Conselho Nacional de Desenvolvimento Científico e Tecnológico / As práticas de cuidado em fisioterapia, em muitas situações, resgatam a função do fisioterapeuta de executor de técnicas que lhe era atribuída nos primórdios da profissão. Ao exercer essa função meramente técnica, muitas vezes deixando-se substituir pelo equipamento nas suas ações, o profissional compromete o estabelecimento do vínculo terapeuta-paciente, contribuindo para o esvaziamento do encontro em saúde. Nessas situações, predomina o êxito técnico (a eficiência na realização do procedimento) sobre o sucesso prático (os benefícios trazidos para vida das pessoas). Para que o sucesso prático seja atingido, é fundamental que haja o questionamento sobre o que sonham as pessoas, profissionais e pacientes, para as suas vidas e para a saúde, quais são suas perspectivas e projetos de vida, seus projetos de felicidade. Nesse sentido, é imprescindível considerar, também, os projetos de felicidade dos profissionais da saúde enquanto sujeitos desse encontro. Afinal, é a partir deles que o profissional elabora o seu projeto de cuidado para cada paciente. Assim, esse trabalho buscou compreender os elementos que configuram a construção de projetos de cuidado em fisioterapia a partir da reflexão dos próprios fisioterapeutas. Para tanto, utilizou-se a metodologia qualitativa de pesquisa por meio de entrevistas semi-estruturadas para que fossem produzidas narrativas da história de vida do trabalho. Os discursos foram analisados integralmente e a categorização foi feita em três sub-temas: exercício profissional, relação com os pacientes e reflexões. Foi possível perceber que muitos dos arranjos de trabalho estabelecidos visam coibir o vínculo profissional-paciente, transformando-o em valor de troca e mercantilizando a relação terapêutica. Expropriada do vínculo, a prática se resume à realização de procedimentos independentes de sua finalidade, minando as possibilidades de sucesso prático. Nesse caso, não é a tecnologia que gera o afastamento e a mecanização, mas são as estratégias de mercantilização do cuidado fisioterápico. Essa situação só pode ocorrer por um processo de subordinação do profissional e seu saber, o que está fortemente associado a condições de trabalho exploratórias. Podemos dizer que a mercantilização do cuidado facilita a restrição sobre as condições de trabalho e também é fruto dela. O problema é que essa restrição é vista pelos profissionais como não definitiva, mas como um caminho para se alcançar reconhecimento na busca pelo exercício liberal da fisioterapia. A intenção desse estudo não foi traçar um plano normativo de conduta para a profissão, mas imaginamos que o equacionamento dessas questões passa necessariamente pelo reconhecimento, pelas inquietações e indignações com o problema. O que se espera, portanto, é facilitar esse processo de desconforto por meio da proximidade dessas questões trazidas pelas narrativas. / Despite the historical fight to prove themselves as health professionals, in many situations physiotherapy care practices bring to surface the physiotherapist‟s function of a mere executor of practical techniques, which used to be attributed to them at the very beginning of their profession. However, when the practice resumes to a set of techniques and the treatment consist of a routine of mechanical acts, the physiotherapist compromises the relationship therapist-patient, leading to a tangent out of healthcare principles. The described situation favor the technical success, measured by the efficiency in the execution, with detriment to the overall success of the practical success, measured by the benefits the treatment brings to the health of patients. To achieve practical success, it is fundamental to question what people (both professionals and patients) dream for their lives, health and what are their life and success projects. In that regard, it is mandatory that healthcare professionals consider their objectives and goals, since they are the starting point for therapeutic plans and each individuals care project. This works investigates deeply the elements that compose the construction of physiotherapy care plans, starting with the reflection of the physiotherapists themselves. A qualitative methodology based semi-structured interviews gathered evidence of life and work of professionals. The answers were analyzed as a whole and three categories were identified: professional practices, relationship patient doctor and reflections. The answers pointed that the current practices aims to eliminate the relationship professional-patient, transforming the professional in a mere service provider instead of a care provider. Deprived from the relationship, the practice resumes to a collection of independent procedures and undermining any possibility of practical success. In that case, it is not the technique that originates the mechanization, but the economics underlying the physiotherapeutic care. This situation can only happen through a process of subordination of the professional and his domain of knowledge, which are strongly correlated to exploratory and predatory working conditions. The monetary policy underlying the care which facilitates the restriction over the work conditions it is also a result of those working conditions, in a vicious cycle. The problem is that this restriction is viewed by professionals not as permanent, but as a stepping stone to reach recognition in the pursuit of the independent practice of physiotherapy. The intention of this study is not to create a norm of professional conduct, but to provide an outline of possible answers to the raised questions to: recognition, anxieties and concerns. This study aims to facilitate the process of assessment that pushes professionals out of their comfort zone.

