Becoming comfortable with the uncomfortable: The tale of adaptability.

Background: With the ever-changing healthcare environment and impact of the coronavirus disease 2019 (COVID-19) pandemic on tertiary education, healthcare students need to constantly adapt their approach to learning, clinical practice and well-being. Adaptive performance is therefore vital. Objectives: To investigate the adaptive performance of final year physiotherapy students at the University of the Free State. Method: A quantitative descriptive study was performed. All consenting final year undergraduate physiotherapy students registered at the University of the Free State in 2021 were approached for inclusion. The short 55-item I-ADAPT measurement was distributed electronically to all possible participants. Results: The response rate was 28.5% (n = 8). Descriptive statistics, namely frequencies and percentages for categorical data and medians and percentages for numerical data were calculated. The dimensions related to handling work stress (50%), uncertainty (62.2%) and creativity (64.0%) scored the lowest. Emotional response to stress (62.5%) and frustration in response to unpredictable situations (62.5%) was reported. Conclusion: Uncertainty and unpredictability are inevitable for healthcare students. Stress management and emotional intelligence development are advised for inclusion in undergraduate physiotherapy programmes. Clinical implications: A need for curricular evaluation to ensure students are equipped with stress management and emotional intelligence skills is proposed.

Exercise interventions used along the continuum of cancer care: A scoping review protocol.

Background: Cancer is one of the leading causes of death worldwide. Exercise is crucial for ameliorating the burden associated with cancer and its management. A broad review of exercise interventions for cancer patients is not available. Objective: Our study aims to review the documented exercise interventions prescribed for adult cancer patients aimed at ameliorating cancer-related and cancer treatment-induced symptoms in patients along the continuum of care. Methods: A three-step search strategy will be used, the research question was developed; the first step in the research process was identified and the search strategy was developed using the Participants-Concept-Context framework. English language publications from 15 electronic databases from 2011 to 2021 will be searched. The Joanna Briggs Institute methodology for scoping reviews will be to guide the review and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews will be used for the report. The search strategy incorporated terms relevant to the research question. The reference lists of articles included in the review will be screened for additional papers. Searched articles will be screened to determine their eligibility for inclusion and a pretested data extraction form will be used to chart the extracted evidence. Results: This article presents a protocol for a scoping review on exercise interventions to affect symptoms in cancer patients from diagnosis to end-of-life care. Conclusion: A broad review of exercise interventions for cancer management in adult patients will elucidate the characteristics and context of exercises used along the cancer care continuum. Clinical implications: Exercise interventions used as part of cancer management will be mapped out to provide an overview of such exercise interventions. This could enhance knowledge among exercise oncology experts regarding exercise interventions for different cancer patient populations.

The PIER framework for healthcare simulation integration in undergraduate physiotherapy education.

BACKGROUND: The need for healthcare curricula renewal to facilitate a continuum in education from classrooms to diverse healthcare settings is undeniable. Simulation has been recognized as an educational strategy to address healthcare education challenges, with limited reporting on the integration of simulation-based learning experiences in physiotherapy education. The study aimed to describe the finalisation of a framework for integration of healthcare simulation in an undergraduate physiotherapy program. METHODS: A qualitative descriptive research design was utilized. Five South African experts in the fields of healthcare simulation and/or physiotherapy education contributed to the finalization of the framework during a consensus meeting. Content analysis was employed and credibility was ensured through double coding. RESULTS: Structural coding yielded five themes- Planning, Implementation, Program Evaluation, Program Revision and Framework. The five themes consisted of fifteen categories, two sub-categories and 44 codes. The planning theme was most robust with seven categories. The Planning, Implementation, Evaluation, Revision (PIER) framework was developed and finalized by expert participants. following the consensus meeting. CONCLUSION: Needs analyses when planning and incorporating simulation is essential. Collaboration through resource and knowledge sharing is vital in developing a responsive curriculum integrating simulation. Furthermore, facilitator and student preparation are paramount in ensuring active engagement in simulated-based learning experiences. The interconnectedness of all framework elements and integration phases, as well as the implied importance of competent facilitators and prepared students is crucial and highlights careful consideration to be given to these aspects. The PIER framework is generic in nature and represents the continuous process of simulation integration for any healthcare program.

Referral practices of medical practitioners in central South Africa to physiotherapy services for patients living with musculoskeletal conditions.

BACKGROUND: Musculoskeletal diseases (MSDs) are a major cause of disability worldwide. It is essential to address effective MSD management, including appropriate referrals to physiotherapists and other healthcare professionals. Limited information is available regarding the referral practices of medical practitioners for patients with MSD. The doctors' referral practices to physiotherapists can impact the patient population and the South African health system. OBJECTIVES: To investigate or understand the referral practices of medical practitioners in Bloemfontein, South Africa, to physiotherapy services, for individuals living with MSD. METHOD: A quantitative study approach, implementing a semi-structured questionnaire, was used. Forty-nine participants completed the questionnaire. RESULTS: The referral of patients with MSDs by medical practitioners to physiotherapy services varied and multidimensional factors influenced their referral practices. Medical practitioners were unsure of the specific role played by physiotherapists in the management of individuals living with MSD. A need for improved relationships and communication between medical practitioners and physiotherapists was identified. CONCLUSIONS: Medical practitioners regularly referred individuals living with MSD to physiotherapists, but referral practices should be optimised in terms of evidence-based practice and the use of specialised physiotherapy services. In an attempt to decrease the burden of MSD, adequate awareness should be created for improved referral practices between medical practitioners and physiotherapists. CLINICAL IMPLICATIONS: Collaborative development of detailed guidelines for apt, evidence-based referrals should be developed, to ensure early detection and management of individuals living with MSD. Health care professionals should be educated and encouraged to refer individuals living with MSD to physiotherapists for appropriate management with clinical benefits including improvement of HRQOL and cost effectiveness of this management not only to the individual but also to the health system in South Africa. Physiotherapists should try to communicate their role in the treatment of individuals living with MSD to medical practitioners for the benefit of the patient.

