Professional Documents
Culture Documents
Submitted To:
Submitted By:
Anin, Jerna C.
Imperial, Charmaine E.
INTRODUCTION
I. Background Study
Patients are individuals who have disorders that require interventions to improve their
function. (Pagliarulo, M.) A patient is any recipient of health care services. The patient is most
often ill or injured and in need of treatment by an advanced practice registered nurse,
Patients have this certain health needs or necessities in which they consult health care
to their expectation levels. It is the act of fulfilling a need, desire, or appetite, or the feeling gained
Patient satisfaction is an important and commonly used indicator for measuring the
quality in health care. Patient satisfaction affects clinical outcomes, patient retention, and medical
malpractice claims. It affects the timely, efficient, and patient-centered delivery of quality health
care. Patient satisfaction is thus a proxy but a very effective indicator to measure the success of
doctors and hospitals. Patient satisfaction is only an indirect or a proxy indicator of the quality of
doctor or hospital performance. Delivery of patient-focused care requires that we provide care in
a particular way, not just sometimes or usually, but always. It must be every patient every time.
Almost all of the patients around the world seek medical attention by means of going to
the hospital. Hospital is an integral part of the medical and social organization which is to provide
for the population complete health care, both curative and preventive; and whose out-patient
services reach out into the family in its home environment. The hospital is also a center for the
Most of the hospitals around the world, patient complains of having problems about their
muscular system and skeletal system or basically the musculoskeletal system. The
Musculoskeletal System provides form, stability, and movement to the human body. It consists of
the body's bones, muscles, tendons, ligaments, joints, cartilage, and other connective tissue. The
term "connective tissue" is used to describe the tissue that supports and binds tissues and organs
together. Its chief components are collagen and elastic fibers, which are composed of different
proteins. The musculoskeletal system incorporates bones, muscles, and connective tissue
(your ligaments, tendons, and fascia). Collectively these body parts provide the
framework for your body, create your movements, and dictate your degree of flexibility.
They comprise approximately sixty percent of your body mass and expend most of your
recovery from injury, illness, or disease to as normal a condition as possible. The purpose of
rehabilitation is to restore some or all of the patient's physical, sensory, and mental capabilities
that were lost due to injury, illness, or disease. Rehabilitation includes assisting the patient to
compensate for deficits that cannot be reversed medically. Rehabilitation should be carried out
only by qualified therapists. Exercises and other physical interventions must take into account the
Most of the patients who are having injuries and disorders that affect the human bodys
movement or musculoskeletal system such as low back pain, sprain, strain, osteoarthritis,
and restore maximum movement and functional ability throughout the lifespan. This includes
providing services in circumstances where movement and function are threatened by ageing,
healthy. Physical therapy is concerned with identifying and maximizing quality of life and
habilitation and rehabilitation. This encompasses physical, psychological, emotional, and social
well- being. Physical therapy involves the interaction between physical therapist, patients/clients,
other health professionals, families, care givers, and communities in a process where movement
potential is assessed and goals are agreed upon, using knowledge and skills unique to physical
Treatments are provided by physical therapist. Physical therapists are health care
professionals who maintain, restore, and improve movement, activity, and health enabling
individuals of all ages to have optimal functioning and quality of life, while ensuring patient safety
and applying evidence to provide efficient and effective care. In addition, physical therapists are
involved in promoting health, wellness, and fitness through risk factor identification and the
implementation of services to reduce risk, slow the progression of or prevent functional decline
exercises, using of heating modalities like hot moist pack, ultrasound, paraffin wax bath, infrared
radiation, and microwave diathermy, cryotherapy, spinal and lumbar traction, use of different
disorders.
