Stuff from chapter 1 focus questions Flashcards
ICF
Impairments in body function
Body functions are the physiological functions of systems of the body
Example: Pain, impaired balance, decreased aerobic capacity, Skin hypomobility (immobile from scaring)
ICF
Impairments in body structure
Problems with the anatomical features of the body.
Example:
Tendonitis of the rotator cuff.
Tear of the talofibular ligament
ICF
Activity limitations
Difficulties an individual may have in executing actions, tasks and activities.
Example:
* Reaching, grasping
* Lifting lowering
* Pushing pulling
* Bending stooping
* Turning and twisting
* Throwing and catching
* Rolling
* Sitting or standing tolerance
* Squatting (crouching) kneeling
* Standing up and sitting down
* Getting in and out of bed
* Moving around
* Ascending and descending stairs
* Hopping and jumping
* Kicking or swinging an object**
ICF
Participation restriction
Problems an individual my experience with involvement in life situations, including difficulties participation in self care; responsibilities in the home, workplace, or the community; and recreational, leisure, and social activites.
Example:
- Self- care
- Mobility in the community
- Occupational tasks
- School-related tasks.
- Home management
- Caring for dependents
- Recreational and leisure activities
- Socializing with friends/ family
- Community responsibilities and service.
ICF
Contextual factors (environmental)
Factors associated with the physical social and attitudinal environment in which functioning (facilitators) or hinder functioning and contribute to disability (barriers)
example:
Outside the individual – for instance USD wouldn’t accommodate me when I herniated a disc in my back and couldn’t sit for long periods, which made me have to drop out of school.
ICF
Contextual factors (personal)
Factors that are unique to the individual and include characteristics such as race, gender, family background, coping styles, education, fitness and psychological assets
example:
Not coded by ICF, but considered.
2. List the 5 steps in the process of evidence-based practice.
a) Examination –
History – Systems review – Tests and measures
List the 5 steps in the process of evidence-based practice.
b) Evaluation
interpret findings
List the 5 steps in the process of evidence-based practice.
c) Diagnosis –
Classification of conditions that will direct interventions within the scope of the pt practice – Differential diagnosis
List the 5 steps in the process of evidence-based practice.
d) Prognosis and plan of care
– prediction of optimal level and time frame for improvement
- comparison capability to desired functional level
– achievable goals and outcomes
– frequency and duration of interventions and discharge plan
List the 5 steps in the process of evidence-based practice.
e) Intervention
– Purposeful interaction with the individual and or others involved in the care
- Hands on provision of services withing the scope of PT practice
- Individual and/or caregiver instruction with every episode of care.
- What is the difference between a physical therapy examination and a physical therapy evaluation?
Examination: includes the components History, Systems review and tests and measures. It provides an overview of current and past information. The Examination includes whether or not the problem falls within the purview of PT. What are the most important tests done and to do?
Evaluation: This information is then evaluated to find a diagnosis. The findings are interpreted leading to a diagnosis and prognosis.
Health Literacy
ability to find, understand, and use health information and services
Health literacy’s effect on patient instruction for exercise
When giving instructions, the clinician may have to spend more time providing background information such as the interrelationship of the primary health condition and the associated impairments and limitations in activity.
3 strategies that may be helpful to foster adherence to an exercise program.
1) Explain the rationale and importance of each exercise and functional activity
2) Keep the exercise program as brief as possible.
3) Allow and encourage the patient to have input into the nature and scope of the exercise program, the selection and scheduling of practice and feedback, and decisions of when and to what extent exercises are progressively made.
- Why is it important for a PTA to understand and be able to articulate (verbally and in written form) the interrelationships among impairments exhibited by patients with various health conditions, activity limitations, and participation restrictions?
1) For documentation purposes and for inter-intra-professional communication.
2) To be able to explain the rational and the importance of each intervention to the patient as part of informed consent.
3) To educate the pt about managing/ living with the health conditions, activity limitations and participation restrictions.
- Why is it important that patient satisfaction be assessed in physical therapy practice?
Indicator of quality of care. Pysical Therapy Outpatient Satisfaction Survey (PTOPS) and Med Risk Instrument for Measuring Patient Satisfaction (MRPS). Determine benefit of treatment based on patient’s own assessment.
- List at least 3 items that the PTA should consider to guide the selection and progression of exercise interventions.
1) Ongoing assessment of patient capacity - clinician must modify the applied load as needed to keep the pt progressing.
2) Manipulation of variables by increasing or decreasing the resistance, reps, intensity, requency, duration.
3) Both of the first two are done with reference to the desired outcome.
What is clinical decision-making?
CDM: A dynamic complex process of reasoning and analytical critical thinking that involves making judgments and determinizations in the context of patient care.
How can a student begin to develop/ improve their clinical decision-making skills?
- learn a unique set of clinical reasoning strategies and hypothesis-forming processes.
- Learn and use tools known as clinical prediction rules. (CPR)
- Understand the application and principles of evidence-based practice as this is the foundation that guides a clinician through the decision-making process during the course of patient care.
What are 4 questions a PTA could use to gather patient data before starting a treatment intervention?
- What activities are most important to you at home, school, work, in the community or during your leisure time?
- What activities do you currently need help with that you would like to be able to do independtly
- Of the problems you are having, which ones do you want to try to eliminate or minimize first?
- Can you describe the difficulties you are having with the activities you would like to do on your own?
- What are your goals by participating in physical therapy?
- What would make you feel you were making progress in achieving your goals?
- How soon do you want to reach your goals?
