Physiotherapists In Ireland Research Articles

Patients’ perceptions and experience of hospital-based, student-led physiotherapy treatment interventions: A survey

BACKGROUND: Clinical education (CE) is an integral part of physiotherapy degree programmes. CE presents a unique learning opportunity for students to implement classroom-based teaching directly with patients and clients. Despite patients being central to CE, limited research exists around patients’ opinions of CE and the impact of student involvement in patient care. To our knowledge, there has been no study exploring patient perceptions of being treated by student physiotherapists in Ireland. OBJECTIVE: The aim of this study was to explore the perceptions and experiences of patients who have been assessed and treated by pre-registration MSc Physiotherapy students. METHODS: This was a cross-sectional survey study, involving both quantitative and qualitative content analysis. RESULTS: A total of 42 inpatient participants male n = 24 (57%) female n = 18 (43%) with 30 participants (71%) aged ≥70 were included in this study. All participants reported satisfaction with the treatment received by a student physiotherapist and reported they would avail of further treatments in the future. The benefits identified from interaction of participants with physiotherapy students included patient education and interpersonal skills. No disadvantages of being assessed and treated by a student physiotherapist were identified. Considerations for improvements identified included timing of physiotherapy sessions, frequency of sessions and the consideration of use of technology with patients. CONCLUSIONS: This study identified that all participants were very satisfied from receiving treatment interventions led by a student physiotherapist. Increased patient education and interpersonal skills were highlighted as key advantages from participants being assessed and treated by a student physiotherapist in clinical practice.

Informing low back pain care from the ground up: Survey of national musculoskeletal triage physiotherapists in Ireland

BackgroundHealthcare is changing to meet the challenge of a rising musculoskeletal burden associated with the expanding, aging population. Clinicians, important stakeholders in healthcare provision, have crucial insights into service improvement, but clinician consultation is a shortcoming in healthcare development. In Ireland, specialist physiotherapist-led musculoskeletal (MSK) triage services operate at the primary-secondary care interface to expedite patient care. ObjectivesTo inform future development of low back pain (LBP) care in Ireland through profiling the operationalisation of the national MSK triage service for LBP, including access, referral management, clinical investigations, onward referral options, access to multidisciplinary team (MDT) services and integration with primary healthcare services. DesignCross-sectional observational study using a bespoke, anonymous electronic survey. ParticipantsThirty-eight clinical specialist physiotherapists working in national programme Irish MSK triage services. ResultsThirty-eight MSK Triage physiotherapists submitted responses (response rate 72%). There was considerable site-dependent variation in LBP service provision, with discrepancies in access to triage services, wait times, referral processing and prioritisation, access to clinical investigations and onward referral options. Most respondents (81%) reported wait times exceeding the three-month target; 75% reported that the level of clinical autonomy associated with their role limited service efficiency; 75% were dissatisfied with primary-secondary care service integration. Respondents identified insufficient availability of primary care multidisciplinary services. ConclusionLack of standardisation of LBP services exists in Ireland. Services would benefit from improved standardisation, reduced wait times, national accreditation and a defined scope of advanced physiotherapy practice and the development of nationwide community multidisciplinary infrastructure with enhanced interservice communication.

Physiotherapists’ experience with online group exercise classes: A nationwide survey

INTRODUCTION: The Covid-19 pandemic provided a research opportunity to explore online group exercise programmes in larger numbers while restrictions on group gatherings were in place. An online survey was conducted with Irish Physiotherapists to ascertain their views on online group exercise programmes and the methods they employed to conduct their online classes in order to guide Physiotherapists with future care delivery. METHODS: A mixed-methods design was employed using a cross-sectional national online survey of Physiotherapists in Ireland. The survey collected both qualitative and quantitative data. Descriptive statistics were used to summarise the ordinal and continuous data and free-text responses were analysed using conventional content analysis. RESULTS: In total, 81 Physiotherapists completed the surveys. The majority of Physiotherapists (62%) feel a blended or hybrid model is the best option for the future. Convenience and decreased travel were cited as the main advantages of online classes. Physiotherapists cited in-person classes as being of higher teaching quality with improved safety and social interaction. Physiotherapists indicated that very little staff or technological resources were needed for their online classes and serious adverse events during the classes were extremely infrequent. CONCLUSION: Online group exercise programmes were well received by Physiotherapists, although the majority of those questioned believe a mixture of both online and in person exercise classes should be offered going forward.

Physiotherapist beliefs and perspectives on virtual reality-supported rehabilitation for the assessment and management of musculoskeletal shoulder pain: a focus group study protocol.