Conceptual framework
encompasses injuries affecting the connective tissues of the body such as muscles, nerves, tendons,
joints, cartilage, or spinal discs (Bureau of Labor Statistics, 2008). Musculoskeletal disorders may occur
Many patients recover their strength and ability to return to normal function as well as becoming
pain free again through physiotherapy treatment. The overriding symptom of most conditions we see as
physiotherapists is pain. Pain can occur from infection such as in osteomyelitis where a bone becomes
infected. Pain can also be caused through injury to muscles, ligaments and tendons.
Physiotherapist in the treatment of musculoskeletal conditions aim is to have pain free again as
soon as possible, Physical Therapist have many ways of treating pain depending on the injury or illness
and these techniques may include joint mobilisation, muscle stretching, massage, heating modalities like
hot moist pack, ultrasound, paraffin wax bath, infrared radiation, and microwave diathermy, cryotherapy,
spinal and lumbar traction, use of different types of electrical stimulators such as functional electrical
stimulator, transcutaneous electrical stimulators, neuromuscular electrical stimulation and a host of other
problems of pain and joint stiffness, in order to allow an earlier return to activities. It involves the
physiotherapist manually gliding the articular surfaces of a joint to produce oscillatory movements
(Maitland GD 1991). 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
elongated to its fullest length in order to improve the muscles felt elasticity. Benefits of stretching may
include increased flexibility, improved range of motion within joints, improved circulation improved
posture, and stress relief. 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, tendons and
ligaments, which in turn increases the range of motion in a joint or group of joints. (Hess and Hecker,
2003). There are three common types of stretches; proprioceptive neuromuscular facilitation (PNF), static
Massage therapy can relieve symptoms and promote complete healing by increasing local
circulation, reducing muscle tension, and relieving muscle spasm and pain. Massage therapy can address
issues by reducing muscle tension and pain, releasing fascial restrictions and excess scar tissue, and
swelling, and it will improve the range of motion. However, there are still some doubts if it is actually
effective for pain relief. So the application of ice may be useful for a variety of musculoskeletal pains, yet
the evidence for its efficacy should be established more convincingly. (Nadler, 2004)
Exercise in warm water, usually called hydrotherapy or balneotherapy, is a popular and effective
treatment with a pain relief effect for many patients with painful neurologic or musculoskeletal conditions.
The warmth of water may block nociception by acting on thermal receptors and mechanoreceptors, thus
influencing spinal segmental mechanisms. It gives positive effects on cutaneous barrier homeostasis and
a anti-inflammatory activity. In addition, the warmth may enhance blood flow and muscle relaxation. The
hydrostatic effect may also relieve pain by reducing peripheral edema and by dampening sympathetic
Ultrasound therapy uses sound waves to impart mechanical vibrations to the tissues to create
heat. Ultrasound waves penetrate homogeneous tissues readily and are absorbed primarily by tissues
with high protein content, such as muscle and connective tissue (Frizzell LA, 1982). The heat produced
by ultrasound elevates the temperature in joint structures 4 to 6C [Lehmann JF 1968). Since ultrasound
was developed in the early 1950s, it has been used to relieve pain and joint immobility in a variety of
musculoskeletal conditions.
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, increase superficial blood flow, and may
increase extensibility of collagen tissue. (Hecox B,2006) Parts of the body are submerged in warm melted
wax to coat the skin in a thick layer, which is then wrapped securely and left for a period of time to "soak".
The heat from paraffin wax treatments is both warming and healing, and the nourishing wax helps to
Physical Therapist not only treat pain, but also deal with the accompanying muscle weakness,
loss of muscle balance and stability and decrease in range of movement and functional use of the body
part. Physical Therapist do this is through the prescription and management of individual exercise
The importance of exercise in dealing with musculoskeletal conditions can never be overstated.
