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Background: Physiotherapy education and practice have country-specific peculiarities which may limit globalization in health care. This study aimed to characterize physiotherapy practice and treatment preferences, educational qualifications, and research in Nigeria, with a view of providing vital information for transnational integration and collaboration.
Methods: A cross-sectional survey of 104 Nigerian physiotherapists was conducted. The Physical Therapy Practice Questionnaire and a self-developed proforma were used as survey tools.
Results: The mean age of respondents was 33.5 ± 9.4 years. About two-fifth of all respondents (39.4%) had an MSc and mostly practice as clinicians (51.0%) in teaching hospitals (34.6%). The respondents were mostly involved in general practice (50.0%), with a caseload of 1–10 patients per day (67.3%). Soft tissue mobilization (83%), proprioceptive neuromuscular facilitation (76%), breathing exercises (77%), and transcutaneous electrical neuromuscular stimulation (83%) were commonly used. Respondents were familiar databases and evidence-based resources (81.2%) and mostly utilize PubMed (73.3%). Regular case conferences with professional colleagues (47.6%) and treatment planning of between 11 and 30 min (40.6%) were common. Educators spend 1–3 h planning educational work (91.8%). Clinical decision-making is mostly based on professional experience, while journals are the primary resource for educational information.
Conclusion: Physiotherapy practice in Nigeria is degree based and requires registration board’s licensure. Practitioners deal with a high caseload and utilize a wide range of techniques and modalities and have tendencies to utilize personal experience and research in making clinical decisions. The parity in education and practice with advanced climes inadvertently gives physiotherapy practice in Nigeria a global purview.
Background: Stratified care has the potential to be efficient in addressing the physical and psychosocial components of low back pain (LBP) and optimise treatment outcomes essential in low-income countries. This study aimed to investigate the perceptions of physiotherapists and patients in Nigeria towards stratified care for the treatment of LBP, exploring barriers and enablers to implementation.
Methods: A qualitative design with semistructured individual telephone interviews for physiotherapists and patients with LBP comprising research evidence and information on stratified care was adopted. Preceding the interviews, patients completed the Subgroups for Targeted Treatment tool. The interviews were recorded, transcribed and analysed following grounded theory methodology.
Results: Twelve physiotherapists and 13 patients with LBP participated in the study (11 female, mean age 42.8 (SD 11.47) years). Seven key categories emerged: recognising the need for change, acceptance of innovation, resistance to change, adapting practice, patient’s learning journey, trusting the therapist and needing conviction. Physiotherapists perceived stratified care to be a familiar approach based on their background training. The prevalent treatment tradition and the patient expectations were seen as major barriers to implementation of stratified care by the physiotherapists. Patients see themselves as more informed than therapists realise, yet they need conviction through communication and education to cooperate with their therapist using this approach. Viable facilitators were also identified as patients’ trust in the physiotherapist and adaptations in terms of training and modification of the approach to enhance its use.
Conclusion: Key barriers identified are the patients’ treatment expectations and physiotherapists’ adherence to the tradition of practice. Physiotherapists might facilitate implementation of the stratified care by communication, hierarchical implementation and utilisation of patients’ trust. Possibilities to develop a consensus on key strategies to overcome barriers and on utilisation of facilitators should be tested in future research.