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Sheill G, Afolabi J, McMahon M, Crowley J, Guinan E. Physical activity and life-limiting conditions. Int J Palliat Nurs 2024; 30:200-206. [PMID: 38630647 DOI: 10.12968/ijpn.2024.30.4.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
BACKGROUND Physical activity can assist people with life-limiting conditions to maintain their wellbeing and quality of life. AIMS To explore the views of clinical nurse specialists (CNS) working in community palliative care towards the role of physical activity for people with life-limiting conditions, and to explore the physical activity needs of patients with life-limiting conditions identified by CNSs. METHODS A purposive sample of CNSs working in community palliative care received an anonymous online survey via email. FINDINGS The response rate was 66% (n=20). Most respondents were practicing for over 20 years (60%, n=12). All respondents (100%, n=20) reported they would like further information on the role of exercise for palliative populations. The main perceived benefit of physical activity was to improve quality of life (95%, n=18). A lack of physical activity guidelines for people living with life-limiting conditions was the most commonly reported barrier to engaging in discussions around physical activity (74%, n=14). CONCLUSION Further education opportunities on the role of physical activity for patients living with life-limiting conditions are needed.
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Affiliation(s)
- Gráinne Sheill
- Department of Physiotherapy, Trinity College Dublin, Ireland
| | - Jide Afolabi
- Department of Physiotherapy, Our Lady's Hospice and Care Services, Dublin, Ireland
| | - Margaret McMahon
- Department of Physiotherapy, Our Lady's Hospice and Care Services, Dublin, Ireland
| | - Jonathon Crowley
- Department of Physiotherapy, Our Lady's Hospice and Care Services, Dublin, Ireland
| | - Emer Guinan
- School of Medicine, Trinity College Dublin, Ireland
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Saini RS, Ibrahim M, Khader MA, Kanji MA, Mosaddad SA, Heboyan A. The role of physiotherapy interventions in the management of temporomandibular joint ankylosis: a systematic review and meta-analysis : Running title: Physiotherapy in TMJ ankylosis. Head Face Med 2024; 20:15. [PMID: 38424599 PMCID: PMC10902984 DOI: 10.1186/s13005-024-00416-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 02/12/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The main aim of this systematic review and meta-analysis was to identify peer-reviewed scholarly journal articles reporting the significance of physiotherapy interventions in managing TMJ ankylosis. In addition, this study aimed to critically appraise the existing evidence on the prevalence and clinical presentation, physiotherapy intervention approaches, efficacy of physiotherapy interventions, adverse effects, and safety of physiotherapy interventions in TMJ ankylosis management. METHODS An all-inclusive literature search was conducted using the PubMed, Google Scholar, and Scopus electronic databases. The researchers screened the potential articles and assessed for eligibility based on the reported inclusion and exclusion criteria. The quality evaluation tool for observational cohort and cross-sectional studies developed by the National Institutes of Health (NIH) and the Cochrane Collaboration's Risk of Bias Tool were used to assess the quality of the included studies. Researchers also comprehensively analyzed the data, reported the results, and discussed them according to the predominant themes. RESULTS The primary electronic database search yielded 409 articles, of which 25 were included in this review. A secondary search was conducted from citations of the included studies, yielding 74 articles, of which six were included in the study. A significantly higher prevalence of bony ankylosis than fibrous ankylosis, with an overall effect size of p < 0.00001. In addition, there were significantly more unilateral than bilateral presentations with an overall effect size of p < 0.00001. Moreover, there were 78 reported complications out of 245 subjects according to five included studies demonstrating a significant effect size with p = 0.001 following the treatment protocols. CONCLUSION This study highlighted the prevalence of bony ankylosis in temporomandibular joint ankylosis, emphasizing its impact on patients' well-being. On the other hand, the results show that physiotherapy is essential to optimize postoperative outcomes and minimize adverse events such as re-ankylosis. Practitioners and healthcare professionals must monitor postoperative recovery and ensure strict adherence to physiotherapy protocols for optimal outcomes.
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Affiliation(s)
- Ravinder S Saini
- Department of Dental Technology, COAMS, King Khalid University, Abha, Saudi Arabia
| | - Mohammed Ibrahim
- Department of Oral Surgery, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohasin Abdul Khader
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Masroor Ahmed Kanji
- Department of Dental Technology, COAMS, King Khalid University, Abha, Saudi Arabia
| | - Seyed Ali Mosaddad
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Qasr-E-Dasht Street, Shiraz, Iran.
| | - Artak Heboyan
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Str. Koryun 2, 0025, Yerevan, Armenia.
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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Magrelli A, Scannavini P, D'Angelo D, Latini CM, Felli S, Di Nitto M, Russo G, Mastroianni C, Navalesi G, Casale G. Cultural Adaptation and Testing of the Italian Version of the Edmonton Functional Assessment Tool-2 (EFAT2-I). J Palliat Care 2024; 39:29-35. [PMID: 34967256 DOI: 10.1177/08258597211059304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Physiotherapy in Palliative Care (PC) is effective in the management of a series of respiratory, circulatory and motor symptoms, and often has a positive impact on the patient's mood. The Edmonton Functional Assessment Tool (EFAT) is the only existing validated tool specifically designed for functional assessment in PC, and its use has been recommended in clinical practice. To date, no Italian version of the tool has been validated. The aim of this study was to translate, cross-culturally adapt, and evaluate the psychometric properties of the Italian version of the EFAT2. METHOD After receiving formal permission from the author, Beaton guidelines for cross-cultural adaptation were followed, namely: (1) forward translation; (2) a multidisciplinary focus group (including 4 physiotherapists, 1 physician, 3 nurses, 1 occupational therapist, 1 psychologist) to assess semantic, idiomatic, experiential, and conceptual equivalence; (3) backward translation. The Content Validity Index (CVI) was used to assess content validity of the tool. Construct and concurrent validity were also evaluated. To evaluate the reliability of the EFAT2-I, reliability was measured using Cronbach alfa, item-total correlation, and Cohen's Kappa. RESULTS 119 patients admitted to a Palliative Care Unit (Italy) agreed to participate in the study. The EFAT2-I mean score was 11.3, ranging from 0 to 30. Very good CVI scores were achieved, both in terms of single item validity (I-CVI) and of whole scale validity (S-CVI). Positive results were obtained from construct, concurrent validity assessment and measures of reliability. DISCUSSION The EFAT2-I showed good psychometric properties and can be used as a rehabilitation assessment tool in palliative care settings. The validation of the Italian version will allow comparison of different centres and palliative care facilities on national and international levels.
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Affiliation(s)
| | | | - Daniela D'Angelo
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, Rome, Italy
| | | | | | | | - Giuseppina Russo
- Provincia della Natività B.M.V. - O.SS.T., Gagliano del Capo, Italy
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Yakasai AM, Maharaj SS, Gidado UM, Nuhu JM, Haruna SA, Danazumi MS. Knowledge, awareness and use of current practice of palliative care amongst physiotherapists. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2023; 79:1786. [PMID: 37928648 PMCID: PMC10623592 DOI: 10.4102/sajp.v79i1.1786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 05/24/2022] [Indexed: 11/07/2023] Open
Abstract
Background Recently, there has been a marked increase in the incidence of cancer, HIV, and other noncommunicable diseases globally. Thus, the demand for palliative care (PC), including end-of-life care, continues to grow worldwide. Physiotherapy has an important role in PC as it aims to alleviate symptoms and improve quality of life by optimising independent levels of function. Objective To assess the level of knowledge, awareness and current practice of PC amongst Nigerian physiotherapists in clinical practice. Method Our study used a cross-sectional descriptive census-based method and recruited practising physiotherapists in Nigeria. An electronic questionnaire was used to collect data over 12 weeks, comprising 36 semistructured questions in four domains: personal information, knowledge, awareness and current practices regarding PC. Data were analysed using a pragmatist paradigm. Results Of the 426 physiotherapists who participated, 50% (n = 213) had a postgraduate degree, 49.5% (n = 211) had a bachelor's degree and 0.5% (n = 2) had a Doctor of Physical Therapy degree. The results also indicate that 73.9% (n = 315) of the participants had sufficient knowledge about PC, 80.5% (n = 343) had a sufficient level of awareness about PC and 66.7% (n = 284) were using current clinical practices in the rehabilitation of critically ill patients or those with chronic conditions. Conclusion It was concluded that most Nigerian physiotherapists had sufficient knowledge and awareness about PC and were involved in the management of patients requiring PC physiotherapy. Clinical implication It can be understood that a large proportion of Nigerian physiotherapists have clinical experience managing patients requiring PC, despite inadequate formal training in this field.
