Physiotherapy in Nigerian emergency departments: a national survey of physiotherapists’ perceptions of practice

Abstract

BACKGROUND: Physiotherapy in emergency departments (EDs) is expanding globally, improving patients' access and outcomes. Although present in Sub-Saharan African countries like Nigeria, there is limited evidence on awareness or specific practices. In addition, there is limited evidence on physiotherapists' perceptions of these services, despite the importance of such perspectives in understanding their knowledge, engagement and potential contributions to effective physiotherapy service delivery within EDs in Nigeria. STUDY AIM: To explore and understand physiotherapists' perceptions of ED practice in Nigeria, within the context of their knowledge and professional experience. METHODS: Between March and August 2024, a nationwide survey was carried out among licensed physiotherapist clinicians domiciled in Nigeria across all geopolitical zones, with any level of experience in ED settings, to assess their knowledge and practice. Data were analysed using descriptive statistics, Chi-square tests assess healthcare setting and regional differences in practice. Alpha level was fixed at 0.05. RESULTS: A total of 108 physiotherapists from six Nigerian regions participated in the survey, with 65% based in tertiary healthcare facilities. Of the eight items assessing knowledge, 48% disagreed that clear ED physiotherapy guidelines exist. In terms of practice, 69% operate under a secondary contact model, and 51% used referrals to schedule ED physiotherapy. Significant differences were found across healthcare settings and specific payment methods (p < 0.001), with a higher percentage of participants from the teaching hospitals reporting out-of-pocket payments (73%). CONCLUSION: This study demonstrates that secondary contact physiotherapy services are perceived to be predominantly provided in Nigerian EDs, typically accessed via referrals, with patients primarily paying out-of-pocket. These findings highlight gaps that may affect the integration, delivery, and utilisation of physiotherapy services within the ED setting in Nigeria.