ABSTRACT Every year, physiotherapists leave the South African public sector in large numbers, citing reasons such as low salaries and unsatisfactory working conditions as the main contributing factors. However, despite this, there are some physiotherapists who continue to choose to stay for the duration of their careers, and it is the aim of this study to investigate the factors that influence these choices. The author has tried to achieve this by trying to predict those factors that cause physiotherapists to stay at their current work places and by finding out if these physiotherapists share any common characteristics and motivations which contribute to their decisions to stay. The participants were also asked to rate their current job satisfaction, rank the importance of given motivation factors for retention and what they knew about their own institutions’ retention strategies. The study population was made up of all the qualified physiotherapists working for the South African public sector in Gauteng between January and December 2006. There were 93 physiotherapists who met these study criteria, 76 (82.0%) of whom completed the questionnaire. The research revealed that characteristics such as gender, age, race, marital status, having children and being the family breadwinner played a significant role as determinants of whether physiotherapists left or stayed at their current public sector jobs in 2007. For example, the female participants and those who had children were twice as likely to stay as the male participants and those who did not have children, respectively. Similarly, the white participants and those who were family breadwinners were three times more likely to stay than those of other racial groups and non-breadwinners, respectively. Physiotherapists over the age of thirty-one were almost five times more likely to stay than their younger counterparts. On the other hand, factors such as professional rankings, having postgraduate qualifications and the type or level of institution seemed to play relatively insignificant roles. According to the results, the respondents’ main source of dissatisfaction was their salaries, followed by what they felt were poor opportunities for promotion. Feeling unappreciated and undervalued in their workplaces, as well as poor recognition for their professional status, were also rated as contributors to dissatisfaction. They felt that more attention needed to be given to improve on these factors if the retention of physiotherapists was to be achieved successfully. The factors which received the highest importance rating and ranking as retention factors, included, once again, better salaries, promotion opportunities, career development and training opportunities, as well as receiving the scarce skills allowance. In terms of knowledge of the existence of retention strategies for physiotherapists in their institutions, only 29% responded positively, the most commonly cited one being the scarce skills allowance. The main conclusion that was drawn from this study is that in addition to better salaries, improved working conditions and more promotion opportunities, there are more characteristic features that are shared by those physiotherapists that stay in the South African public sector. These, as mentioned earlier, include being a female, being over the age of 31, being married, having children and carrying the financial responsibilities of a family breadwinner. Finally, in terms of some of the key recommendations made, the findings of this study reveal a heightened necessity for the government of South Africa to review the salary structure of public sector physiotherapists in an effort to motivate them and encourage them to stay. Furthermore, it is recommended that physiotherapy managers improve their human resource record keeping, particularly worker flow and turnover data, and that they encourage more evidence-based research in the field of physiotherapy human resources.

This thesis is an examination of the practice of physiotherapy, an exploration of the context within which the profession of physiotherapy developed and an identification of the theoretical frameworks within which it is practised. The experiences of physiotherapists and nurses working in particular settings at a specific point in the development of the profession provided a starting point for the study. Physiotherapy, a profession openly dependent for a significant part of its history on medicine for its practice and knowledge base, is contextualised with reference to the development of a medical hegemony, the changing role of women in society, and the development of specialisms within physiotherapy. A methodological framework was developed through the use of a naturalistic design which places the researcher within the study and legitimises personal perspectives. Knowledge of the field prior to the study, fieldwork observations, and findings from two sets of interviews generated the data which provided the framework for an exploration of the theoretical base for the practice of physiotherapy. The thesis concludes by examining the components of context and theory which are fundamental to the practice of theory, and places them within a new framework. This new framework or paradigm is based on a re-evaluation of the concept of holism and goes back to the origins of this model which developed amidst the chaos of post-Boer was South Africa. The meaning of holism has been changed to make it nearer the concept of summative dualism which fits well with key concepts of balance, harmony and homeostasis. True holism is about movement and change and this is proposed as an appropriate model on which to base a paradigm for physiotherapy.

