Week 1 - Clinical Foundations Flashcards
What is health?
Ability to function in society
What are 4 states that contribute to health?
Biological, Psychological, Sociological, Spiritual
Must incorporate all into approach!
Why is the disablement model of management of health care flawed?
Believes in a linear relationship between Pathology to Disability. Not true! Many baseball players have a labral tears and so no disability!
Fails to Realize three things:
- Person’s individual reaction to his/her own condition/situation (Patient’s education and personal beliefs of what they can and cannot do)
-How other’s react to o define the person’s condition/situation (Tell patient to shrug injury off vs overprotective over scrape.
-Person’s environment/society may present with barriers or provide ways to overcome barriers (Ex: Not having elevators when in a wheelchair)
Enablement Model (ICF MODEL)
ICF: International Classification of Function
Change in focus & wording from one of “disablement” (What you can’t do) to “enablement” (What you can do with your condition)
Patient Centered Care Focus
Contextual Factors Included
Outcomes and prognosis can be effected by multiple reasons: Psychological, Sociological, Economical, etc.
What is Patient Centered Care?
Focus is now on the patient and their beliefs and their environment as well as the condition.
What are Contextual Factors?
Understand patient beliefs/values/needs and other factors affecting function.
Ex: Coaches, Parents, Peers, Enjoyment
What are some questions you can ask to find out more about a patients contextual factors?
Do you enjoy your sport?
What part of the season are you in?
What is your playing time like?
Do you have a history of this injury?
Do you like your coach?
Is there a negative or positive parental support?
Were parents with the child when you asked the questions?
What are the 3 Levels of Functioning in the ICF MODEL?
Body Functions (Impairments) - “Tissue Level” (Joint mobility, Flexibility)
Activities (Activity Limit) - ADL
Participation (Participation constrictions) - Work may not have stairs, patient can’t ascend stairs yet, therefore cannot work.
What are the 2 Contextual Factors in the ICF MODEL?
Personal Factors (Coach Pressure)
Environmental Factors (Don’t have access to prescription)
What are the two physiologies of Health Care?
Biomedical “Healing”: Pathology exists. Cause/Effect Relationship
Biopsychosocial & Spiritual - Healing & Adaptation: Identifies functional activities and participation and people’s abilities to achieve these. Role of health care is to empower patient to manage their condition.
What does ADL mean?
Activities of Daily Living
Why is pain complicated to treat?
Physical, Emotional, Psychological and Social Factors
We are not able to treat all pain conditions BUT we help patients learn to accommodate their lives.
Example of treatments we don’t know how to treat: Pain, Fibromyalgia, Autism
ICF MODEL COVID EXAMPLE
COVID
Body Function
Shortness of breath, body aches, etc.
Functional Limitations
Cardiovascular Fitness, Exercise
Participation Restrictions
Can’t go anywhere
Contextual Factor
Don’t want to quarantine, don’t get tested
No pill available to reduce effect of virus
What are the five steps in the patient client model?
- Examination and Evaluation
- Diagnosis
- Goals and Prognosis
- Intervention
- Outcomes
What do you during an examination/evaluation?
- Exclude serious pathologies (red flags)
- Identify nature of the symptoms
- If in pain, consider pain mechanisms
- Determine influence of contextual factors
- Understand influence of psychosocial factors
- ID the most appropriate course of treatment
