Experiencias de educación para la salud en fisioterapia

Experiences of health education in physical therapy

Jacqueline Hernández Sánchez, Leidy Johanna Lozano García, Yurley Andrea Murillo Varela

Resumen

Introducción: La educación para la salud es una herramienta fundamental en salud pública, donde los fisioterapeutas cumplen un rol importante; fomentando comportamientos que protegen la salud o previniendo aquellos que la ponen en riesgo. Objetivo: Identificar las características de experiencias en educación para la salud que llevan a cabo fisioterapeutas a nivel mundial. Materiales y métodos: Estudio descriptivo, mediante revisión documental de experiencias divulgadas en artículos publicados entre 1995 y 2014. Resultados: Se identificaron 30 experiencias de fisioterapeutas como educadores para la salud, reportadas en artículos científicos. Las áreas de aplicación fueron, musculo-esquelética (20; 66,6%) y actividad física o ejercicio físico (6; 20%). Existen debilidades en las bases teóricas; además, se utilizan principalmente estrategias metodológicas tradicionales como la consejería (24,2%), la educación individual (21,2%) y la combinación de consejería con material de educación y comunicación (9,1%); los impresos son ampliamente usados. Las evaluaciones que se realizan son principalmente de tipo cuantitativo. Conclusiones: Son escasas las publicaciones científicas sobre intervenciones de educación para la salud realizadas por fisioterapeutas. Las reportadas en este artículo se desarrollan principalmente en el área músculo-esquelética, pero no se encuentra una clara fundamentación teórica; existiendo confusión y uso indiscriminado del término educación para la salud y promoción de la salud. Se plantean retos normativos y formativos para los fisioterapeutas como educadores para la salud, así como problemas para ser resueltos en futuras investigaciones.

Abstract

 Introduction: Health education is a fundamental tool in public health, where the physiotherapists play an important role by either promoting behaviors that protect the health or preventing those that put it at risk. Objective: To identify the characteristics of experiences of HE that physiotherapists carry out worldwide. Materials and methods: A descriptive study was performed by using documentary review of experiences reported in articles published from 1995 to 2014. Results: 30 experiences of physiotherapists as health educators were identified, which were reported in scientific papers. The areas of application were musculoskeletal (20; 69%) and physical activity or exercise (6; 20.6%). There are weaknesses in the theoretical foundations; in addition, traditional methodological strategies such as counseling (24.2%), individual education (21.2%) and the combination of counseling with educational material (9.1%) are used. Printed materials are also widely used. Evaluations carried out are mainly quantitative. Conclusions: There are few scientific publications of experiences about Health education in physiotherapy. Those reported in this article are mainly developed in the muscle-skeletal area. However, there is not a clear theoretical foundation; there is confusion and an indiscriminate use of the term Health education and health promotion. There are normative and training challenges for physiotherapists as health educators; as well as problems to be solved in future research.

Palabras clave

Educación para la salud; fisioterapia; comportamiento en salud; estilos de vida; promoción de la salud; Health education; physiotherapy; health behavior; lifestyles; health promotion

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Referencias

Organización Mundial de la Salud. Carta de Ottawa. Primera Conferencia Internacional de Promoción de la Salud. Ottawa, Canadá. 1986.

Organización Panamericana de la Salud. Declaración de Alma-Ata. Conferencia Internacional sobre Atención Primaria de Salud. Alma-Ata, URSS. 1978.

Perea R. Promoción y educación para la salud. Tendencias innovadoras. Madrid: Díaz de Santos; 2009.

Educación. Diccionario etimológico. [última actualización 4 abril de 3013, a las 17:17.http://www.elcastellano.org/palabra.php. [acceso 2013-04-04].

World Health Organization. Health education: Theoretical concepts, effective strategies and core competencies: a foundation document to guide capacity development of health educators. Regional Office Forthe Eastern Mediterranean; 2012.

Organización Mundial de la Salud. Glosario de Promoción de la Salud [Internet] 1998 [acceso 4 de marzo de 2013] Disponible en: http://apps.who.int/iris/bitstream/10665/67246/1/WHO_HPR_HEP_98.1_spa.pdf

Wilkinson R, Marmot M. Social determinants of health. The solid facts. Copenhagen: Word Health Organization; 2003.

Anaya L. Los estilos de vida saludables: Componente de la calidad de vida [Internet] 2001 [acceso 4 de abril de 2013] Disponible en: http://www.funlibre.org/documentos/lemaya1.htm.

Rimer B, Glanz K. Theory at a glance. A guide for health promotion practice, 2nd ed. Bethesda, Maryland: Department of Health and Human Services; 2005.

Bandura A. Social learning theory. Englewood Cliff, NJ: Prentice-Hall; 1977.