Magister Scientiae (Physiotherapy) - MSc(Physio) / Reduced adherence levels have been demonstrated by some patients affected with Osteoarthritis. Therefore, this study aimed at exploring the barriers and facilitators regarding patient adherence towards physiotherapy rehabilitation programs in the management of osteoarthritis in Nairobi, Kenya. The objectives of the study were to determine the clinical profile of patients with osteoarthritis on physiotherapy rehabilitation programs, to explore the patient-reported barriers and facilitators towards physiotherapy rehabilitation programs and exploring physiotherapists’ perceptions of patient adherence towards physiotherapy rehabilitation programs. The study setting was at the Kenyatta National Hospital physiotherapy clinic in Nairobi, Kenya.

Magister Scientiae (Physiotherapy) - MSc(Physio) / Background: Hypertension is a risk factor for both cerebrovascular accidents and cardiovascular diseases, holistic and cost effective measure are called upon to reduce its impact on society. One of the methods advocated for achieving this is health promotion. Therefore, health professionals, including physiotherapists, are called upon to redirect their health care management approaches towards preventative care. Aim: The aim of this study was to determine the knowledge, attitude and practice as well as to explore the perceptions of physiotherapists regarding their role in the management of hypertension in Dar es Salaam, Tanzania.

Ph.D. Faculty of Health Sciences, University of the Witwatersrand, 2008 / The research reported in this thesis investigated factors that predict academic success of African black physiotherapy students. The first part of the literature review focused on higher education and access into higher education. It refers to the National Plan on Higher Education and the international debate around widening access. Significance within the international literature is that while there has been rapid expansion in higher education numbers there has not been a parallel increase in participation by underrepresented groups. Most of the literature found on predictors of success indicates that high school performance and aptitude tests are predictors of success. It also indicates that the predictive strength of these variables reduces when race is taken into consideration and in physiotherapy it reduces in the clinical years of study. Non-cognitive variables have also been found to predict success. Although many quantitative studies on prediction of academic success have been performed, it was noted in the literature analysis that there is minimal investigation of predictors of success that have been done in the physiotherapy profession. No recent studies were found that pertain to physiotherapy specifically, and the few studies available were found not to have taken race differences into consideration. Throughout South Africa universities that have physiotherapy programmes admit students on the basis of their high school performance. Some of them use other criteria such as involvement in sports, leadership qualities and community involvement. Moreover, most African black students do not have the opportunity to fulfill these criteria and therefore other factors that may predict academic success were investigated. One hundred and twenty eight graduates (66 black and 62 white) who graduated between 2000 – 2005 from eight universities and six Heads of Physiotherapy Departments participated in the research. For the purposes of this study, graduates who completed the degree in four years or four and a half years were defined as successful and those that completed in five years and above were defined as unsuccessful. The graduates responded to a questionnaire which had two sections: Section A had closed ended questions and Section B had open ended questions. Face-to-face, in-depth interviews were conducted with Heads of Departments using semistructured interview schedule. The data were subjected first to simple descriptive statistical analysis. These analyses revealed that 59% of blacks were successful compared to 90% of whites and that there were more successful females than males. The average time taken to complete physiotherapy degree is 5 years for blacks and 4 years for white; black students were less likely to succeed in physiotherapy programmes. Frequency analysis was done using Chi square test and the results showed an association between race and success (X2 = 16.29; p < 0.01). Logistic regression was done and the results revealed that high school performance was not a predictor of success for black students and that sharing a residence room (OR = 3.09; p = 0.05), obtaining information about university support systems from classmates (OR = 6.25; p < 0.05), feeling part of the group of classmates (OR = 3.23; p < 0.05) and choosing physiotherapy as the first choice of career (OR = .33; p < 0.05) were predictors of success of black physiotherapy students. These results indicate that a supportive learning environment is conducive for black students’ academic success Responses to the open ended questions