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Patient Education
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Educational Domains Cognitive:
information area (teaching joint protection principles to patient with Rheumatoid Arthritis
Psychomotor: deal with motor skills; using crutches NWB
Affective: deals with attitude and feelings; does
patient value performing their HEP
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Stages of Learning Cognitive:
requires attention to focus on understanding the activity of skill and developing strategy to achieve it
Associative: improve the efficiency and technique of
the activity or skill, need time to practice Autonomous Stage:
activity becomes automatic, requires little attention or thought
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Teaching Techniques to Improve Pt’s Performance Allow patient to think through process
before they perform
Ask patient to evaluate their performance for errors before PTA gives feedback
Give as little feedback as needed for the patient to be successful, gradually decrease as patient improves
Practice
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Teaching Techniques to Improve Pt’s Performance Exploit Biomechanics
Provide patient with challenging yet achievable activity and let them problem solve to complete it
Practice Variability: change speeds of walking, change environment, change surface for transfer bed, chair, car, etc
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Tools for Educating Pt’s, Pt’s Families & CaregiversVerbal Instructions:
need to be at patient’s level of comprehension
Written Instructions: need to be clear, and concise
Demonstration: go slow, break skill into parts as needed
Other: video, patient group, three dimensional models etc.
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Assessing Effectiveness of Teaching Strategies
Have patient repeat instructions back to you to verify they know what you want them to do and how to do it
Have patient demonstrate
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Principles of Learning Pt’s Learn when: They feel actively involved in the process
There is respect and trust between them and the PTA
They are working on something that meets their needs
PTA is supportive and non-judgmental; patients need to be able to express their own ideas, beliefs, concerns
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Principles of Learning Pt’s Learn when: Adequate time to practice, must be able
to make mistakes and go at their own pace
Opportunity for self-assessment. Let them reflect on what they might have done wrong or forgotten, give them time to process, provide a supportive environment
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Teaching a Skill Ensure patient understands why this skill is
important to them – how it will effect their ability to function and relate it to their goals
Explain the skill to them
Demonstrate skill
Break skill into parts, demonstrate parts, have patient demonstrate parts
Practice
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Patient Compliance with Exercise Programs
Patient must choose to perform (Values)
Know when/how often to perform & what to perform
Have the psychomotor skills to perform
Remain motivated to follow through
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Areas of teaching PTA’s will be providing to pt.’s, caregivers, HCP’s
Gait training Transfer Training HEP Safety precautions/issues Body mechanics Rationale for treatment Equipment needs and maintenance Postural Awareness Teaching caregiver how to assist patient *not all inclusive list
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Types of Communication
Written
Verbal
Non-Verbal
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Teaching & Documenting Psychomotor Skills
Teaching Most common mistake is making
treatment regimen to complex &
Giving pt too much to do with little specific instruction
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Teaching & Documenting Psychomotor Skills
Practice components of task pt is having difficulty with this allows information processing
After practicing components of task, may perform whole task each Rx session or not depends on task & pt abilities
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Teaching Psychomotor skills
Perform part task training Repetition Practice Encourage problem solving rather
than providing all answers; allows pt to retain information through active learning
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Teaching Psychomotor Skills Move through task slowly which
allows for error detection by pt Error detection requires memory of
sensory feedback from previous practice
Strengthen skill by progressively changing from controlled environment to less controlled environment
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Teaching Psychomotor Skills
Goal: skill can be performed in different environments
Increase difficulty by Increasing speed Moving to more open environment Decreasing assistance & verbal
cueing
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Documenting Psychomotor Skills DON”T document pt.’s one time
best performance unless they can repeat it at the next treatment session
Check their retention by having them perform skill at beginning of next Rx session Shows carryover
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Home Exercise Programs Tailor exercise to pt.’s lifestyle or valued
activitiesInclude specific instructions Practice Provide written instructions
What to do How to do it How often When Progression
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Home Exercise Program
At follow up for adherance to HEP Ask pt questions Have pt show you