Carlatan, City of San Fernando, La Union

In Partial Fulfillment for the Requirements in Research

Levels of Satisfaction on Treatment, Facilities and Services Rendered to

Patients with Musculoskeletal Condition on Selected Hospitals in La Union

Submitted To:

Sir Bernard Tayaban Jr., PTRP, MDA

Submitted By:

Anin, Jerna C.

Bisquera, John Glenn D.

Campos, Bianca Joyce U.

Gurtiza, Joanna Eden A.

Imperial, Charmaine E.

Laureta, Chloei Ann D.

It is the act of fulfilling a need. M. or other health care provider. efficient. podiatrist. Patients have this certain health needs or necessities in which they consult health care providers or services to attain satisfaction. Scott G. patient complains of having problems about their muscular system and skeletal system or basically the musculoskeletal system. Hospital is an integral part of the medical and social organization which is to provide for the population complete health care. USA: AHA company. It affects the timely. (Wendy L. 1994) Almost all of the patients around the world seek medical attention by means of going to the hospital. Background Study Patients are individuals who have disorders that require interventions to improve their function. Patient satisfaction affects clinical outcomes. not just sometimes or usually. physician. but always. Patient satisfaction is thus a proxy but a very effective indicator to measure the success of doctors and hospitals. both curative and preventive. or appetite. Satisfaction is individuals’ feelings of pleasure or disappointment resulting from comparing their perceptions of a product or service’s performance to their expectation levels. and medical malpractice claims. (Pagliarulo. Delivery of patient-focused care requires that we provide care in a particular way. Patient satisfaction is only an indirect or a proxy indicator of the quality of doctor or hospital performance. and patient-centered delivery of quality health care. The patient is most often ill or injured and in need of treatment by an advanced practice registered nurse. or the feeling gained from such fulfillment. The . Patient satisfaction is an important and commonly used indicator for measuring the quality in health care. desire. physician assistant. patient retention. physiotherapist. Chapter I INTRODUCTION I.) A patient is any recipient of health care services. It must be every patient every time. psychologist. veterinarian. The hospital is also a center for the training of health workers and for bio-social research. and whose out-patient services reach out into the family in its home environment. Most of the hospitals around the world.

habilitation and rehabilitation.Musculoskeletal System provides form. and mental capabilities that were lost due to injury. tendons. This includes providing services in circumstances where movement and function are threatened by ageing. maintain and restore maximum movement and functional ability throughout the lifespan. Collectively these body parts provide the framework for your body. muscles. Some patients undergoes rehabilitation in order to recover from a certain condition or disorders. Its chief components are collagen and elastic fibers. illness.being. and social well. This encompasses physical. sprain. illness. rheumatoid arthritis undergoes physical therapy rehabilitation. (Lipman. and movement to the human body. and dictate your degree of flexibility. The term "connective tissue" is used to describe the tissue that supports and binds tissues and organs together. treatment/intervention. . disease or environmental factors. muscles. osteoarthritis. ligaments. and other connective tissue. They comprise approximately sixty percent of your body mass and expend most of your energy. patients/clients. and connective tissue (your ligaments. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion. cartilage. tendons. The purpose of rehabilitation is to restore some or all of the patient's physical. Rehabilitation includes assisting the patient to compensate for deficits that cannot be reversed medically. strain. 2010). create your movements. psychological. or disease to as normal a condition as possible. Functional movement is central to what it means to be healthy. (Medical Dictionary) Most of the patients who are having injuries and disorders that affect the human body’s movement or musculoskeletal system such as low back pain. injury. Rehabilitation is a treatment or treatments designed to facilitate the process of recovery from injury. which are composed of different proteins. or disease. joints. Rehabilitation should be carried out only by qualified therapists. stability. prevention. sensory. Physical therapy provides services to individuals and populations to develop. The musculoskeletal system incorporates bones. Physical therapy involves the interaction between physical therapist. Exercises and other physical interventions must take into account the patient's deficit. emotional. It consists of the body's bones. and fascia).