were collated for each question and then analysed using content analysis as described by Mayan (2002). Themes that emerged with regards to student success indicate that according to the respondents, a student who is determined to succeed and become a physiotherapist, who has the support they need (particularly finance and family), and favourable learning environment will be successful in their studies. Themes that emerged regarding factors that are barriers to students’ academic success were: lack of academic discipline, academic problems, psychosocial difficulties, poor learning environment. A question was raised regarding reasons of students leaving the physiotherapy programme before completion. The responses represent secondary data because it was difficult to locate students who had left physiotherapy programmes. The most cited reasons were multiple failures resulting in academic exclusion, and decision to change career. The interviews with the Heads of Department were transcribed verbatim. These transcripts were then subjected to data-reducing procedures described by Tesch (1990). Firstly the analysis confirmed that black students take an average of 5 years to complete the degree and that the failure occurred mainly in first two years of study. The analysis also revealed that there were few (2 – 10) black students admitted into physiotherapy each year particularly at the Historically White Universities although there were additional criteria that sought to widen access for black students. Secondly, themes that emerged regarding factors that are perceived to contribute to students’ academic success indicated that a successful student is a student who has adequate knowledge about the physiotherapy profession, has academic discipline, has all the relevant support needed and is integrated well with classmates. On the other hand, a student who is inadequately prepared for higher education, has poor proficiency of language of instruction, lacks financial support and has difficult social circumstances, will not be successful in his or her studies. The HODs indicated that there are support systems put in place within their departments and the university at large. The support is academic, financial and psychosocial. vi The results of this study have shown that black students are less likely to be successful than white students, and that average time taken to complete the degree is 5 years. According to Graves (2008), in America the gap between black and white graduation rates still exists and it has been found that many colleges and universities graduate black students at significantly lower rates than white students. The immediate reaction to this result in the South African context would be that the reason for this outcome is that most black students are admitted with lower high school performance. The results in this study did indeed show that the distribution of aggregate and per-subject marks was lower for black respondents than for white respondents, and that at these lower ranges there were equal chances of success and failure. In other words, in dealing with black physiotherapy students, one must look beyond the matric results to identify factors that predict success. Uncertainty about the validity of matric as a predictor of further performance has long existed for low-scoring, disadvantaged students from the previous Department of Education and Training’s, black only educational systems. The rapidly changing South African situation complicates the use and evaluation of the use of matric results for selection. A supportive learning environment has proved to be important for success of African black physiotherapy students.

Masters report: Faculty of Health Sciences / ABSTRACT This study was conducted to determine the opinion of physiotherapists and physiotherapy assistants with regards to physiotherapy services required at a Primary Health Care (PHC) level in two provinces of South Africa, one being urban (Gauteng) and the other one more rural (Limpopo). Using a descriptive study design, a sample size consisting of 728 physiotherapists and assistants was selected from HPCSA register list. Data collection was by a self-administered questionnaire. Sixty six percent of physiotherapists in Gauteng Province and 68% in Limpopo Province agreed that promotive services are required whereas the percentage for physiotherapy assistants in Gauteng province and Limpopo province were 78% and 89% respectively. Preventative services were required by 82% and 85% by Physiotherapists and 95% and 96% by Physiotherapy assistants in Gauteng and Limpopo. 89% and 88% of Physiotherapists, 80% and 85% of Physiotherapy assistants in Gauteng and Limpopo respectively agreed that curative services are required. The rehabilitative services were required 83% and 90% by Physiotherapists, 85% and 95% by Physiotherapy assistants in Gauteng and Limpopo respectively. The provision of promotive, preventative, curative and rehabilitative services were seen as required in the two provinces in terms of physiotherapy services at a PHC level by both professional categories.

