Background: The purpose of this study was to explore physiotherapists’ knowledge, attitude, and practice behavior in assessing and managing patients with non-specific, non-traumatic, acute- and subacute neck pain, with a focus on prognostic factors for chronification. Method: A qualitative study using in-depth semi-structured interviews was conducted with 13 physiotherapists working in primary care. A purposive sampling method served to seek the broadest perspectives. The knowledgeattitude and practice framework was used as an analytic lens throughout the process. Textual data were analyzed using qualitative content analysis with an inductive approach and constant comparison. Results: Seven main themes emerged from the data; physiotherapists self-estimated knowledge and attitude, role clarity, therapeutic relationship, internal- and external barriers to practice behavior, physiotherapists’ practice behaviors, and self-reflection. These findings are presented in an adjusted knowledge-attitude and practice behavior framework. Conclusion: A complex relationship was found between a physiotherapist’s knowledge about, attitude, and practice behavior concerning the diagnostic process and interventions for non-specific, non-traumatic, acute, and subacute neck pain. Overall, physiotherapists used a biopsychosocial view of patients with non-specific neck pain. Physiotherapists’ practice behaviors was influenced by individual attitudes towards their professional role and therapeutic relationship with the patient, and individual knowledge and skills, personal routines and habits, the feeling of powerlessness to modify patients’ external factors, and patients’ lack of willingness to a biopsychosocial approach influenced physiotherapists’ clinical decisions. In addition, we found self-reflection to have an essential role in developing self-estimated knowledge and change in attitude towards their therapeutic role and therapist-patient relationship.
MULTIFILE
OBJECTIVE: The aim of this study was to investigate whether dynamic balance, measured with the anterior component of the Star Excursion Balance Test (SEBT-ANT), is a risk factor for ankle injuries in physical education teacher education (PETE) students.DESIGN AND SETTING: A prospective monocentre study in first-year PETE students.PARTICIPANTS: A total of 196 subjects, of which 137 men (70%) and 59 women (30%).OUTCOME MEASURES: This study consisted of measures of the SEBT-ANT at baseline (September 2015) and an injury registration procedure during a follow-up period (September 2015-June 2016). The association between the SEBT-ANT score and subsequent ankle injury was analysed with generalised estimating equations analysis at the leg level.RESULTS: Men and women had an average SEBT-ANT score of, respectively, 65.1% and 67.7% of leg length. In 20 (15%) subjects, the first injured body site involved the ankle. Across all participants, a below average SEBT-ANT score was not associated with increased ankle injury odds (OR OR=2.43, 95% CI: 0.94 to 6.29, p=0.07). In men, a below average SEBT-ANT score indicated sevenfold increased odds for ankle injury (OR=7.06, 95% CI: 1.43 to 34.92, p=0.02). In women, this relationship was not significant (OR=0.72, 95% CI: 0.19 to 2.71, p=0.62).CONCLUSIONS: Below average normalised SEBT-ANT scores were associated with sevenfold likelihood for ankle injuries in men. In contrast, no relationship was found for the SEBT-ANT score and ankle injuries in woman. These results may provide directions for the implementation of screening tools, as part of an injury prevention programme, to identify male PETE students with an increased likelihood for ankle injuries.
NeuroDevelopmental Treatment (NDT) is the most used rehabilitation approach in the treatment of patients with stroke in the Western world today, despite the lack of evidence for its efficacy. The aim of this study was to conduct an intervention check and measure the nurses' competence, in positioning stroke patients according to the NDT approach. The sample consisted of 144 nurses in six neurological wards who were observed while positioning stroke patients according to the NDT approach. The nurses' combined mean competence scores within the wards was 195 (70%) of 280 (100%) possible, and for each ward the mean score varied between 181 (65%) and 206 (74%). This study indicates that nurses working in hospitals where the NDT approach has been implemented have the knowledge and skills to provide NDT nursing.
Ongeveer één op de vijf vrouwen die borstkanker overleven, ontwikkelen (lymf)oedeem. Oedeem is een ophoping van vocht in een lichaamsdeel en kan zeer ingrijpende gevolgen hebben voor het dagelijks leven. Behandelingen van oedeem worden uitgevoerd door bijvoorbeeld huid -en oedeemtherapeuten, (mammacare)verpleegkundigen, fysiotherapeuten en bandagisten. Vaak bestaan deze behandelingen uit een combinatie van manuele lymfedrainage (massagetechniek), lymfetaping en compressietherapie. De behandelingen van odeem zijn voor patiënten zeer pijnlijk, langdurig, intensief en kostbaar. Tevens is het geven van massagetechnieken voor fysiotherapeuten en oedeemtherapeuten lichamelijk zeer zwaar, wat resulteert in eerder ziekteverzuim en hogere zorgkosten. Daarnaast zijn deze behandelingen vooral gericht op armen en benen, en niet op de borst. Speciale compressie bh’s of inleg-pads die in de markt verkrijgbaar zijn werken onvoldoende of zijn zo volumineus dat dagelijks gebruik eigenlijk onmogelijk is. De focus van dit KIEM project ligt op het ontwikkelen van een innovatieve bh die oedeem na borstkanker kan beperken en/of voorkomen. De specifieke samenwerking tussen Bratelle, ISKO, Vechtstreek Fysiotherapie, Witte Vlinder Fysiotherapie en de lectoraten Verpleegkunde en Sustainable & Functional Textiles biedt nieuwe mogelijkheden en inzichten. Dit project kan een doorbraak betekenen voor innovatieve textielmaterialen met medische toepassingen, specifiek oedeem. Door gebruik te maken van hightech apparatuur op Saxion, kunnen nieuwe concepten of materialen ontwikkeld worden, die ‘op-schaalbaar’ zijn. Ook kunnen ontwikkelingen van speciale materialen in combinatie met confectietechnieken, tot nieuwe inzichten leiden. Daarnaast zetten we een onderzoeksplan op gericht op het meten van de werking van de bh, waarbij de rol van verschillende zorgprofessionals essentieel is. Tevens is het streven om het consortium verder uit te breiden met praktijkprofessionals en leveranciers van textielmaterialen.