Hand rehabilitation programmes for second to fifth metacarpal fractures: A systematic literature review.

BACKGROUND: Metacarpal fractures, one of the most prevalent upper limb fractures, account for 10% of all bony injuries. OBJECTIVE: Our systematic review aimed to review, appraise and collate available evidence on hand rehabilitation programmes for the management of second to fifth metacarpal fractures in an adult human population after conservative and surgical management. Since 2008, no review on a similar topic has been performed, thus informing clinical practice for physiotherapists and occupational therapists. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) principles guided the reporting. Experimental, quasi-experimental, cohort and case-control studies between January 2008 and September 2018 were included. Searches were conducted on Medline, Academic Search Ultimate, CINAHL, CAB Abstracts, Health Source - Consumer Edition, Health Source: Nursing/Academic Edition, SPORTDiscus, Africa-Wide Information and MasterFILE Premier, Web-of-Science and Scopus. Screening, selection, appraisal and data extraction were independently performed by two reviewers. No meta-analysis was performed. RESULTS: A total of 1015 sources were identified, 525 duplicates removed and 514 excluded. Three articles were included in the final data extraction: one randomised controlled trial (RCT) and two observational studies. CONCLUSION: Limited evidence is available that a well-designed, well-implemented home-based exercise programme results in statistically significant improved hand function (p ˂ 0.0001) and digital total active motion (TAM) (p = 0.013) compared with traditional physiotherapy (PT) post-surgically. CLINICAL IMPLICATIONS: Our study contributes to the knowledge base of hand rehabilitation after an individual sustained a second to fifth metacarpal fracture. The authors identified a gap where future studies should further investigate the effect of hand rehabilitation after conservative and surgical management.

Improvements in health-related quality of life and function in middle-aged women with chronic diseases of lifestyle after participating in a non-pharmacological intervention programme: A pragmatic randomised controlled trial.

BACKGROUND: Musculoskeletal diseases consume a large amount of health and social resources and are a major cause of disability in both low- and high-income countries. In addition, patients frequently present with co-morbid chronic diseases of lifestyle. The area of musculoskeletal disease is restricted by a lack of epidemiological knowledge, particularly in low- and middle-income countries. OBJECTIVES: This pragmatic randomised controlled trial assessed the benefits of a 6-week physiotherapy intervention for middle-aged women with musculoskeletal conditions compared to usual care. METHOD: A weekly 2-h educational programme utilising a workbook, discussion group and exercise class was presented for the intervention group, while the control group received usual care. The primary outcome was health-related quality of life. Parametric and non-parametric data were used to determine the equivalence between the groups. RESULTS: Twenty-two participants were randomised to the intervention and 20 to the control group. The control group demonstrated no within-group improvement in health-related quality of life items, compared to significant improvements in two items in the intervention group. The change in median utility score within the intervention group was twice as large as the change in the control group. With regard to self-efficacy, the intervention group demonstrated significant within-group changes in perceived management of fatigue and discomfort. CONCLUSION: The positive impact of the intervention on the participants suggests that the programme should continue at the clinic in question, but should be presented at a more convenient time for participants who work, as recruitment to the study was less than anticipated. Primary health care systems in South Africa urgently need to put structures in place for effective management of the functional impact of chronic diseases of lifestyle and musculoskeletal conditions. It is time for physiotherapists and possibly other health care professionals to participate in the development of appropriate community level interventions to address the functioning and quality of life of individuals living with the diseases.

Joint pain within adult middle-aged women, attending a community clinic in a peri-urban area in South Africa: a cross-sectional survey.

BACKGROUND: This study aimed to investigate the prevalence of joint pain in women between the ages of 40 and 64 years who attended a community clinic in the Free State to provide micro-information for health care planners. METHODS: A sample of convenience was utilized in the cross-sectional survey. Health care workers were recruited to conduct the survey. Outcome measures included the Community-Oriented-Programme-For-The-Control-Of-Rheumatic-Disease questionnaire and European Quality of Life - 5 Dimensions health related quality of life measure. Descriptive statistics were calculated for categorical data and non-parametric tests for ordinal data. Quality Adjusted Life Years lost were based on the preference weights generated by the European Quality of Life - 5 Dimensions. RESULTS: One thousand three hundred seventy-six participants were enrolled. The prevalence of joint pain experienced in either the short or the long term was 62.1% (CI 59.5-64.6%). The total number of Quality Adjusted Life Years lost in this sample was 41.4, that is a rate of 3008.7 (CI 2740-3310) per 100,000. CONCLUSION: Epidemiological transition seems to be rapidly taking place in South Africa and the prevalence of joint pain is considerable. Primary health care systems should develop a cost-effective approach to manage and identify joint pain and improve the health-related quality of life of those living with this. Implications for Rehabilitation Prevalence of joint pain is considerable. Consume large amounts of health and social resources. A protocol for routine screening should be developed in community clinics. Cost-effective approach to manage joint pain should be identified to improve healthrelated quality of life of individuals living with joint pain.