Week 3 Treatment Considerations

Question 1

what are some reasons patients get better

Answer 1

treatment specific things, history, progression, repeated measures, scheming changes, getting treatment quicker, expectations, therapeutic alliance.

Question 2

TF: the PT, environment does not determine how a patient will respond

Answer 2

false, it does determine response.

Question 3

what are the two patients contextual factors

Answer 3

expectation and preference

Question 4

what is expectation

Answer 4

this is the idea that people have expectations, and it can influence the outcome, like a placebo group and an experimental group.

Question 5

what is a nocebo

Answer 5

you get negative expectations, and negative outcomes. For example, you are told about the negative side effects, and what can go wrong. you are given a placebo pill, but now you start complaining about the side effects and that you have them all

Question 6

do patients want a say in their treatment, or do they want a role in clinical decision making?

Answer 6

no always, they sometimes just want information.

Question 7

there are two groups. massage and acupuncture. You go in thinking that massage will be better for you. so what are the results of the two treatments

Answer 7

the massage had better results, since they had higher expectations.

Question 8

what is the open hidden paradigm

Answer 8

two groups were hooked up to medicine. one group saw the machine next to the bed. The other groups machine was behind the curtain. The group that could see the medicine go into them had better results (even though it was the same medicine and same dose)

Question 9

what is a therapist contextual factor

Answer 9

clinical equipoise.

Question 10

what is clinical equipoise

Answer 10

lack of preference or uncertainty for a treatment.

Question 11

is clinical equipoise good? why

Answer 11

yes! we want our providers to not have a preference, and avoid bias.

Question 12

TF: clinicians often treat with things they feel very strongly about

Answer 12

true

Question 13

TF; lack of clinical equipoise can impact clinical outcome

Answer 13

true

Question 14

but can a lack of clinical equipoise affect treatment and how

Answer 14

yes, it can cause people to do treatments that they feel strongly about, and we might be able to see that in our outcomes that they work

Question 15

what is therapeutic alliance (TA)

Answer 15

collaboration, warmth, support between the therapist and the patient.

Question 16

TF: TA is not associated with improved outcomes in rehab

Answer 16

false

Question 17

which has been proven to be more effective? warm friendly and reassuring? or impersonal, formal and uncertain

Answer 17

warm, friendly and reassured.

Question 18

what are some components of shared decision making

Answer 18

the PT informs the patient, and they share information. The PT thinks about patient preference. PT helps the patient decide on things, and are only as involved as the patient wants us to be. ALWAYS respect the patient.

Question 19

what is a way you can give them a choice without taking away your expertise

Answer 19

this is what I found to be effective, and this may be beneficial to you, so you can pick from this list.

Question 20

in clinical decision making, what do we want to maximize?

Answer 20

realistic expectations of the patient

Question 21

in what ways can we prevent nocebo

Answer 21

do not tell patients, this is going to hurt. or you will feel a bee sting before I prick you. or you’ll be sore tomorrow. All this leads to negative expectations

Question 22

what does pain mean from person to person

Answer 22

some folks find child birth pain regarding, and then cancer pain is horrendous.

Question 23

what are 5 great ways to build TA

Answer 23

1. warm and friendly
2. active listening
3. empathy
4. periods of thoughtful silence
5. communication of confidence and positive expectations.

Question 24

TF: you don’t get any more out of a treatment session with TA

Answer 24

FALSE