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Affiliation(s)
- Abdulsalam M Yakasai
- Discipline of Physiotherapy, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Sonill S Maharaj
- Discipline of Physiotherapy, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Umar M Gidado
- Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University, Kano, Nigeria
| | - Jibril M Nuhu
- Discipline of Physiotherapy, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University, Kano, Nigeria
| | - Sani A Haruna
- Department of Biochemistry, Faculty of Basic Medical Sciences, Maitama Sule University, Kano, Nigeria
| | - Musa S Danazumi
- Department of Physiotherapy, Federal Medical Center, Nguru, Nigeria
- Department of Physiotherapy, Faculty of Health Sciences, La Trobe University, Bundoora, Australia
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Singh H, Haghayegh AT, Shah R, Cheung L, Wijekoon S, Reel K, Sangrar R. A qualitative exploration of allied health providers' perspectives on cultural humility in palliative and end-of-life care. BMC Palliat Care 2023; 22:92. [PMID: 37434238 DOI: 10.1186/s12904-023-01214-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/26/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Cultural factors, including religious or cultural beliefs, shape patients' death and dying experiences, including palliative and end-of-life (EOL) care preferences. Allied health providers must understand their patients' cultural preferences to support them in palliative and EOL care effectively. Cultural humility is a practice which requires allied health providers to evaluate their own values, biases, and assumptions and be open to learning from others, which may enhance cross-cultural interactions by allowing providers to understand patients' perceptions of and preferences for their health, illness, and dying. However, there is limited knowledge of how allied health providers apply cultural humility in palliative and EOL care within a Canadian context. Thus, this study describes Canadian allied health providers' perspectives of cultural humility practice in palliative and EOL care settings, including how they understand the concept and practice of cultural humility, and navigate relationships with patients who are palliative or at EOL and from diverse cultural backgrounds. METHODS In this qualitative interpretive description study, remote interviews were conducted with allied health providers who currently or recently practiced in a Canadian palliative or EOL care setting. Interviews were audio-recorded, transcribed, and analyzed using interpretive descriptive analysis techniques. RESULTS Eleven allied health providers from the following disciplines participated: speech-language pathology, occupational therapy, physiotherapy, and dietetics. Three themes were identified: (1) Interpreting and understanding of cultural humility in palliative and EOL care (i.e., recognizing positionality, biases and preconceived notions and learning from patients); (2) Values, conflicts, and ethical uncertainties when practicing cultural humility at EOL between provider and patient and family, and within the team and constraints/biases within the system preventing culturally humble practices; (3) The 'how to' of cultural humility in palliative and EOL care (i.e., ethical decision-making in palliative and EOL care, complexities within the care team, and conflicts and challenges due to contextual/system-level factors). CONCLUSIONS Allied health providers used various strategies to manage relationships with patients and practice cultural humility, including intra- and inter-personal strategies, and contextual/health systems enablers. Conflicts and challenges they encountered related to cultural humility practices may be addressed through relational or health system strategies, including professional development and decision-making support.
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Affiliation(s)
- Hardeep Singh
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada.
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.
| | - Arta Taghavi Haghayegh
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Riya Shah
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Lovisa Cheung
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sachindri Wijekoon
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Kevin Reel
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
- Ethics Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Ruheena Sangrar
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
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Cimino V, Chisari CG, Toscano S, Patti F. Palliative care in multiple sclerosis. HANDBOOK OF CLINICAL NEUROLOGY 2023; 191:129-138. [PMID: 36599504 DOI: 10.1016/b978-0-12-824535-4.00009-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Main target in palliative care (PC) is burden care of patients and their families, with the aim to reduce suffering through the management of symptoms, rehabilitation, psychosocial issues, and spiritual well-being, using a multidisciplinary approach. Multiple sclerosis (MS) is a chronic disease which induces physical and psychosocial symptoms, with a significant impact on the quality of life. As a consequence, despite advances in research in disease-modifying drugs, MS remains a life-limiting disease with symptoms negatively impacting the lives of MS patients and their families. PC has been developed for end-of-life treatment in oncology, being little used in MS. Specific issues in MS, like pain due to spasticity, requires a different approach respect to cancer pain management. Moreover, it is difficult to anticipate life expectancy in people with severe MS, who often need palliative care for a long extended period. PC teams are trained to keep open full and competent lines of communication about symptoms and disease progression, advanced care planning, and end-of-life issues and wishes. Many studies investigated the effects of home-based PC in advanced MS, showing weak evidences about the efficacy of PC versus usual care in MS. However, current evidence does not support or refute the routine use of PC interventions for people with MS.
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Affiliation(s)
- Vincenzo Cimino
- Rehabilitation Division, Centro Neurolesi "Bonino Pulejo", IRCSS, Messina, Italy
| | - Clara Grazia Chisari
- Department G.F. Ingrassia, Section of Neuroscience, University of Catania, Catania, Italy
| | - Simona Toscano
- Department G.F. Ingrassia, Section of Neuroscience, University of Catania, Catania, Italy
| | - Francesco Patti
- Department G.F. Ingrassia, Section of Neuroscience, University of Catania, Catania, Italy.
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Yakasai AM, Danazumi MS, Gidado UM, Nuhu JM, Haruna SA. Knowledge, awareness and use of current practice of palliative care amongst physiotherapists. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2022. [DOI: 10.4102/sajp.v78i1.1786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Srivastava R, Srivastava S. Bibliometric Analysis of Indian Journal of Palliative Care from 1995 to 2022 using the VOSviewer and Bibliometrix Software. Indian J Palliat Care 2022; 28:338-353. [DOI: 10.25259/ijpc_30_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/19/2022] [Indexed: 11/04/2022] Open
Abstract
Introduction:
The Indian Journal of Palliative Care (IJPC) is an open-source, interdisciplinary and peer-reviewed journal started in 1994 that publishes high-quality articles in the field of palliative care in India. The purpose of this study is to analyse the bibliometric data of its publications using bibliometric analysis to understand the key bibliometric factors affecting the journal and its contribution to the field of palliative care research.
Material and Methods:
A software-assisted bibliometric analysis of the IJPC was conducted. The dimensions database was used to mine the bibliometric data of the journal from 1995 to 2022. A total of 1046 records were analysed using the VOSviewer and Biblioshiny by Bibliometrix software.
Results:
The analysis represented a vivid and graphically elaborate picture of the journal. It gives insight into the most productive and influential authors, countries, affiliations, sources and documents along with a picture of the network among them.
Conclusion:
This study highlights a gradual upward trend in the annual production of the journal. A strong connection of the IJPC could be seen with leading journals publishing in the field of palliative care globally.