Submitted by Marlene Santos (marlene.bc.ufg@gmail.com) on 2016-04-01T20:40:52Z No. of bitstreams: 2 Tese - Patricia Leite Alvares Silva - 2015.pdf: 1889213 bytes, checksum: 5114509cfac2ba2f1692aa6bf63a00f6 (MD5) license_rdf: 19874 bytes, checksum: 38cb62ef53e6f513db2fb7e337df6485 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-04-04T14:54:56Z (GMT) No. of bitstreams: 2 Tese - Patricia Leite Alvares Silva - 2015.pdf: 1889213 bytes, checksum: 5114509cfac2ba2f1692aa6bf63a00f6 (MD5) license_rdf: 19874 bytes, checksum: 38cb62ef53e6f513db2fb7e337df6485 (MD5) / Made available in DSpace on 2016-04-04T14:54:56Z (GMT). No. of bitstreams: 2 Tese - Patricia Leite Alvares Silva - 2015.pdf: 1889213 bytes, checksum: 5114509cfac2ba2f1692aa6bf63a00f6 (MD5) license_rdf: 19874 bytes, checksum: 38cb62ef53e6f513db2fb7e337df6485 (MD5) Previous issue date: 2015-12-10 / This thesis follows the scientific article model. The first article is entitled "Occupational stress in physiotherapists: integrative review" and was submitted to Science and Public Health journal. Objectives: select, evaluate and critically analyze the publications that have focused on stress therapists. Methods: This is an integrative review, using the key words: burnout; Professional wear; professional burnout; occupational stress; professional stress; emotional exhaustion; physical exhaustion; professional exhaustion; job satisfaction; quality of life. Inclusion criteria were: studies that investigated the occupational stress experienced by physiotherapists from any area of operation without time limit; articles in Portuguese, English or Spanish. Results: 409 studies were identified, we proceeded to read the title, description and summary to make the selection. They remained 35 articles, and of these, selected and evaluated nine studies that show that the work of physiotherapy professional features is exposed to stress and the factors related to occupational stress. They also identified the main physical and emotional symptoms such as headache, muscle and joint pains, stomach problems, fatigue, decreased concentration, nervousness, anxiety and sleep disorders. Regarding coping with stress, strategies cited by physiotherapists were: exercise, leisure, vacation, blame others, alcohol, share problems with peers and / or superiors; part course on stress management; Massage and financial independence. The articles highlight an inherent complexity to the characteristics of the profession that carries a high risk of physical, mental and emotional ailments linked to an occupational activity, which reinforces the need to incorporate the theme in the academic training of physiotherapists for preventing and coping with occupational stress. The second article to be submitted to the Public Health Notebooks magazine is entitled "Factors associated with stress in physical therapists." Objectives: The objective of this study was to investigate the existence and the level of stress in physical therapists from the city of Goiania-Go and identify the presence of predominant symptoms and associate the presence of stress and sociodemographic variables. Methods: A cross-sectional descriptive study of 401 physiotherapists in the city of Goiania. Two instruments were used a sociodemographic questionnaire and the Inventory of Stress Symptoms for Adults Lipp (ISSL) in the period from July 2013 to October 2014. Results: The stress was identified in 56.6% physiotherapists, and of these, 82 , 0% were in the resistance phase and psychological symptoms was found in 67.4% of participants. There was a greater distribution of stress among female physiotherapists (n = 192; 85%; p <0.001), who are dissatisfied with physical therapy (n = 87; 38.5%; p <0.001) and those who attribute stress to labor (n = 95; 42%; p <0.001). The results are discussed considering the associations between