Öz
Introduction and Aim
The first step has been taken in primary health clinics to offer physiotherapy and rehabilitation health care service for better addressing the needs of society within the scope of Performance Program in Turkey. The purpose of the study was to assess general patient profile and their need for physiotherapy, and physical conditions for physiotherapy services in case of physiotherapy employment.
Materials and Methods
The study was carried out with 437 Primary Health Care Clinics in 35 districts of Istanbul between June 2017 and October 2018 within Marmara University Health Care Service Politics Application and Research Center. The questionnaire, developed by the researchers based on expert opinions and literature, was performed to collect data.
Results
It was found that 69% of the medical doctors and 8% of the nurses participated in the study advised exercises to the patients. In addition, it was indicated that 23% of the medical doctors gave brochures to advice exercise. 632 medical doctors (89% of the doctor participants) declared that they had encourage their patients to perform any physical activity for healthy life style. The majority of the patients (83,5%) followed in Primary Health Care Clinics were consulted to a physiotherapy clinic because of musculoskeletal pain compliant.
Conclusion
The employment of variety of health professionals in the Primary Health Clinics would improve efficiency of primary health care services for better addressing the needs of Turkish society.
Anahtar Kelimeler
Primary Health Care Services Physiotherapy and Rehabilitation Physiotherapist
Kaynakça
- 1. Starfield, B., (1998), Primary care: balancing health needs, services, and technology: Oxford University Press, USA. 2. Starfield, B., (2003), The effectiveness of primary health care, Oxon (UK): Radcliffe. 3. Başer, D.A., R. Kahveci, M. Koç, İ. Kasım, İ. Şencan, and A. Özkara, (2015), Etkin sağlık sistemleri için güçlü birinci basamak, Ankara Medical Journal, 15(1). 4. Hung, D., (2007), Improving the delivery of preventive care services, Managed care interface, 20(5); 38-44. 5. Lee, A., A. Kiyu, H.M. Milman, and J. Jimenez, (2007), Improving health and building human capital through an effective primary care system, Journal of Urban Health, 84(1); 75-85. 6. Engels, Y., S. Campbell, M. Dautzenberg, P. van den Hombergh, H. Brinkmann, J. Szécsényi, H. Falcoff, L. Seuntjens, B. Kuenzi, and R. Grol, (2005), Developing a framework of, and quality indicators for, general practice management in Europe, Family Practice, 22(2); 215-222. 7. Khalid, M.T., M.F. Sarwar, M.H. Sarwar, and M. Sarwar, (2015), Current role of physiotherapy in response to changing healthcare needs of the society, International Journal of Education and Information Technology, 1(3); 105-110. 8. Ojha, H.A., R.S. Snyder, and T.E. Davenport, (2014), Direct access compared with referred physical therapy episodes of care: a systematic review, Physical therapy, 94(1); 14-30. 9. Ganiyu, L., (2008), Physiotherapy in primary health care: are we ready?, Journal of the Nigeria Society of Physiotherapy, 16(1); 37-44. 10. Eldar, R., (2000), Integrated institution-community rehabilitation in developed countries: a proposal, Disability and rehabilitation, 22(6); 266-274. 11. Bingisser, R., B. Frühauf, and M. Caravatti, (2001), Pulmonary rehabilitation in outpatients with asthma or COPD, Swiss medical weekly, 131(2728). 12. Stanley, I., J. Miller, M.A. Pinnington, G. Rose, and M. Rose, (2001), Uptake of prompt access physiotherapy for new episodes of back pain presenting in primary care, Physiotherapy, 87(2); 60-67. 13. Cott, C.A., R.M. Devitt, L.-B. Falter, L.J. Soever, and L.A. Passalent, (2007), Barriers to rehabilitation in primary health care in Ontario: funding and wait times for physical therapy services, Physiotherapy Canada, 59(3); 173-183. 