Test 2 Flashcards
What do you need to accomplish during the interview?
- Build Therapeutic Alliance
- Learn patient’s story
- Learn about patient’s chief complaint, prior treatment, pain
- Gain some information about living environment, support network
- Learn Patient’s learning styles
- For diagnosis
- Build rapport with patient
- Learn patient goals
What are barriers to a good interview?
- Time
- Language
- Patient attitudes, beliefs, emotionally laded
- Patient’s fear or distrust of healthcare
- Insurance, 3rd party payment
- The physical environment- is there a quiet space available
- Therapists ability to listen attentively, respond helpfully
- Therapists lack of knowledge about signs/symptoms
How do we use the interview as a diagnostic tool?
- Objectivity
- Precision
- Sensitivity and Specificity
- Reliability
- Skill
What things will impact a patient’s utilization and outcomes of PT?
- Access to healthcare
- Language
- Socioeconomic status
- Insurance
- Distance to travel to receive care
What are the three core qualities in clinical interviewing when building the therapeutic relationship?
- Respect: the ability to accept the patient as he or she is
- Empathy: the ability to understand the patient’s experiences and feelings accurately; it also includes demonstrating that understanding to the patient
- Genuineness: the ability to be congruent in your professional role
Define congruency?
when the words you say and your emotions add up
Define microaggresion?
responses that may be interpreted as put-downs
Why do we document at PTs?
- To provide a basis for clinical reasoning
- Communication tool for providers
- Meet legal requirements
- Payment for service
- Data collection for outcome assessment/EBP
What does SOAP stand for?
• Subjective (what the patient said)
• Objective (what the practitioner observed)
• Assessment of what this meant
• Plan for future care
(The progress notes, narrative note flow sheets documenting changes in data over time, and a discharge note)
What are characteristics of qualitative research?
- Involves unstructured interviews, observation, and content analysis
- Subjective
- Inductive
- Little structure
- Little manipulation of subjects
- Takes a great deal of time to conduct
- Little social distance between researcher and subject
- Different people can perceive the truth differently
- Qualitative research attempts to find out how people perceive their lives
- Different people will have different perspectives
- The researcher’s experiences, beliefs, and values are incorporated into the research design and analysis of the data
What are the methods?
- Observation
- Interviews
- Data analysis and interpretation
- Trustworthiness and generalizability (Credibility, Transferability, Triangulation)
- Sampling
What are the characteristics of Quantitative Research?
- Involves experiments, surveys, testing and structured content analysis, interviews and observation
- Objective
- Deductive
- High degree of structure
- Some manipulation of subjects
- May not require a lot of researcher time
- Much social distance between researcher and subject
What is a paradigm?
• A “worldview” or a set of assumptions about how things work; “shared understandings of reality”
• Primary Paradigms:
o Positivism: Associated with quantitative research. Involves hypothesis testing to obtain “objective” truth.
o Interpretivism: Associated with qualitative research. Used to obtain an understanding of the world from an individual perspective.
What are the 3 components of the Biopsychosocial model, adopted by the WHO?
• The WHO defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
• The three components are:
——-Biology, Psychology, and Social Environment
• The model assumes that the person’s response to any state of health or illness is a result of the interaction of the person’s psychology and social environment with the biological determinants of disease and trauma
describe the NAGI?
o Active pathology: interruption or interference with normal processes and effort of the organism to regain normal state
o Impairment: anatomical, physiological, mental or emotional abnormalities
o Functional Limitations: limitation in performance at the level of the whole organism or person
o Disability: limitation in performance of socially defined roles and tasks within a sociocultural and physical environment
Describe ICF?
o Integrates social and environmental aspects of disability and health
o Provides a framework for integrating; Sensory, Intellectual, Mental and Physical together
o Health Conditions: diseases, disorders and injuries
o Body Function: physiological functions of body systems, Body Structures: anatomical parts of the body, Impairments: problems in body functions or structure
o Activity: the execution of a task or action by an individual, Activity Limitation: difficulties an individual may have in executing activities
o Participation: involvement in a life situation, Participation Restriction: problems an individual may experience in involvement in life situations
WHO goals for ICF?
- Establish a common language
- Data collection and comparison – across countries, disciplines, services
- Stimulate research
- Promote improved care
- Provide a systematic coding scheme
- Influence policy changes
What is the APTA ICF learning system?
o Body Functions – Physiological functions
o Body Structures – Anatomical parts
o Activities and Participation – Performance of a task/action
—–Involvement in a life situation
o Environmental Factors – Physical, social, and attitudinal environment in which people live/conduct their lives
o Personal Factors – The background of a person’s life
—–Factors such as gender, race, age, social background, upbringing, etc.
What does ICF stand for?
International classification of functioning model → which classifies patient care based primarily on the patient’s pathology and which was also developed by the WHO
What does NAGI stand for?
person who provided the first organized descriptions of a concept of disablement as distinct from disease.
o He identified that in order to understand disability, it was necessary to make distinctions among four separate but linked concepts: pathology, impairment, functional limitation, and disability
Define clinical judgement?
the ability of the clinician to blend his or her skills and experience to make good clinical judgments in a timely clinical fashion
define patient values?
the preferences that each patient, and often the patient’s family, brings to the clinical encounter. The preferences can arise form cultural or religious norms, from personal attitudes and beliefs, or from the patient’s prior experiences and knowledge
Define patient circumstances?
the situation in which the patient finds him or herself. Can refer to the location of care, the resources available to provide care, including funding for care or to the resources for the patient to deal with short term and long term sequence of the illness or trauma.
Define best research evidence?
the information available from the basic sciences that underlie our care, but primarily from the clinical research, to help us answer specific questions about our patient care