stress and labor activity of the physiotherapist. It was observed that physiotherapists in the work environment, are exposed to factors that lead to stress. Thus, there is need for action, particularly in the recognition of stressors, in order to develop mechanisms for effective coping in order to reduce the psychological and physical impact of stress. / Tese construída na modalidade artigo científico. O primeiro artigo tem como título “Estresse ocupacional em fisioterapeutas: revisão integrativa” e foi submetido à revista Ciência e Saúde Coletiva. Objetivos: selecionar, avaliar e analisar criticamente as publicações que tiveram como foco o estresse em fisioterapeutas. Métodos: trata-se de uma revisão integrativa, utilizando os descritores: esgotamento profissional; desgaste profissional; estafa profissional; estresse ocupacional; estresse profissional; exaustão emocional; exaustão física; exaustão profissional; satisfação no emprego; qualidade de vida. Os critérios de inclusão foram: pesquisas que investigaram o estresse ocupacional vivenciado por fisioterapeutas de qualquer área de atuação, sem limite de data; artigos em português, inglês ou espanhol. Resultados: Foram identificados 409 trabalhos, procedeu-se a leitura do título, descritores e resumo para fazer a seleção. Permaneceram 35 artigos, e destes, selecionados e avaliados nove estudos que mostram que o trabalho do profissional de fisioterapia apresenta-se exposto à tensão e a fatores ligados ao estresse ocupacional. Identificaram-se também os principais sintomas físicos e emocionais como cefaleia, algias musculares e articulares, problemas gástricos, cansaço, diminuição da concentração, nervosismo, ansiedade e distúrbios do sono. Em relação enfrentamento do estresse, as estratégias citadas pelos fisioterapeutas foram: exercício físico, lazer, férias, culpar outras pessoas, bebidas alcoólicas, compartilhar os problemas com colegas e/ou superiores; participar de curso sobre o manejo do estresse; massagem e independência financeira. Os artigos ressaltam uma complexidade inerente às características da profissão que acarreta um risco elevado de doenças físicas, mentais e emocionais ligadas à atividade laboral, o que reforça a necessidade de incorporar o tema na formação acadêmica de fisioterapeutas para a prevenção e enfrentamento do estresse ocupacional. O segundo artigo a ser submetido à revista Cadernos de Saúde Pública tem como título “Fatores associados ao estresse em fisioterapeutas”. Objetivos: o objetivo deste trabalho foi investigar a existência e o nível de estresse em fisioterapeutas da cidade de Goiânia-Go e identificar a presença dos sintomas predominantes e associar a presença de estresse e com as variáveis sociodemográficas. Métodos: estudo transversal e descritivo com 401 fisioterapeutas da cidade de Goiânia. Foram utilizados dois instrumentos, um questionário sociodemográficos e o Inventário de Sintomas de Stress para Adultos de Lipp (ISSL) no período de julho de 2013 a outubro de 2014. Resultados: o estresse foi identificado em 56,6% fisioterapeutas e, destes, 82,0% estavam na fase de resistência e os sintomas psicológicos foi encontrado em 67,4% dos participantes. Houve maior distribuição de estresse entre fisioterapeutas do sexo feminino (n=192; 85%; p<0,001), que estão insatisfeitos com a fisioterapia (n=87; 38,5%; p<0,001) e aqueles que atribuem o estresse ao trabalho (n=95; 42%; p<0,001). Os resultados são discutidos considerando as associações entre o estresse e atividade laboral do fisioterapeuta. Observou-se que fisioterapeutas, no ambiente de trabalho, estão expostos a fatores que levam ao estresse. Assim, há necessidade de uma intervenção, principalmente no reconhecimento dos fatores estressantes, para que se desenvolvam mecanismos para o enfrentamento eficaz, a fim de diminuir o impacto psicológico e físico do estresse.