nerves. joint mobilization in managing musculoskeletal disorders. 2008). Musculoskeletal disorders may occur when muscles or tendons are stretched or over-used beyond their capabilities. Conceptual framework Physical therapist . Pain can also be caused through injury to muscles. families. (PPTA) Physical Therapist in La Union provides treatments like stretching and strengthening exercises. restore. use of different types of electrical stimulators such as functional electrical stimulator. infrared radiation. wellness. care givers. The overriding symptom of most conditions we see as physiotherapists is pain. and health enabling individuals of all ages to have optimal functioning and quality of life. neuromuscular electrical stimulation. physical therapists are involved in promoting health. cartilage. and communities in a process where movement potential is assessed and goals are agreed upon. other health professionals. and enhance participation in chosen life situations. transcutaneous electrical stimulators. or spinal discs (Bureau of Labor Statistics. (Bernice Krumhansl) Treatments are provided by physical therapist. Many patients recover their strength and ability to return to normal function as well as becoming pain free again through physiotherapy treatment. cryotherapy. activity. joints. using of heating modalities like hot moist pack. slow the progression of or prevent functional decline and disability. and microwave diathermy. Physical therapists are health care professionals who maintain. Pain can occur from infection such as in osteomyelitis where a bone becomes infected. treat a number of musculoskeletal conditions – a broad term that encompasses injuries affecting the connective tissues of the body such as muscles. spinal and lumbar traction. using knowledge and skills unique to physical therapists. while ensuring patient safety and applying evidence to provide efficient and effective care. In addition. and improve movement. ligaments and tendons. tendons. paraffin wax bath. . ultrasound. and fitness through risk factor identification and the implementation of services to reduce risk.

It is commonly believed that stretching before or after physical activity can reduce the chance of a strain or sprain injury by increasing the flexibility of muscles. Benefits of stretching may include increased flexibility. infrared radiation. and relieving muscle spasm and pain. 1981) . It involves the physiotherapist manually gliding the articular surfaces of a joint to produce oscillatory movements (Maitland GD 1991). massage. and microwave diathermy. and stress relief. cryotherapy. proprioceptive neuromuscular facilitation (PNF). static and isometric. 2006). neuromuscular electrical stimulation and a host of other scientifically-based treatment techniques. improved range of motion within joints. tendons and ligaments. improved circulation improved posture. which in turn increases the range of motion in a joint or group of joints. muscle stretching. transcutaneous electrical stimulators. ultrasound. in order to allow an earlier return to activities. 1997) Stretching is a form of physical exercise in which a specific skeletal muscle is deliberately elongated to its fullest length in order to improve the muscle’s felt elasticity. paraffin wax bath. (Hess and Hecker. Massage therapy can relieve symptoms and promote complete healing by increasing local circulation. and helping patients avoid dysfunctional patterns of compensation. ( Thrash. use of different types of electrical stimulators such as functional electrical stimulator. releasing fascial restrictions and excess scar tissue. spinal and lumbar traction. 2003). Massage therapy can address issues by reducing muscle tension and pain. heating modalities like hot moist pack. It has been proposed that manual therapy such as joint mobilization produces analgesic effects and increases elasticity of joint structures through interactions at the local. central nervous system and psychological levels (Lederman E. Physical Therapist have many ways of treating pain depending on the injury or illness and these techniques may include joint mobilisation. reducing muscle tension. (Sharman et al. There are three common types of stretches. Physiotherapist in the treatment of musculoskeletal conditions aim is to have pain free again as soon as possible. Passive joint mobilization is a technique commonly used by physiotherapists to address the problems of pain and joint stiffness.

Ultrasound waves penetrate homogeneous tissues readily and are absorbed primarily by tissues with high protein content. which is then wrapped securely and left for a period of time to "soak". It gives positive effects on cutaneous barrier homeostasis and a anti-inflammatory activity. (http://www. increase superficial blood flow.jill-lusk. but also deal with the accompanying muscle weakness. (Nadler.2006) Parts of the body are submerged in warm melted wax to coat the skin in a thick layer.co. ( Kiichiro T. such as muscle and connective tissue (Frizzell LA. and may increase extensibility of collagen tissue.uk/treatments/paraffin-wax-treatments) Physical Therapist not only treat pain. it has been used to relieve pain and joint immobility in a variety of musculoskeletal conditions. Cryotherapie (ice application) as an effective treatment for soft tissue injuries. 2010) Ultrasound therapy uses sound waves to impart mechanical vibrations to the tissues to create heat. The hydrostatic effect may also relieve pain by reducing peripheral edema and by dampening sympathetic nervous system activity. and the nourishing wax helps to moisturise dry and cracked skin. and it will improve the range of motion. In addition. (Hecox B. Paraffin wax bath is a heat modality (mixture of paraffin wax and mineral oil) that delivers heat through superficial conduction to relieve pain and inflammation. It reduces the swelling. However. there are still some doubts if it is actually effective for pain relief. The heat from paraffin wax treatments is both warming and healing. is a popular and effective treatment with a pain relief effect for many patients with painful neurologic or musculoskeletal conditions. Since ultrasound was developed in the early 1950s. thus influencing spinal segmental mechanisms. So the application of ice may be useful for a variety of musculoskeletal pains. The heat produced by ultrasound elevates the temperature in joint structures 4 to 6°C [Lehmann JF 1968). usually called hydrotherapy or balneotherapy. 2004) Exercise in warm water. loss of muscle balance and stability and decrease in range of movement and functional use of the body . 1982). the warmth may enhance blood flow and muscle relaxation. The warmth of water may block nociception by acting on thermal receptors and mechanoreceptors. yet the evidence for its efficacy should be established more convincingly.