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Affiliation(s)
- Rajashree Srivastava
- Department of Psychology, School of Liberal Education, Galgotias University, Greater Noida, Uttar Pradesh, India,
| | - Shikha Srivastava
- Department of Psychology, School of Liberal Education, Galgotias University, Greater Noida, Uttar Pradesh, India,
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Katta MR, Valisekka SS, Agarwal P, Hameed M, Shivam S, Kaur J, Prasad S, Bethineedi LD, Lavu DV, Katamreddy Y. Non-pharmacological integrative therapies for chronic cancer pain. J Oncol Pharm Pract 2022; 28:1859-1868. [DOI: 10.1177/10781552221098437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective Chronic pain is one of the most detrimental symptoms exhibited by cancer patients, being an indication for opioid therapy in up to half of the patients’ receiving chemotherapy and in 90% of advanced cases. Various successful non-pharmacological integrative therapy options have been explored and implemented to improve the quality of life in these patients. This review aims to highlight the mechanisms implicated; assessment tools used for cancer pain and summarize current evidence on non-pharmacological approaches in the treatment of chronic cancer pain. Data sources A review of the literature was conducted using a combination of MeSH keywords including “Chronic cancer pain,” “Assessment,” “Non-pharmacological management,” and “Integrative therapy.” Data summary Data on the approach and assessment of chronic cancer pain as well as non-pharmacological integrative options have been displayed with the help of figures and tables. Of note, non-pharmacological integrative management was divided into three subcategories; physical therapy (involving exercise, acupuncture, massage, and transcutaneous electric nerve stimulation), psychosocial therapy (e.g. mindful practices, supportive therapy), and herbal supplementation. Conclusions The use of non-pharmacological integrative therapy in the management of chronic cancer pain has been grossly underestimated and must be considered before or as an adjuvant of other treatment regimens to ensure appropriate care.
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Affiliation(s)
| | | | - Pahel Agarwal
- Bhaskar Medical College, Hyderabad, Telangana, India
| | - Maha Hameed
- AlFaisal University, College of Medicine, Riyadh, Kingdom of Saudi Arabia
| | - Swadha Shivam
- Bhaskar Medical College, Hyderabad, Telangana, India
| | | | - Sakshi Prasad
- Faculty of Medicine, National Pirogov Memorial Medical University, Vinnytsya, Ukraine
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Cabrini-Back D, Clark C. Does palliative care education lead to a change in the attitudes and beliefs of pre-registration Physiotherapy students about palliative care: a literature review. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2021.2000277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- David Cabrini-Back
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, Dorset, UK
| | - Carol Clark
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, Dorset, UK
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Ortiz-Campoy S, Lirio-Romero C, Romay-Barrero H, Álvarez DMC, López-Muñoz P, Palomo-Carrión R. The Role of Physiotherapy in Pediatric Palliative Care: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2021; 8:1043. [PMID: 34828756 PMCID: PMC8617633 DOI: 10.3390/children8111043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/09/2021] [Accepted: 11/09/2021] [Indexed: 11/25/2022]
Abstract
Pediatric palliative care (PPC) is a set of actions aimed at children who suffer from a severe or life-threatening disease to alleviate the symptoms of the disease and improve the quality of life of both the child and his/her family. One of the tools used to control symptoms is physiotherapy; however, its application in the child population has not been thoroughly studied. The main objective of this study was to gather, analyze, and critically evaluate the available scientific evidence on physiotherapy in children who require palliative care through a systematic review of the studies published in the last 10 years in the following databases: PubMed, Cochrane Library, PEDro, CINAHL, and Scopus. Of a total of 622 studies, the inclusion criteria were only met by seven articles, which were focused on the relationship between physiotherapy and PPC. This study analyzed: (1) the main pathologies treated, with a predominance of cerebral palsy and cancer; (2) the interventions applied, such as respiratory physiotherapy, neurological physiotherapy, therapeutic massage, and virtual reality; (3) the effects achieved in the child and his/her family, highlighting the control of symptoms and the improvement of the quality of life; and (4) the knowledge of the physiotherapists on PPC, observing that most of the professionals had not received training in this scope. The findings of this review indicate a lack of an adequate evidence foundation for physiotherapy in PPC.
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Affiliation(s)
| | - Cristina Lirio-Romero
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, 45071 Toledo, Spain; (H.R.-B.); (D.M.-C.Á.); (P.L.-M.); (R.P.-C.)
- Group of Researching in Physiotherapy in Toledo, GIFTO, 45071 Toledo, Spain
- Pediatric-Unit, Hemi-Child-Research (GIFTO), UCLM, 45071 Toledo, Spain
| | - Helena Romay-Barrero
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, 45071 Toledo, Spain; (H.R.-B.); (D.M.-C.Á.); (P.L.-M.); (R.P.-C.)
| | - David Martín-Caro Álvarez
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, 45071 Toledo, Spain; (H.R.-B.); (D.M.-C.Á.); (P.L.-M.); (R.P.-C.)
- Group of Researching in Physiotherapy in Toledo, GIFTO, 45071 Toledo, Spain
| | - Purificación López-Muñoz
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, 45071 Toledo, Spain; (H.R.-B.); (D.M.-C.Á.); (P.L.-M.); (R.P.-C.)
- Group of Researching in Physiotherapy in Toledo, GIFTO, 45071 Toledo, Spain
- Pediatric-Unit, Hemi-Child-Research (GIFTO), UCLM, 45071 Toledo, Spain
| | - Rocío Palomo-Carrión
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, 45071 Toledo, Spain; (H.R.-B.); (D.M.-C.Á.); (P.L.-M.); (R.P.-C.)
- Group of Researching in Physiotherapy in Toledo, GIFTO, 45071 Toledo, Spain
- Pediatric-Unit, Hemi-Child-Research (GIFTO), UCLM, 45071 Toledo, Spain
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Schöngut-Grollmus N, Energici MA. Decisiones médicas en enfermedades raras: de su definición estadística a su comprensión social. SAUDE E SOCIEDADE 2021. [DOI: 10.1590/s0104-12902021200393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumen Este ensayo teórico pretende analizar las decisiones médicas en el caso de las enfermedades raras. Una decisión médica es un proceso que orienta la producción de un diagnóstico o un tratamiento de salud, utilizando la información y evidencia disponible, en el cual muchas veces se incorporan las preferencias de los pacientes. En el caso de las enfermedades comunes o frecuentes, existe información clara y disponible sobre las distintas alternativas frente a un problema de salud. En el caso de las enfermedades raras, que están estadísticamente definidas como aquellas patologías que tienen prevalencia inferior a 1:2000, no suelen existir tales alternativas. Por la cronicidad y gravedad que este tipo de patologías suelen revestir, la ausencia de posibilidades se convierte en un problema que tiene dimensiones sanitarias y sociales. En este sentido, este artículo propone una transición de una definición estadística de las enfermedades a una definición social, que permita a futuras investigaciones conocer y profundizar en los procesos y efectos sanitarios, psicológicos y sociales sobre las enfermedades raras y su padecimiento.
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Burke S, Utley A, Belchamber C, McDowall L. Physical Activity in Hospice Care: A Social Ecological Perspective to Inform Policy and Practice. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2020; 91:500-513. [PMID: 31990633 DOI: 10.1080/02701367.2019.1687808] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 10/24/2019] [Indexed: 06/10/2023]
Abstract
Purpose: Physical activity (PA) is increasingly being used in hospice care as a rehabilitation strategy to help patients manage symptoms and improve quality of life. However, little is known about how to design and deliver interventions that promote uptake and maintenance of PA in this population. Single-level approaches (i.e., psychological models) have primarily been used to study factors that influence PA engagement among patients with advanced, incurable disease and therefore offer a limited perspective on strategies that target changes beyond the individual level. This study explored perspectives on factors perceived important for influencing PA participation in hospice care using a social-ecological framework. Method: Patients (n = 27) and health providers (n = 5) from multiple hospices (n = 5) across the UK were involved in this study. Data were collected using focus group and individual semi-structured interviews and analyzed using a thematic framework approach. Results: Eight main themes were perceived to be important for influencing PA engagement at the individual, interpersonal, physical environment, community, and policy levels including: (1) PA as therapy; (2) apprehension about PA-induced harm; (3) group-based PA with peers; (4) supervised PA sessions; (5) limited facilities and access; (6) patient-centered approach; (7) lack of a strong PA culture and; (8) absence of a policy and guidance for PA provision. Conclusion: Hospice-based PA interventions that target multiple levels simultaneously may be more effective at successfully changing and sustaining patients' PA behavior. Study findings provide evidence-based recommendations that may facilitate the effective delivery of PA interventions in hospice care.