Made available in DSpace on 2016-03-15T19:40:24Z (GMT). No. of bitstreams: 1 Cintia Mara Persona Nogueira.pdf: 437404 bytes, checksum: 99617ca25af1ea88ce874979e552d2d4 (MD5) Previous issue date: 2007-08-28 / Fundo Mackenzie de Pesquisa / After the graduation the physiotherapist find the most varied subjects in the daily practice and, starting from the experience and professional existence in the area the same happen not only to know your patients as well as the difficulties faced by them in the several atmospheres that he/she occupies, being in study situations, work or leisure. The present study had for objective to identify and to analyze the point of view of professionals of the physiotherapy in relation to the accessibility of the physical deficient ones. It was interviewed 10 physiotherapists that act in the neurology area, close to a University in the State of Paraná. Starting from the results it was identified the great support need to the physical deficient seeing that although there is specific legislation about the accessibility there are not services and enough supports offered for them. The interviewees considered important the approach of the inclusion of the physical deficient during the physiotherapist's formation, as well as the participation in debates, seminars and lectures about the theme. It was also considered important the approach of that thematic in the new professionals' formation, so the same ones can perform with larger conscience his/her social paper in the process of rehabilitation of a person with physical deficiency. / Após sua formação o fisioterapeuta se depara com os mais variados assuntos na sua prática diária e, a partir da experiência e vivência profissional na área o mesmo passa não somente a conhecer seus pacientes como também as dificuldades enfrentadas por eles nos diversos ambientes que ocupa, seja em situações de estudo, trabalho ou lazer. O presente estudo teve por objetivo identificar e analisar o ponto de vista dos profissionais da fisioterapia em relação à acessibilidade dos deficientes físicos. Foram entrevistados 10 fisioterapeutas que atuam na área de neurologia, junto a uma Universidade no Estado do Paraná. A partir dos resultados identificou-se a grande necessidade de apoio aos deficientes físicos visto que embora exista legislação específica sobre a acessibilidade não há serviços e suportes suficientes oferecidos para eles. Os entrevistados consideraram importante a abordagem da inclusão do deficiente físico durante a formação do fisioterapeuta, assim como a participação em debates, seminários e palestras sobre o tema. Considerou-se relevante também a abordagem dessa temática na formação dos novos profissionais, para que os mesmos possam desempenhar com maior consciência seu papel social no processo de reabilitação da pessoa com deficiência física.

Bakgrund: Fotboll bidrar till en stor andel idrottsskador och damfotbollsspelare löper generellt högre risk att drabbas av vissa skador samt har ett annat skademönster än manliga spelare. Existerande skadeförebyggande program har visat minskad förekomst av skador. Dock är färre studier gjorda på kvinnliga än manliga fotbollsspelare och studier kring fysioterapeutens syn på skadeförebyggande träning i damlag saknas. Syfte: Syftet var att undersöka fysioterapeutens tankar om, erfarenheter av och roll kring skadeförebyggande träning i svenska damfotbollslag på elitnivå.  Metod: En kvalitativ metod med deskriptiv design tillämpades. Datainsamlingen genomfördes med fem semistrukturerade intervjuer och bearbetades med kvalitativ innehållsanalys. Resultat: Resultatet visar att fysioterapeuterna anser att orsaker till skador ofta beror på personalbrist, för hög belastningsmängd samt spelares mående och livssituation. Fysioterapeutens ansvarsområden innefattar att ta beslut, göra individuella bedömningar, kommunicera med involverade i det skadeförebyggande arbetet samt att utforma den skadeförebyggande träningen. Viktiga faktorer som påverkar det skadeförebyggande arbetet lyfts fram som spelarens eget ansvar och ekonomiska resurser. Det skadeförebyggande arbetet i damfotbollslag kan utvecklas genom forskning, mer resurser samt förändrat arbetssätt gällande skadeförebyggande träning. Konklusion: Orsaker till skador, fysioterapeutens ansvarsområden, åtgärder samt begränsande faktorer bör tas i beaktning inom det skadeförebyggande arbetet i damfotbollsklubbar. Vidare behöver dessa delar utvecklas och få högre prioritet i klubbarna för att optimera det skadeförebyggande arbetet. Även mer forskning behövs inom ämnet för att täcka in alla områden och för att styrka fysioterapeutens roll i det skadeförebyggande arbetet. / Background: Football generates a large proportion of injuries and female football players are generally at higher risk of suffering certain injuries and have a different injury pattern than male players. Existing injury prevention programs have shown a reduced incidence of injuries. However, fewer studies have been done on female than male football players and studies regarding physiotherapist’s view of injury prevention in women’s teams are lacking. Purpose: The aim was to investigate the physiotherapist’s thoughts about, experiences of and role in injury prevention training in Swedish women’s football teams at the elite level. Method: A qualitative method with descriptive design was applied. The data collection was conducted with five semi-structured interviews and processed with qualitative content analysis. Results: The results showed that the physiotherapist’s believed that the causes of injuries are often due to shortage of staff, high total load and players well-being and life situation. The physiotherapist’s areas of responsibility include decisions, individual assessments, communication with those involved in the injury prevention work and designing the injury prevention training. Important factors that affect the injury prevention work are highlighted as the players own responsibility and financial resources in the team. The injury prevention work in women’s football teams can be developed through research, more resources and a changed way of working regarding injury prevention training. Conclusion: Causes of injuries, the physiotherapist’s areas of responsibility, interventions and limiting factors should be taken into account regarding injury prevention work in women’s football clubs. Furthermore, these factors need to be developed and given higher priority in the clubs in order to optimize the injury prevention work. More research is also needed regarding the subject to cover all the areas and to strengthen the physiotherapist’s role in injury prevention work.

