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Morrow B.1, Pitt S.2, Luhlaza Z.2, Naidoo K.2, Barnard C.2
1University of Cape Town, Paediatrics and Child Health, Cape Town, South Africa, 2University of Cape Town, Physiotherapy, Cape Town, South Africa
Background: Palliative care encompasses the holistic care of people and their families when faced with life-threatening and life-limiting illnesses. As members of the multidisciplinary palliative care team, physiotherapists should have sufficient knowledge, experience and skills to manage patients with such conditions at different life stages. However, there is currently little known about the experience, attitudes, beliefs and knowledge of palliative care amongst South African physiotherapists.
Purpose: To describe the amount and adequacy of palliative care training received by South African physiotherapists, as well as their interest, knowledge, attitudes, beliefs and experiences of palliative care.
Methods: This was a cross-sectional descriptive study of a convenience sample of physiotherapists registered with the South African Society of Physiotherapy (SASP), using an online survey (Physical Therapy in Palliative Care-Knowledge, Attitudes, Beliefs and Experiences (PTiPC-KABE) Scale). Likert scale scores were converted to continuous data for analysis. Seven universities offering undergraduate physiotherapy degree programs were contacted to determine palliative care curriculum content.
Results: 303 participants (8.4% response rate) completed the questionnaire, and 289 reponses were included in the study (5.35% margin of error with 95% confidence interval). Participants had median (IQR) 16 (6 27) years of experience, with 85.5% private practitioners. On a five-point Likert Scale, the average rating of overall interest in palliative care in physiotherapy was 3.8. 66.7% and 79.0% of participants reported not receiving any palliative care training at undergraduate or postgraduate levels respectively, with >80% feeling that training at both levels was inadequate. University Physiotherapy Departments (n=4/7; 57.1%) reported a maximum three hours undergraduate training in palliative care. 79.5% of respondents had clinical experience in palliative care, however Knowledge was the lowest scoring domain (median (IQR) percentage of ideal total score 56.3% (43.8% 62.5%), with many respondents perceiving palliative care to be limited to end-of-life/terminal care. The Beliefs domain scored highest at 82.6% (69.6 91.3%).
Conclusion(s): The majority of South African physiotherapists have experience managing patients requiring palliative care, despite inadequate training and limited knowledge in this field. The impact of practising palliative care, in the face of inadequate knowledge and preparation, on the emotional well-being of physiotherapists, and the effectiveness and appropriateness of patient care given, requires further investigation.
Implications: Palliative care is an important aspect of physiotherapy practice, yet inadequate attention has been given to this area in South Africa. It is therefore recommended that more under- and postgraduate learning opportunities be made available for physiotherapists in the area of palliative care, in order to improve knowledge and optimise clinical practice in this field.
Funding acknowledgements: No funding received
Topic: Oncology, HIV & palliative care
Ethics approval: Approval was obtained from the University of Cape Towns Faculty of Health Sciences Human Research Ethics Committee (Reference Number 080/2016).
All authors, affiliations and abstracts have been published as submitted.
