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Shakya NR1, Norderhaug TCH2, Stensdotter A-K3
1Kathmandu University School of Medical Sciences, Department of Physiotherapy, Dhulikhel, Nepal, 2Norwegian University of Science and Technology, NTNU, Department of Public Health and Nursing, Trondeim, Norway, 3Norwegian University of Science and Technology, NTNU, Faculty of Medicine and Health Sciences, Department of Neuromedicine and Movement Science, Trondheim, Norway
Background: The last decade there has been tremendous changes concerning health, both in the world and Nepal. According to statistics from the Nepal NCDI Poverty Commission National Report-2018, 51% of the DALYs (Disability Adjusted Life Years) are due to non-communicable diseases (NCDs).The largest proportions of DALYs were cardiovascular and respiratory diseases, followed by diabetes, which with addition of cancer account for 40% of the DALYs. Musculoskeletal and Neurological disorders contribute to 9% and 5% respectively, whereas injuries due to forces of nature and war, and transport add to 14% of the DALYs. Physiotherapy is recognized as an important service to manage NCDs, but it remains unknown whether physiotherapy in Nepal reaches those in need and those who would benefit from the service.
Purpose: To investigate characteristics and expectations of patients visiting physiotherapy outpatient department (OPD) in Dhulikhel Hospital. The OPD was established as a low threshold service for easy access to the general population visiting without referral.
Methods: A cross-sectional descriptive study, using survey interviews was conducted. The survey questions assessed demographic variables, reason for visiting the clinic (pain location, intensity, and duration), physical activity level, and expectation of treatment.100 patients, 57 women and 43 men were randomly and consecutively recruited to the study during one month. Descriptive statistics was used to identify characteristics of samples visiting clinic.
Results: Number of patients included amounted to 20% of the visiting patients during time of the study (N=508). Mean age was 40.11±13.44, women/men(57/43%), living in both rural and urban areas. Majority (43%) lacked proper or had no education(26%). Patients were mainly referred by doctors(74%). Predominant findings for physical activity weekly, were “never” (25%) and “rarely” (28%).Overweight (36%) and obesity (6%) was common. Pain was most common in lower back(34%) followed by knee(15%), hand(15%), hip(12%), upper back(11%), shoulder(11%), and heel (4%). 57% of patients waited for more than 3 weeks before seeking the treatment.The most common expectation from physiotherapy treatment was massage(46%),medicine/drugs(34%) and exercise(5%).
Conclusion(s): Results reveal that only a fraction of those in need of and who would benefit from physiotherapy according to the 2018 national report on NCDs, are reached by the service provided by the OPD. This fraction represents the 9% of musculoskeletal disorders, and possibly conditions due to accidents. A substantial part of those in other above mentioned categories are not reached by this service. Statistics on in-patients with NCDs admitted and receiving physiotherapy in the hospital and polyclinic was not included here.
Implications: Awareness level of what physiotherapy is, should to be improved in Nepal in order to reach those in need and those who would benefit from the service, in particular for health promotion and prevention. Future studies need to assess and identify the factors that promote or hinder physiotherapy as an effective tool to combat NCDs in the general population in Nepal.
Keywords: physiotherapy, outpatient department, patient characteristics
Funding acknowledgements: Norwegian University of Science and Technology (NTNU)
Purpose: To investigate characteristics and expectations of patients visiting physiotherapy outpatient department (OPD) in Dhulikhel Hospital. The OPD was established as a low threshold service for easy access to the general population visiting without referral.
Methods: A cross-sectional descriptive study, using survey interviews was conducted. The survey questions assessed demographic variables, reason for visiting the clinic (pain location, intensity, and duration), physical activity level, and expectation of treatment.100 patients, 57 women and 43 men were randomly and consecutively recruited to the study during one month. Descriptive statistics was used to identify characteristics of samples visiting clinic.
Results: Number of patients included amounted to 20% of the visiting patients during time of the study (N=508). Mean age was 40.11±13.44, women/men(57/43%), living in both rural and urban areas. Majority (43%) lacked proper or had no education(26%). Patients were mainly referred by doctors(74%). Predominant findings for physical activity weekly, were “never” (25%) and “rarely” (28%).Overweight (36%) and obesity (6%) was common. Pain was most common in lower back(34%) followed by knee(15%), hand(15%), hip(12%), upper back(11%), shoulder(11%), and heel (4%). 57% of patients waited for more than 3 weeks before seeking the treatment.The most common expectation from physiotherapy treatment was massage(46%),medicine/drugs(34%) and exercise(5%).
Conclusion(s): Results reveal that only a fraction of those in need of and who would benefit from physiotherapy according to the 2018 national report on NCDs, are reached by the service provided by the OPD. This fraction represents the 9% of musculoskeletal disorders, and possibly conditions due to accidents. A substantial part of those in other above mentioned categories are not reached by this service. Statistics on in-patients with NCDs admitted and receiving physiotherapy in the hospital and polyclinic was not included here.
Implications: Awareness level of what physiotherapy is, should to be improved in Nepal in order to reach those in need and those who would benefit from the service, in particular for health promotion and prevention. Future studies need to assess and identify the factors that promote or hinder physiotherapy as an effective tool to combat NCDs in the general population in Nepal.
Keywords: physiotherapy, outpatient department, patient characteristics
Funding acknowledgements: Norwegian University of Science and Technology (NTNU)
Topic: Human movement analysis
Ethics approval required: Yes
Institution: Kathmandu University School of Medical Sciences, Nepal
Ethics committee: Kathmandu University School of Medical Sciences-Institutional review committee
Ethics number: Ethical approval number: 118/16
All authors, affiliations and abstracts have been published as submitted.