Sammanfattning Bakgrund  Långvarig smärta hos barn och ungdomar är vanligt förekommande och flickor är mer drabbade än pojkar. Smärtan påverkar den drabbade i stor utsträckning vilket ofta visar sig i det sociala livet, vid dagliga aktiviteter och under skolgången. Syfte  Syftet med denna studie var att utforska flickor med långvarig smärtas upplevelser och erfarenheter av fysioterapeutisk behandling.  Metod En kvalitativ studie genomfördes med data baserat på semistrukturerade intervjuer. Bekvämlighetsurval användes för att rekrytera informanter. Data analyserades genom en kvalitativ innehållsanalys med abduktiv ansats.   Resultat Under intervjuerna framgick det att den långvariga smärtan bidrog till både fysiska och psykologiska begränsningar. Det som framförallt upplevdes som positivt med den fysioterapeutiska behandlingen var att känna sig delaktig och att kunna påverka utfallet, samtidigt som restriktioner från fysioterapeuten upplevdes begränsande. Behandlingen bidrog bland annat till en positivare inställning, en ökad aktivitetsnivå och ett förbättrat psykiskt välmående. Alla informanter var positivt inställda till att ha träffat en fysioterapeut även om vissa fått begränsade resultat av behandlingen. Det framkom att det var viktigt att fysioterapeuten visade intresse och kommunicerade med ungdomen i första hand.  Slutsats  Flickor som lever med långvarig smärta hade erfarenheter av både fysiska och psykologiska begränsningar. De positiva effekterna av den fysioterapeutiska behandlingen beskrevs som en ökad aktivitetsnivå och delaktighet i det sociala livet. Trots att behandlingen inte alltid givit den effekt som informanten eller dess anhöriga förväntat sig, hade fysioterapeutens bemötande och engagemang gjort ett stort avtryck hos informanten. / Abstract  Background  Chronic pain in children and adolescents is common and girls are more affected than boys. The pain effects the affected person widely which is often showed in the social life, in daily activities and in school. Aim  The aim of this study was to explore experiences of physiotherapeutic treatment among girls with chronic pain. Methods A qualitative study was made, and data were collected through semi structured interviews. Convenience sample was used to recruit informants. Data were analysed using a qualitative content analysis with an abductive approach.   Results Chronic pain in young girls caused both physical and psychological limitations. Positive experiences of the physiotherapeutic treatment included to feel involved in one’s own treatment and to be able to influence the outcome, while getting restrictions from the physiotherapist seemed limiting. The treatment contributed to a more positive attitude, an increased level of physical activity and an improved mental well-being. The informants had a positive attitude towards meeting a physiotherapist, even though some of them had seen limited results of the treatment. It was important that the physiotherapist showed an interest and communicated with the adolescent in the first place.  Conclusion Girls who live with chronic pain had experiences of both physical and psychological limitations. The positive effects of the physiotherapeutic treatment were described as an increased activity level and participation in social life. Even though some of the girls had seen limited results of the treatment, the physiotherapist’s commitment made a great impression on the informants.

