4.2 Promoting Self-Management Flashcards
What is self-management
- Pt takes an active role in managing their rehabilitati on and health
- PT can increase Pt adherence and improve outcomes through effective communication, support & education
- The goal of promoting self-managment:
Involve the Pt in their care to their maximum ability - Effective self-managmeent :
*Empowers Pts to take control of their rehabilitation and maintain their physical health more effectively
Every Successful Medical Facility Prioritizes
1. Educate to ensure comprehension
2. Self-monitoring techniques by Pt
3. Motivate to increase adherence
4. Follow up to review progress
5. Problem-solving to overcome barriers
- Educate to ensure comprehension
Education:
- allows Pt to understand cause and effect
- empower them to implement better health-related behaviors
- Education also ensures that Pt performs tasks correctly and receives the benefits.
For these reasons, I must ensure the Pt understands what they have been taught throughtout their treatment.
This could be related to education about their condition, activity modification strategies, fall prevention or their program.
Ways to enhance Pt comprehension
1. Use clear and simple language (no physio jargon) when explaining concepts
- Check for non-verbal cues that indicate Pt may be confused or not understanding such as facial expressions and body language
- Ask Pt to demonstrate exercises, safe functional mobility and other physical tasks to ensure their understanding
- Use visual aids and wirtten materials to help enhance learning and improve understanding
E.g.
- Demonstrate the activity modification strategies I want them to perform
- Show them a video of a model performing an activity while maintaining precautions
- Use the Pt’s phone to record them performing an exercise for their reference
- Use printouts with clear descriptions and images to help the Pt remember what exercises they should be doing - Encouraged the Pt to ask questions and reassure them that no question is too small or irrelevant
- Ask Pt to repeat the information taught in their own words
- Involve family members/friends when relevant to help reinforce the information being taught and assist with care
- Self-monitoring techniques by Pt
- Ensures Pt particiaptes safely and provides them with a way to track their progress
- Also helpful for me to see if the Pt is adhering to their program
Teach Pts how to self-monitor using tools such as:
- Subjective measures to ensure safety (RPE, NPRS)
- Physical activiy logs, mobiles apps to track progress, monitor adherence and increase Pt accountability
- Diary to self-reflect on how Pt felt before, during and after exercise
- Motivate to increase adherence
- Motivated Pt are more likely to stick to their treatment programs which will improve health outcomes
I will motivate my Pt in the following ways:
- Encourage Pt to use self-reflection and improvements in their health status as motivation to continue
- Set realistic Pt-centre goals to keep Pt stay on track and motivated to achieve each goal
- Encourage Pt to join community groups for people with similar conditions for shared experience and encouragement (chronic)
- Encourage Pt to share their goals with family members/friends who can help motivate them
- Encourage Pt to share their goals with family members/friends who can help motivate them
- Encourage Pt to perform exercises with friends/family members to help them stay motivated
- Encourage Pt to go to the community gym if they find they are not motivated to exercise at home
- Use reward systems to help Pt stay motivated (e.g. every time you perform your exercise, you put a dollar in the jar)
- Follow up to review progress
It is critical to follow up with Pt to ensure they are on the right track
- Provide Pt with your professional contact information (e.g. work email) so they can contact you if there are any issues or if they are no longer completing the prescribed tasks
- Check in with the Pt to ensure they are adhering to their program
- Review the Pt progress and adjust the treatment plan as needed
- Problem-solving to overcome barriers
- Barriers can derail progress. It is important to be able to identify what these barriers are and work with the Pt to find ways to overcome them
- If the Pt is not participating, investigate and find out why so that you can implement a plan of action to try to increase adherence
E.g. If the Pt cannot remember to do their exercises:
- Suggest using memory aids like suggesting that the Pt set reminders on their phone or use a paper calendar to document when they have performed their exercises
- Advise the Pt to set up a daily routine incorporating exercises (e.g. perform exercises every morning after breakfast)
E.g. Pt is feeling overwhelmed by the number of exercises
- Streamline the program→Prioritize and pick the most important exercises for them to continue to perform
Case example: 1. Education to ensure comprehension
I would first want to make sure that my Pt understands everything I have taught them. To ensure comprehension, I would
- Use layman’s terms and avoid using physio jargon when speaking with the Pt
- Encourage the Pt to ask questions and watch for non-verbal cues that indicate thay may be confused about something I am teaching team
- Provide them with a printout that has clear descriptions and images to help Pt remember what exercises Pt should be doing.
- Have the Pt demonstrate all their exercise, including their breathing exercises, so I can ensure they have good technique
Case example: 2. Self-Monitor by the Pt
I would teach the patient
- how to self-monitor using a dyspnea scale and a modified borg scale to ensure safe participation in their exercise program.
- I would encourage the Pt to use a diary to improve adherence and track their progress.
Case example: 3. Motivate to increase adherence
I would encourage the patient to also use their diary to self-reflect on the improvements they have noted in their general health and use that as motivation to continuse to participate in their rehabilitation program
Case example: 4. Follow up to review progress
Follow-up sessions would be important to check in on the patient,
- review their progress and adjust their treatment program as necessary.
- The Pt’s diary could also be a helpful way to monitor adherence during follow-up sessions.
- I would ensure the Pt has my contact information so they can get a hold of me if they have any questions or concerns.
Case example: 5. Problem-solving the identify any barrier
During the follow-up, I would identify and address any barriers that are negatively affecting the Pt’s participation.
It would be important to investigate and find out why they are not participating and implement a plan of action to try to increase adherence
