our review indicates that psychiatry is not stigmatized among EMR medical students, and they have generally positive attitudes toward it. The findings of studies evaluating influencing factors are contradictory and demand further exploration.