Bakgrund: Fysisk aktivitet har ett flertal goda hälsoeffekter samt positiv inverkan på, kognition, prestation i skolan och motorisk utveckling. I dagens Sverige rör sig barn och ungdomar allt mindre och få uppnår rekommendationerna för fysisk aktivitetsnivå. Fysioterapeuter har god kunskap om fysisk aktivitet och rörelse och nyttjas i andra länder inom skolans värld, i dagsläget är detta dock mycket ovanligt i Sverige. Syfte: Utforska hur fysioterapeuter verksamma inom skolans värld i Sverige upplever sin möjlighet och handlingsutrymme att påverka barns rörelsebeteende. Metod: Studien bygger på kvalitativ metod och tre semikonstruerade intervjuer genomfördes med fysioterapeuter verksamma inom elevhälsan. Intervjuerna spelades in och transkriberades. Materialet analyserades sedan enligt Graneheim och Lundmans kvalitativa innehållsanalys. Resultat: Fem huvudkategorier framkom: Vårdnadshavarnas avgörande roll för beteendeförändring, Att använda ett systematisk men samtidigt individanpassat arbetssätt, Elevernas medverkan och möjligheten att få lyckas: nyckel till framgång, Socialt stöd och gruppens betydelse för både elev och fysioterapeut, Fysioterapeuten är beroende av och utgår ifrån skolans egna resurser i sitt arbete. Dessa kategorier delades därefter in i 16 underkategorier. Slutats: Skolfysioterapeuterna i Sverige arbetar huvudsakligen för att aktivera och identifiera elever med motorisk svårighet som skolan själva inte når. I arbetet med dessa elever identifieras skolmiljön och dess resurser som viktiga för skolfysioterapeutens förmåga och handlingsutrymme att arbeta med elevers rörelsebeteende. / Introduction: Physical activity has been proven to be beneficial for cognition, academic results, overall health, and motor development. Physiotherapists have a profound knowledge in how to promote physical activity and movement. This knowledge is made use of in other countries, where school-based physiotherapists are common. In Sweden, on the other hand, school-based physiotherapists are scarce.  Purpose: To explore how school-based physiotherapists in Sweden experience their ability and room for manoeuvre when it comes to affecting children's movement behaviours.  Method: A qualitative study based on three semi-structured interviews with school-based physiotherapists in Sweden. The interviews were recorded, transcribed, and later analysed according to Graneheim and Lundman’s qualitative content analysis. Result: The results revealed five main categories and 16 subcategories. The main categories that were identified were: Guardians crucial role for behaviour change, Using a systematic but at the same time individualised approach, Students participation and the opportunity to succeed: the key to success, Social support and the group's importance for both student and physiotherapist and Physical therapists are dependent on the school's own resources.  Conclusion: The school-based physiotherapists in Sweden mainly work to activate and identify students with motor difficulties that the school itself does not have the ability to help. School-based physiotherapists identified the school environment and its resources as important for their ability and room for manoeuvre to work with students' movement behaviours.

Bakgrund:  Idag erbjuds idrottsutbildning på runt 200 skolor i Sverige för elever som vill kombinera sina gymnasiestudier med elitsatsning inom sin idrott. Aktuell forskning visar en hög prevalens av skador hos unga elitsatsande idrottare samt att skador är en av de vanligaste orsakerna till att unga slutar med sin idrott. Medicinskt stöd på idrottsgymnasium kan minska konsekvenserna av att vara skadad samt förebygga nya skador och det är därför motiverat att dessa skolor har tillgång till detta. Syftet med denna studie var att undersöka tillgång till medicinskt stöd vid riksidrottsgymnasium (RIG) och nationellt godkända idrottsutbildningar (NIU) i Sverige.  Metod Studien genomfördes med en tvärsnittsdesign och omfattade RIG och NIU i Sverige. Data samlades in genom rektor eller annan ansvarig som besvarade en webbaserad enkät på uppdrag av skolan. Totalt bjöds 180 skolor in att delta i studien varav 86 besvarade enkäten och inkluderades i studien. Datainsamling pågick under perioden 211122–220204. Statistisk analys gjordes med Fisher exact test och Chi-square test för att jämföra tillgång till medicinskt stöd på RIG och NIU. P-värde ≤ 0,05 valdes som statistiskt signifikant. Resultat Av de 86 skolor som svarade på enkäten hade 73% tillgång till medicinskt stöd och 52% hade tillgång till fysioterapeut.  Det förelåg ingen skillnad gällande medicinskt stöd mellan de som endast erbjuder RIG och endast NIU (p=0,554). Det fanns 35 olika idrotter på de skolor som deltog i studien. Följande professioner fanns representerade på skolorna: fysioterapeut, sjuksköterska, läkare, psykolog, kurator och dietist.  Konklusion Denna studie visar att majoriteten (71%) av skolorna som erbjuder idrottsutbildning i Sverige tillgång till medicinskt stöd men endast hälften (52%) hade tillgång till fysioterapeut. Det behövs mer samlad information om vilka skolor som erbjuder idrottsutbildning samt fler studier för att utvärdera vilken betydelse medicinskt stöd har för elevernas hälsa och risken för skador. / Background There are 200 schools in Sweden for students who wants to combine their high school studies with elite sports. Today many are specializing in competitive sports at young age and current research shows a high injury prevalence in young elite athletes. Injuries is one of the main reasons many quit their sport at a young age. Medical support can reduce the consequences of an injury and prevent new injuries. Thus, medical team in sports high school programs could be strongly recommended. The aim of this study was to investigate access to a medical team at national sports high school (RIG) and nationally approved sport educations (NIU) in Sweden,    Method The study was a cross-sectional study and included RIG and NIU in Sweden. Data was collected by a web-designed survey. A total of 180 schools were invited, 86 responded to the survey and were included in the study. Data was collected from December 2021 to February 2022. Statistical analysis was done with Fisher exact test and Chi square test to compare access to medical support at RIG and NIU. P-value ≤ 0,05 was selected as statistically significant.  Result A total of 86 schools replied to the survey, 73% of these stated that they had access to medical support and 52% had access to a physiotherapist. There was no disparity between RIG and NIU regarding medical support (P= 0,554).  There were 35 different sports at the schools and the following professions were represented: physiotherapist, nurse, doctor, psychologist, curator, and dietician.  Conclusion  Based on this study most (71%) sports high schools in Sweden seem to have access to medical support but only 52% had access to a physiotherapist. More information is needed regarding which schools offer a sports education and there need to be more studies to evaluate the importance of medical support for students’ health and the risk of injury.

