i've always read about the importance of communication but i never realised that how it actually impacted the patient. My patient had a full thickness rotator cuff tear in 2006 and now has outstanding issues with hypomobility in the GH joint and decreased strength. Today was the first time he came for a physiotherapy session with me.
Subjectively, he said he was improving but upon objective assessment, i discovered that his range and strength was much worse than it was 3 weeks ago (the last time he came for physio). Intrigued, i had a look at his home exercises and discovered that even though he said he had been doing them at least once a day, he did not know how to most of them.
After a little more investigation, i realised that even with the exercise sheet, he did not understand what most of the exercises were referring to and thus was unable to follow them. The exercise sheet had stick figures but single word instructions eg "elevation" which he did not understand.
I then went through all his exercises again and wrote the exercises in "layman terms" and with the same cues for the same directions (eg sideways for abduction and turning outwards for external rotation so he wouldn't get confused). This proved to be really useful as he felt a lot more confident with the exercises and were able to do them without any prompts.
It also helped me to understand that even in the outpatient setting, communication is key- both written and verbal. Also, it's just a good reminder that we should not take for granted that the patients necessarily know what we are referring to even with pretty stick figures and that we should always check that they understand and are able to interpret the program written up for them.
Subscribe to:
Post Comments (Atom)
1 comment:
Hey Sharon,
I think you have made a very important point there. I guess we as clinicians sometimes forget that individuals of society are often not familiar with the terms that we use as physios such that we forget when we are writing up programs for patients.
From my experience, I always think the best way to do it is to ask the patients how they will remember the exercise in terms of giving it a name and then a description and then at least you know that when they go back to ready it they'll be familiar with what the exercise involves!
Additionally- in regards to HEP from these cases in which people deteriorate from not doing their programs it makes us realise how important both physio Rx and self management together play equal roles in a persons rehabilitation and people can't expect us to 'cure' them from our sessions with them.
See you tomorrow :)
Debs
Post a Comment