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Latorraca COC, Martimbianco ALC, Pachito DV, Torloni MR, Pacheco RL, Pereira JG, Riera R. Palliative care interventions for people with multiple sclerosis. Cochrane Database Syst Rev 2019; 10:CD012936. [PMID: 31637711 PMCID: PMC6803560 DOI: 10.1002/14651858.cd012936.pub2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND People with multiple sclerosis (MS) have complex symptoms and different types of needs. These demands include how to manage the burden of physical disability as well as how to organise daily life, restructure social roles in the family and at work, preserve personal identity and community roles, keep self-sufficiency in personal care, and how to be part of an integrated care network. Palliative care teams are trained to keep open full and competent lines of communication about symptoms and disease progression, advanced care planning, and end-of-life issues and wishes. Teams create a treatment plan for the total management of symptoms, supporting people and families on decision-making. Despite advances in research and the existence of many interventions to reduce disease activity or to slow the progression of MS, this condition remains a life-limiting disease with symptoms that impact negatively the lives of people with it and their families. OBJECTIVES To assess the effects (benefits and harms) of palliative care interventions compared to usual care for people with any form of multiple sclerosis: relapsing-remitting MS (RRMS), secondary-progressive MS (SPMS), primary-progressive MS (PPMS), and progressive-relapsing MS (PRMS) We also aimed to compare the effects of different palliative care interventions. SEARCH METHODS On 31 October 2018, we conducted a literature search in the specialised register of the Cochrane MS and Rare Diseases of the Central Nervous System Review Group, which contains trials from CENTRAL, MEDLINE, Embase, CINAHL, LILACS, Clinical trials.gov and the World Health Organization International Clinical Trials Registry Platform. We also searched PsycINFO, PEDro and Opengrey. We also handsearched relevant journals and screened the reference lists of published reviews. We contacted researchers in palliative care and multiple sclerosis. SELECTION CRITERIA Randomised controlled trials (RCTs) and cluster randomised trials were eligible for inclusion, as well as the first phase of cross-over trials. We included studies that compared palliative care interventions versus usual care. We also included studies that compared palliative care interventions versus another type of palliative interventions. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodological procedures. We summarised key results and certainty of evidence in a 'Summary of Finding' table that reported outcomes at six or more months of post-intervention. MAIN RESULTS Three studies (146 participants) met our selection criteria. Two studies compared multidisciplinary, fast-track palliative care versus multidisciplinary standard care while on a waiting-list control, and one study compared a multidisciplinary palliative approach versus multidisciplinary standard care at different time points (12, 16, and 24 weeks). Two were RCTs with parallel design (total 94 participants) and one was a cross-over design (52 participants). The three studies assessed palliative care as a home-based intervention. One of the three studies included participants with 'neurodegenerative diseases', with MS people being a subset of the randomised population. We assessed the risk of bias of included studies using Cochrane's 'Risk of Bias' tool.We found no evidence of differences between intervention and control groups in long-time follow-up (> six months post-intervention) for the following outcomes: mean change in health-related quality of life (SEIQoL - higher scores mean better quality of life; MD 4.80, 95% CI -12.32 to 21.92; participants = 62; studies = 1; very low-certainty evidence), serious adverse events (RR 0.97, 95% CI 0.44 to 2.12; participants = 76; studies = 1, 22 events, low-certainty evidence) and hospital admission (RR 0.78, 95% CI 0.24 to 2.52; participants = 76; studies = 1, 10 events, low-certainty evidence).The three included studies did not assess the following outcomes at long term follow-up (> six months post intervention): fatigue, anxiety, depression, disability, cognitive function, relapse-free survival, and sustained progression-free survival.We did not find any trial that compared different types of palliative care with each other. AUTHORS' CONCLUSIONS Based on the findings of the RCTs included in this review, we are uncertain whether palliative care interventions are beneficial for people with MS. There is low- or very low-certainty evidence regarding the difference between palliative care interventions versus usual care for long-term health-related quality of life, adverse events, and hospital admission in patients with MS. For intermediate-term follow-up, we are also uncertain about the effects of palliative care for the outcomes: health-related quality of life (measured by different assessments: SEIQoL or MSIS), disability, anxiety, and depression.
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Affiliation(s)
- Carolina OC Latorraca
- Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em SaúdeCochrane BrazilRua Borges Lagoa, 564 cj 63São PauloSPBrazil04038‐000
| | - Ana Luiza C Martimbianco
- Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em SaúdeCochrane BrazilRua Borges Lagoa, 564 cj 63São PauloSPBrazil04038‐000
| | - Daniela V Pachito
- Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em SaúdeCochrane BrazilRua Borges Lagoa, 564 cj 63São PauloSPBrazil04038‐000
| | - Maria Regina Torloni
- Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em SaúdeCochrane BrazilRua Borges Lagoa, 564 cj 63São PauloSPBrazil04038‐000
| | - Rafael L Pacheco
- Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em SaúdeCochrane BrazilRua Borges Lagoa, 564 cj 63São PauloSPBrazil04038‐000
| | | | - Rachel Riera
- Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em SaúdeCochrane BrazilRua Borges Lagoa, 564 cj 63São PauloSPBrazil04038‐000
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Sheehan KJ, Smith TO, Martin FC, Johansen A, Drummond A, Beaupre L, Magaziner J, Whitney J, Hommel A, Cameron ID, Price I, Sackley C. Conceptual Framework for an Episode of Rehabilitative Care After Surgical Repair of Hip Fracture. Phys Ther 2019; 99:276-285. [PMID: 30690532 PMCID: PMC8055063 DOI: 10.1093/ptj/pzy145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 08/24/2018] [Indexed: 12/23/2022]
Abstract
Researchers face a challenge when evaluating the effectiveness of rehabilitation after a surgical procedure for hip fracture. Reported outcomes of rehabilitation will vary depending on the end point of the episode of care. Evaluation at an inappropriate end point might suggest a lack of effectiveness leading to the underuse of rehabilitation that could improve outcomes. The purpose of this article is to describe a conceptual framework for a continuum-care episode of rehabilitation after a surgical procedure for hip fracture. Definitions are proposed for the index event, end point, and service scope of the episode. Challenges in defining the episode of care and operationalizing the episode, and next steps for researchers are discussed. The episode described is intended to apply to all patients eligible for entry to rehabilitation after hip fracture and includes most functional recovery end points. This framework will provide a guide for rehabilitation researchers when designing and interpreting evaluations of the effectiveness of rehabilitation after hip fracture. Evaluation of all potential care episodes facilitates transparency in reporting of outcomes, enabling researchers to determine the true effectiveness of rehabilitation after a surgical procedure for hip fracture.
