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K.-Y. Lin1,2, Y.-J. Tsai1,2, M.-H. Wu3,4
1National Cheng Kung University, Department of Physical Therapy, Tainan, Taiwan, 2National Cheng Kung University, Institute of Allied Health Sciences, Tainan, Taiwan, 3National Cheng Kung University, Department of Obstetrics and Gynecology, Tainan, Taiwan, 4National Cheng Kung University Hospital, Department of Obstetrics and Gynecology, Tainan, Taiwan
Background: As part of a multidisciplinary team in gynecologic and obstetric care, physical therapists play an important role in management of the physical and psychological symptoms during antepartum and postpartum period by providing advices on physical activity, teaching appropriate exercises including pelvic floor muscle training, treating musculoskeletal problems and giving specialized treatment (e.g. therapeutic ultrasound and massage). However, little is known about the physical therapists’ practice and beliefs toward management of pregnancy/postpartum-related disorders in Taiwan.
Purpose: (1) To explore physical therapists’ current practice, attitude and perception in the management of pregnancy/postpartum-related disorders in Taiwan, (2) to identify barriers/facilitators perceived by physical therapists to service provision in antepartum and postpartum care.
Methods: A descriptive, exploratory, cross-sectional study was conducted in registered physical therapists living in Taiwan. An anonymized online survey was designed and piloted. The survey included various sections about demographics, education, current work setting, experience of managing women with pregnancy/postpartum-related disorders, and perceived self-efficacy, attitudes, and barriers/facilitators to management of pregnancy/postpartum-related disorders. The survey was advertised widely on social media, via email to members of the Taiwan Corporation Aggregate National Federation of Associations of Physical Therapists, and through personal contacts and snowballing from March to August 2020. Data were analyzed using descriptive statistics including mean, frequency counts and percentages.
Results: A total of 278 physical therapists completed the questionnaires. The mean age of the respondents was 31 ± 8.3 years and 67% were female. The majority of respondents reported that they had graduated with a Bachelor degree (69.8%), had practiced physical therapy for more than 5 years (53%), and had been working in the hospital (38.5%). There were 49% who worked in Taipei. Of the 278 respondents, 38% had experience of treating pregnant or postpartum women in their clinical practice.
Of 106 respondents who had treated antepartum or postpartum women, the majority took referrals from Physical Medicine and Rehabilitation (39.3%), Orthopedic (25.2%) and Gynecology (17.2%). The most commonly treated pregnancy/postpartum-related disorder in practice was low back pain (59.4%). Content of physical therapy treatment for women with pregnancy/postpartum-related disorder varied. The respondents reported a mean treatment effect of 7±1.6 on a 0–10 scale (0 = no effect, 10 = completely effective).
Among all respondents, 34.6% reported that they were able to deal with the range of patient conditions which may be seen with an antepartum/postpartum caseload. The three most reported barriers were “lack of professional training” (27.9%), “insufficient knowledge” (23.8%), and “lack of opportunity to have patient contact” (22.4%). The most frequent facilitators were “knowledge and skill” (27.3%), “having a quiet and private room” (20.7%), and “sufficient time” (12.8%).
Of 106 respondents who had treated antepartum or postpartum women, the majority took referrals from Physical Medicine and Rehabilitation (39.3%), Orthopedic (25.2%) and Gynecology (17.2%). The most commonly treated pregnancy/postpartum-related disorder in practice was low back pain (59.4%). Content of physical therapy treatment for women with pregnancy/postpartum-related disorder varied. The respondents reported a mean treatment effect of 7±1.6 on a 0–10 scale (0 = no effect, 10 = completely effective).
Among all respondents, 34.6% reported that they were able to deal with the range of patient conditions which may be seen with an antepartum/postpartum caseload. The three most reported barriers were “lack of professional training” (27.9%), “insufficient knowledge” (23.8%), and “lack of opportunity to have patient contact” (22.4%). The most frequent facilitators were “knowledge and skill” (27.3%), “having a quiet and private room” (20.7%), and “sufficient time” (12.8%).
Conclusion(s): The majority of participating physical therapists indicated a positive attitude but were not confident in management of various pregnancy/postpartum-related disorder in practices. Several barriers to service provision were identified.
Implications: The findings of this study may be useful to inform and develop professional training courses related to antepartum and postpartum care in clinical practice through collaboration with all stakeholders.
Funding, acknowledgements: The study is funded by Ministry of Science and Technology (Taiwan) MOST 108-2314-B-006-103 -.
Keywords: physical therapy, pregnancy, postpartum
Topic: Professional practice: other
Did this work require ethics approval? Yes
Institution: National Cheng Kung University Hospital
Committee: Institutional Review Board of National Cheng Kung University Hospital
Ethics number: --/A-ER-108-221
All authors, affiliations and abstracts have been published as submitted.