Exercise improves flexibility.part. Treatment b. What do patients prefer? a. Occupation f. What is the level of satisfaction as to: a. Statement of the problems This study aims to determine the Levels of Satisfaction among Musculoskeletal Condition on Selected Hospitals in La Union. 1. promotes movement. Public Hospital b. Length of service 2. Services 3. Gender d. What is the profile respondent as to: a. Physical Therapist do this is through the prescription and management of individual exercise programs for patients. Age b. The importance of exercise in dealing with musculoskeletal conditions can never be overstated. Strengthening exercises are just as important in restoring function and condition to weak muscles. and increases blood flow to the area which all help to reduce pain and increase function. Educational attainment e. Civil status c. Private Hospital Hypotheses The following were the research hypotheses that were formulated in the study: . Facilities c. What is the significant Relationship between the profiles? 4.

The result of the study focus on achieving high or excellent ratings of patient satisfaction to improve the quality of service delivery among the patient. the quality of care delivered and the impact of the treatment facilities on improving their quality of life. In old age on Ireland they are satisfied to the Treatment done… Significant of the Study The study will benefit the Rehabilitation Center of the different hospitals in La Union in promoting excellent rehabilitation services among the patients with musculoskeletal conditions. therefore physical therapist need to characterize the factors influencing patient satisfaction which are used as a means to assess the quality of healthcare delivery. The purpose of this study is to survey the patient level of satisfaction in rehabilitation services in public and private hospitals in La Union. . 1. Scope and Delimitation The study focused on the reaction of the Musculoskeletal patients from the three selected hospitals in La Union regarding on the levels of their satisfaction within treatments. Patient satisfaction surveys can help gauge patients’ perceptions of practice services and functions. facilities and services. This study measures the quality of care in patients with musculoskeletal condition wherein it helps the patient to overlook on the costs of services. These study are invaluable means for improving communication between providers and patients and engaging patients in their care. This study also helps the physical therapist in expanding their roles in different aspects of health care. This study aims to determine the patient’s rating of their care experienced based on what they did or did not experience in their interaction in obtaining health care. The study will benefit the Physical Therapist in helping the patient to understand the treatment and procedures given by them and their role in providing a care to prevent the condition of the patient with musculoskeletal problems.

performing or functioning in the best possible manner with the least waste of time and effort 4.Level of active concern. Health care embraces all the goods and services designed to promote health including “preventive. it is a "State of complete physical. and palliative. optometrical service. interventions whether directed to individuals or to populations.As defined by World Health Organization (WHO). nursing. or piece of equipment provided for a particular purpose. Definition of Terms 1. amenity. towards avoidance of possible dangers. 8. 7. curative. Effective . complementary health services or any . demanded of a party as a duty or legal obligation. and not merely the absence of disease or infirmity. services and hospital facility." Health is a dynamic condition resulting from a body's constant adjustment and adaptation in response to stresses and changes in the environment for maintaining an inner equilibrium called homeostasis.a place.medical or surgical treatment. nursing. 5. Facility . and risks. Care . dental. dental service. Health Care Service . This study is interested on how the musculoskeletal patients reacts on the treatments and services given by the hospital they chose and also the hospital facilities. Health . Fulfillment . it means it has an intended or expected outcome. This research study is limited or focuses only on the musculoskeletal patients from the three selected hospitals in La Union. complementary and alternative medicine. It aims to recognize the patient’s reactions. is a feeling of satisfaction that you get from doing or achieving something. clinical sciences. pharmaceutical. hospital service. mistakes. This study would also like to know the patient’s perception about the treatments. 2. vivid impression 3. When something is deemed effective. pitfalls.is the capability of producing a desired result. 6. mental. and social well-being. especially something useful. or lack of negligence. the furnishing of medicine.The treatment and management of illness and the preservation of health. and allied health professions. or produces a deep. Efficient . Health Care .

