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Masters Degrees (Physiotherapy)

Permanent URI for this collectionhttps://hdl.handle.net/10413/6754

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Browsing Masters Degrees (Physiotherapy) by Author "Nadasan, Thayananthee."

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    Investigating occupational risk factors of low back pain and related disability among patients attending a private physiotherapy practice in Gaborone, Botswana.
    (2018) Chihumbiri, Noreen Vimbiso.; Nadasan, Thayananthee.
    Globally, low back pain (LBP) is regarded as the most common cause of occupational illness, job- related disability and absenteeism from work. The presence of LBP in the working age is a great cause for concern, as it is this population that contributes greatly to the productivity and economic viability of a country. However, in order to effect meaningful changes, such as formulating primary prevention and subsequent management strategies aimed at curbing the rising burden of occupational LBP, it is necessary to understand the physical activities that workers are frequently exposed to in the work place that put them at risk of developing LBP. Botswana is largely dependent on the working age population to drive its economy therefore necessitating introductory research, as reported in various industries on occupational risk factors that may hamper optimal worker participation. This research therefore aimed to determine the occupational risk factors and the resulting back-related disability in patients presenting with LBP to a private physiotherapy practice in Gaborone, Botswana. The objectives were fulfilled by using a structured, self–administered questionnaire to describe the demographics of the individuals, determine the extent of sickness absenteeism from work owing to LBP and to establish the resulting back-related disability through the Roland-Morris Disability Questionnaire (RDQ). Furthermore, the relationship between occupational risk factors and the level of back-related disability as well as the demographic profile of the study participants and the level of back-related disability were determined based on statistical analysis. The study was successful in establishing that the slight majority were females (52%) and the mean age of participants was 41 years. 35.3 percent of the study participants had between 10 to 19 years of work experience while 43.7 percent were classified as overweight. The results also reflect that minor LBP disability level was reported by 79.8% while 57.2 percent had missed between three to seven days of work in the previous year because of LBP. The occupational risk factors dynamic loads, static loads, repetitive loads, ergonomic environmental conditions, vibrations, prolonged standing, prolonged sitting, prolonged walking were significantly associated with LBP. The odds of having severe back-related disability are increased approximately 163 % for females (p-value= .043613). The presence of LBP and its associated disability in the working age, a population that drives the commercial hub of a nation, calls for recognition of this growing burden as a liability to the economic growth of Botswana. Investigating occupational factors of LBP would assist in making policies that address the different risk factors of LBP particularly in females and the 30 to 39 years age group as these are the commonly affected. In addition, emerging industries with increased risk of back-related disability can be prioritised in terms of ergonomic interventions as well as implementing health policies to help curb the escalating burden of LBP and facilitate optimal worker participation whose indefinite benefits would go a long way in enhancing the economy. Keywords: Low back pain, Risk factors, Disability, Occupational Health, Health Promotion
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    Rehabilitation service in the northern KwaZulu-Natal, uThungulu and service providers’ knowledge and attitudes towards public private partnerships.
    (2018) Mazibuko, Senzelwe Mfihlakalo.; Nadasan, Thayananthee.; Olagbegi, Oladapo Michael.
    Rehabilitation assists persons with disabilities attain physical independence and self-determination. In South Africa, the distribution of rehabilitation services is largely poor. Rehabilitation services in uThungulu District, KwaZulu-Natal are covered by the public sector. The uThungulu public health sector provides limited rehabilitation services, with physiotherapists working in multidisciplinary teams. Consequently, achieving rehabilitation goals of functional independence is affected. Public and private rehabilitation service providers working together can help to combat this problem. Furthermore, rehabilitation services are unevenly distributed in rural uThungulu. This study explores current rehabilitation service provision practices in uThungulu and the possibility of Public Private Partnerships (PPPs). A sample of 50(37 public and 13 private) rehabilitation service providers were interviewed; using a mixed methods exploratory case study. Through the use of focus groups, individual interviews and questionnaires, participants were requested information on their perception of the availability, accessibility and equitability of rehabilitation services in uThungulu district. The knowledge and attitude service providers had towards PPPs were also explored. Rehabilitation practitioners reported poor rehabilitation service provision in uThungulu due to the poor socio-economic circumstance of uThungulu, limited multidisciplinary rehabilitation service providers and poor delivery of rehabilitation services. Sixty-four percent of the participants reported that their rehabilitation was not sufficient. Ninety-two percent of the participants reported working in a multidisciplinary team however human resource shortages were also reported resulting in institutions being constantly short-staffed. Sixty-nine percent of the participants reported the non-availability of designated rehabilitation units in their institutions. Professionals working at institutions with designated rehabilitation units evaluated the effectiveness of the rehabilitation programme significantly more positively than those working at institutions without such designated units (U= 98.5, p=0.01). Participants stated that they receive an average of 5.37±4.79 rehabilitation referrals per day. Forty percent of the participants stated that rehabilitation sessions occur daily, with 38% of respondents reporting rehabilitation sessions lasting between 30 to 45 minutes. A moderate, positive correlation was found between participants’ perceptions of managerial support and perceived rehabilitation programme effectiveness (rs= 0.45, p=0.01). A weak, positive and statistically significant correlation between perceived effectiveness of rehabilitation programme and ease of administrative process was found (rs= 0.29, p= 0.04). Two thirds (66%) of the participants did not know about PPP and only a third (34%) knew about it. Rehabilitation service in uThungulu is provided predominantly in hospital departments and less so at community-based centres such as clinics. UThungulu’s rehabilitation services are multidisciplinary, but often with an incomplete quota of rehabilitation practitioners. Rehabilitation services were perceivednegatively by providers in the uThungulu District. These negative perceptions were due to a lack of equipment, the absence of designated rehabilitation units, human resource shortages, a lack of managerial support and cumbersome administrative processes. Furthermore, rehabilitation service providers perceived rehabilitation as insufficient and ineffective. Rehabilitation service providers in uThungulu were not aware of PPPs. The possible utilisation of PPPs as tools for adequate rehabilitation service provision thus could not be ascertained sufficiently. The few providers who were aware of PPPs reported a positive potential for PPPs as vehicles of rehabilitation service provision.