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Publication
Fisioterapia no Serviço Nacional de Saúde: Perceções sobre a qualidade dos cuidados, autonomia profissional e práticas baseadas na evidência
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Advisor(s)
Abstract(s)
A adoção de boas práticas em Fisioterapia implica o exercício de uma abordagem de
prática baseada na evidência (PbE), pelos seus efeitos na qualidade dos cuidados. O
cumprimento desta matriz de atuação depende da autonomia profissional, capaz de
recorrer a técnicas de base científica com fins de promoção da saúde e de prevenção,
diagnóstico e tratamento da doença, ou de reabilitação, conforme prevê a
regulamentação da profissão. Contudo, ao contrário do que acontece nos serviços
privados em Portugal, no Serviço Nacional de Saúde (SNS), incluindo clínicas
convencionadas, a Fisioterapia adquire um enquadramento integrado no processo de
referenciação de Medicina Física e Reabilitação (MFR), comprometendo a autonomia.
Esta pesquisa teve como objetivo caracterizar as perceções dos fisioterapeutas do SNS
sobre a predisposição para a autonomia profissional e as PbE, nos cuidados que
prestam. Foi realizado um inquérito por questionário online dirigido aos fisioterapeutas
que atuam com doentes do SNS, obtendo-se 151 respostas. Os dados foram sujeitos a
análise estatística descritiva, redução de dimensões, fatorial e correlacional com recurso
ao software SPSS. Os Fisioterapeutas inquiridos identificam o tempo dispensado por
utente como o principal fator inibidor da PbE, sendo mais problemático nas clínicas
convencionadas. Por sua vez, consideram as suas skills tecnológicas e interesse em PbE
os principais facilitadores. Para os inquiridos, a PbE influencia positivamente a qualidade
dos cuidados de saúde, sendo sobretudo limitada pela falta de recursos nos locais de
trabalho. Destaca-se ainda que, num cenário de iminente restruturação da Fisioterapia
no SNS, os fisioterapeutas inquiridos estão predispostos ao crescimento de sua
autonomia profissional, quer individual quer de classe, favorecendo a PbE.
Evidence Based Practice in Physiotherapy is key for good professional practice with a positive effect in the quality of Health care services standards. This is only possible due to the professional autonomy of Physiotherapy, meaning that a physiotherapist can promote Health, prevent Health issues, diagnose, rehab and treat injuries as it is stated in the regulation of the profession. Physiotherapy in the Portuguese National Health System is only possible with a strong link to Physiatry that is responsible for the prescription of this service, which compromises autonomy. The integration of Physiotherapy in this Physiatry web generates a problem within the configuration of professional autonomy of physiotherapists in the Portuguese National Health System, opposite to the private service situation. This study wants to report about physiotherapist’s perceptions on their predisposition for professional autonomy and Evidence Based Practice in their jobs. To assess this data, we used an online questionnaire getting a final number of 151 Portuguese National Health System physiotherapist’s answers. SPSS software was chosen to process the data, making descriptive statical analysis, factor dimension reduction and coefficient correlation. The Portuguese National Health System physiotherapists identify the time per patient as the main barrier for Evidence Based Practice. On the other hand, technological skills and personal interest in Evidence Based Practice are the main facilitators. With the possibility of changing the structure of rehabilitation in Portuguese National Health System, physiotherapists do feel ready for individual and global autonomy. They believe that Evidence Based Practice has a positive influence in Health Care standards, but they stated that the lack of resources and work conditions are limiting it.
Evidence Based Practice in Physiotherapy is key for good professional practice with a positive effect in the quality of Health care services standards. This is only possible due to the professional autonomy of Physiotherapy, meaning that a physiotherapist can promote Health, prevent Health issues, diagnose, rehab and treat injuries as it is stated in the regulation of the profession. Physiotherapy in the Portuguese National Health System is only possible with a strong link to Physiatry that is responsible for the prescription of this service, which compromises autonomy. The integration of Physiotherapy in this Physiatry web generates a problem within the configuration of professional autonomy of physiotherapists in the Portuguese National Health System, opposite to the private service situation. This study wants to report about physiotherapist’s perceptions on their predisposition for professional autonomy and Evidence Based Practice in their jobs. To assess this data, we used an online questionnaire getting a final number of 151 Portuguese National Health System physiotherapist’s answers. SPSS software was chosen to process the data, making descriptive statical analysis, factor dimension reduction and coefficient correlation. The Portuguese National Health System physiotherapists identify the time per patient as the main barrier for Evidence Based Practice. On the other hand, technological skills and personal interest in Evidence Based Practice are the main facilitators. With the possibility of changing the structure of rehabilitation in Portuguese National Health System, physiotherapists do feel ready for individual and global autonomy. They believe that Evidence Based Practice has a positive influence in Health Care standards, but they stated that the lack of resources and work conditions are limiting it.
Description
Dissertação para obtenção de grau de Mestre em Sociedade, Risco e Saúde
Keywords
Fisioterapia Reabilitação Serviço Nacional de Saúde Autonomia Prática baseada na evidência Physiotherapy Rehabilitation, National Health System Autonomy Evidence Based Practice