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Affiliation(s)
- Katie J Sheehan
- Department of Population Health Sciences, School of Population Health and Environmental Sciences, King's College London, London SE1 1UL, United Kingdom,Please address all correspondence to Dr Sheehan at:
| | - Toby O Smith
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Antony Johansen
- Trauma Unit, University Hospital of Wales, Cardiff, United Kingdom
| | - Avril Drummond
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Lauren Beaupre
- Department of Physical Therapy and Division of Orthopaedic Surgery, University of Alberta, Edmonton, Canada
| | - Jay Magaziner
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Julie Whitney
- Department of Population Health Sciences, School of Population Health and Environmental Sciences, King's College London
| | - Ami Hommel
- Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia
| | - Iona Price
- Royal College of Physicians Patient and Carer Network, London, United Kingdom
| | - Catherine Sackley
- Department of Population Health Sciences, School of Population Health and Environmental Sciences, King's College London
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Morrow BM, Barnard C, Luhlaza Z, Naidoo K, Pitt S. Knowledge, attitudes, beliefs and experience of palliative care amongst South African physiotherapists. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2018; 73:384. [PMID: 30135908 PMCID: PMC6093105 DOI: 10.4102/sajp.v73i1.384] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 03/28/2017] [Indexed: 12/03/2022] Open
Abstract
Background Palliative care encompasses holistic management of patients and families facing life-threatening and life-limiting conditions. There is currently little known about South African physiotherapists’ palliative care knowledge, attitudes, beliefs, experience and training needs. Objectives To describe the amount and adequacy of palliative care training received by South African physiotherapists, and their interest, knowledge, attitudes, beliefs and experiences of palliative care. Methods This was a cross-sectional descriptive survey study of a convenience sample of physiotherapists, using an adapted Physical Therapy in Palliative Care-Knowledge, Attitudes, Beliefs and Experiences Scale (PTiPC-KABE Scale). Likert scale scores were converted to continuous data for analysis, presented as median (IQR). Seven universities were contacted to determine undergraduate palliative care curriculum content. Results A total of 303 participants (8.4% response rate) completed the questionnaire, and 289 responses were included (5.35% margin of error with 95% CI). Participants had 16 (6–27) years of experience, with 85.5% in private practice. About 66.7% and 79% of participants reported not receiving any training at undergraduate and postgraduate levels, respectively, with more than 80% expressing that training was inadequate at both levels. Universities (n = 4/7; 57.1%) reported a maximum 3 hours undergraduate palliative care training. Seventy-nine percent of respondents had clinical experience in providing palliative care; however ‘knowledge’ was the lowest scoring domain (56.3% (43.8%–62.5%). The ‘beliefs’ domain scored highest at 82.6% (69.6%–91.3%). Conclusion Many South African physiotherapists manage patients requiring palliative care, despite inadequate training and limited knowledge in this field. More under- and postgraduate learning opportunities should be made available for physiotherapists in the area of palliative care.
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Affiliation(s)
- Brenda M Morrow
- Paediatrics and Child Health, University of Cape Town, South Africa
| | - Charlotte Barnard
- Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| | - Zimkhitha Luhlaza
- Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| | - Kelisha Naidoo
- Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| | - Sarah Pitt
- Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
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Best Practices for Public Policies for Palliative Care Physical Therapy: A Critical Review of the Literature. REHABILITATION ONCOLOGY 2018. [DOI: 10.1097/01.reo.0000000000000090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Olsson Möller U, Stigmar K, Beck I, Malmström M, Rasmussen BH. Bridging gaps in everyday life - a free-listing approach to explore the variety of activities performed by physiotherapists in specialized palliative care. BMC Palliat Care 2018; 17:20. [PMID: 29378566 PMCID: PMC5789614 DOI: 10.1186/s12904-018-0272-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 01/16/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND A growing body of studies indicate benefits of physiotherapy for patients in palliative care, for symptom relief and wellbeing. Though physiotherapists are increasingly acknowledged as important members of palliative care teams, they are still an underutilized source and not fully recognized. The aim of this study was to explore the variety of activities described by physiotherapists in addressing the needs and problems of patients and their families in specialized palliative care settings. METHODS Using a free-listing approach, ten physiotherapists working in eight specialized palliative care settings in Sweden described as precisely and in as much detail as possible different activities in which patients and their families were included (directly or indirectly) during 10 days. The statements were entered into NVivo and analysed using qualitative content analysis. Statements containing more than one activity were categorized per activity. RESULTS In total, 264 statements, containing 504 varied activities, were coded into seven categories: Counteracting a declining physical function; Informing, guiding and educating; Observing, assessing and evaluating; Attending to signs and symptoms; Listening, talking with and understanding; Caring for basic needs; and Organizing, planning and coordinating. In practice, however, the activities were intrinsically interwoven. The activities showed how physiotherapists aimed, through care for the body, to address patients' physical, psychological, social and existential needs, counteracting the decline in a patient's physical function and wellbeing. The activities also revealed a great variation, in relation not only to what they did, but also to their holistic and inseparable nature with regard to why, how, when, where, with whom and for whom the activities were carried out, which points towards a well-adopted person-centred palliative care approach. CONCLUSIONS The study provides hands-on descriptions of how person-centred palliative care is integrated in physiotherapists' everyday activities. Physiotherapists in specialized palliative care help patients and families to bridge the gap between their real and ideal everyday life with the aim to maximize security, autonomy and wellbeing. The concrete examples included can be used in understanding the contribution of physiotherapists to the palliative care team and inform future research interventions and outcomes.
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Affiliation(s)
- U Olsson Möller
- Institute for Palliative Care, Lund University and Region Skåne, Lund, Sweden. .,Faculty of Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
| | - K Stigmar
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
| | - I Beck
- Institute for Palliative Care, Lund University and Region Skåne, Lund, Sweden.,Faculty of Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Faculty of Health Science, The Research Platform for Collaboration for Health, Kristianstad University, Kristianstad, Sweden
| | - M Malmström
- Institute for Palliative Care, Lund University and Region Skåne, Lund, Sweden.,Department of Clinical Sciences Lund, Surgery, Lund University, Skåne University Hospital, Lund, Sweden
| | - B H Rasmussen
- Institute for Palliative Care, Lund University and Region Skåne, Lund, Sweden.,Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
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Sujatha R, Jayagowri K. Assessment of Palliative Care Awareness among Undergraduate Healthcare Students. J Clin Diagn Res 2017; 11:JC06-JC10. [PMID: 29207739 DOI: 10.7860/jcdr/2017/29070.10684] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 07/05/2017] [Indexed: 11/24/2022]
Abstract
Introduction Palliative care knowledge is being given meager importance in the curriculum of medical and other allied medical sciences. It is vital that all health care practitioners including medical, pharmacy, physiotherapy and nursing are aware and apply the best principles of palliative care. Aim To assess the awareness of palliative care among undergraduate students of medical, nursing, pharmacy and physiotherapy. Materials and Methods The study population included total of 200 students. Among 200 students, 50 were from each of the colleges of medicine, nursing, pharmacy and physiotherapy. After obtaining informed consent, questionnaire was given. The questionnaire contained the sociodemographic profile and 35 statements under nine groups, for which the respondents were expected to answer one out of the three options (Yes, No, Don't know). The groups of statements deal with palliative care definition, its philosophy, communication issues, non-pain symptoms, medications use and context of application of palliative care. Results It was found that less than 20% of nursing students were unaware of palliative care. Among the undergraduates of college of pharmacy, more than 50% had no knowledge of palliative care. More than 80% of physiotherapy, nursing and medical students agree that death should occur without any pain or symptoms. The need of palliative care was well understood by more than 70% of students of physiotherapy, pharmacy, nursing and medical colleges. Conclusion Basic knowledge about palliative care was inadequate among the undergraduate students related to healthcare.
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Affiliation(s)
- Rajaragupathy Sujatha
- Assistant Professor, Department of Biochemistry, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Karthikeyan Jayagowri
- Undergraduate Student, Department of Biochemistry, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
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A Descriptive Report of Early Mobilization for Critically Ill Ventilated Patients with Cancer. REHABILITATION ONCOLOGY 2017; 35:144-150. [PMID: 28713659 DOI: 10.1097/01.reo.0000000000000070] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Early mobilization protocols have been successfully implemented to improve function in critically ill patients; however, no study has focused on the oncology population. OBJECTIVES To investigate the feasibility of early mobilization and describe the rehabilitation interventions and discharge outcomes in a cohort of critically ill patients with cancer. DESIGN Retrospective review. METHODS A retrospective analysis of patients with cancer who participated in occupational and physical therapy while on mechanical ventilation utilizing an institutional early mobilization protocol from June 2010 - July 2011, was completed. Demographic and clinical variables were abstracted, as well as occupational and physical therapy interventions. RESULTS A cohort of 42 cancer patients on mechanical ventilation in the mixed medical/surgical intensive care unit of a comprehensive cancer center received early mobilization during the study period. The majority of participants demonstrated improved cognitive and functional status from the intensive care unit to hospital discharge. There were no reported adverse events during the occupational and physical therapy sessions. Among the 30 hospital survivors, 53% required continued rehabilitation services in their home environment and 40% were transferred to a rehabilitation facility. LIMITATIONS Due to the small sample size, these findings are not generalizable to all critically ill cancer patients. There was no post-acute care follow-up of cognitive and physical functional performance. CONCLUSION Early mobilization appears feasible in addressing the cognitive and functional needs of oncology patients in the intensive care unit.
