Aktiivisuuden ja omatoimisuuden kehittäminen fysioterapian tavoitteena : kehittävän työntutkimuksen sovellus lääkintävoimistelijan työhön

Abstract

The research follows the cycle of developmental work research based on Leontievian activity theory in which work is seen as an activity system structured in terms of sub-triangles relating to three dominant interrelated aspects of human activity: subject, instrument and object. The aims of the study are to determine the contradictions subsisting between the work activities of physiotherapists and to define problems of the workplace. The principal goals of the developmental work are to get the physiotherapists themselves to identify the problems they find in relation to their working methods and then to suggest solutions for improving them. The research and developmental work was carried out in the Central Hospital of Central Finland. The physiotherapists were divided up into four working groups. The subcategories of the developmental projects were 1) the Physiotherapy of low-back patients, 2) Physiotherapy of premature babies, 3) Guidance and counselling in patients with early-stage rheumatoid arthritis and 4) the Physiotherapy of patients after anterior cruciate ligament (ACL) reconstruction. The physiotherapy treatment of patients with ACL and rheumatoid arthritis was changed completely. Some changes in the physiotherapy of low-back patients have been partially implemented, whereas the physiotherapists of the pediatric department saw no need to change existing practices. As the result of the historical and actual-empirical analyses it was possible to demonstrate that the physiotherapists had not mastered their profession theoretically. The model directing their work activity was fragmented. A patient was seen as "moving parts", not as an active, social being, responsible for his own life. There were no methods for assessing patients' functional status in the hospital, except in the physiatric polyclinic. The degree of cooperation existing between physicians and physiotherapists was very much dependent on the department in question. The physiotherapists very seldom took the initiative in cooperating with physicians.