ABSTRACT
Más de mil millones de personas viven en el mundo en situación de discapacidad. La Medicina Física y Rehabilitación (MFR) o Fisiatría es la especialidad médica que con un enfoque transdisciplinario es responsable de la prevención, diagnóstico y tratamiento rehabilitador de las personas en situación de discapacidad (PSD). La literatura internacional reporta que un importante número de personas en situación de discapacidad no han recibido el manejo y soporte adecuados, pudiendo ello deberse en parte a la falta de conocimientos de los médicos sobre los alcances de la MFR. OBJETIVO: Explorar el conocimiento existente respecto a la especialidad MFR entre los médicos que trabajan en el sistema público de salud (SPS) de la Región Metropolitana (RM) de Chile. MÉTODO: Estudio descriptivo de corte transversal. Se aplicó una encuesta confeccionada y validada para explorar el conocimiento de los médicos sobre la MFR en 27 centros de salud de la RM. RESULTADOS: 131 médicos de diferentes especialidades contestaron la encuesta. El 24,07% de los pacientes por ellos atendidos correspondía a PSD. El 39,7% de los encuestados respondió "nunca" derivar pacientes al médico fisiatra y el 74,8% reconoció no estar completamente interiorizado sobre las áreas que involucra la MFR. CONCLUSIÓN: El conocimiento sobre la MFR entre los encuestados es parcial. Áreas específicas del quehacer del fisiatra y algunas instituciones en las cuales trabajan son desconocidas. Un importante número de pacientes podría no estar recibiendo oportunamente evaluación fisiátrica y tratamiento rehabilitador, perpetuando o incluso agravando la condición inicial. Se deben crear mecanismos de difusión de esta rama médica en los equipos de salud para un mejor conocimiento e integración de la rehabilitación en Chile.
More than one billion people in the world live with a disability. Physical Medicine and Rehabilitation (PMR), or Physiatry, is a medical specialty with a transdisciplinary approach that is responsible for the prevention, diagnosis, treatment and rehabilitation of people with disabilities (PD). The international literature reports that a significant number of people with disabilities have not received proper handling and support; this may be partly due to lack of knowledge concerning PMR. OBJECTIVE: To explore the existing knowledge of PMR among physicians working in the public health system (PHS) of the metropolitan region (MR), Chile. METHOD: Descriptive cross-sectional study. A validated survey was applied to physicians in 27health centers in the MR. RESULTS: 131 physicians from different specialties responded to the survey: 24.07% of their patients corresponded to PD. 39.7% of respondents answered they "never" refer patients to the physiatrist and 74.8% admitted not being completely familiar with the areas involved in PMR. CONCLUSION: Knowledge about PMR among respondents is partial. Specific areas of the physiatrist's role and institutions in which they work at are unknown. A significant number of patients might not be receiving opportune physiatric evaluation and rehabilitation, possibly perpetuating or even exacerbating their initial condition. Mechanisms for disseminating this medical branch among health teams should be created for a better understanding and integration of rehabilitation in Chile.
Subject(s)
Humans , Physical and Rehabilitation Medicine , Physicians/psychology , Health Knowledge, Attitudes, Practice , Public Health Services , Referral and Consultation/statistics & numerical data , Chile , Cross-Sectional Studies , Surveys and Questionnaires , Disabled Persons/rehabilitation , Physiatrists/supply & distributionABSTRACT
OBJECTIVES:The study aimed to determine the perceptions, attitudes, knowledge and practice of Evidence-Based Medicine (EBM) among Rehabilitation Medicine trainees and faculty. It aimed to compare trainees and faculty in terms of perceptions, attitudes, knowledge and practice. The study also intended to identify the barriers in the practice of EBM.METHODS: The study utilized a cross-sectional design. The study included residents or trainees and consultants at the Department of Rehabilitation Medicine-Philippine General Hospital. A questionnaire exploring the perceptions, knowledge, attitudes and practice of EBM and the barriers in its practice was developed based on review of previous studies. Focus group discussions were conducted with the residents and consultants separately to probe the responses in the questionnaire.RESULTS: Thirty-four trainees and consultants participated in the study. Trainees considered themselves having received more training in literature search (p=0.005) and critical appraisal (p=0.01) than consultants. Majority had fairly accurate conceptions of EBM. Thirty-eight percent of participants considered themselves competent in developing a clinical question and in doing a literature search. About 18% considered themselves competent in appraising literature. There were no significant differences between trainees and consultants in terms of their perceived knowledge and skills in EBM techniques. Consultants and trainees expressed positive attitudes towards EBM. In a week, some 50% search the literature at least twice and appraised an article. Eighty percent of Rehabilitation Medicine physicians (physiatrists) spent at least 2 hours per week reading related literature. In terms of practice of EBM, the trainees rated themselves higher in searching and appraising literature than the consultants but the differences were not significant. More than 90% indicated interest in further training in EBM. Majority cited lack of time, lack of understanding of statistics and inadequate information sources as barriers to EBM.CONCLUSION: Physiatrists have fairly accurate perceptions; positive attitudes; some knowledge / skills; and a high level of interest in EBM. There were no significant differences between consultants and trainees except in the aspect of training in literature search and appraisal. The lack of personal time, lack of understanding of statistical analyses and inadequate information sources were the most common perceived barriers in the practice of EBM in Physiatry.