Shoulder pain accounts for a large proportion of musculoskeletal disorders and years lived with disability. Musculoskeletal shoulder pain is challenging to manage and while research evidence suggests that exercise should be a cornerstone of shoulder pain rehabilitation, the exact type and dosage of exercise is unclear. Adherence is a barrier to successful outcomes with exercise-based management of musculoskeletal pain, especially for those with co-morbidities, high pain levels and reported boredom associated with competing prescribed exercise. Virtual reality (VR) may offer an effective platform for rehabilitation of musculoskeletal shoulder pain. Virtual Reality has been shown to be effective for management of acute and chronic pain conditions, for delivering education around various health conditions, and for supporting rehabilitation of neurological conditions. Therefore, it is possible that VR may have a role in the delivery of exercise and education for individuals with musculoskeletal shoulder pain. VR intervention design should involve several steps and begin with establishing early acceptability from users as to the suitability of the technology in clinical practice as well as potential barriers and facilitators to using the technology successfully. This study will therefore aim to explore physiotherapists beliefs and perspectives of immersive VR as a platform for assessment and rehabilitation in patients with musculoskeletal shoulder pain. Further, this study will inform the development of a VR intervention for use in the rehabilitation of musculoskeletal shoulder pain. A series of online focus groups will be conducted with physiotherapists in Ireland using a qualitative descriptive approach to data analysis. A six-phase process of data analysis will be carried out to identify important patterns and themes within the data. The current study will be the first to explore clinician's perspectives on the role of VR in musculoskeletal practice.

Physiotherapist beliefs and perspectives on virtual reality–supported rehabilitation for the assessment and management of musculoskeletal shoulder pain: a focus group study protocol

Shoulder pain accounts for a large proportion of musculoskeletal disorders and years lived with disability. Musculoskeletal shoulder pain is challenging to manage and while research evidence suggests that exercise should be a cornerstone of shoulder pain rehabilitation, the exact type and dosage of exercise is unclear. Adherence is a barrier to successful outcomes with exercise-based management of musculoskeletal pain, especially for those with co-morbidities, high pain levels and reported boredom associated with competing prescribed exercise. Virtual reality (VR) may offer an effective platform for rehabilitation of musculoskeletal shoulder pain. Virtual Reality has been shown to be effective for management of acute and chronic pain conditions, for delivering education around various health conditions, and for supporting rehabilitation of neurological conditions. Therefore, it is possible that VR may have a role in the delivery of exercise and education for individuals with musculoskeletal shoulder pain. VR intervention design should involve several steps and begin with establishing early acceptability from users as to the suitability of the technology in clinical practice as well as potential barriers and facilitators to using the technology successfully. This study will therefore aim to explore physiotherapists beliefs and perspectives of immersive VR as a platform for assessment and rehabilitation in patients with musculoskeletal shoulder pain. Further, this study will inform the development of a VR intervention for use in the rehabilitation of musculoskeletal shoulder pain. A series of online focus groups will be conducted with physiotherapists in Ireland using a qualitative descriptive approach to data analysis. A six-phase process of data analysis will be carried out to identify important patterns and themes within the data. The current study will be the first to explore clinician’s perspectives on the role of VR in musculoskeletal practice.

Project ECHO: Enhancing palliative care for primary care occupational therapists and physiotherapists in Ireland.

Project ECHO (Extension for Community Healthcare Outcomes) uses videoconferencing technology to support and train healthcare professionals (HCPs) remotely. A 4-month fortnightly ECHO programme was developed and implemented to enhance palliative care provision by primary care therapists. Teaching and case-based discussions were facilitated by palliative care specialists. A mixed-methods cohort study was used to evaluate the project. ECHO participants completed pre- and post-programme questionnaires regarding their knowledge and skills across key palliative care domains. Focus groups were held before programme commencement to explore participants' attitudes and experiences of palliative care and after programme conclusion to explore their experiences of ECHO. Twenty-six primary care HCPs commenced the ECHO programme. Mean scores in self-rated confidence in knowledge and skill improved significantly(p<.002) following the programme. Twenty-one primary care HCPs completed the post-ECHO surveys and scores of self-rated confidence in knowledge and skills were significantly higher than pre-ECHO scores. Ninety-five percent of participants (n=19) reported ECHO met their learning needs and was an effective format to enhance clinical knowledge. Eighty-five percent of participants (n=17) would recommend ECHO to their colleagues. Project ECHO improved palliative care knowledge and skills of primary care HCPs in Ireland, with potential to address the growing need for integrated palliative care services.

