Objectives. The aims of this study were to: investigate physiotherapists' knowledge about the professional health responsibility, identify the main reasons for complaints against the category and extend this research abroad. -Methods. A multi-method investigation was conducted in which the databases of the Ministry of Justice, the Supreme Court of Cassation and the Court of Auditors were consulted to search for sentences; three types of questionnaires were forwarded to undergraduates in the three-year course in physiotherapy, to graduates registered with the Order and to physiotherapists registered as CTU by sending them to the addresses respectively: of the coordinators of the 21 offices in Italy where the third year of the course is present and active three-yearly, of the 18 Regional AIFI offices and of the 38 territorial Orders and finally of the 9 direct addresses of CTU physiotherapists found both in the electronic portal of the Ministry of Justice and by consulting the lists in the individual Italian Courts, to be added to 2 telephone interviews. A narrative review of the scientific literature was also conducted by consulting the MEDLINE, Cochrane Library, PEDro, Google Scholar databases, using "malpractice, litigation, torts, professional assistance, Physical Therapists, Physiotherapist" as keywords. -Results. A total of 184 sentences in civil, criminal and administrative fields were selected and read and the main reasons for complaints against physiotherapists appear to be their predominantly imprudent and negligent conduct which causes damage to patients including bone fractures, joint dislocations or prosthetic device, nerve and muscle-tendon damage and falls resulting in head or skeletal trauma; Furthermore, reports of illegal signatures, incorrect compilation of medical records and irregular work were found. In most cases, physiotherapists have been found guilty. The following were completed and received respectively: 79 questionnaires from graduating physiotherapists, 91 from graduating physiotherapists, 5 from CTU physiotherapists plus two interviews, from which it mainly emerged that: more than 60% of graduating students and more than 80% of graduates know the Gelli Law , but over 90% of students and over 50% of graduates have never heard of the figure of the CTU; no expert was able to describe their experience in court and among these only 66% followed a specific training course, furthermore none of them had received information on this figure during their university studies. A total of 7 studies taken from the international scientific literature were selected and read in which it is noted that complaints against healthcare workers mainly occur due to errors during treatments, especially incorrect maneuvers or negligent and imprudent behavior that causes damage; Numerous reports relating to sexual abuse and transgressive behavior by healthcare workers were also found. -Conclusions. The results highlight the need to increase and standardize knowledge on the subject of health responsibility and on the figure of the CTU by the category of Italian physiotherapists. This research can provide the basis for further studies and insights in order to improve physiotherapists' knowledge on the subject, to increase the levels of safety and appropriateness of clinical practice, to raise physiotherapists' awareness of the importance of becoming CTU to support category in case of need and to ensure that cases of physiotherapy malpractice are adequately punished. -Keywords: professional healthcare liability, physiotherapist, medical malpractice, Gelli-Bianco Law, Office Technical Consultant, court appointed expert, CTU.
-Obiettivi. Gli obiettivi di questo studio sono i seguenti: sondare le conoscenze dei fisioterapisti in materia di responsabilità professionale sanitaria, identificare i principali motivi delle denunce nei confronti della categoria e ampliare la ricerca anche a livello internazionale. -Metodi. E’ stata condotta un’indagine multi-metodica in cui sono state consultate per la ricerca delle sentenze le banche dati del Ministero della Giustizia, della Suprema Corte di Cassazione e della Corte dei Conti; sono state inoltrate tre tipologie di questionari ai laureandi alla triennale in fisioterapia, ai laureati iscritti all’Ordine e ai fisioterapisti iscritti come CTU tramite invio agli indirizzi rispettivamente: dei coordinatori delle 21 sedi in Italia in cui è presente e attivo il terzo anno del cdL triennale, delle 18 sedi AIFI Regionali e dei 38 Ordini territoriali e infine dei 9 indirizzi diretti di fisioterapisti CTU trovati sia nel portale telematico del Ministero della Giustizia, sia consultando gli elenchi nei singoli Tribunali italiani, da aggiungersi a 2 interviste telefoniche. È stata condotta anche una revisione narrativa della letteratura scientifica consultando i database MEDLINE, Cochrane Library, PEDro, Google Scholar, utilizzando come parole chiave “malpractice, litigation, torts, professional responsibility, Physical Therapists, physiotherapist”. -Risultati. Sono state selezionate e lette un totale di 184 sentenze in ambito civile, penale ed amministrativo e i motivi principali di denunce contro i fisioterapisti risultano essere le loro condotte prevalentemente imprudenti e negligenti che causano danni ai pazienti tra cui fratture ossee, lussazioni articolari o di un dispositivo protesico, danni nervosi e muscolo-tendinei e cadute, con conseguenti traumi cranici o scheletrici; sono state riscontrate anche denunce per firme illecite, errata compilazione della cartella clinica e lavoro illegale. Nella maggioranza dei casi i fisioterapisti sono stati ritenuti colpevoli. Sono stati compilati e ricevuti rispettivamente: 79 questionari da parte dei fisioterapisti laureandi, 