Thesis (MPH.) -- University of Limpopo, 2022 / Background: The demand of providing physiotherapy services have increased due to the population growth, an increase in number of aging people, accidents and rising cases of chronic diseases. A sudden increase in number of patients seen by physiotherapists is worthwhile for exploration since overcrowding is a concern in many public hospital facilities in South Africa. The purpose for this study was to profile physiotherapy patients and barriers to obtaining optimal physiotherapy services at Nkensani Hospital. Methodology: A quantitative, cross- sectional study was conducted for profiling of physiotherapy patients and barriers to obtaining optimal physiotherapy services at Nkensani Hospital. A simple random sampling was used to sample 398 patients who were receiving physiotherapy services at Nkhensani Hospital. Data was collected using a designed questionnaire that was administered by the researcher to patients who were receiving physiotherapy services at Nkhensani hospital between November 2020 to February 2021. Data was analysed using the statistical package for social sciences (SPSS) version 25. Results: Approximately 46.3% of the participants were males and 53.7% were females. Majority of the participants had Primary education at 55.5%, followed by those who did not attend school at all, tertiary and secondary education level at 23.1%, 11.3% and 10.1% respectively. Most of the participants were unemployed at 81.2%. The patients who required Physiotherapy services were diagnosed with conditions related to Orthopaedic or Musculoskeletal at 52%, followed by Neurological, geriatric, paediatric and cardio/respiratory conditions at 27%, 13%, 7%and 1% respectively.The barriers to obtaining optimal physiotherapy services by patients were lack of family support, lack of support from friends, the use of traditional medicines, the costs of hiring a caregiver, affordability of services and affordability of transport to hospital. Conclusion: The study reveals that orthopaedic or musculoskeletal conditions are the most prevalent conditions. It is recommended that adequate community health education and intervention services be provided and made affordable and accessible to rural communities. Key concepts: Barrier, Physiotherapy services, Physiotherapist, Physiotherapy patients, Optimal.

Bakgrund: Långvarig smärta är ett komplext sjukdomstillstånd som kräver särskilda rehabiliteringsåtgärder. Ofta tillämpas ett interdisciplinärt arbetssätt vid smärtrehabilitering. Teamarbete är en viktig aspekt av det interdisciplinära arbetet. Det finns fortfarande ett begränsat antal studier som undersöker fysioterapeutens upplevelser av interdisciplinärt teamarbete. En studie som undersöker fysioterapeuters perspektiv kan bidra till ökad förståelse och kunskap inom området.   Syfte: Att undersöka fysioterapeuters upplevelser av teamarbete inom interdisciplinär rehabilitering vid långvarig smärta.  Metod: En kvalitativ studiedesign baserad på fem semistrukturerade intervjuer med fysioterapeuter som arbetat mellan ett och tolv år inom smärtrehabilitering bearbetades med kvalitativ innehållsanalys.  Resultat: Den kvalitativa innehållsanalysen resulterade i fyra kategorier och 15 underkategorier. De fyra huvudkategorierna som identifierades var följande: vikten av kommunikation vid teamarbete, organisatoriska förutsättningar som bidrar till gott samarbete, samspel en viktig grund för teamarbete och professionella och sociala färdigheter som påverkar teamarbete.  Konklusion: Resultatet från studien överensstämmer med tidigare forskning inom närliggande områden. Framgångsfaktorer vid kliniskt teamarbete kan vara utarbetade strukturer för kommunikation som reflektion och att sitta i närheten av varandra inom teamet. Olika synsätt och förändringar i teamets sammansättning kan försvåra teamarbete. För att främja ett effektivt teamarbete krävs det att individen kan samspela med andra professioner samt besitter både professionella och sociala färdigheter. / Background: Chronic pain is a complex condition that requires special attendance. Interdisciplinary care is a frequently used method in chronic pain rehabilitation. Teamwork is an important part of interdisciplinary care. Previous research considering physiotherapists' experiences in chronic pain rehabilitation is of limited extent. Hence, a study examining this topic could be of value. Purpose: The study's purpose was to explore physiotherapists' teamwork experiences in interdisciplinary rehabilitation of chronic pain.   