Physiotherapist beliefs and perspectives on virtual reality–supported rehabilitation for the assessment and management of musculoskeletal shoulder pain: a focus group study protocol

Shoulder pain accounts for a large proportion of musculoskeletal disorders and years lived with disability. Musculoskeletal shoulder pain is challenging to manage and while research evidence suggests that exercise should be a cornerstone of shoulder pain rehabilitation, the exact type and dosage of exercise is unclear. Adherence is a barrier to successful outcomes with exercise-based management of musculoskeletal pain, especially for those with co-morbidities, high pain levels and reported boredom associated with competing prescribed exercise. Virtual reality (VR) may offer an effective platform for rehabilitation of musculoskeletal shoulder pain. VR has been shown to be effective for management of acute and chronic pain conditions, for delivering education around various health conditions, and for supporting rehabilitation of neurological conditions. Therefore, it is possible that VR may have a role in the delivery of exercise and education for individuals with musculoskeletal shoulder pain. VR intervention design should involve several steps and begin with establishing early acceptability from users as to the suitability of the technology in clinical practice as well as potential barriers and facilitators to using the technology successfully. This study will therefore aim to explore physiotherapists beliefs and perspectives of immersive VR as a platform for assessment and rehabilitation in patients with musculoskeletal shoulder pain. Further, this study will inform the development of a VR intervention for use in the rehabilitation of musculoskeletal shoulder pain. A series of online focus groups will be conducted with physiotherapists in Ireland using a qualitative descriptive approach to data analysis. A six-phase process of data analysis will be carried out to identify important patterns and themes within the data. The current study will be the first to explore clinician’s perspectives on the role of VR in musculoskeletal practice.

An investigation of the acute management of closed intra-articular fractures of the proximal interphalangeal joint in Ireland

PurposeMany treatment methods for intra-articular fractures of the proximal interphalangeal (PIP) joint are described in the literature without a consensus on the most effective approach. The purpose of this study was to investigate the methods of treatment of PIP joint fractures being used by trauma surgeons in the Republic of Ireland currently and the timing of referral to therapy.Design/methodology/approachA cross-sectional descriptive study methodology was used to survey trauma surgeons, occupational therapists and physiotherapists in Ireland. An online platform was used. A total of 21 surveys were returned by surgeons and 37 by therapists. Descriptive statistical analysis was used to present the results.FindingsBuddy strapping was reported as the primary treatment method for stable PIP joint fractures. All levels of fracture severity were reported to be treated using traction constructs, which include static and dynamic fixation and orthoses. Unstable fractures were managed using open reduction with internal fixation by 50 per cent of surgeons. Early timing of referral to therapy is reported by more surgeons than therapists. The majority of therapists indicated that they did not have the resources to see patients at the optimal time.Originality/valueTo the authors’ knowledge, this study provides the first description of the management of PIP joint fractures across the Irish health service. The findings of this study suggest that additional therapy resources are required within the health service executive to facilitate the desired early referral to therapy and to enable service development for this category of hand fractures.

A profile of physiotherapy supply in Ireland.

The lack of information on public and private physiotherapy supply in Ireland makes current and future resource allocation decisions difficult. This paper estimates the supply of physiotherapists in Ireland and profiles physiotherapists across acute and non-acute sectors, and across public and private practice. It examines geographic variation in physiotherapist supply, examining the implications of controlling for healthcare need. Physiotherapist headcounts are estimated using Health Service Personnel Census (HSPC) and Irish Society of Chartered Physiotherapists (ISCP) Register data. Headcounts are converted to whole-time equivalents (WTEs) using the HSPC and a survey of ISCP members to account for full- and part-time working practices. Non-acute supply per 10,000 population in each county is estimated to examine geographic inequalities and the raw population is adjusted in turn for a range of need indicators. An estimated 3172 physiotherapists were practising in Ireland in 2015; 6.8 physiotherapists per 10,000, providing an estimated 2620 WTEs. Females accounted for 74% of supply. Supply was greater in the non-acute sector; 1774 WTEs versus 846 WTEs in the acute sector. Physiotherapists in the acute sector were located mainly in publicly financed institutions (89%) with an even public/private split observed in the non-acute sector. Non-acute physiotherapist supply is unequally distributed across Ireland (Gini coefficient = 0.12; 95% CI 0.08-0.15), and inequalities remain after controlling for variations in healthcare needs across counties. The supply of physiotherapists in Ireland is 30% lower than the EU-28 average. Substantial inequality in the distribution of physiotherapists across counties is observed.