91 da parte dei fisioterapisti laureati, 5 da parte dei fisioterapisti CTU più 2 interviste, da cui si riscontra principalmente che: più del 60% dei laureandi e più dell’80% dei laureati è a conoscenza della Legge Gelli, ma che più del 90% tra gli studenti e più del 50% tra i laureati, non ha mai sentito parlare della figura del CTU; nessun CTU ha potuto descrivere la sua esperienza in tribunale e tra loro solo il 66% ha seguito un corso di formazione apposito, inoltre nessuno di loro ha ricevuto informazioni su questa figura durante il percorso universitario. Dalla letteratura scientifica internazionale sono stati selezionati e letti un totale di 7 studi in cui si riscontra che le denunce contro i professionisti sanitari avvengono prevalentemente per errori durante i trattamenti, soprattutto per manovre errate o comportamenti negligenti e imprudenti che provocano un danno; sono state trovate anche numerose denunce relative ad abusi sessuali e comportamenti trasgressivi da parte dei professionisti sanitari. -Conclusioni. I risultati evidenziano la necessità di aumentare e uniformare le conoscenze in materia di responsabilità sanitaria e sulla figura del CTU da parte della categoria dei fisioterapisti italiani. Questa ricerca può fornire le basi per ulteriori studi e approfondimenti al fine di migliorare la conoscenza in materia da parte dei fisioterapisti, per aumentale i livelli di sicurezza e appropriatezza della pratica clinica, per sensibilizzare i fisioterapisti riguardo all’importanza di diventare CTU per supportare la categoria in caso di necessità e per far sì che vengano adeguatamente puniti i casi di malpractice fisioterapica. -Parole chiave: responsabilità professionale sanitaria, fisioterapista, malasanità, Legge Gelli-Bianco, Consulente Tecnico d’Ufficio, CTU.
Il ruolo del fisioterapista Consulente Tecnico d’Ufficio (CTU): indagine su diffusione e conoscenza in Italia; responsabilità professionale sanitaria e sentenze in contesto nazionale e internazionale.
AGARICI, MARTINA
2023/2024
Abstract
Objectives. The aims of this study were to: investigate physiotherapists' knowledge about the professional health responsibility, identify the main reasons for complaints against the category and extend this research abroad. -Methods. A multi-method investigation was conducted in which the databases of the Ministry of Justice, the Supreme Court of Cassation and the Court of Auditors were consulted to search for sentences; three types of questionnaires were forwarded to undergraduates in the three-year course in physiotherapy, to graduates registered with the Order and to physiotherapists registered as CTU by sending them to the addresses respectively: of the coordinators of the 21 offices in Italy where the third year of the course is present and active three-yearly, of the 18 Regional AIFI offices and of the 38 territorial Orders and finally of the 9 direct addresses of CTU physiotherapists found both in the electronic portal of the Ministry of Justice and by consulting the lists in the individual Italian Courts, to be added to 2 telephone interviews. A narrative review of the scientific literature was also conducted by consulting the MEDLINE, Cochrane Library, PEDro, Google Scholar databases, using "malpractice, litigation, torts, professional assistance, Physical Therapists, Physiotherapist" as keywords. -Results. A total of 184 sentences in civil, criminal and administrative fields were selected and read and the main reasons for complaints against physiotherapists appear to be their predominantly imprudent and negligent conduct which causes damage to patients including bone fractures, joint dislocations or prosthetic device, nerve and muscle-tendon damage and falls resulting in head or skeletal trauma; Furthermore, reports of illegal signatures, incorrect compilation of medical records and irregular work were found. In most cases, physiotherapists have been found guilty. The following were completed and received respectively: 79 questionnaires from graduating physiotherapists, 91 from graduating physiotherapists, 5 from CTU physiotherapists plus two interviews, from which it mainly emerged that: more than 60% of graduating students and more than 80% of graduates know the Gelli Law , but over 90% of students and over 50% of graduates have never heard of the figure of the CTU; no expert was able to describe their experience in court and among these only 66% followed a specific training course, furthermore none of them had received information on this figure during their university studies. A total of 7 studies taken from the international scientific literature were selected and read in which it is noted that complaints against healthcare workers mainly occur due to errors during treatments, especially incorrect maneuvers or negligent and imprudent behavior that causes damage; Numerous reports relating to sexual abuse and transgressive behavior by healthcare workers were also found. -Conclusions. The results highlight the need to increase and standardize knowledge on the subject of health responsibility and on the figure of the CTU by the category of Italian physiotherapists. This research can provide the basis for further studies and insights in order to improve physiotherapists' knowledge on the subject, to increase the levels of safety and appropriateness of clinical practice, to raise physiotherapists' awareness of the importance of becoming CTU to support category in case of need and to ensure that cases of physiotherapy malpractice are adequately punished. -Keywords: professional healthcare liability, physiotherapist, medical malpractice, Gelli-Bianco Law, Office Technical Consultant, court appointed expert, CTU.| File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12075/19105