An exploration of ethical issues encountered by physiotherapy practitioners in Lusaka, Zambia in Managing patients with low back pain

Abstract

Introduction: Management of patients with Low Back Pain (LBP) may raise ethical issues in physiotherapy clinical practice that may affect practitioners‟ efficiency and effectiveness in healthcare delivery. The aim of this study was to explore and provide additional insight into the nature and scope of ethical issues and dilemmas encountered by physiotherapy practitioners in Lusaka. Furthermore, the study aimed to determine whether physiotherapy practitioners were adequately prepared in training to handle ethical issues encountered in clinical practice. Methodology: An exploratory mixed method study design was used. The study captured 66 physiotherapy practitioners working in Lusaka district. The qualitative method had 16 participants in two Focus Group Discussions (FGDs), which were analyzed according to the principle of Giorgi‟s phenomenological analysis. Quantitative data collected through a structured questionnaire was analyzed using descriptive statistics. Triangulation was done by comparing and combining insights from both qualitative and quantitative data which increased the reliability of findings. Ethical approval was obtained from ERES-Converge Research Ethics Committee.Results: Both study methods revealed that practitioners had difficulties in handling conflict of culture and treatment process; Patient/Physiotherapy practitioner relationships; Communication; and dilemmas of practice. Most respondents agreed that they were adequately prepared in training to handle ethical issues even though 62% in the quantitative component indicated that they would benefit from further training in clinical ethics. Conclusion: Outcomes highlight that physiotherapy practitioners encounter ethical issues in the management of patients with LBP. Majority had difficulties in handling the ethical issues raised. Recommendations: Emphasis on ethical decision-making skills; sensitisation workshops/seminars on good Standards of Practice; and further research on ethical issues raised in this study is recommended