Orientation: Job satisfaction, which is usually lower among healthcare workers than in other types of organisations, has a major influence on job-related behaviour, such as turnover, absenteeism, and self-reported job performance. Research purpose: The aim of this study was to compare the level of job satisfaction between publicly employed and privately employed physiotherapists. Research design: A non-probability research design was used to choose a convenient sample. One group was from the public sector and the other from the private sector all working in Gauteng Province (N=200). A structured self-administered Minnesota Satisfaction Questionnaire (MSQ) (Weiss, et al., 1967), validated by Ian Rothmann for South African circumstances, was identified for this purpose. Main findings: There was a significant difference in support work value factor (supervision, company policies and practices) and work conditions work value (activity, independence, variety, compensation, security and working conditions) between publicly employed and privately employed physiotherapists. The privately employed had a higher mean value 3.59 and publicly employed a smaller mean value of 3.33 on support work value. The mean values of work conditions and value for publicly employed physiotherapists and privately employed physiotherapists were 3.44 and 3.84 respectively. Practical implications: Managers should pay particular attention on the job satisfaction levels of employees in the public sector. Value add: The study adds to the literature and also confirms that there is a difference between publicly employed and privately employed physiotherapists‘ levels of job satisfaction. / MBA (Business Administration), North-West University, Potchefstroom Campus, 2015

Orientation: Job satisfaction, which is usually lower among healthcare workers than in other types of organisations, has a major influence on job-related behaviour, such as turnover, absenteeism, and self-reported job performance. Research purpose: The aim of this study was to compare the level of job satisfaction between publicly employed and privately employed physiotherapists. Research design: A non-probability research design was used to choose a convenient sample. One group was from the public sector and the other from the private sector all working in Gauteng Province (N=200). A structured self-administered Minnesota Satisfaction Questionnaire (MSQ) (Weiss, et al., 1967), validated by Ian Rothmann for South African circumstances, was identified for this purpose. Main findings: There was a significant difference in support work value factor (supervision, company policies and practices) and work conditions work value (activity, independence, variety, compensation, security and working conditions) between publicly employed and privately employed physiotherapists. The privately employed had a higher mean value 3.59 and publicly employed a smaller mean value of 3.33 on support work value. The mean values of work conditions and value for publicly employed physiotherapists and privately employed physiotherapists were 3.44 and 3.84 respectively. Practical implications: Managers should pay particular attention on the job satisfaction levels of employees in the public sector. Value add: The study adds to the literature and also confirms that there is a difference between publicly employed and privately employed physiotherapists‘ levels of job satisfaction. / MBA (Business Administration), North-West University, Potchefstroom Campus, 2015

