Chapter 8 Flashcards
Communication
The most immediate tool used to interact with others.
Therapeutic relationships
Partnerships among the PT, PTA, and patient/client.
Therapeutic communication
Occurs when the PT or PTA interact with a patient/client in a therapeutic or a healing manner.
Two forms of communication used by the PTA and PT
-verbal
-nonverbal
What does a complete therapeutic relationship between the PT/PTA and the patient/client consist of…
- if the PT/PTA is able to understand, develop, and use the inner abilities of self awareness and empathy in the communication process.
Empathy
The ability to imagine oneself in another persons place and to understand the other persons feelings, idea, desires, and actions.
In order to feel empathy you must develop what first?
-Selfawareness
Selfawareness
growing awareness of ones own emotional states and the ability to discern and interpret emotions of others.
Absence of empathy means… (4)
-emotional and cognitive immaturity
-inability to love and truly relate to others
-failure to respect other peoples boundaries
-inability to accept other peoples needs, feelings, hopes, choices, and fears
3 stages of empathy between healthcare provider and patient/client
1) Cognitive stage
2) Crossing over stage
3) Coming back to own feelings stage
Cognitive stage
-Involves getting into the position of the other person
-Involves listening to the patient/client and trying to imagine what it must be like for the patient/client to experience what they are describing
Crossing over stage
-Most significant
-PT/PTA can feel themselves as the patient/client, living in their world
Coming back to own feelings stage
PT/PTA comes back to their own person and feels special alliance with patient.
Sympathy
-understanding and having compassion for a person, but not feeling the same feelings.
“i am sorry for your loss”
sympathy
Pity
-not appropriate
-it is sympathy with condescension
Attributes a PTA should display in order to form a therapeutic relationship with patient
-punctuality
-friendliness
-culturally sensitive
-communicative
-communication with patient should be at their level of understanding
-patient-focused behaviors
-knowledgeable
-trustworthy
-helpfulness
-comfortable
Strategies for dealing with difficult people
-stay calm.
-focus on solving the problem
-Let go of things you cannot control.
What is more successful than therapeutic exercises for patients who have dementia and mental illness?
simple directions with a focus on functional activities.
Topics that should be explored between team members to help promote utility
-education
-state laws
-professional and ethical aspects of care
-personal attributes
two documents that guide PT/PTAs in professional and ethical aspects of care
-Minimum required skills of PTA graduates at entry level
-Standards of ethical conduct for PTA
Physical therapist-Physical therapist assistant team toolkit
-Electronic document created by APTA
-helps educate newly formed PT/PTA team on the importance of the relationship between a PT/PTA.
Verbal/oral communication
-uses messages conveyed orally from a sender to a reciever
Nonverbal communication
-uses messages conveyed through methods other than orally or in writing.
Two types of nonverbal communication
-communication through body language
-communication through facial expression including gestures and eye contact.
What do PT/PTAs need to be considerate about in regards to their patient/client.
-health beliefs
-health perceptions
-attitudes
-level of education
For healthcare providers, the success of verbal communication is dependent on the following factors:
-the way the material is presented
-the attitude of provider
-tone and volume of providers voice
-degree to which the patient/clients listens, including their mental status
Channels of verbal communication that can be delivered to a patient/client
-face to face discussion
-telephone discussion
-group discussion
-third party discussion
Face to face discussion
-best delivery method of verbal communication
telephone discussion
-confidential patient/client medical information should not be discussed over the telephone
group discussion
-PT/PTA can communication the same message to a group of patients/clients.
-the message is not personalized because patients/clients medical information is not confidential
-can be used for group exercise programs
third-party discussions
-PT/PTA can communicate with patient/client through another person
-limited due to delivering intended meaning and medical information confidentiality.
Closed questioning
asks for short factual answers
EX of closed questioning
“Do you have pain today”
Open questioning
asks the person to give a more detailed answer
EX of open question
“What types of activities are difficult because of your pain?”
EX of leading question
“Does that hurt?”
-the patient may have not considered that they had felt pain and should not be led to wonder if that is a possibility
8 kinds of listening
-Analytical
-Directed
-Reflective
-Exploratory
-Appreciative
-Attentive
-Courteous
-Passive
Analytical listening
-used for a specific type of info. and for arranging the info. in categories
EX of analytical listening
listening to the patients description of pain
Directed listening
-used to listen to the patients answers to specific questions
EX of directed listening
-listening to patients answers about the activities and positions that increase or decrease their pain
Reflected listening
-used to clarify what the patients said
EX of reflected listening
-listening to the patient explain why the task is difficult to perform and then the PTA repeating their understanding of what they heard to clarify that they understand the patient.
Exploratory listening
-used when a persons own interest in the subject is being discussed
EX of exploratory listening
-patient listening to the PTs recommendations of positioning techniques in sleeping to decrease the pain
Appreciative listening
used for esthetic pleasure
-EX: listening to music
Attentive listening
-used for general info. to get the overall picture of the patient.
EX of attentive listening
PTA listening to PTs specific recommendations for a patients treatment
Courteous listening
-used when feeling obligated to listen
-EX: listening to a story the patient is describing even it has no relevance to the patients examination and treatment
Passive listening
-used when not being attentive to the matter being discussed but overhearing the conversation
EX of passive listening
-a patient in a hospital bed listening to the other patients conversation in the next bed
What kind of listening can provide some relevant info. about the patient to be included in the patients documentation?
-general
-analytical
-directed
-attentive
What kind of listening can provide the most relevant info. about the patient?
-exploratory
Body language
-includes a persons posture and gestures.
-reveals a persons inner character and emotions
Open posture
-convey a persons willingness to receive a message
open postures include:
-a person standing or sitting with their arms and legs uncrossed
-a person standing and sitting straight
-a person standing or sitting positioned at the same eye level with the receiver
-person as receiver facing the sender
Closed posture
-conveys a persons unwillingness to receive a message
closed posture include:
-arms and legs crossed
-being slumped over
-receiver turned away from the sender
Facial expressions
-include gestures and eye contact
-convey acceptance or rejection of thoughts and ideas presented
Acceptance of thoughts and ideas can be conveyed through a….
-smile
-nodding
-direct eye contact
Rejection of thoughts and ideas can be conveyed through a….
-rolling of eyes
-looking up or down or away from sender
-shaking the head
-frowning
Self-regulation
-learning to respond to a patients behaviors and emotions with calmness and awareness
-will allow for a better outcome for the patient.
EX of written communication given to the patient/client
-reinforce instructions to perform activities or exercises
-informed consent documents
-surveys
guidelines for written communication
-write the info. like you would talk to the patient/client
-use an active voice
-use short sentences and common words
-for complicated words, use examples
-include interaction
What must HEPs be specific about?
-number of repetitions
-amount of exercise resistance
-positions for performing the exercises or activites
What must HEPs contain?
-diagrams or pictures
-contact info of PT/PTA
When does HEP start?
-first day of treatment and continues to the day of discharge.
Specific guidelines for HEP
-each sentence should present only one idea and contain only no more than three syllable word
-lines of copy no more than 5 inches wide
-type size should be 12 points or larger
-written in 5th grade reading level
-stored in logical manner (all sitting together, all standing together, etc.)
