Week 1 Principles of interview

Question 1

signs vs symptoms

Answer 1

signs: observable (eg: swelling)
symptoms: experienced by the patient (rg: pain, feeling unstable)

Question 2

history of presenting condition (HOPC)

Answer 2

• how long habe they had the problems?
• was there a particular incident that triggered the onset, or was it a gradual onset?
• mechanism of injury: acute or insidious onset
• were there any factors or activities that may have predisposed the patient to injury? (eg: change of surface, equipment, training volume, new or different activity)

Question 3

body chart: WOCSNOR

Answer 3

§ Where is the pain (symptoms)?
§ Any Other areas of pain?
§ Constancy of symptoms? Eg. Is the pain constant or intermittent? (include frequency here if pain is intermittent eg. headaches tend to be episodic)
§ Severity of pain? (use visual analogue scale)
§ Nature of symptoms? (patient’s description eg.
sharp, dull, throbbing, out of place, loose, numb
§ Other symptoms eg. pins and needles, numbness, weakness
§ Relationship between symptoms

Question 4

behaviour of symptoms

Answer 4

• AGGS (type, duration, frequenct, intensity of activity)
• EASES (activity, rest, certain positions, medication, hot pack/ ice/ shower)
  -24 hour behaviour (night pain –> difficult to sleep or WIN, morning –? what happens when they get out of the bed, how do you feel when you first wake up, day)

Question 5

irritability

Answer 5

1. What does it take to bring on the pain?
2. How severe is the pain?
3. How long does it take for the pain to settle?

Question 6

red flag questions

Answer 6

1. general health
2. medications
3. steroids
4. UWL
5. cord or cauda equina involvement
6. vertebral artery (5D’s)
7. imaging

Question 7

yellow flag questions

Answer 7

relate topsychosocial factors
- pain beliefs
- anxiety
- poor social support
- depression
- poor expectations to recovery
- post traumatic stress syndrome

Question 8

past history

Answer 8

§ Do the current symptoms feel similar to the symptoms in the past episodes?
§ History of earlier episodes, their cause, duration, treatment sought, and effectiveness of treatment
§ Particularly important if the problem is a re- occurrence

Question 9

social history

Answer 9

§ Work
§ ADLs
§ Hobbies §Sport/activity (quantify) §Social support
§Home set-up
§ Goals

Question 10

patient goals

Answer 10

§ What does the person hope to gain from physiotherapy?

§What are their goals?
– ADLs
– pain free
– return to work
– compete in wife carrying championships in 3
weeks
– get a wife in next 2 weeks……….