SOAP notes Dissected

Question 1

What is S.O.A.P?

Answer 1

S: Subjective
O: Objective
A: Assessment
P: Plan

Question 2

What is Subjective?

Answer 2

How the patient feels. Patient words:

• pain
• fears
• pain pattern
• effect on activity
• emotions

Question 3

What is Objective?

Answer 3

-Must be reproducible and measurable.
-Results of test and measures.
Examples:
-results of measurement and tests
-describe patients function
-Describe interventions
-Objective observations of patient
-Any patient education provided during treatment.

Question 4

What is Assessment?

Answer 4

• Patient progress
• Treatment effectiveness
• Completion of or changes recommended for goals or treatment plan
• response to treatment/ interpretation of tests
• change in status (ROM, strength, pain)
• Patients comprehension of treatment

Question 5

What is Plan?

Answer 5

What is the plan for the future?
need a referral to other HCP?
-Change resistance, distance, assistive devices.