14. Dufour, S.P., S.D. Lucy, and J.B. Brown, (2014), Understanding physiotherapists' roles in Ontario primary health care teams, Physiotherapy Canada, 66(3); 234-242. 15. Dufour, S., A. Hondronicols, and K. Flanigan, (2019), Enhancing Pelvic Health: Optimizing the Services Provided by Primary Health Care Teams in Ontario by Integrating Physiotherapists, Physiotherapy Canada, 71(2); 168-175. 16. Phillips, R.L., M.S. Dodoo, L.A. Green, G.E. Fryer, A.W. Bazemore, K.I. McCoy, and S.M. Petterson, (2009), Usual source of care: an important source of variation in health care spending, Health Affairs, 28(2); 567-577. 17. Ansari, Z., J.N. Laditka, and S.B. Laditka, (2006), Access to health care and hospitalization for ambulatory care sensitive conditions, Medical care research and review, 63(6); 719-741. 18. Boerma, W. G., & Fleming, D. M. (1998). The role of general practice in primary health care. 19. Phelan, E.A., J.E. Mahoney, J.C. Voit, and J.A. Stevens, (2015), Assessment and management of fall risk in primary care settings, Medical Clinics, 99(2); 281-293. 20. Desjardins-Charbonneau, A., J.-S. Roy, J. Thibault, V.T. Ciccone, and F. Desmeules, (2016), Acceptability of physiotherapists as primary care practitioners and advanced practice physiotherapists for care of patients with musculoskeletal disorders: a survey of a university community within the province of Quebec, BMC musculoskeletal disorders, 17(1); 400. 21. Bijnen, F., C. Caspersen, and W. Mosterd, (1994), Physical inactivity as a risk factor for coronary heart disease: a WHO and International Society and Federation of Cardiology position statement, Bulletin of the World Health Organization, 72(1); 1. 22. Venables, M.C. and A.E. Jeukendrup, (2009), Physical inactivity and obesity: links with insulin resistance and type 2 diabetes mellitus, Diabetes/metabolism research and reviews, 25(S1); 18-23. 23. Bryan, S.N. and P.T. Katzmarzyk, (2011), The association between meeting physical activity guidelines and chronic diseases among Canadian adults, Journal of Physical Activity and Health, 8(1); 10-17. 24. Ludvigsson, M.L. and P. Enthoven, (2012), Evaluation of physiotherapists as primary assessors of patients with musculoskeletal disorders seeking primary health care, Physiotherapy, 98(2); 131-137. 25. Jackson, J., (1994), Approaches to neurological rehabilitation by physiotherapists, British Journal of Therapy and Rehabilitation, 1(2); 71-74. 26. Snow, B.L., E. Shamus, and C. Hill, (2001), Physical therapy as primary health care: public perceptions, Journal of Allied Health, 30(1); 35-38. 27. Desmeules, F., J.-S. Roy, J.C. MacDermid, F. Champagne, O. Hinse, and L.J. Woodhouse, (2012), Advanced practice physiotherapy in patients with musculoskeletal disorders: a systematic review, BMC musculoskeletal disorders, 13(1); 107. 28. Jones, R.C., S. Copper, O. Riley, and F. Dobbs, (2002), A pilot study of pulmonary rehabilitation in primary care, Br J Gen Pract, 52(480); 567-568. 29. Stanley, I., (2001), Uptake of prompt access physiotherapy for new episode of low back pain presenting in primary care, Physiotherapy, 872. 30. Grahn, B., C. Ekdahl, and L. Borgquist, (2000), Motivation as a predictor of changes in quality of life and working ability in multidisciplinary rehabilitation, Disability and Rehabilitation, 22(15); 639-654. 31. Sheppard, L., (1995), Changing the public perception of physiotherapeutic treatment, Health marketing quarterly, 12(2); 77- 96. 32. Consortium, O.P.L., (2011), Physiotherapists in health promotion: findings of a forum, Physiotherapy Canada, 63(4); 391.
Öz
GİRİŞ VE AMAÇ
Türkiye’de Performans Programı kapsamında Aile Sağlığı Merkez’lerinde (ASM) toplumun ihtiyaçlarına daha fazla cevap verebilmek amacıyla fizyoterapi ve rehabilitasyon hizmeti sunması için ilk adım atılmıştır. Çalışmamızın amacı fizyoterapistlerin istihdamı durumunda ASM’lerde karşılaşacakları hastaların genel profili, fizyoterapi gereksinimleri ve fizyoterapiye yönelik fiziki koşulların değerlendirilmesidir.
