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RESEARCH REPORT
a
Department of Physiotherapy, Bayero University, Kano, Kano State, Nigeria
b
Department of Physiotherapy, Rasheed Shekoni Specialist Hospital, Dutse, Jigawa State, Nigeria
KEYWORDS Abstract This study was conducted to assess the perception of efficacy of ultraviolet (UV)
barriers; light therapy and barriers to its use among physiotherapists. A purpose-designed questionnaire
efficacy; containing 29 items, seeking information on perception of efficacy of UV therapy and
perception; perceived barriers to its use, was administered to physiotherapists in Northwestern Nigeria.
UV therapy With a response rate of 97%, it was demonstrated that almost 70% of the respondents
perceived UV therapy to be effective and only 59.3% of them had ever used UV therapy for
treatment purposes. In general, the major barrier to the use of the modality was nonavail-
ability of UV therapy machine (66.1%) followed by availability of a substitute treatment modal-
ity (13.5%). Lack of referral of patients with indications for possible use of UV therapy
accounted for 10.2%. The study also found significant association between the use of UV ther-
apy by the respondents and the perception of its therapeutic efficacy (p < 0.05), and percep-
tion of the modality as being abandoned by physiotherapists (p < 0.05). It was concluded that
despite the low level of use of UV therapy mainly due to its unavailability, physiotherapists in
Northwestern Nigeria perceived the modality as being efficacious.
Copyright ª 2014, Hong Kong Physiotherapy Association Ltd. Published by Elsevier (Singapore)
Pte Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.hkpj.2014.02.002
1013-7025/Copyright ª 2014, Hong Kong Physiotherapy Association Ltd. Published by Elsevier (Singapore) Pte Ltd. All rights reserved.
45
therefore a promising adjunctive therapy for chronic Questionnaire description and administration
wounds infected with resistant bacteria [6]. More than 30
dermatoses have been reported to have been treated with The study used a purpose-designed questionnaire, which
phototherapy and/or photochemotherapy; the most com- included both closed- and open-ended questions, seeking
mon ones being psoriasis, atopic dermatitis, vitiligo, information on the perception of efficacy and barriers to
mycosis fungoides, and hand/feet eczema [2,7,8]. the use of UV therapy. Questions were developed by three
The extent of use or application of a particular ther- physiotherapists in the AKTH who had discussions on
apeutic modality and the manner in which it is perceived methods for developing questionnaires and on UV therapy
by its operators may be associated with its therapeutic as a therapeutic modality in physiotherapy. These discus-
effectiveness and acceptability among both professionals sions resulted in the construction of a questionnaire con-
and patients. Perception can be influenced in many sisting of three sections. Section A sought information on
ways, depending on the perceiver’s education, knowl- demographic characteristics (such as age, sex, and educa-
edge, motivation, wants, memory, expectations, and tional qualification). Section B assessed perception of
personality [9e11]. These variables may either promote therapeutic efficacy of UV therapy, whereas Section C
or act as barriers to the use of any therapeutic modality. sought information on potential barriers to the use of the
In spite of the well-established role and effectiveness of modality. To ensure face and content validity, the ques-
UV therapy in the management of wounds and other skin tionnaire was pretested using a sample of convenience (5
conditions [1,2,4e6,12] and the significant role physio- physiotherapists working in AKTH were sampled) to improve
therapists play in its application, anecdotal evidence sug- comprehensibility and clarity of the questions and in-
gests that the modality is not routinely applied for structions. In addition, potential problems with item
treatment purposes in physiotherapy clinical practice. To interpretation were identified and resolved.
the best knowledge of the researchers, no study has Once ethical approval was obtained, respondents were
investigated the perceived effectiveness and barriers to the approached and the purpose of the study was explained.
use of UV therapy among physiotherapists. Therefore, the Physiotherapists who accepted to participate in the survey
purpose of this study was to investigate the perception of signed informed consent document before the question-
efficacy of UV therapy and perceived barriers to its use naires were administered. A cover letter of introduction
among physiotherapists with a view to making appropriate explaining the purpose of the study with assurance on
recommendations. confidentiality and an instruction sheet (with instructions
on how the questions would be answered) were also
Methods included with the questionnaires. Participants were
requested to complete the questionnaires and return them
within 1 week.
