Client education in physiotherapy

CLIENT EDUCATION IN PHYSIOTHERAPY

NORZULAIKA BINTI ALIASPENGAJAR JURUPULIH PERUBATAN ANGGOTA

Who is your clients

• Individual patient• Patient’s family or caregiver• Health care provider(e.g.nurese,doctor)• Support group(e.g.NGO)• General public

Types of client education

• Patient education(e.g. home exercise program)• Health education(e.g. joint pain, chronic pain

management)• Community education(e.g. smoking cessation)• Health promotion(e.g. benefit of exercise,

healthy lifestyle promotion)

Client: patient/caregiver

• Treatment and rehabilitation-%?• Consultation-%?• Education%?

Consultation

• “seeking and giving of advice,information and opinion,usually involving a consideration”.

• Physiotherapist provides customized advice which enable individual or caregiver to achieve client’s established goals or objective.

• This approach can inform the client how to effectively contributes to rehab outcome.

EDUCATION• Defined as a planned learning experience using a

combination of method such as teaching, counseling and behavior modification techniques which influence patient knowledge and health behavior.(Barlett,1985)

• Physiotherapy provided general information to individual and caregivers.

• Education enables client to modify his/her lifestyle and environment in order to have increase control over health status or to promote improvement in functioning.

Purpose of Patient Education

• Patient education cuts down medication non-compliance and mistakes,which cuts health care costs,improves patient care and satisfaction.

• Education also decreases anxiety,promotes better planning,provides a sense of self control and well being and improves psychological health.

Benefits of Patient Education

• Facilitate patients and families’ understandings of their health status, options and consequences of care.

• Encourage patients to help with decision making.• Increase the patient’s ability to cope with and manage

their health.• Help patients learn behaviours, promote recovers and

improve function.• Increase patients’ potential to follow a health care plan.• Increase patient confidence in their self care• Decrease complications.

Role of Patient Education

• A planned and systematic approach to patient education contributes to its effectiveness.

• Supported by various research finding.

The patient has right to know…

• About their condition or illness(information about diagnostic,causes and prognosis)

• What is being done(treatment,medication,rehabilitation)

• How they can actively participate(e.g. rehabilitation of self care)

Patient education

• Refers to all educational experiences planned with and for the patient by physiotherapist as a component part to total care to positively effect knowledge,attitudes and corresponding behaviors and developing necessary skills for purposes of reaching and maintaning a high level of wellness.

• Mayo,1978 cautions physiotherapist against overloading the patients;often because of a therapist enthusiasm,a patient is given more instructions than he can cope with,and changes in lifestyle are demanded than the patient is willing to make.

• Ley,1982 founded that the more information patients receive,the more they forget.

• In fact,patient appears to forget about half of the information their receive.

• They forget less when the information is adjusted to their particular demands and perception and when they not embarrassed by worries or distressed by pain.

(Ley,1982)

PATIENT EDUCATION CONSIST OF…

1. Teaching and informing the patients about their complaints or illness.

2. Instructions for home exercises3. Advice and information.4. General health education.5. Counseling on stress-related problems.

1.Teaching and informing the patient

• Information about diagnostic,illness,complaint and prognosis.

• Origin and significant of symptom• Causes of pain

First treatment session

• At the start of treatment, many patient suffer from pain, are anxious about their complaint

• They may be worried and feel insecure about the significance of the symptoms and prognosis.

• Accordingly, they:-may focus on particular kind of information(e.g: explanations about symptom, pain relief)-and less reception to other information(e.g: exercise,advice and counseling)

Cont…

• Adequate patient education require the right balance between patient’s wishes and therapist’s plan.

• Information is programmed to prevent overload.• Dishman,1988-in the first few session,follow

instruction and perform exercis,1/3 to ½ do not comply with exercise.

• Sluijis & Knibbe,1991-Second phase of treatment should involve with attention to patient compliance with exercise program.Compliance-enhance strategies.

• Problem contribute towards poor compliance to prescribed strategies/education

a.Poor application of methods.-inadequate information given on prescribed

treatment given-treatment regime too complex-information and advice given not properly

programmed.-educational plan not properly drawn up and

evenly carried out in stages, throughout the course of patient

education.

b. Patient negative health belief and attitudes.c. Poor patient-care provider relationshipd. Lack of social supporte. Under utilization of medicine.

Model of planning patient education

Step 5Evaluate

patient and family

education

How to approach your client

Cont..

Patient education for effective rehab programme

• Need to be goals• Training to agree and plan together.• Training need to be frequent and intensive.• Time specific and not lifelong.

COMMUNICATION METHOD FOR PATIENT EDUCATION

Cont..

• Visual material is the most effective way to reinforce our ideas and ensure proper recall of the exercises we want our clients to perform.Most of us remember picture,images and colours longer than the spoken word.

• Providing clients with visual hand-outs and exercise instructions is one of the best methods to make sure our information is understood and retained

Factor That Contribute Ineffective Communication

a. Provider related

• Language problem.• Information overload.• One way communication.• Lack of communication skill.

b. Patient related

• Not listening-not pat attention.• Patients anxiety status.• Selective perception-different people interpret

idea differently.

c. Environment related

• External factor-noise,limited space.• Lack of time to educate patient.

d. Massage related

• Encoding problem-ability to explain in a form understood by patient.

• Unorganized massage.• Incomplete massage-miss out important

information.

How to reduce communication barriers

1. Location-no disturbances/noise.2. Language-simple and clear.3. Need to know the feel forward-can suit the

massage according to receiver’s need.4. Reduce communication link-personal verbal

massage/written of convey through someone.5. Need to obtain feedback-find out weakness.6. Use educational aids.

2. Instruction For Home Exercise

• E.g. stretching and strengthening exercise.• Structure exercise programme.• Required frequency.• Monitoring exercise performance.• Motivating patient to do it at home.

3. Advice and Information

• Defined as informing patient about the correct way to deal with illness or symptom and about measures to prevent recurrent of the symptom.

• E.g. using aid, self care, making adjustment in work or sport.

4. General Health Education

• Defined as advice on healthy lifestyle• E.g. information about fitness,obesity and effect

of smoking.

5. Counseling on Stress Related Problem

• Defined as explaining to patient the way which their physical complaints may be connected to stress related problem and giving patient care and support when they suffer discomfort, pain and handicap.

• Counted by 4 relevant behavior; exploring ,listening, supporting and explaining.

Important of patient education

1. Education Develops Credibility

• Patient who are educated will have a greater understanding of their condition and treatment,and will be better equipped to take an active part in the treatment process.

• Education will improve your patient’s treatment outcome.

2.Educational Develop Trust

• Patient education send the message that you completely understand your client's condition and what it take to make them feel better.

• Educational material fro a trusted health professional is valued more than similar information obtained from a magazine,bok or internet.

• Educational will have your clients quoting you to their friends and family.

3.Educational Increase Understanding

• Patient who are educated will have a greater understanding of their condition and treatment and will be better equipped to take an active part in the treatment process.

• Education will improve your patient's treatment outcome.

4. Education Improve Compliancy

• When a client is discharge from your care they will be greatly influence by the education material they receive from you.

• If the material impresses them by being informative and professional in appreance, they will be left with a positive reaction to your overall treatment process.