Method: A qualitative design with semi-structured interviews was employed. Five physiotherapists that have been working in chronic pain rehabilitation between one to twelve years were recruited using convenient sampling. Qualitative content analysis was conducted to analyze the data.   Results: Four main categories and 15 subcategories were identified. The main categories described the importance of communication in teamwork, organizational structures and factors that influence teamwork, interplay between individuals in the team and how professional and social skills impact teamwork.   Conclusion: The findings in this study have previously been confirmed in studies conducted in related research areas. Well-designed structures for communication such as reflection and also having workspace close to each other within the team are suggestions for creating good teamwork. Different viewpoints among team members could be a barrier for effective teamwork as well as changes in the team constellation. An efficient teamwork is promoted when the individuals in the team are possessing both professional and social skills.

Bakgrund: Efter graviditet påverkas kroppen anatomiskt och fysiologiskt vilket fysioterapeuter har kunskap om. Fysioterapeuten kan spela en viktig roll efter förlossning för att vägleda kvinnor att återuppta sin fysiska aktivitet eller som hjälp vid besvär efter graviditet. Fysioterapeutens roll efter graviditet är dock inte tydlig. Många vet inte var de ska söka vård vid graviditetsrelaterade komplikationer vilket leder till att många vänder sig till internet som har både för- och nackdelar. Syfte: Syftet med studien var att ta reda på om kvinnor som genomgått en graviditet anser att de har fått tillräckligt med information om träning och fysisk aktivitet från hälso- och sjukvården i Sverige. Metod: En kvantitativ enkätstudie med ett positivistiskt och holistiskt synsätt valdes. Insamlingen av data genomfördes i form av en enkätstudie med egenformulerade frågor som lades ut med länk på sociala medier. Resultat: Totalt svarade 105 kvinnor på enkäten. Största andelen av kvinnorna angav att de inte fått någon information om träning och fysisk aktivitet efter graviditet. De som angav att de fått information ansåg den vara måttligt eller tillräckligt viktig. Den källa som flest fått information ifrån var internet, följt av barnmorska och fysioterapeut. Nästan två av tre visste inte att de kunde besöka en fysioterapeut för hjälp efter en graviditet. Konklusion: Idag finns brister inom vården när det kommer till information om träning efter graviditet. Fysioterapeuten är en outnyttjad resurs. Studien visar att majoriteten av kvinnorna vänder sig till internet för information. Vidare forskning behövs inom området. / Background: After pregnancy, the body undergoes anatomical and physiological changes, which physiotherapists are knowledgeable about. A physiotherapist can play an important role postpartum by guiding women in resuming physical activity or assisting with pregnancy-related issues. However, the role of the physiotherapist after pregnancy is not clearly defined. Many women do not know where to seek care for pregnancy-related complications, leading many to turn to the internet, which has both advantages and disadvantages. Aim: The aim of the study was to determine whether women who have gone through pregnancy feel they have received sufficient information about exercise and physical activity from the healthcare system in Sweden. Method: A quantitative survey study with a positivist and holistic approach was chosen. Data collection was carried out through a survey with self-formulated questions, which was distributed via a link on social media. Results: A total of 105 women responded to the survey. The majority of the women indicated that they did not receive any information about exercise and physical activity postpartum. Those who did receive information considered it to be moderately or sufficiently important. The most common source of information was the internet, followed by midwives and physiotherapists. Nearly two out of three did not know they could visit a physiotherapist for help after pregnancy. Conclusion: There are shortcomings in the healthcare system regarding information about exercise after pregnancy. Physiotherapists are an underutilized resource. The study shows that the majority of women turn to the internet for information. Further research is needed in this area.