PHYSIOTHERAPY

Author: SERRANO GISBERT M. FRANCISCA.
Year: 2004.
University: MURCIA [More theses of this university] [www.um.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: UNIVERSIDAD DE MURCIA.

Summary: The overall objective of the investigation is to determine the factors related to the workplace, in the labor field of health care, they can influence the health of the physiotherapist. The welfare of working physiotherapist care has been considered the influence of factors of employment context, the presence / absence of skeletal muscle injury generated by the professional work, and the presence / absence of disorder in the context of diseases or syndromes adaptation to work. It has conducted a descriptive correlational study cross, which analyzed both in physical activities and in the emotional and relational, in which the physical therapist is involved in their work environment. Participants included 261 occupational therapists in the field of care in the communities of Murcia and Valencia, with average age of 34.67 years (DT = 10.45), and 64.4% of the female gender. We use a self-administered questionnaire divided into three parts: 1-consists of a series of questions about aspects of identification and socio-demographic variables. 2 - Questionnaire developed for the study with 52 items related to the workplace, such as physical environment, overload factors, availability of resources, organizational factors, personal factors and aspects of relations with superiors, peers, patients and higher. 3-Burnout Inventory (MBI) Maslach and Jacson (1981.1986), which includes 23 items for measuring work stress care. RESULTS Three quarters of physiotherapists welfare participants in the study, are in the public health system. The 29% of fisiioterapeutas has great experience with over 10 years in the job. In the workplace, factors overload adversely affect the organizational factors and the relationship with the superior and influence positively in relation to organizational stressors. Unavailability of influences on the resource and organizational stressors factors surcharges. Also, the perceived availability of resources having a positive impact on organizational factors. In the physical environment, lighting and temperature are seen as appropriate in the public health system and private, but the public system is considered the working environment noisy and distracting elements in hospitals, and little noisy and without distraction in health centers. The 86% of physiotherapists have physical discomfort to his workday ends, but continues to work. These professionals spercibenmas overload and stress, less availability of resources, worst relations with the upper and good relationships with patients. The 32% of the inconvenience relate to the regions of spine and upper limbs. In the private health sector, with workday more than 7 hours, the percentage of physical therapists who perceived discomfort at the end of the day is 96-5. The 27.5% of physiotherapists attends daily to a higher number of 20 patients. The overhead is higher in labor professionals who remain more than five hours in the same position, as well as those who use techniques orthopedic and neurological and treat between 10 and 20 patients a day. On the other hand, physiotherapists who make short rest periods between each patient, and that afectúan hygiene postural relaxation and to prevent lesio 8 tions, with 489 sideran who have more resources. Regarding the Burnot, 4% of fisioterapetuas active presents the three dimensions of the syndrome, 35.3% suffer from emotional exhaustion, and 20% suffer from either of the other two dimensions (depersonalization and low personal accomplishment). Likewise, the organizational factors and relations with the superior influence on the development of Burnout, especially in the dimensions of emotional exhaustion and low personal accomplishment.

Author: MESEGUER HENAREJOS ANA BELÉN.
Year: 2006.
University: MURCIA [More theses of this university] [www.um.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA. UNIVERSIDAD DE MURCIA.

