Problems, difficulties and solutions in pediatric physical therapy in community hospitals

Abstract

The aim of this study was to survey community physical therapists’ (PTs) opinions regarding clinical problems, difficulties, and barriers as well as solutions of pediatric physical therapy (PedPT) in community hospitals in Thailand.  The questionnaire was sent to all community PTs via e-mail and postal.  The data were coded and analyzed by descriptive statistics.  Opinions regarding problems and difficulties as well as solutions were categorized as thematic analysis by the researcher and 2 experts. Sixty percent of the respondents (i.e., 302 of the total 500 PTs) completed the questionnaires.  The respondents’ attitudes revealed that they agreed and realized that PedPT improved the quality of life in children with disabilities (CWD), however, the responsibility areas were too large, clinical practicum in pediatric physical therapy during bachelor curriculum affected providing services in CWD, poor families and no support by governmental and/or non-governmental organizations were problems and difficulties in providing services.  In terms of knowledge and skills, the study revealed insufficiency of both clinical practicum and continuing education in pediatric and community physical therapy.  In terms of the work system, the study revealed that there are insufficiency of policies and supports in pediatric physical therapy, ineffective home visits, unclear in coordination of involved staff and unclear in community based rehabilitation for caring CWD.  Suggestions in solutions are as following: regular home visits or community visits; educating and coordinating with families, communities and related staffs; effective referral and hospital system; self-study and increasing pediatric and community related seminars or workshops; good consultation by major hospitals; and good supports by both hospital and ministry levels.  According to this study, it is concluded that the community physical therapists have the problems and difficulties in knowledge and skills as well as work system in providing pediatric physical therapies in community. The further study should be conducted to solve the problems and difficulties effectively in order to improve pediatric physical therapy services in primary health care.