Launceston physiotherapist Ianthe Boden talks about research published in BMJ

22 Mar 2018

Reduced time at work over the years can impact gender equality in the workplace, according to Launceston physiotherapist Ianthe Boden.

She said the only gender-based impact on her career came from fewer overall working hours, due to maternity leave and school pick-ups and drop-offs.

“Other than that, I don’t think I’ve had any gender-based discrimination at work and I’ve achieved everything I need to do regardless of the fact I don’t have a Y chromosome,” she said.

The mother of three has, in fact, been extremely successful in her career.

The Examiner caught up with Ms Boden ahead of International Women’s Day to find out about her work.

A trial at the Launceston General Hospital led to her research being published in the esteemed British Medical Journal in December last year.

The study found teaching patients breathing exercises before abdominal surgery reduced the mortality rate.

“When we looked at the most common major surgery performed here at the LGH, it’s major abdominal surgery,” she said.

“More than 350 patients every year get operated in this particular operation. Then when we looked at the information and the data, we found the most common complication after this type of surgery was a chest infection.

“It’s not anything that goes wrong in the operation, it’s actually a lung problem that occurs in the first few weeks after the operation.

“From a physiotherapy point-of-view, I thought, we could do something about that – something preventable. Let’s not wait for that horse to bolt. Let’s try to stop it in the first place.”

The findings suggested preparing patients before surgery could reduce the risk of chest infections after surgery.

“Unfortunately though, in Australia, hardly any hospital provides pre-operative preparation of that type,” Ms Boden said.

”I thought, let’s give this a crack and see if we can answer this quite important question, because a chest infection is quite serious – it’s one of the most likely causes of death after surgery and people are still four to five times more likely to be dead one year after surgery if they get a chest infection in that first week.

“So it’s not just a short-term problem, it can lead to long-term issues as well.”

The team of researchers measured chest infections as costing the hospital $18,000 in addition to the primary cost of $15,000 for surgery.

”So for every chest infection we could prevent, we could theoretically have enough money to operate on a whole new person, separately, if we could prevent those chest infections.”

Along with the LGH, the North West Regional Hospital and a major hospital in Auckland, New Zealand, took part in the study.

Patients were met by a physiotherapist at the pre-admission clinic before surgery, where half received a booklet that told them about breathing exercises and how to prevent a chest infection.

The other half were given a 30-minute face-to-face session with the physiotherapist, who taught them the breathing exercise, along with memory cues and motivation to practice the exercise as soon as they woke up from surgery.

“It was just a slow deep breath, hold that breath, sniff on top of it to really jack the lungs up a little deeper, do that 10 times, follow it up by three coughs and do it again.

“The only difference in those patients was that 30-minute session before surgery and being taught breathing exercises they needed to do as soon as they woke up.

“We found the pneumonia rates in the people who just got the information booklet was about 30 percent, and we dropped that down to 12 percent in the treatment group.

“We looked at 12-month mortality as well and found if a patient was seen by an experienced physiotherapist that the death rates one year on from surgery were also reduced by 70 percent, which is quite a profound and impactful finding – that not just the education makes a difference, but it looks like experience and how you educate a patient also matters.”

 

Carly Dolan – The Examiner, Launceston