Musculoskeletal triage: The experiences of advanced practice physiotherapists in Ireland

Musculoskeletal triage: The experiences of advanced practice physiotherapists in Ireland

Physical activity and metastatic disease: the views of physiotherapists in Ireland

Physical activity and metastatic disease: the views of physiotherapists in Ireland

Management of headaches by physiotherapists in Ireland

Management of headaches by physiotherapists in Ireland

Perceptions of Leadership: Comparing Canadian and Irish Physiotherapists' Views.

Purpose: To contribute to the growing body of research on leadership in physiotherapy by comparing leadership-related perceptions of physiotherapists in Ireland and in Canada. Methods: This article compares the results of a survey of Canadian physiotherapists with those of the same survey administered to Irish physiotherapists. The results of both studies have previously been reported and are used here to allow a cultural comparison of the perceptions of physiotherapists. The present study used two-portion Z-tests to compare the percentage of physiotherapists in Ireland who self-declared as a leader with the percentage of physiotherapists in Canada who did so. Results: Physiotherapists in both Ireland and Canada most often rated communication and professionalism as extremely important characteristics. Physiotherapists in Canada were more likely than those in Ireland to perceive themselves as leaders (Z=2.67, p < 0.05; 95% CI: 1.33, 9.87). Factors associated with self-declaration as a leader differed between the two countries. Conclusion: Physiotherapists in Canada and Ireland showed both similarities and differences in their perceptions of leadership characteristics. Results from this study may aid the development of future leadership training programmes specifically targeted at physiotherapists.

An investigation into leadership and leadership development within the profession of physiotherapy in Ireland

Background:Health service reform, physiotherapy graduate unemployment and the impending introduction of state regulation mean that physiotherapists in Ireland are facing many challenges in this period of transition and development. Leadership is needed to ensure that the professionwill be able to continue to adapt to the demands and inevitable changes ahead. This is the first investigation into leadership and leadership development within the profession of physiotherapy in Ireland. Purpose: To investigate the perceptions of physiotherapists in Ireland of leadership and to explore their participation in leadership development training. Methods: In this cross-sectional nationwide study, an internet-based survey was administered via e-mail to members of the Irish Society of Chartered Physiotherapists (n= 2787). The original questionnaire was designed using information obtained through a literature review on leadership characteristics described in healthcare and business settings. Adaptations weremade to the original questionnaire to make it applicable to an Irish participant and additional questions were asked. The questionnaire asked participants to rate how important they perceive fifteen leadership qualities to be for physiotherapists in each of three settings–the workplace, the healthcare system and society, using a 5 point likert scale (1 = not at all important, 5 = extremely important). Participants were also asked to rate how important attaining a leadership position was to their overall sense of career success and if they had participated in any leadership development training. Chi-square analyses were performed to investigate factors associated with self-declaration as a leader and the importance placed on attaining a leadership position. Mann–Whitney U tests were used to compare the ratings of leadership characteristics across the three settings. Results: The response rate was 22% (n= 615) in keeping with other studies where physiotherapists have been surveyed. Over 74% of respondents perceived themselves to be a leader. Factors associated with self-declaration as a leader were time since graduation, highest qualification attained and leadership development training.Leadership trainingwas also associated with increased importance placed on achieving a leadership position. Some form of leadership training had been completed by 44% of respondents (24.2% formal training, 32.4% informal training). Communication and professionalism were the leadership characteristics most highly rated across the three settings. Leadership characteristics were consistently more highly rated in the workplace than in the healthcare system and society. Conclusion(s): The majority of respondents to this questionnaire perceived themselves to be leaders and rated attainment of a leadership position as important to their overall sense of career success. Physiotherapists who have had leadership development training weremore likely to perceive themselves to be leaders. Communication and professionalism were the leadership characteristic perceived to be most important to physiotherapists in Ireland. Development of communication skills and professional attributes should, therefore, be considered when designing leadership training initiatives appropriate to physiotherapists in Ireland. Implications: Leadership development opportunities should be offered to physiotherapists to aid them to demonstrate leadership both clinically and non-clinically. Further research is needed to explore the mode and content of leadership development training that would be most effective for physiotherapists.