Magister Scientiae (Physiotherapy) - MSc(Physio) / Lack of adherence to the correct working conditions exposes workers to ergonomics-related hazards and eventually work-related musculoskeletal disorders (WRMDs) which are estimated at 160 million per year globally. Literature shows that with modernization by use of computers, administrators are exposed to prolonged sitting and long working hours which predisposes them to ergonomic hazards. Low back pain and neck pain are the leading work-related musculoskeletal disorders with a lifetime prevalence of 70 - 80% and 50 - 60% respectively.Both low back pain and neck pain have a multifactorial aetiology that includes work-related and individual related factors. Lack of reporting of work-related injuries has led to paucity of statistical literature with regards to work-related low back pain and neck pain, especially in the developing countries. The aim of this study was to determine the prevalence of ergonomics related low back pain and neck pain, and describe the effect of a knowledge-based ergonomic intervention among administrators in Aga Khan University Hospital, Nairobi (AKUH, N). A mixed method design was used in this study using a survey and two focus group discussions(FGD). A self-administered questionnaire that is in four sections was administered to 208 participants. The questionnaire sought the prevalence of musculoskeletal disorders, the knowledge of participants with regards to low back pain and neck pain as well as the work-related and individual risk factors related to the same. The dissemination of the study results involved a one hour knowledge-based ergonomic session given to all interested participants, based on the information from the survey. Two FGD with purposive selection of eight participants were held to explore their experience on the value of the information provided.The statistical package for social sciences (SPSS) version 20 was used to capture and analyze the quantitative data. Descriptive statistics was used to summarize the study findings in the form of means, frequencies, standard deviations and percentages. Inferential statistics (chi-square) was used to test the associations between different categorical variables (p<0.05). For the qualitative data, the tape recorded interviews were transcribed verbatim, field notes typed, sorting and arranging data was done and themes were generated. Thematic content analysis was used to generate the themes. The aim of the study, confidentiality and the participants‘ freedom to withdraw from the study were explained. Informed consent was also obtained before the survey and FGD and referral was made where necessary. The findings of the current study revealed that the study participants were knowledgeable about ergonomics-related low back pain and neck pain however this knowledge was not directly translated into behaviour. Low back pain (LBP) had the highest twelve month prevalence at 75.5% followed by neck pain at 67.8%, and LBP showed significant associations at p< 0.05 with some work-related and individual risk factors. The results of the FGDs showed that most participants had positive behavioural and attitudinal change post the knowledge-based ergonomic intervention despite the challenges they met in implementing the behavioural change. These results therefore show the need for continual education about ergonomics to create awareness on the predisposing factors to work-related LBP and neck pain, hence promoting a healthier quality of life amongst employees through adherence to healthy work behavioural practice.

Theses (MPH.) -- University of Limpopo, 2017 / INTRODUCTION: Since the introduction of Anti-retroviral therapy, People Living With HIV/AIDS (PLWHA) now live longer and present with various opportunistic neuro-musculoskeletal and cardio-pulmonary conditions among other complications. This has led to a surge in the number of patients that visit the physiotherapy department presenting with many complications which include mobility problems, neurological deficits, muscle weakness and developmental delay in children among others as experienced by the researcher in the work place. AIM: To determine the knowledge of physiotherapists with regard to HIV/AIDS and their attitude towards HIV/AIDS patients in the Kingdom of Swaziland. METHOD: In this study a quantitative, descriptive cross-sectional survey was used to determine the knowledge and attitudes of Physiotherapists in the management of HIV/AIDS in the Kingdom of Swaziland. RESULTS: The results of the study revealed that physiotherapists in the Kingdom of Swaziland have a good knowledge and a positive attitude towards people living with HIV/AIDS. Amongst other attributes that were looked at in the study it was reported that 100% of the participants were knowledgeable on the complications associated with HIV/AIDS and 94% of the physiotherapists reported that they are familiar with complications that will benefit from physiotherapy. On the attributes related to attitude of physiotherapist towards HIV/AIDS patients the study found that 100% of the physiotherapists reported that they would take precautions and continue seeing the patients. There was no statistical significant relationship between years of experience and attitude (Pearson chi-square =0.25, p-value =0.61), familiarity with commonly used ARVS (Pearson chi square =1.13, p-value =0.76) and familiarity with Universal Precautions (Pearson chi-square =2.55, p-value =0.46).There was no statistically significant relationship between knowledge and attitude (Pearson chi square =1.000, p-value =0.61). CONCLUSION: The study revealed that the physiotherapists have good knowledge on HIV/AIDS and they also have positive attitude towards managing People Living with HIV/AIDS at their respective departments. There is need for the physiotherapy training schools to include HIV/AIDS in their curricula since some of the schools of physiotherapy where the participants trained did not include it during their time of training and the practising physiotherapists need continuing health education on HIV/AIDS. There is a need for the work setting libraries where physiotherapists work to have current books and journals for the physiotherapists to update themselves on issues pertaining to HIV/AIDS and internet access in the departments. The physiotherapists are also encouraged to take the initiative to utilise the libraries in their work settings and get information on HIV/AIDS. Keywords: Knowledge; attitudes; Physiotherapists; HIV/AIDS; Patients