GEREÇ VE YÖNTEM
Marmara Üniversitesi Sağlık Hizmet Politikaları Uygulama ve Araştırma Merkezi bünyesinde Haziran 2017–Ekim 2018 tarihleri arasında İstanbul ilinde 35 ilçede 437 Aile Sağlığı Merkezi’nde gerçekleştirildi. Araştırmacılar tarafından literatür taraması ve uzman görüşleri alınarak oluşturulan bir soru formu kullanıldı.
BULGULAR
Çalışmaya katılan hekimlerin %69 ve hemşirelerin %8’inin egzersiz önerisinde bulunduğu saptandı. Hekimlerin ayrıca %23’ünün egzersiz önerisi için broşür verdiği belirlendi. Katılımcılardan 632 hekim (%89) takip ettiği hastasını sağlıklı yaşam için fiziksel aktiviteye yönlendirdiğini bildirdi. ASM’lerde hastaların en çok muskuloskeletal ağrı (%83,5) nedeniyle hekim tarafından fizyoterapi hizmetine yönlendirildiği saptandı.
SONUÇ
ASM’lerde farklı sağlık profesyonellerinin istihdamı toplum ihtiyaçlarının karşılanmasında birinci basamak sağlık hizmetlerinin verimliliğini arttıracaktır.
Anahtar Kelimeler
Birinci Basamak Sağlık Hizmetleri Fizyoterapist Fizyoterapi ve Rehabilitasyon
Kaynakça
- 1. Starfield, B., (1998), Primary care: balancing health needs, services, and technology: Oxford University Press, USA. 2. Starfield, B., (2003), The effectiveness of primary health care, Oxon (UK): Radcliffe. 3. Başer, D.A., R. Kahveci, M. Koç, İ. Kasım, İ. Şencan, and A. Özkara, (2015), Etkin sağlık sistemleri için güçlü birinci basamak, Ankara Medical Journal, 15(1). 4. Hung, D., (2007), Improving the delivery of preventive care services, Managed care interface, 20(5); 38-44. 5. Lee, A., A. Kiyu, H.M. Milman, and J. Jimenez, (2007), Improving health and building human capital through an effective primary care system, Journal of Urban Health, 84(1); 75-85. 6. Engels, Y., S. Campbell, M. Dautzenberg, P. van den Hombergh, H. Brinkmann, J. Szécsényi, H. Falcoff, L. Seuntjens, B. Kuenzi, and R. Grol, (2005), Developing a framework of, and quality indicators for, general practice management in Europe, Family Practice, 22(2); 215-222. 7. Khalid, M.T., M.F. Sarwar, M.H. Sarwar, and M. Sarwar, (2015), Current role of physiotherapy in response to changing healthcare needs of the society, International Journal of Education and Information Technology, 1(3); 105-110. 8. Ojha, H.A., R.S. Snyder, and T.E. Davenport, (2014), Direct access compared with referred physical therapy episodes of care: a systematic review, Physical therapy, 94(1); 14-30. 9. Ganiyu, L., (2008), Physiotherapy in primary health care: are we ready?, Journal of the Nigeria Society of Physiotherapy, 16(1); 37-44. 10. Eldar, R., (2000), Integrated institution-community rehabilitation in developed countries: a proposal, Disability and rehabilitation, 22(6); 266-274. 11. Bingisser, R., B. Frühauf, and M. Caravatti, (2001), Pulmonary rehabilitation in outpatients with asthma or COPD, Swiss medical weekly, 131(2728). 12. Stanley, I., J. Miller, M.A. Pinnington, G. Rose, and M. Rose, (2001), Uptake of prompt access physiotherapy for new episodes of back pain presenting in primary care, Physiotherapy, 87(2); 60-67. 13. Cott, C.A., R.M. Devitt, L.-B. Falter, L.J. Soever, and L.A. Passalent, (2007), Barriers to rehabilitation in primary health care in Ontario: funding and wait times for physical therapy services, Physiotherapy Canada, 59(3); 173-183. 14. Dufour, S.P., S.D. Lucy, and J.B. Brown, (2014), Understanding physiotherapists' roles in Ontario primary health care teams, Physiotherapy Canada, 66(3); 234-242. 