Musculoskeletal triage: the experiences of advanced Practice Physiotherapists in Ireland

Musculoskeletal triage: the experiences of advanced Practice Physiotherapists in Ireland

Health promotion knowledge, attitudes and practices of chartered physiotherapists in Ireland: A national survey

Background: A growing emphasis is being placed on the role of health promotion in tackling chronic conditions faced by the health services. This research study sought to investigate the health promotion knowledge, attitudes and practices of chartered physiotherapists in Ireland, as it has been suggested that physiotherapists are particularly well positioned to engage in health promotion strategies in the 21st century. Methods: An online self-administered questionnaire, which had been modified from a previously established tool, was emailed to 2753 registered members of the Irish Society of Chartered Physiotherapists on two occasions. 526 completed surveys were returned giving a response rate of 19.1%. Data was analysed using PASW Statistics 18. Results: Physiotherapists hold a traditional view of health promotion relating it primarily to the provision of information and advice to bring about individual behaviour change. Self reported knowledge of the wider determinants of health and key action areas of health promotion was low. Physiotherapists displayed positive attitudes to their role in health promotion but identified significant barriers to its implementation in the form of time constraints, lack of health promotion training and patient attitudes. Conclusions: Collaboration must take place between the disciplines of health promotion and physiotherapy to ensure that clarity in both roles and terminology is established. Interventions to improve health are complex. Pre- and post-registration physiotherapy education should be reviewed to ensure that physiotherapists have the knowledge base and skill set required to successfully engage in health promotion action.

Use of Outcome Measures in Physiotherapy Practice in Ireland from 1998 to 2003 and Comparison to Canadian Trends

The purposes of this study were to examine changes in the use of standardized outcome measures by practising physiotherapists in Ireland and to compare those trends to the results of a similar survey conducted previously in Canada. A survey methodology was employed. The review of practice occurred at two points in time. Senior clinical physiotherapists working with older people participated. Questions were asked about the use of standardized outcome measures, the nature and pattern of their use, and the level of confidence the respondents had in using such measures. The results chart the changes in practice over a 5-year period. Although there was an increase in the use of standardized outcome measures, the respondents acknowledged barriers to their systematic use in routine practice (e.g., lack of time, resources/administrative support). There was a lack of professional consensus on what instruments to use in general, as well as which to use for particular client groups. Concern was expressed that none of the available instruments met their clients' needs. Where possible and appropriate, comparison was made between the data from the 2003 Irish study and a survey of Canadian physiotherapists conducted in 1998. This review of practice illustrates that changes that have occurred in Ireland in the use of standardized outcome measures are similar to those that have occurred in Canada, but barriers remain to their complete integration into clinical practice and clinical decision making.

The prevalence of violence encountered by community physiotherapists in Ireland

The aim of this study was to establish the prevalence of violence encountered by community physiotherapists in Ireland and to identify any influential factors pertaining to this issue. A self-administered questionnaire was sent to members of the Chartered Physiotherapists in Community Care Group. Seventy were returned (68 per cent). Fifty-one respondents (73 per cent) had experienced violent incidents while working in the community. All had experienced verbal aggression and ten had also experienced physical violence. Violent incidents were often perpetrated by a relative or friend.

Contra-indications to shortwave diathermy: survey of Irish physiotherapists

Background and purpose Minimal research has been completed on contra-indications to electrotherapy, but one study has reported that a large percentage of adverse effects occurred due to shortwave diathermy application. Since most contra-indications are primarily based on a common-sense approach rather than on evidence-based practice, it was decided to examine the level of agreement among physiotherapists in Ireland on the contra-indications to continuous and pulsed shortwave diathermy. Methods A questionnaire survey was carried out in all Irish hospital-based physiotherapy departments that use shortwave diathermy (41 departments). The participants were physiotherapists with 3 or more years post-qualification experience, working in these departments (74 respondents). They were asked to categorise 35 symptoms or conditions as either ‘always’, ‘sometimes’, or ‘never’ contra-indicated, or ‘don’t know’ whether contra-indicated for both continuous and pulsed shortwave diathermy. Results There was a 75% response rate to the study. Good (>90%) agreement was found among respondents for traditional contra-indications to both continuous shortwave diathermy (metal implants, pacemakers, malignancy, tuberculous joints, over the eyes) and pulsed shortwave diathermy (malignancy and pacemakers). Higher levels of agreement were evident in the continuous shortwave diathermy section compared to pulsed shortwave diathermy. The use of pulsed shortwave diathermy where metal implants were present and in the treatment of rheumatoid arthritis were considered to be priority areas for future research. Conclusions For safe and effective shortwave diathermy treatment, physiotherapists should be aware of all conditions or symptoms that contra-indicate treatment. Overall a lack of research-based evidence was found regarding most contra-indications to treatment.