Pelvic floor dysfunction is often poorly recognised, diagnosed, and managed. As a result, it can have a significant effect upon a person’s health and add substantial cost to the healthcare system in Australia. Physiotherapists are in an ideal position within the healthcare system to provide conservative management to those with pelvic floor dysfunction. Access to physiotherapists with knowledge and clinical skills to manage pelvic floor dysfunction is imperative to improve the quality of life and health of all people. This thesis aims to explore access to physiotherapists with the clinical skills to manage people with pelvic floor dysfunction. Pelvic organ prolapse is an example of pelvic floor dysfunction. Women with pelvic organ prolapse often lack knowledge of the symptoms and appropriate conservative interventions available. As a result, many women reduce their exercise and activity levels in response to their symptoms, and without conservative management options there may be significant long-term effects upon their overall health. Physiotherapists gain knowledge of the profession and foundation level clinical skills from entry-level education programs at universities in Australia. Further post-graduate training and clinical experience is needed to expand the scope of practice of individual physiotherapists to safely manage people with pelvic floor dysfunction. Access to appropriate post-graduate professional development therefore needs to be available to physiotherapists no matter where they live and work. Access to physiotherapists by people needing assistance may be variable and dependent upon the location of where you live in Australia, let alone access to physiotherapists with the knowledge and clinical skills to manage the symptoms associated with pelvic floor dysfunction. This inequity in the availability of physiotherapy will affect the quality of life of people, as well as increasing the overall costs of health care when conservative options are simply not available. There are also the indirect costs to the community if people are unable to fully participate in work and life due to their symptoms. The overall aims of this thesis were to understand: 1) the experience of women with pelvic organ prolapse, 2) conservative approaches used to manage pelvic organ prolapse by physiotherapists, 3) the knowledge of physiotherapists in identifying pelvic organ prolapse, 4) the training provided to physiotherapists in entry-level programs in women’s and men’s health physiotherapy, and 5) the knowledge and clinical skills available by physiotherapists for people living in regional, rural and remote communities in Australia. To answer these aims a series of studies were developed and involved interviews and targeted surveys sent to physiotherapists and universities. The findings described in this thesis reveal that fundamental changes need to be made to improve access to women’s and men’s health physiotherapists throughout Australia. These include; better entry-level and post graduate education to ensure symptoms are recognised, appropriate assessments are available, enabling management to commence sooner in order to reduce the longer-term impacts to people and to the cost of the healthcare system. Therefore, greater scope needs to be provided within entry-level physiotherapy programs and greater opportunities in post-graduate degrees and training. This is particularly important for regional, rural, and remote communities of Australia where opportunities for further training by physiotherapists are often limited, thereby limiting access to those with the clinical skills needed to improve the quality of life of those living in regional, rural and remote Australia.
Pelvic organ prolapse knowledge in women’s and men’s health physiotherapy in entry-level education and in regional, rural, and remote Australia
Mcpherson, K. (Author). 2023
Student thesis: Doctoral Thesis