Summary: The evaluation of the quality of health care has been based for a long time in the application of professional standards of scientific quality, and are now tending increasingly mainstream perception of quality of the patients. The source of data used for the evaluation of the scientific quality has been the medical records. However, in the presence of constraints, a new data source, the report user to evaluate whether certain professional standards diagnostic or therapeutic being implemented. Various reports have been developed in the medical field, however, no report has been developed in Physiotherapy. In connection with the assessment of the perceived quality, satisfaction surveys have been sources of data more employees. However, because they are little operational in the sense of identifying the underlying processes to the satisfaction or dissatisfaction of users, the user has been proposed as a possible source of information capable of providing objective information about the perceptions of patients on their experiences care. No report has to be done in Physiotherapy. In the absence of reports of Physiotherapy user to evaluate both the scientific and technical quality as perceived quality, this study has been undertaken with the following objectives: 1. Identify those aspects of care fisioterápica that patients with cervicalgia mechanical perceive as relevant. 2. To build and validate a tool in Physiotherapy capable of measuring the attributes associated with perceived quality for patients with cervicalgia. 3. To assess the validity and reliability of information provided by patients with cervicalgia on using physiotherapy interventions. 4. To describe and compare the frequency in which patients with cervicalgia perceive different aspects of the perceived quality. To achieve these objectives are used sequentially different methodological approaches. To identify aspects of care fisioterápica that patients perceive as relevant technology is used qualitative focus group. The results, together with a review of the scientific literature on the subject, guiding the selection process variables for the next study. Through a validation study, a questionnaire was obtained valid and reliable in measuring patients' perceptions regarding attributes attention fisioterápica related to the quality (organization, information, waiting time and expertise), being useful to identify specific problems. Regarding the scientific quality, patient physiotherapy is able to provide valid information regarding the implementation of some physical agents, such as infrared, traction, microwave and ultrasonic TENS, and most aspects of the selection and instruction the exercises. Through a cross-sectional descriptive analytical study has been observed variability in the levels of perceived quality among primary care centers with physiotherapy unit who participated in the study. It is advisable measures to improve global and common to all schools in relation to aspects relating to the Information and Professional, and specific to each institution in relation to Timeouts and Organization.

Author: MARTÍNEZ GONZÁLEZ MARIANO.
Year: 2006.
University: MURCIA [More theses of this university] [www.um.es].
Place of defense: FACULTAD DE MEDICINA, ODONTOLOGÍA Y FISIOTERAPIA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: Alterations musculo-esqueléticas in the back and neck show a marked prevalence in the adult population being the first back pain cause of disability in this population. The origin of these changes lies in the lack of adequate hygiene posture. Along the children will acquire the major behaviors that develops later, and the school therefore, the ideal place to promote the acquisition of healthy habits. OBJECTIVES 1-Evaluate the effectiveness of a program of physical therapy education for the care of the back and neck in escorales. 2-evaluate the psychometric properties of a questionnaire to apply knowledge of hygiene and care of the back. 3-Know the prevalence and characteristics of back and neck discomfort in primary school education, with shows in the municipality of Murcia, their knowledge of hygiene and postural variables that can relate to them. MATERIALS AND METHODS 603 schoolchildren from third to sixth in the first of two schools in the municipality of Murcia and surroundings were assigned to two groups, experimental (n = 314 schoolchildren, mean age = 9.46 years; dt = 1.26) and controls (n = 285 schoolchildren, mean age = 9.66 years; dt = 1.19). It assessed the effectiveness of a program fisioterapeútico educational, health posture, with 5 sessions of one hour's duration. Knowledge about hygiene postural were measured by a test of 29 items with 3 response options used with both groups before and after the intervention. A second study was conducted with a sample of 146 school children between 7 and 12 years (mean age = 9.90 years; dt = 1.12) to determine the prevalence of back and neck discomfort, and the level of knowledge on hygiene Postural. We administered a semi-structured interview, with information about the physical condition of the school, a history of back pain and neck, economic and educational level of parents, and so on. Knowledge about hygiene postural were evaluated with the questionnaire administered in the first study. RESULTS The experimental intervention to increase knowledge for the care of the back and neck has proved effective by comparing the results of the experimental group and control, being also the higher grades to the school that best retain this knowledge (p = 0000). Analysis of the psychometric properties of the test used for evaluating the skills of school shows an adequate reliability and validity. The factorial analysis of the four subscales which constitute the questionnaire knowledge about hygiene posture reflects the unidimensionalidad three of them, harvesting and transportation of weights, and attitudes and behaviors related to the recumbent position and the sedestación. A fourth subscale, postures and behaviors related bipedestación, precise increase its strength. The results of the second study, showing a prevalence of back pain and neck in children aged between 7 and 12 years of 30.1%, with a sore neck the most prevalent (47.73%). The level of knowledge about hygiene postulate of the sample is inadequate, since only 21.9% of school children responded correctly to 20 or more items of the 29 that make up the test postural hygiene, being related behaviors collection and transport pesos better-known ones. The variable gender, in favor of girls, says a relationship with the significant level of knowledge (p = 0035).