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Zalaf LR, Bianchim MS, Alveno DA. Assessment of knowledge in palliative care of physical therapists students at a university hospital in Brazil. Braz J Phys Ther 2017; 21:114-119. [PMID: 28460709 PMCID: PMC5537467 DOI: 10.1016/j.bjpt.2017.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/26/2016] [Accepted: 05/12/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In Brazil there are several challenges to reach a humanized health care. Among them is the well-known lack in academic education and training in palliative care field. This lack is mostly due to the modern medical care culture that prioritize curative medicine ahead of palliative care. As the goal of saving lives is rooted in medical training, death is still confronted as the main enemy of the health professionals. OBJECTIVE To analyze the knowledge of palliative care among the physical therapists of a University Hospital. METHOD This is a cross-sectional and descriptive study. The volunteers were physical therapists, who had worked in the hospital for more than six months, were included undergraduate students, experienced professionals and graduate students. A questionnaire with closed questions about palliative care was applied during the volunteers working hours. Data were analyzed descriptively. CONCLUSION We conclude that, the vast majority of the evaluated professionals presented basic palliative care knowledge, but not in palliative care core components. The palliative care practice seemed often guided by the knowledge acquired in other fields, always with an intuitive character. Therefore, we detected a lack in the physical therapist training regarding palliative care. Summarily, physical therapists should receive a general training in palliative care still as an undergraduate, for a more effective and consistent professional practice later on.
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Affiliation(s)
- Livia R Zalaf
- Hospital São Paulo, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
| | - Mayara S Bianchim
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFSP), Baixada Santista, Santos, SP, Brazil
| | - Daniel A Alveno
- Hospital São Paulo, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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Lizarondo L, Turnbull C, Kroon T, Grimmer K, Bell A, Kumar S, McEvoy M, Milanese S, Russell M, Sheppard L, Walters J, Wiles L. Allied health: integral to transforming health. AUST HEALTH REV 2017. [PMID: 26210992 DOI: 10.1071/ah15044] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objective South Australia is taking an innovative step in transforming the way its healthcare is organised and delivered to better manage current and future demands on the health system. In an environment of transforming health services, there are clear opportunities for allied health to assist in determining solutions to various healthcare challenges. A recent opinion piece proposed 10 clinician-driven strategies to assist in maximising value and sustainability of healthcare in Australia. The present study aimed to seek the perspectives of allied health clinicians, educators, researchers, policy makers and managers on these strategies and their relevance to allied health. Methods A survey of allied health practitioners was undertaken to capture their perspectives on the 10 clinician-driven strategies for maximising value and sustainability of healthcare in Australia. Survey findings were then layered with evidence from the literature. Results Highly relevant across allied health are the strategies of discontinuation of low value practices, targeting clinical interventions to those getting greatest benefit, active involvement of patients in shared decision making and self-management and advocating for integrated systems of care. Conclusions Allied health professionals have been involved in the South Australian healthcare system for a prolonged period, but their services are poorly recognised, often overlooked and not greatly supported in existing traditional practices. The results of the present study highlight ways in which healthcare services can implement strategies not only to improve the quality of patient outcomes, but also to offer innovative solutions for future, sustainable healthcare. The findings call for concerted efforts to increase the utilisation of allied health services to ensure the 'maximum value for spend' of the increasingly scarce health dollar. What is known about the topic? In medicine, clinician-driven strategies have been proposed to minimise inappropriate and costly care and maximise highly appropriate and less expensive care. These strategies were developed based on clinical experiences and with supporting evidence from scientific studies. What does this paper add? Major changes to the health system are required to slow down the growth in healthcare expenditure. This paper describes opportunities in which allied health practitioners can implement similar strategies not only to improve the quality of patient outcomes, but also to offer cost-effective solutions for a sustainable healthcare. What are the implications for practitioners? Allied health practitioners can provide solutions to healthcare challenges and assist in the transformation of healthcare in Australia. However, for this to happen, there should be concerted efforts to increase recognition of and support for the use of allied health services.
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Affiliation(s)
- Lucylynn Lizarondo
- International Centre for Allied Health Evidence (iCAHE), P4-18 City East Campus, University of South Australia, Adelaide, SA 5001, Australia. ; ; ; ; ; ;
| | - Catherine Turnbull
- Allied & Scientific Health Office (ASHO), SA Health, Level 5, 11 Hindmarsh Square, Adelaide, SA 5000, Australia.
| | - Tracey Kroon
- Allied & Scientific Health Office (ASHO), SA Health, Level 5, 11 Hindmarsh Square, Adelaide, SA 5000, Australia.
| | - Karen Grimmer
- International Centre for Allied Health Evidence (iCAHE), P4-18 City East Campus, University of South Australia, Adelaide, SA 5001, Australia. ; ; ; ; ; ;
| | - Alison Bell
- International Centre for Allied Health Evidence (iCAHE), P4-18 City East Campus, University of South Australia, Adelaide, SA 5001, Australia. ; ; ; ; ; ;
| | - Saravana Kumar
- International Centre for Allied Health Evidence (iCAHE), P4-18 City East Campus, University of South Australia, Adelaide, SA 5001, Australia. ; ; ; ; ; ;
| | - Maureen McEvoy
- International Centre for Allied Health Evidence (iCAHE), P4-18 City East Campus, University of South Australia, Adelaide, SA 5001, Australia. ; ; ; ; ; ;
| | - Steve Milanese
- International Centre for Allied Health Evidence (iCAHE), P4-18 City East Campus, University of South Australia, Adelaide, SA 5001, Australia. ; ; ; ; ; ;
| | - Mary Russell
- International Centre for Allied Health Evidence (iCAHE), P4-18 City East Campus, University of South Australia, Adelaide, SA 5001, Australia. ; ; ; ; ; ;
| | - Lorraine Sheppard
- International Centre for Allied Health Evidence (iCAHE), P4-18 City East Campus, University of South Australia, Adelaide, SA 5001, Australia. ; ; ; ; ; ;
| | - Julie Walters
- International Centre for Allied Health Evidence (iCAHE), P4-18 City East Campus, University of South Australia, Adelaide, SA 5001, Australia. ; ; ; ; ; ;
| | - Louise Wiles
- International Centre for Allied Health Evidence (iCAHE), P4-18 City East Campus, University of South Australia, Adelaide, SA 5001, Australia. ; ; ; ; ; ;
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Putt K, Faville KA, Lewis D, McAllister K, Pietro M, Radwan A. Role of Physical Therapy Intervention in Patients With Life-Threatening Illnesses. Am J Hosp Palliat Care 2016; 34:186-196. [DOI: 10.1177/1049909115623246] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Physical therapy encompasses the skilled treatment and care for patients across the life span through a multitude of different practice settings. This includes caring for individuals within end-of-life or palliative care settings. The goal of treatment in this stage of care is to relieve physical, social, psychological, and spiritual suffering in order to improve overall quality of life in patients with terminal illnesses. There has been limited research conducted to investigate the utilization of physical therapy interventions in palliative care settings. Purpose: The purpose of this study was to contribute to the current research involving physical therapy and end-of-life care in terms of its efficacy, value, and how this value is perceived by patients and their caregivers. Methods: This was completed by independently screening and reviewing the studies that were published between the years 1994 and 2014 and related to this topic. The databases and journals searched included CINAHL, PUBMED, MEDLINE, Cochrane, PEDro, the Journal of Palliative Care, the American Journal of Hospice and Palliative Medicine, and Google Scholar. Results: Thirteen qualitative articles were selected which met all inclusion criteria and discussed the role of physical therapy intervention in the palliative care setting. Methodological quality of articles were assessed using the QASP, scale and their findings were summarized and presented in table format. Conclusion: These articles support the utilization of physical therapy in palliative care settings and emphasizes the impact of physical therapy on improving patients’ physical, social, and emotional well-being.