15. Dufour, S., A. Hondronicols, and K. Flanigan, (2019), Enhancing Pelvic Health: Optimizing the Services Provided by Primary Health Care Teams in Ontario by Integrating Physiotherapists, Physiotherapy Canada, 71(2); 168-175. 16. Phillips, R.L., M.S. Dodoo, L.A. Green, G.E. Fryer, A.W. Bazemore, K.I. McCoy, and S.M. Petterson, (2009), Usual source of care: an important source of variation in health care spending, Health Affairs, 28(2); 567-577. 17. Ansari, Z., J.N. Laditka, and S.B. Laditka, (2006), Access to health care and hospitalization for ambulatory care sensitive conditions, Medical care research and review, 63(6); 719-741. 18. Boerma, W. G., & Fleming, D. M. (1998). The role of general practice in primary health care. 19. Phelan, E.A., J.E. Mahoney, J.C. Voit, and J.A. Stevens, (2015), Assessment and management of fall risk in primary care settings, Medical Clinics, 99(2); 281-293. 20. Desjardins-Charbonneau, A., J.-S. Roy, J. Thibault, V.T. Ciccone, and F. Desmeules, (2016), Acceptability of physiotherapists as primary care practitioners and advanced practice physiotherapists for care of patients with musculoskeletal disorders: a survey of a university community within the province of Quebec, BMC musculoskeletal disorders, 17(1); 400. 21. Bijnen, F., C. Caspersen, and W. Mosterd, (1994), Physical inactivity as a risk factor for coronary heart disease: a WHO and International Society and Federation of Cardiology position statement, Bulletin of the World Health Organization, 72(1); 1. 22. Venables, M.C. and A.E. Jeukendrup, (2009), Physical inactivity and obesity: links with insulin resistance and type 2 diabetes mellitus, Diabetes/metabolism research and reviews, 25(S1); 18-23. 23. Bryan, S.N. and P.T. Katzmarzyk, (2011), The association between meeting physical activity guidelines and chronic diseases among Canadian adults, Journal of Physical Activity and Health, 8(1); 10-17. 24. Ludvigsson, M.L. and P. Enthoven, (2012), Evaluation of physiotherapists as primary assessors of patients with musculoskeletal disorders seeking primary health care, Physiotherapy, 98(2); 131-137. 25. Jackson, J., (1994), Approaches to neurological rehabilitation by physiotherapists, British Journal of Therapy and Rehabilitation, 1(2); 71-74. 26. Snow, B.L., E. Shamus, and C. Hill, (2001), Physical therapy as primary health care: public perceptions, Journal of Allied Health, 30(1); 35-38. 27. Desmeules, F., J.-S. Roy, J.C. MacDermid, F. Champagne, O. Hinse, and L.J. Woodhouse, (2012), Advanced practice physiotherapy in patients with musculoskeletal disorders: a systematic review, BMC musculoskeletal disorders, 13(1); 107. 28. Jones, R.C., S. Copper, O. Riley, and F. Dobbs, (2002), A pilot study of pulmonary rehabilitation in primary care, Br J Gen Pract, 52(480); 567-568. 29. Stanley, I., (2001), Uptake of prompt access physiotherapy for new episode of low back pain presenting in primary care, Physiotherapy, 872. 30. Grahn, B., C. Ekdahl, and L. Borgquist, (2000), Motivation as a predictor of changes in quality of life and working ability in multidisciplinary rehabilitation, Disability and Rehabilitation, 22(15); 639-654. 31. Sheppard, L., (1995), Changing the public perception of physiotherapeutic treatment, Health marketing quarterly, 12(2); 77- 96. 32. Consortium, O.P.L., (2011), Physiotherapists in health promotion: findings of a forum, Physiotherapy Canada, 63(4); 391.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Mart 2021 |
| Kabul Tarihi | 17 Kasım 2020 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 8 Sayı: 1 |
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