Exercise improves flexibility, promotes movement, and increases blood flow to the area which all help to
reduce pain and increase function. Strengthening exercises are just as important in restoring function and
This study aims to determine the Levels of Satisfaction among Musculoskeletal Condition
a. Age
b. Civil status
c. Gender
d. Educational attainment
e. Occupation
f. Length of service
a. Treatment
b. Facilities
c. Services
a. Public Hospital
b. Private Hospital
Hypotheses
The following were the research hypotheses that were formulated in the study:
1. In old age on Ireland they are satisfied to the Treatment done
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. This study aims to
determine the patients rating of their care experienced based on what they did or did not experience in
their interaction in obtaining health care. Patient satisfaction surveys can help gauge patients perceptions
of practice services and functions. These study are invaluable means for improving communication
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. This study also helps the physical therapist in expanding their roles in different
The purpose of this study is to survey the patient level of satisfaction in rehabilitation services in
public and private hospitals in La Union. This study measures the quality of care in patients with
musculoskeletal condition wherein it helps the patient to overlook on the costs of services, the quality of
care delivered and the impact of the treatment facilities on improving their quality of life.
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, 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 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, facilities and services.
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. It aims to recognize the patients
reactions.
This study would also like to know the patients perception about the treatments, services and
hospital facility.
This research study is limited or focuses only on the musculoskeletal patients from the three
Definition of Terms
1. Care - Level of active concern, or lack of negligence, towards avoidance of possible dangers,
2. Effective - is the capability of producing a desired result. When something is deemed effective, it
3. Efficient - performing or functioning in the best possible manner with the least waste of time and
effort
6. Health - As defined by World Health Organization (WHO), it is a "State of complete physical, mental,
and social well-being, and not merely the absence of disease or infirmity." Health is a dynamic
condition resulting from a body's constant adjustment and adaptation in response to stresses and
7. Health Care - The treatment and management of illness and the preservation of health, dental,
complementary and alternative medicine, pharmaceutical, clinical sciences, nursing, and allied health
professions. Health care embraces all the goods and services designed to promote health including
nursing, hospital service, dental service, optometrical service, complementary health services or any
or all of the enumerated services or any other necessary services of like character, whether or not
contingent upon sickness or personal injury, as well as the furnishing to any person of any and
all other services and goods for the purpose of preventing, alleviating, curing or healing human
9. Low back pain - Low back pain is pain, muscle tension, or stiffness localized below the costal margin
and above the inferior gluteal folds, with or without sciatica, and is defined as chronic when it persists
10. Maslows Hierarchy of Needs - is a motivational theory in psychology comprising a five tier model of
11. Need - A motivating force that compels action for its satisfaction. Needs range from basic survival
needs (common to all human beings) satisfied by necessities, to cultural, intellectual, and social
needs (varying from place to place and age group to age group) satisfied by necessaries. Needs are
finite but, in contrast, wants (which spring from desires or wishes) are boundless.
12. Osteoarthritis- is the most common form of arthritis, affecting millions of people worldwide. It occurs
when the protective cartilage on the ends of your bones wears down over time.
13. Rheumatoid arthritis- is the most common type of autoimmune arthritis. It is triggered by a faulty
immune system (the bodys defense system) and affects the wrist and small joints of the hand,
14. Sprain - Severe stress, stretch, or tear of soft tissues such as the joint capsule, ligament, tendon, or
muscle
15. Strain - Overstretching, overexertion, overuse of soft tissue; tends to be less severe than a sprain;
results from slight trauma or unaccustomed repeated trauma of a minor degree. It also refers to the
e. Occupation
f. Length of service
Bureau of Labor Statistics (2008). Nonfatal occupational injuries and illnesses requiring
days away from work, 2007. Washington, D.C., U.S. Department of Labor, Retrieved on
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Thrash A. Home Remedies: Hydrotherapy, Massage, Charcoal and Other Simple
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MD; The Physiologic Basis and Clinical Applications of Cryotherapy and Thermotherapy
for the Pain Practitioner, pain physician, 2004. 1A
Hiroharu K., Kiichiro T., Effectiveness of Aquatic Exercise and Balneotherapy: A Summary
Sanko J, editors. Integrating physical agents in rehabilitation. 2nd ed. Upper Saddle