Castro LE, Rodríguez YL. Tendencias epistemológicas de las acciones de la salud pública. Una revisión desde la fisioterapia. Rev. Fac. Nac. Salud Pública. 2015;33(2): 239-251. doi:

17533/udea.rfnsp.v33n2a11

Agredo V, Franco JA, Mina EP. Perfil profesional y ocupacional de los fisioterapeutas en Colombia. Revista CES Movimiento y Salud. 2015; 3(1): 35-43.

Cerpa J. Análisis de las acciones del fisioterapeuta en la ejecución de la política de salud pública en el Hospital de Suba. Informe final. Bogotá D.C: Escuela Superior de Administración Pública; 2010.

World Health Organization. Global Status Report on noncommunicable diseases 2014. Geneva: World Health Organization; 2014.

República de Colombia. Ministerio de la Protección Social. Guía de atención integral basada en la evidencia para dolor lumbar y enfermedad discal relacionados con la manipulación manual de cargas y otros factores de riesgo en el lugar de trabajo. Bogotá: Ministerio de la Protección Social; 2006.

República de Colombia. Ministerio de la Protección Social. Guía de atención integral basada en la evidencia para hombro doloroso relacionado con factores de riesgo en el trabajo. Bogotá: Ministerio de la Protección Social; 2006.

República de Colombia. Ministerio de la Protección Social. Guía de atención integral basada en la evidencia para desórdenes músculo-esqueléticos relacionados con movimientos repetitivos de miembros superiores. Bogotá: Ministerio de la Protección Social; 2006.

World Confederation for Physical Therapy. Guideline for standards of physical therapy practice. [última actualización 18 de octubre de 2011]. [acceso 3 de marzo de 2013] Disponible en: http://www.wcpt.org/sites/wcpt.org/files/files/Guideline_standards_practice _complete.pdf.

American Physical Therapy Association. Standards of practice for physical therapy.[última actualización 27 de enero de 2012]. [acceso 3 marzo de 2013] Disponible en: http://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/BOD/Practice/CriteriaforStandardsofPractice.pdf.

Alexander J, Bambury E, Mendoza A, Reynolds J, Veronneau R, Dean E. Health education strategies used by physical therapists to promote behaviour change in people with lifestyle-related conditions: A systematic review. Hong Kong Physiother J. 2012; 30:57-75.

Hernandez-Sampieri R, Fernández C, Baptista P. Metodología de la investigación. México D.F: Mc Graw Hill; 2014.

Kim P, Hayden J, Mior S. The cost-effectiveness of a back education program for firefighters: a case study. J Can Chiropr Assoc ,2004; 48(1):13-19.

Mayorga MJ, Fernández I, Bullón F, Morales C, Herrera J, Echevarría M. Impacto de un programa de educación sanitaria en pacientes con fibromialgia. Rev. Soc Esp Dolor. 2010;17(5):227-232.

Pakkala I, Read S, Leinonen R, Hirvensalo M, Lintunen T, Rantanen T. The effects of physical activity counseling on mood among 75- to 81-year-old people: A randomized controlled trial. Preventive Medicine. 2008; 46: 412–418.

Frost H, Lamb SF, Doll HA, Taffe P, Stewart-Brown S. Randomised controlled trial of physiotherapy compared with advice for low back pain. BMJ. 2004 doi:10.1136/bmj.38216.868808.7C

Klaber J, Jackson D, Richmond S, Hahn S, Coulton S, Farrin A, Manca A, Torgerson D. Randomised trial of a brief physiotherapy intervention compared with usual physiotherapy for neck pain patients: outcomes and patients’ preference. BMJ. 2004 doi:10.1136/bmj.38286.493206.82

Kerssens J, Sluijs E, Verhaak P, Knibbe H, Hermans I. Back care instructions in physical therapy: a trend analysis of individualized back care programs. Phys Ther. 1999; 79:286–95.

De Vitta A, Bertaglia RS, Padovani CR. Efeitos de dois procedimentos educacionais sobre os sintomas musculoesqueléticos em trabalhadores administrativos. Rev Bras Fisioter, São Carlos. 2008; 12(1): 20-5.

Sheedy J, Smith B, Bauman A, Barnett A, Calderan A, Culbert J and Jacka. A controlled trial of behavioural education to promote exercise among physiotherapy outpatients. Australian Journal of Physiotherapy. 2000; 46: 281-289.

Tipping C, Scholesb R, Coxb N. A qualitative study of physiotherapy education for parents of toddlers with cystic fibrosis. Journal of Cystic Fibrosis. 2010; 9: 205–211.

Echsner J, Domholdt D. Amount of patient education in physical therapy practice and perceived effects. Phys Ther. 1996; 76:1089-1096.

Linton S, Andersson T. Can chronic disability be prevented? A randomized trial of a cognitive-behavior intervention and two forms of information for patients with spinal pain. Spine. 2000; 25(21): 2825–31.

Brown C, Gottschalk M, Van P. Changes in physical therapy providers’ use of fall prevention strategies following a multicomponent behavioral change intervention. Phys Ther. 2005; 85:394-403.