Participants
Table 1 Demographic characteristics of respondents Table 3 Perception of the respondents about UV therapy
(N Z 59) (N Z 59)
Variables Mean SD n (%) Perception Strongly Agree, Disagree,
Age (y) 35.4 6.9 agree, n (%) n (%) n (%)
Years of practice 7.9 5.6 As being abandoned 23 (39) 20 (33.9) 16 (27.1)
Sex Efficacious for 8 (13.6) 33 (55.9) 18 (30.5)
Male 42 (71.2) treatment
Female 17 (28.8) Should be 2 (3.4) 5 (8.5) 52 (88.1)
Location of practice abolished
Jigawa 3 (5) Demands 23 (39) 16 (27.1) 20 (33.9)
Kaduna 9 (15) ultraprecision
Kano 20 (34) N Z number of respondents; n Z frequency.
Katsina 4 (6.8)
Kebbi 8 (13.6)
Sokoto 10 (17) Significant relationship was found between use and
Zamfara 5 (8.6) perceived efficacy of the modality among the respondents
Highest qualification (c2 Z 10.68; df Z 1; p Z 0.002; Table 5). Relationship
Bachelor’s degree 45 (76.2) between use and perceived abandonment of the modality
Postgraduate 14 (23.8) by physiotherapists was also shown to be significant
N Z number of respondents; n Z frequency; SD Z standard (c2 Z 9.64; df Z 1; p Z 0.002; Table 6).
deviation.
Discussion
whereas 30.5% perceived the modality as ineffective.
Approximately 73% of respondents either strongly agreed or The study was carried out to investigate physiotherapists’
agreed that UV therapy, as an electrotherapeutic modality, perception of the therapeutic efficacy and barriers to the
has been abandoned by physiotherapists. Responses use of UV therapy. To the best knowledge of the authors, no
regarding whether UV therapy should be abolished and the published studies have investigated the perception of effi-
demand in terms of application are also presented. cacy and barriers to the use of UV therapy by physiother-
Table 4 presents barriers to the use of UV therapy among apists. Therefore, speculations or assumptions regarding
the respondents. Sixty-six percent of them reported un- responses by physiotherapists in this study were mainly
availability of a UV therapy machine as a barrier to its use. provided.
Of the 20 physiotherapists (33.9%) who had a functional UV Most of the respondents perceived UV therapy to be an
therapy machine, approximately 14% reported availability effective treatment modality. This could be attributed
of an alternative treatment modality as being responsible partly to impressive clinical outcome with the modality and
for the lack of use. Lack of referral of patients, with con- partly to the huge amount of literature that has docu-
ditions treatable with UV therapy, to physiotherapy mented its effectiveness for a variety of skin disorders such
accounted for approximately 10% of the barrier. Only two as pressure ulcers [1,2,4e6,13]. The majority of the re-
respondents (4%) reported possession of insufficient spondents did not use the modality for treatment purposes.
knowledge of application of the modality as a barrier to its Unavailability of the device that delivers UV therapy,
use. availability of a substitute treatment modality, and lack of
referral of patients with indications for UV therapy were
the major barriers to its use or application. In one or two
Table 2 Responses to UV therapy availability, use and facilities, only very old UV therapy units, which had broken
awareness of alternative treatment (N Z 59) down several years ago, were available. The low use of UV
Responses n (%) therapy demonstrated in this study is in disparity with the
Availability of UV therapy machine
Yes 20 (33.9) Table 4 Barriers to the use of UV therapy among re-
No 39 (66.1) spondents (N Z 59)
Ever used UV therapy in practice
Once 7 (11.9) Barriers n (%)
Twice 9 (15.2) Unavailability of UV therapy machine 39 (66.1)
Several times 19 (32.2) Insufficient knowledge of application 2 (3.4)
Never 24 (40.7) Difficulty in manipulating UV 4 (6.8)
Modalities in lieu of UV therapy therapy machine
Ultrasound therapy 4 (6.8) Lack of referral of conditions 6 (10.2)
Low-level laser therapy 18 (30.5) amenable to UV therapy
Microcurrent 1 (1.7) Availability of alternative 8 (13.5)
Not sure 36 (61) treatment modality
N Z number of respondents; n Z frequency. N Z number of respondents; n Z frequency.
47
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