Osteoarthritis.Low back pain is pain. curing or healing human illness. Interview with the patients Level of satisfaction on having problems about II. Low back pain . Rheumatoid arthritis.A motivating force that compels action for its satisfaction. 9. whether or not contingent upon sickness or personal injury. wants (which spring from desires or wishes) are boundless. muscle tension.Overstretching. physical disability or injury. to cultural. tends to be less severe than a sprain. or all of the enumerated services or any other necessary services of like character. Extent of patients treatment. intellectual. overuse of soft tissue. facilities and their muscular system a. 12. It occurs when the protective cartilage on the ends of your bones wears down over time.is a motivational theory in psychology comprising a five tier model of human needs. Need . stretch. including the knuckles and the middle joints of the fingers. ligament. in contrast. results from slight trauma or unaccustomed repeated trauma of a minor degree. alleviating. and is defined as chronic when it persists for 12 weeks or more. It also refers to the amount of deformation that occurs in tissues when a stress is applied The Paradigm of the Study Input Process Output Extent of the patients I. 13. 11. tendon.Severe stress. and social needs (varying from place to place and age group to age group) satisfied by necessaries. as well as the furnishing to any person of any and all other services and goods for the purpose of preventing. or tear of soft tissues such as the joint capsule. or muscle 15. Age services rendered to patients . It is triggered by a faulty immune system (the body’s defense system) and affects the wrist and small joints of the hand. Needs range from basic survival needs (common to all human beings) satisfied by necessities. Sprain . often depicted as hierarchical levels within a pyramid. Needs are finite but. with or without sciatica. Maslow’s Hierarchy of Needs . overexertion.is the most common type of autoimmune arthritis. or stiffness localized below the costal margin and above the inferior gluteal folds.is the most common form of arthritis. 10. affecting millions of people worldwide. 14. Strain .

 Lederman E: Fundamentals of manual therapy. pain physician. Boston. Kurt Weingand. phd. Nonfatal occupational injuries and illnesses requiring days away from work. Journal of epidemiology. 1981. Mehreteab TA. 18(5). 1991. Charcoal and Other Simple Treatments. 331-338.. Proprioceptive neuromuscular facilitation stretching: Mechanisms and clinical implications. D. Applied Occupational and Applied Hygiene. Gender conditions on selected system d. Weisberg J. The Physiologic Basis and Clinical Applications of Cryotherapy and Thermotherapy for the Pain Practitioner. Civil status with musculoskeletal basically musculoskeletal c. 2010. 2007. 2006. Dunn F: Biophysics of ultrasound.1 4. Kiichiro T. New York. M. J.  (http://www.and skeletel system or b. Baltimore.bls. Upper Saddle River. A. delateur BJ. Integrating physical agents in rehabilitation.C.. Churchill Livingstone  Maitland GD: Peripheral manipulation.gov/iif/oshwc/osh/case/osnr0031. Kruse. (2006). 2009 from http://www. Length of service  Bureau of Labor Statistics (2008).. & Riek.co. 3rd ed. Sanko JP.jill-lusk. 1A  Frizzell LA. (2003). Retrieved on March 1. Home Remedies: Hydrotherapy.  ↑ 4. Department of Labor.. NJ: Pearson Prentice Hall. 1A  Hiroharu K. Warren CG. p 60. 1997. In: Hecox B. MD.uk/treatments/paraffin-wax-treatments) . Educational attainment hospitals in La Union e. Occupation f. London. Arch Phys Med Rehabil49:28-30. & Hecker. S.  Sharman. 36(11).. Seale.2 Scott F. and Roger J. 1982  Lehmann JF. Massage.pdf. Sports Medicine. 3rd  Thrash A. AL: Thrash. In Lehmann JF (ed): Therapeutic Heat and Cold.0 4. S. Stretching at work for injury prevention: Issues. 929-939. Effectiveness of Aquatic Exercise and Balneotherapy: A Summary of Systematic Reviews Based on Randomized Controlled Trials of Water Immersion Therapies. Sanko J. editors..  Hess. U. Williams and Wilkins. 1968  Hecox B. Butterworth-Heinemann. Washington. FACSM. evidence and recommendations. Stonebridge JB: Heating of joint structures by ultrasound. 2004. DVM.S. Cresswell. DO. Superficial thermotherapy. 2nd ed. Nadler.