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Ángel García D, Martínez Nicolás I, Saturno Hernández PJ. «Abordaje clínico de la fibromialgia: síntesis de recomendaciones basadas en la evidencia, una revisión sistemática». ACTA ACUST UNITED AC 2016; 12:65-71. [DOI: 10.1016/j.reuma.2015.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 04/20/2015] [Accepted: 06/04/2015] [Indexed: 10/22/2022]
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Chandrasekaran B, Kumar SS, Sekar CS. Mobilization in Indian intensive care units: Where do we stand? Indian J Crit Care Med 2015; 19:188-9. [PMID: 25810621 PMCID: PMC4366924 DOI: 10.4103/0972-5229.152782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Baskaran Chandrasekaran
- Department of Pulmonary and Critical Care Medicine, Peelamedu Samanaidu Govindarajulu Hospitals, Coimbatore, Tamil Nadu, India
| | - Senthil S Kumar
- Department of Pulmonary and Critical Care Medicine, Peelamedu Samanaidu Govindarajulu Hospitals, Coimbatore, Tamil Nadu, India
| | - Chandra S Sekar
- Department of Pulmonary and Critical Care Medicine, Peelamedu Samanaidu Govindarajulu Hospitals, Coimbatore, Tamil Nadu, India
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Chiarelli PE, Johnston C, Osmotherly PG. Introducing Palliative Care into Entry-Level Physical Therapy Education. J Palliat Med 2014; 17:152-8. [DOI: 10.1089/jpm.2013.0158] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Pauline E. Chiarelli
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Catherine Johnston
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Peter G. Osmotherly
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
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Silver JK, Baima J, Mayer RS. Impairment-driven cancer rehabilitation: an essential component of quality care and survivorship. CA Cancer J Clin 2013; 63:295-317. [PMID: 23856764 DOI: 10.3322/caac.21186] [Citation(s) in RCA: 247] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 03/18/2013] [Accepted: 03/18/2013] [Indexed: 02/06/2023] Open
Abstract
Adult cancer survivors suffer an extremely diverse and complex set of impairments, affecting virtually every organ system. Both physical and psychological impairments may contribute to a decreased health-related quality of life and should be identified throughout the care continuum. Recent evidence suggests that more cancer survivors have a reduced health-related quality of life as a result of physical impairments than due to psychological ones. Research has also demonstrated that the majority of cancer survivors will have significant impairments and that these often go undetected and/or untreated, and consequently may result in disability. Furthermore, physical disability is a leading cause of distress in this population. The scientific literature has shown that rehabilitation improves pain, function, and quality of life in cancer survivors. In fact, rehabilitation efforts can ameliorate physical (including cognitive) impairments at every stage along the course of treatment. This includes prehabilitation before cancer treatment commences and multimodal interdisciplinary rehabilitation during and after acute cancer treatment. Rehabilitation appears to be cost-effective and may reduce both direct and indirect health care costs, thereby reducing the enormous financial burden of cancer. Therefore, it is critical that survivors are screened for both psychological and physical impairments and then referred appropriately to trained rehabilitation health care professionals. This review suggests an impairment-driven cancer rehabilitation model that includes screening and treating impairments all along the care continuum in order to minimize disability and maximize quality of life.
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Affiliation(s)
- Julie K Silver
- Associate Professor, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA
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Kumar SP, Prasad K, Kumar VK, Shenoy K, Sisodia V. Mechanism-based Classification and Physical Therapy Management of Persons with Cancer Pain: A Prospective Case Series. Indian J Palliat Care 2013; 19:27-33. [PMID: 23766592 PMCID: PMC3680836 DOI: 10.4103/0973-1075.110225] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Context: Mechanism-based classification (MBC) was established with current evidence and physical therapy (PT) management methods for both cancer and for noncancer pain. Aims: This study aims to describe the efficacy of MBC-based PT in persons with primary complaints of cancer pain. Settings and Design: A prospective case series of patients who attended the physiotherapy department of a multispecialty university-affiliated teaching hospital. Material and Methods: A total of 24 adults (18 female, 6 male) aged 47.5 ± 10.6 years, with primary diagnosis of heterogeneous group of cancer, chief complaints of chronic disabling pain were included in the study on their consent for participation The patients were evaluated and classified on the basis of five predominant mechanisms for pain. Physical therapy interventions were recommended based on mechanisms identified and home program was prescribed with a patient log to ensure compliance. Treatments were given in five consecutive weekly sessions for five weeks each of 30 min duration. Statistical Analysis Used: Pre–post comparisons for pain severity (PS) and pain interference (PI) subscales of Brief pain inventory-Cancer pain (BPI-CP) and, European organization for research and treatment in cancer-quality of life questionnaire (EORTC-QLQ-C30) were done using Wilcoxon signed-rank test at 95% confidence interval using SPSS for Windows version 16.0 (SPSS Inc, Chicago, IL). Results: There were statistically significant (P < 0.05) reduction in pain severity, pain interference and total BPI-CP scores, and the EORTC-QLQ-C30. Conclusion: MBC-PT was effective for improving BPI-CP and EORTC-QLQ-C30 scores in people with cancer pain.
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Affiliation(s)
- Senthil P Kumar
- Department of Physiotherapy, Kasturba Medical College, Manipal University, Mangalore, India
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Veqar Z. The perspectives on including palliative care in the Indian undergraduate physiotherapy curriculum. J Clin Diagn Res 2013; 7:782-6. [PMID: 23730677 DOI: 10.7860/jcdr/2013/4637.2913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 12/04/2012] [Indexed: 11/24/2022]
Abstract
According to the guidelines which were published by WHO in 2008, palliative care has been defined as "An approach that improves the quality of life of the patients and their families who face the problems which are associated with life-threatening illnesses, through the prevention and relief of suffering by means of an early identification, an impeccable assessment and the treatment of pain and other problems, physical, psychosocial and spiritual". The intervention which is provided as a part of the palliative care has to be provided by health professionals who strictly work as a part of multidisciplinary team and have been specifically trained to an optimal level of competency in the field. The impairment of the physical function and pain are two key problem areas in palliative care, which a physiotherapist deals with. Is a physiotherapist who is trained in India, trained to work as an efficient member of the team in this field? THIS ARTICLE DEALS WITH THE FOLLOWING: What is palliative care and what is its importance?A multidisciplinary approach to palliative careThe scenario of palliative care in IndiaThe role of physiotherapy in palliative care.The current scenario of physiotherapy education vis a vis palliative care.
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Affiliation(s)
- Zubia Veqar
- Assistant Professor, Centre for Physiotherapy and Rehabilitation Sciences , Jamia Millia Islamia, New Delhi, India
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Cobbe S, Nugent K, Slattery S, Lynch M, Real S. A profile of hospice-at-home physiotherapy for community-dwelling palliative care patients. Int J Palliat Nurs 2013; 19:39-45. [PMID: 23354432 DOI: 10.12968/ijpn.2013.19.1.39] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | - Shirley Real
- Milford Care Centre, Castletroy, Limerick, Ireland
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Kumar SP, Sisodia V. An Exploratory Analysis of Levels of Evidence for Articles Published in Indian Journal of Palliative Care in the years 2010-2011. Indian J Palliat Care 2013; 19:170-9. [PMID: 24347908 PMCID: PMC3853396 DOI: 10.4103/0973-1075.121535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
CONTEXT Indian Journal of Palliative Care (IJPC) provides a comprehensive multidisciplinary evidence base for an evidence-informed clinical decision making. AIMS To analyze the levels of evidence of articles published in IJPC in the years 2010-2011. SETTINGS AND DESIGN Systematic review of palliative care journals. MATERIALS AND METHODS Systematic review of articles was done and was scored according to Center for Evidence-Based Medicine levels of evidence into any of the five grades. The articles were categorized based upon article type, number of authors, study approach, age focus, population focus, disease focus, goals of care, domains of care, models of care, and year of publication. STATISTICAL ANALYSIS USED All descriptive analysis was done using frequencies and percentiles, and association between all categorical variables was done using Chi-square test at 95% confidence interval (CI) using Statistical Package for Social Sciences (SPSS) version 16 for Windows (SPSS Inc, Chicago, IL). RESULTS There was a greater prevalence of low level evidence (level 4: n = 46, 51%; level 5: n = 35, 39%) among the 90 selected articles, and article type (original articles with higher level of evidence, P = 0.000), article approach (analytical studies with higher level of evidence, P = 0.000), domains of palliative care (practice-related studies with higher level of evidence, P = 0.000) and models of care (biological or psychosocial model with higher level of evidence, P = 0.044) had a significant association with the grade of levels of evidence. Association with other factors was not statistically significant (P < 0.05). CONCLUSIONS The levels of research evidence for palliative care provided by articles published in IJPC were predominantly level 4 and level 5, and there is scope for more high quality evidence to inform palliative care decisions in the developing countries.
