More allied health professionals needed

Singapore wants more and better qualified allied health-care professionals because the important role they play in patient care is increasingly being recognised.

As recently as a decade ago, up to one in three patients who had undergone abdominal surgery in some hospitals would also suffer from collapsed lung - which would lead to infection and longer stays in hospital.

Today, lung collapse is hardly seen in hospitals, said Associate Professor Alan Wong of the Singapore Institute of Technology (SIT), which will offer four allied health-care degree courses from next year.

The change came primarily from getting physiotherapists to teach patients how to breathe properly in spite of the pain in their abdomen.

In the past, patients would stay in bed for a day or two till the pain eased.

The lung collapse was caused by their not daring to take deep breaths or to cough out phlegm because of the pain caused, as well as from sitting slouched in bed, which compressed their lungs.

The longer stays also meant weakened muscles, which needed to be built up, said Prof Wong.

Occupational therapists, too, have made great strides in getting patients back to work faster, and speech therapists to help them regain their ability to speak and be understood.

Today, Singapore has close to 2,000 fully-registered physio-, occupational and speech-language therapists. There are another 500 with conditional, restricted or temporary registration.

The majority work in hospitals, which now also have them working with patients who are still in intensive care.

One of the first was National University Hospital (NUH), which had physiotherapists working in intensive care from the time it was set up in 1985.

Ms Ng Tze Siong, NUH's senior principal physiotherapist, said they help critically-ill patients "breathe better and regain their physical functions".

While the Singapore General Hospital has had physiotherapists helping patients with breathing since 1970, getting ICU patients to exercise started only in 2013.

Tan Tock Seng Hospital started getting physiotherapists to work with patients in ICU in 2012.

Physiotherapists teach patients how to move with little added pain, such as avoiding pressing down on the wound when they move and the proper way of getting up and out of bed without straining the abdominal muscles.

A spokesman for Khoo Teck Puat Hospital said patients in ICU get stiff joints, muscle tightness and reduced cardiovascular fitness.

He said having physiotherapists working in the ICU speeds up "the physiological, psychological and physical recovery of critcally-ill patients".

Ms Hermione Poh, principal physiotherapist at Alexandra Hospital, said exercises get more oxygen to all parts of the body, which improves patients' mood and sleep.

Health Minister Gan Kim Yong announced last year that physio- and occupational therapists are increasingly needed outside of hospitals - offering both rehabilitation and preventive care in the community and patients' homes.

By working with the elderly to strengthen their muscles and improve their balance, they reduce their risk of falling and fractures that would land them in hospital and immobilised for weeks.

The SIT courses will add about 90 physio- and 60 occupational therapists a year.

salma@sph.com.sg

This article was first published on Feb 27, 2015.
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