RT info:eu-repo/semantics/doctoralThesis
T1 Aplicabilidad de la CIF en las unidades de fisioterapia en Atención Primaria del Servicio de Salud de Castilla y León
A1 Hernández Lázaro, Héctor
A2 Universidad de Valladolid. Escuela de Doctorado
K1 Músculos
K1 Physical Therapy Modalities
K1 Fisioterapia
K1 Primary Health Care
K1 Atención Primaria de la Salud
K1 ICF
K1 CIF
K1 Musculoskeletal Diseases
K1 Enfermedad musculoesquelética
K1 3213.11 Fisioterapia
AB The biopsychosocial model integrates the biological, psychological and social factors that intervene in the disease. Primary Health Care (PHC), in order to increase the level of health of the population, is aligned with this approach promoting health, preventing and treating disease; and recovering its consequences through rehabilitation.Musculoskeletal diseases are the second cause of disability in the world and have a significant impact on society. The early management of these disorders from PHC has the potential to reduce disability and improve people's quality of life. Primary care physiotherapy units are responsible for providing community-based rehabilitation services in the Public Health System of Castilla y León (Spain).Primary care physiotherapists perform a functional assessment of patients, set person-centered goals, design and implement physiotherapy treatments, and also monitor the evolution of the disease. All these actions originate from the physiotherapy assessment, in which the description of the patient's functional status is essential.The International Classification of Functioning, Disability and Health (ICF) is the framework established by the World Health Organization to describe functioning and disability and to integrate the biopsychosocial approach into health care. The use of the ICF is a challenge at the clinical level due to its exhaustiveness. For this reason, abbreviated ICF versions (known as ICF core sets) have been developed to describe the essential aspects of functioning in certain health conditions, patients and/or healthcare contexts.The ICF core set for post-acute musculoskeletal conditions covers the spectrum of disorders that are usually addressed in the primary care physiotherapy units. Therefore, the validation of this ICF-based tool could be an adequate starting point to incorporate the ICF in physiotherapy assessments. The validation of ICF core sets is based on a scientific process that contemplates the perspectives of researchers, professionals, patients and the clinical context.In the development of this Doctoral Thesis, four studies have been carried out to analyze these perspectives and compare them with the ICF core set for post-acute musculoskeletal conditions. The physiotherapist's perspective has been analyzed through a survey of experts using the Delphi method. The patient's experience has been captured through a qualitative study based on focus groups. The researcher's point of view has been described through a scoping review of the scientific literature. Finally, the content validity of the basic set has been confirmed in a multicenter cross-sectional study carried out in the clinical context of the primary care physiotherapy units.The results of these studies have shown that the ICF core set for post-acute musculoskeletal conditions has adequate content validity for all stakeholders involved in healthcare in primary care physiotherapy units. However, a finding common to the studies carried out has been the inability of this tool to describe certain aspects of functioning related to PHC. This is consistent with the very nature of the ICF core set analysed, as it was intended to be used in multidisciplinary rehabilitation centers. On the other hand, the primary care physiotherapy units present differential characteristics derived from a provision of services on the community level, with the consequent establishment of interdisciplinary relations in a wider field than that of rehabilitation.In conclusion, although the ICF core set for post-acute musculoskeletal disorders has confirmed its validity in a primary care physiotherapy context, it is necessary to develop more specific ICF-based tools that allow adequately representing the reality of primary care physiotherapy units.
YR 2024
FD 2024
LK https://uvadoc.uva.es/handle/10324/67152
UL https://uvadoc.uva.es/handle/10324/67152
LA spa
NO Escuela de Doctorado
DS UVaDOC
RD 21-sep-2024