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Affiliation(s)
- Senthil Paramasivam Kumar
- Srinivas College of Physiotherapy, Pandeshwar, Mangalore, India,Address for correspondence: Dr. Senthil P Kumar E-mail:
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Campbell L. Men’s experiences delivering palliative home health care in rural South Africa:an exploratory study. Int J Palliat Nurs 2012; 18:612-8. [DOI: 10.12968/ijpn.2012.18.12.612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Laura Campbell
- School of Education, University of KwaZulu-Natal, Durban, South Africa
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Kumar SP. Reporting of "quality of life": a systematic review and quantitative analysis of research publications in palliative care journals. Indian J Palliat Care 2012; 18:59-67. [PMID: 22837613 PMCID: PMC3401736 DOI: 10.4103/0973-1075.97475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
CONTEXT Palliative care clinical practice depends upon an evidence-based decision-making process which in turn is based upon current research evidence. One of the most important goals in clinical palliative care is to improve patients' quality of life (QoL). AIM This study aimed to perform a quantitative analysis of research publications in palliative care journals for reporting characteristics of articles on QoL. SETTINGS AND DESIGN This was a systematic review of palliative care journals. MATERIALS AND METHODS Twelve palliative care journals were searched for articles with "QoL" in the title of the articles published from 2006 to 2010. The reporting rates of all journals were compared. The selected articles were categorized into assessment and treatment, and subsequently grouped into original and review articles. The original articles were subgrouped into qualitative and quantitative studies, and the review articles were grouped into narrative and systematic reviews. Each subgroup of original article category was further classified according to study designs. STATISTICAL ANALYSIS USED Descriptive analysis using frequencies and percentiles was done using SPSS for Windows, version 11.5. RESULTS The overall reporting rate among all journals was 1.95% (71/3634), and Indian Journal of Palliative Care (IJPC) had the highest reporting rate of 5.08% (3/59), followed by Palliative Medicine (PM) with 3.71% (20/538), and Palliative and Supportive Care (PSC) with 3.64% (9/247) reporting. CONCLUSIONS The overall reporting rate for QoL articles in palliative care journals was 1.95% and there were very few randomized clinical trials and systematic reviews found. The study findings indicate further high-quality research to establish an adequate evidence base for QoL.
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Affiliation(s)
- Senthil P Kumar
- Department of Physiotherapy, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
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Kumar SP. Cancer Pain: A Critical Review of Mechanism-based Classification and Physical Therapy Management in Palliative Care. Indian J Palliat Care 2011; 17:116-26. [PMID: 21976851 PMCID: PMC3183600 DOI: 10.4103/0973-1075.84532] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Mechanism-based classification and physical therapy management of pain is essential to effectively manage painful symptoms in patients attending palliative care. The objective of this review is to provide a detailed review of mechanism-based classification and physical therapy management of patients with cancer pain. Cancer pain can be classified based upon pain symptoms, pain mechanisms and pain syndromes. Classification based upon mechanisms not only addresses the underlying pathophysiology but also provides us with an understanding behind patient's symptoms and treatment responses. Existing evidence suggests that the five mechanisms – central sensitization, peripheral sensitization, sympathetically maintained pain, nociceptive and cognitive-affective – operate in patients with cancer pain. Summary of studies showing evidence for physical therapy treatment methods for cancer pain follows with suggested therapeutic implications. Effective palliative physical therapy care using a mechanism-based classification model should be tailored to suit each patient's findings, using a biopsychosocial model of pain.
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Affiliation(s)
- Senthil P Kumar
- Department of Physiotherapy, Kasturba Medical College, Manipal University, Mangalore, India
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Kumar SP, Jim A, Sisodia V. Effects of Palliative Care Training Program on Knowledge, Attitudes, Beliefs and Experiences Among Student Physiotherapists: A Preliminary Quasi-experimental Study. Indian J Palliat Care 2011; 17:47-53. [PMID: 21633621 PMCID: PMC3098543 DOI: 10.4103/0973-1075.78449] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Physiotherapists play an inherent role in the multidisciplinary palliative care team. Existing knowledge, attitudes, beliefs and experiences influence their team participation in palliative care. Aims: The objective of this study was to assess the changes in knowledge, attitudes, beliefs and experiences among student physiotherapists who attended a palliative care training program. Settings and Design: Preliminary quasi-experimental study design, conducted at an academic institution. Materials and Methods: Fifty-two student physiotherapists of either gender (12 male, 40 female) of age (20.51±1.78 years) who attended a palliative care training program which comprised lectures and case examples of six-hours duration participated in this study. The study was performed after getting institutional approval and obtaining participants’ written informed consent. The lecture content comprised WHO definition of palliative care, spiritual aspects of life, death and healing, principles, levels and models of palliative care, and role of physiotherapists in a palliative care team. The physical therapy in palliative care-knowledge, attitudes, beliefs and experiences scale (PTiPC-KABE Scale)- modified from palliative care attitudes scale were used for assessing the participants before and after the program. Statistical Analysis: Paired t-test and Wilcoxon signed rank test at 95% confidence interval using SPSS 11.5 for Windows. Results: Statistically significant differences (P<0.05) were noted for all four subscales- knowledge (7.84±4.61 points), attitudes (9.46±8.06 points), beliefs (4.88±3.29 points) and experiences (15.8±11.28 points) out of a total score of 104 points. Conclusions: The focus-group training program produced a significant positive change about palliative care in knowledge, attitudes, beliefs and experiences among student physiotherapists.
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Affiliation(s)
- Senthil P Kumar
- Department of Physiotherapy, Kasturba Medical College (Manipal University), Mangalore, India
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Kumar SP, Saha S. Mechanism-based Classification of Pain for Physical Therapy Management in Palliative care: A Clinical Commentary. Indian J Palliat Care 2011; 17:80-6. [PMID: 21633629 PMCID: PMC3098553 DOI: 10.4103/0973-1075.78458] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Pain relief is a major goal for palliative care in India so much that most palliative care interventions necessarily begin first with pain relief. Physical therapists play an important role in palliative care and they are regarded as highly proficient members of a multidisciplinary healthcare team towards management of chronic pain. Pain necessarily involves three different levels of classification–based upon pain symptoms, pain mechanisms and pain syndromes. Mechanism-based treatments are most likely to succeed compared to symptomatic treatments or diagnosis-based treatments. The objective of this clinical commentary is to update the physical therapists working in palliative care, on the mechanism-based classification of pain and its interpretation, with available therapeutic evidence for providing optimal patient care using physical therapy. The paper describes the evolution of mechanism-based classification of pain, the five mechanisms (central sensitization, peripheral neuropathic, nociceptive, sympathetically maintained pain and cognitive-affective) are explained with recent evidence for physical therapy treatments for each of the mechanisms.
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Affiliation(s)
- Senthil P Kumar
- Department of Physiotherapy, Kasturba Medical College, Manipal University, Mangalore, India
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