Abstract
AbstractContext: Access to physical therapy (PT) services is sorely limited in many developing countries due to the constraints of poverty and regional insufficiency in the number of PT providers. Opportunities exist for physical therapists to participate in short term mobile medical mission (STMMM) efforts to provide PT services in many of those regions. However, there is a relative dearth of research regarding the utility of including PT services in STMMM endeavors.Objective: The aim of this study was to ascertain the impressions and recommendations of medical mission team members regarding the inclusion of PT services during a STMMM trip to underserved areas of Nicaragua.Methods: This was a qualitative description study conducted in 2014. Data were derived from interviews with STMMM participants and analyzed using conventional content analysis as described by Hsieh and Shannon.Results: Emergent themes included evidence of: (1) patient need for and benefit from PT services; (2) team member need for physical therapy services for trip related disorders; and (3) a high prevalence of patient orthopedic disorders related to strenuous activities of daily living. There were also a number of reported limitations in the delivery of PT services including: (1) language barriers; (2) lack of medical provider familiarity with PT capability; and (3) limited means of providing follow up care. Respondent recommendations included: (1) addition of more translators; (2) inclusion of additional treatment modalities; (3) utilization of Nicaraguan therapists or health care workers to facilitate patient follow up; and (4) the provision of a comprehensive screening program to improve identification of patients in need of PT services.Conclusion: This results of this study contributes to the understanding of corollaries associated with the addition of PT services to a STMMM and provides recommendations to improve PT services in that context. Additional research is needed to evaluate the soundness of participant responses and whether this information is transferable to STMMM efforts in other communities. Also, further research is needed to establish best PT practices in the STMMM context.
Highlights
The need to improve global health care is agonizingly evident but that mission is fraught with barriers
Qualitative description was used to address the research questions, “What are the observations of medical mission team members regarding the inclusion of physical therapy (PT) services on a mobile medical mission team to Nicaragua, and what are their recommendations for improvement in the delivery of those services?” Sandelowski purports that qualitative description is the ideal research method to facilitate a straightforward depiction of phenomena which was the goal of this study.[18]
Patients willingness to travel and wait in long lines for PT demonstrated the need for PT services (Respondent 001) “They come and they walk to get to this clinic; some parents walk up to an hour to get to the clinic
Summary
The need to improve global health care is agonizingly evident but that mission is fraught with barriers. In 2013, the WHO Global Health Observatory revealed that 83 primarily low income countries located in Central Africa, Southern Asia, Indonesia, and Central America fell below a density threshold of 22.8 skilled health professionals per 10,000 in population.[2]. This deleterious synergy of poverty and regional inadequacy of health care providers is a major factor in limiting access to rehabilitation services as well. A 2011 study by Gupta et al revealed similar findings of low and middle income countries having the greatest need for rehabilitation services and the least availability of skilled rehabilitation professionals.[5]
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