THE ROLE OF PHYSIOTHERAPISTS IN HEALTH PROMOTION AND PREVENTION OF NON-COMMUNICABLE DISEASES AT PRIMARY HEALTH CARE LEVEL IN SLOVENIA

¹National Institute of Public Health, Ljubljana, Slovenia

Background: Physical therapy is concerned with identifying and maximising quality of life and movement potential within the spheres of health promotion, prevention, treatment, habilitation and rehabilitation. In consequence of population aging and the global pandemic of non-communicable chronic diseases (NCDs), the need for physiotherapists is increasing. Opinions of physiotherapists about their performance in the area of health promotion and prevention are, however, divided.

Purpose: In 2015 WCPT adopted a new Political Statement on NCDs which indicates that physiotherapists play a vital role in preventing and managing NCDs by providing evidence-based primary and secondary prevention programmes, promoting health and quality of life, reducing sedentary behaviour, and improving and maintaining physical activity level and functional independence. Primary health care Slovenian physiotherapists are becoming more engaged in those particular roles throughout some national preventive approaches.

Methods: Public health system in Slovenia allows primary health workers to act in the fields of health promotion and prevention throughout national prevention approaches for adults. The National Program for Primary Prevention of Cardiovascular Diseases was implemented since 2002. It consists of screening, preventive medical exam, laboratory tests and mostly cardiovascular disease threat assessment performed by general practitioners. A concept of Module Practice was also introduced since 2011, where specially trained nurses manage NCDs. If needed non-medication structured intervention is followed and performed by specially trained nurses and physiotherapists at 61 Health Education Centres countrywide through individual counselling and behaviour change workshops (´2 Km Walk Test´, ´Healthy Weight Loss´, ´Physical Activity Workshop´). Those approaches are financially supported by the Health Insurance Institute of Slovenia and coordinated by National Institute of Public Health. Recently within national project Towards Better Health, a number of physiotherapists modified existing system of health education for all population groups in relation to physical activity and expanded it to the most of NCDs and specific health conditions. They also proposed and tested a screening system for functional disability for elderly.

Results: In all 61 health education centres, 58 physiotherapists carry out specific health education workshops, attended by 6000 adults every year. Within the project Towards Better Health four physiotherapists carried out joint 37 screenings for functional disability in two pilot environments from March to July 2015. A total of 56 participants were tested with senior fitness test battery in modular form, 69 individuals attended the basic workshops ´Am I fit?´ and 29 individuals participated in the advanced workshop ´I am moving´.

Conclusion(s): Every physiotherapist must be a health promoter as a lifestyle of patients/clients has a significant influence on physiotherapy treatment outcomes. Therefore, the future of the profession in the area of health promotion and prevention should be directed towards systematic education and training of physiotherapists through formal and informal learning.

Implications: Since the implementation of all above described national prevention approaches at primary health care level, Slovenian physiotherapists have become more involved in health promotion and NCDs prevention in general.

Funding acknowledgements: Special thanks to National Institute of Public Health in Slovenia and the Health Insurance Institute of Slovenia.

Topic: Health promotion & wellbeing/healthy ageing

Ethics approval: The approval from ethics committee was not required.

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