Leskelä J, Viitanen E, Piirainen A. Client feedback on physiotherapy counselling in primary health care. Patient Education and Counseling. 2005; 56: 218–224.

Moseley L. Combined physiotherapy and education is efficacious for chronic low back pain. Australian Journal of Physiotherapy. 2002; 48: 297-302.

Alewijnse D, Metsemakers J, Mesters I, Van den Borne B. Effectiveness of pelvic floor muscle exercise therapy supplemented with a health education program to promote long-term adherence among women with urinary incontinence. Neurourology and Urodynamics. 2003; 22:284-295.

Molenaara E, van Ameijdena E, Vergouwea Y, Grobbeea D, Numansa M. Effect of nutritional counselling and nutritional plus exercise counselling in overweight adults: A randomized trial in multidisciplinary primary care practice. Family Practice. 2010; 27:143–150.

Hay E, Foster N, Thomas E, Peat G, Phelan M, Yates H et al. Effectiveness of community physiotherapy and enhanced pharmacy review for knee pain in people aged over 55 presenting to primary care: pragmatic randomised trial. BMJ. 2005 doi:10.1136/bmj.38977.590752.0B

Finkler M, Alvarenga L. Fisioterapia e educação em saúde: investigando um serviço ambulatorial do sus. Boletim da Saúde Porto Alegre. 2005; 19(2):73-82.

Talvitie U, Pyöriä O. Discourse analytic study of counseling sessions in stroke physiotherapy. Health Communication. 2006; 20(2): 187–196.

Trede, FV. ‘Physiotherapists’ approaches to low back pain education’. Physiotherapy. 2000; 86(8): 427-433.

Miilunpalo S, Laitakari J, Vuori I. Strengths and weaknesses in health counseling in Finnish primary health care. Patient Education and Counseling. 1995; 25: 317-328.

Taylor JD, Fletcher JP, Tiarks J. Impact of physical therapist–directed exercise counseling combined with fitness center–based exercise training on muscular strength and exercise capacity in people with type 2 diabetes: a randomized clinical trial. Phys Ther. 2009; 89:884–892.

Hollis J, Corden E, Williams P. Longitudinal evaluation of a weight reduction program for patients on peritoneal dialysis. Perit Dial Int. 2005; 25(S3):S152–S154.

Miller JS, Litva A, Gabbayb M. Motivating patients with shoulder and back pain to self-care: can a videotape of exercise support physiotherapy? Physiotherapy. 2008; 95: 29–35.

Rasinaho M, Hirvensalo M, Kangas T, Leinonen R, Lintunen T, Rantanen T. Effect of physical activity counseling on physical activity of older people in Finland. Health Promotion International. 2011. doi:10.1093/heapro/dar057

Tsauo J, Yi Lee H, Huei Hsu J, Ying Chen C, Jong Chen C. Physical exercise and health education for neck and shoulder complaints among sedentary workers. J Rehabil Med. 2004; 36: 253–257.

Lambeek L, Van Mechelen W, Knol D, Loisel P, Anema J. Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life. BMJ. 2010;340:c1035 doi:10.1136/bmj.c1035

Friedrich M, Gittler G, Arendasy M, Friedrich K. Long-term effect of a combined exercise and motivational program on the level of disability of patients with chronic low back pain. Spine. 2005; 30(9): 995–1000.

Rueda E, Cantos J, Valdivia A, Martínez J. Effectiveness of health education in low back pain in adults. Journal of Sport and Health Research. 2011;3(2):101-12.

Kerssens J, Sluijs E, Verhaak P, Knibbe H, Hermans I. Educating patient educators: enhancing instructional effectiveness in physical therapy for low back pain patients. Patient Education and Counseling. 1999; 37: 165–176.

World Confederation for Physical Therapy. Physical therapy, physical activity and health. Salud [Internet] 2012 [acceso 4 de marzo de 2015] Disponible en: http://www.wcpt.org/node/33329]

World Confederation for Physical Therapy. Disaster management. [Internet] 2016 [acceso 4 de marzo de 2016] Disponible en: http://www.wcpt.org/node/33329

Glanz K, Rimmer B, Lewis F. Health behavior and health education. Theory, research and practice. San Francisco: Jossey-Bass; 2002.

MCkenzie J, Neiger B, Smeltzer J. Planning, implementing, and evaluating health promotion programs. 4th ed. San Francisco: Pearson; 2005.

Giguère A, Légaré F, Grimshaw J, Turcotte S, Fiander, M, Grudniewicz, A, et al. Printed educational materials: effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews 2012. doi: 10.1002/14651858.CD004398.pub3.

Farmer A, Légaré F, Turcot L, Grimshaw J, Harvey E, McGowan J, et al. Printed educational materials: effects on professional practice and health care outcomes. 2008 Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD004398.pub2.

World Health Organization. National Health strategy toolkit. Geneve: World Health Organization and International Telecommunication Union; 2012.

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