M. Charette1, J. King2, L. McLean2
1University of Ottawa, Population Health, Ottawa, Canada, 2University of Ottawa, Rehabilitation Sciences, Ottawa, Canada

Background: As we have observed unfortunately during the recent COVID-19 pandemic, all healthcare professionals are at a high risk of both acquiring and spreading infections. This includes physiotherapists working in pelvic health. If proper guidelines for infection control measures are lacking, there may be an increased risk of infection transmission. It is known that health-related behaviours are affected by knowledge, attitudes and practices.  Yet, no studies exploring these concepts have been conducted in pelvic health physiotherapy practice, where assessment and treatment approaches can involve practices that are more invasive in nature than other areas of physiotherapy practice.

Purpose: To explore the Knowledge, Attitudes, Practices & Clinical Settings (KAP) pertaining to infection prevention and control (IPAC) among Canadian physiotherapists working in pelvic health.

Methods: This was a cross-sectional, observational study that received ethic approval (University of Ottawa, #H-10-19-4764). Using a convenient sampling approach, Canadian pelvic health physiotherapists were recruited through pelvic health physiotherapy groups on social media and a Canadian continuing education provider.  Between May 6th and 22, 2020, while clinics were closed, participants completed an investigator designed on-line questionnaire pertaining to respondents’ KAP using current best-practices.  The questionnaire was comprised of 81 closed & open-ended questions and options to provide comments as well general demographic information. An exploratory data & descriptive analysis was performed. For open-ended questions, thematic coding was conducted.

Results: A total of 80 eligible physiotherapists completed the questionnaire. Results of this study revealed that participants achieved a mean score of 17.95/24 (74.8±10%) pertaining to IPAC on the knowledge section of the survey, a mean score of 8.66/10 (88.7±11.6) on recommended IPAC practices and a mean score of 9.09/14 (64.9±19%) on desirable attribute of clinical settings in terms of IPAC. Although physiotherapists’ answers were mostly in agreement with best-practices, some concerning items were observed: 1-Knowledge: modes of transmission of infections are not well known and medical gel recommendations for IPAC are poorly understood. 2-Attitudes: hepatitis B & influenza vaccination were perceived by a large proportion of respondents (33/70 and 41/80 respectively) as being somewhat or not important; vaccine uptake was 70/80 and 44/80 respectively. 3-Practices: non-bacteriostatic single packet lubricant is not universally used (23/80) for intravaginal/intra-anal palpation, and intra-rectal balloon catheters are used repeatedly in a given patient by most (19/30) physiotherapists who use them. 4-Clinical setting: 30% of participants (24/78) were not aware of infection control guidelines in the workplace prior to COVID-19, where some clinics (22/78) were carpeted and more than half (41/77) did not have a dedicated sink for cleaning equipment or handwashing (i.e. shared with kitchen or washroom).

Conclusion(s): While our findings demonstrate that pelvic health physiotherapists in Canada were generally following IPAC recommendations, some problematic KAP were observed. Further studies should look into the impact of IPAC training for pelvic health physiotherapists, and the evolution of IPAC KAP throughout the COVID-19 pandemic.

Implications: This study identifies behaviours and practices that may hinder optimal IPAC in pelvic health physiotherapy practice. These findings provide guidance for the development of IPAC training and guidelines for pelvic health physiotherapists.

Funding, acknowledgements: This project was unfunded.

Keywords: Infection control, Pelvic health physiotherapy, KAP survey

Topic: Pelvic, sexual and reproductive health

Did this work require ethics approval? Yes
Institution: University of Ottawa
Committee: Health Sciences and Sciences Research Ethics Board
Ethics number: #H-10-19-4764

All authors, affiliations and abstracts have been published as submitted.

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