FALL 2011: WEEK 9 , LECTURE 1

PTHA 1301: The Profession of Physical

Therapy

DARIUS GOES WEST

QUIZ

Today’s Theme Song

Something Beautiful

Goals for Today: Personality Part 2 & Motivation

Discuss upcoming research paper/presentation

Identify 16 personality types listed on the MBTI Self-Scorable Form M

Describe the effect of personality type on physical therapy care

Describe factors affecting motivationExplore the phenomenon of adherence to

treatmentDiscuss the role of health care professionals

in promoting motivation and adherence

Research Paper Due Dates

Rough Draft w/citations (at least 5 pages) due Sunday 10/30/11 at 11pm via Blackboard

Rough Draft of Visual Presentation due Tuesday 11/01/11 at 2:30pm via Blackboard or in

personPrinted Draft w/your edits & at least 1 peer edit

show Elaine 11/03/11 by 2:30pmPrinted Final Paper (7-10 pages)

due Tuesday 11/08/11 by 2:30pmFINAL Visual Presentation & Handout

due Tuesday 11/08/11 by 2:30pm via Blackboard or hard copy

due Tuesday 11/08/11 by 2:30pm via hard copy

Research Paper Requirements

APA Format – writing style guidelines published by The American Psychological Association

7-10 pages (Introduction, Body, Conclusion) PLUS: Title Page & Works Cited (Reference Page)

Double Spaced 1” margins on all sides 12 point, Times New Roman font (per APA

recommendations)

At least 5 sources cited in your paper One of the 5 sources must be a personal interview

Research Presentation Requirements

8-10 minutes in length

Utilize a visual aide during your presentation Power Point Flip Chart Prezi

Prepare & issue a written handout for the class AT LEAST 1 page Be creative!

Personality – Part 2

MBTI: Myers-Briggs Type Indicator Based on theory of psychological types (Carl Jung, 1920’s) MBTI Developed in the 1940s (Isabel Briggs Myers) Original Research for MBTI 1940s-1950s MBTI was first published in 1962 Millions have taken the MBTI & research is ongoing

MBTI: 16 personality types/personality preferences What is your type?

What is the effect of personality type on PT care?

Behavior ChangeSmall Group Activity: Background Information

Ted is a 45 year old construction worker who has come to you for treatment of low back pain. This is not his first time receiving treatment. You find that he has been to PT, a nutritionist, and a back school in the past. He admits that he had trouble following through with the home programs. Ted continues to be 50 pounds overweight and smokes a pack of cigarettes per day. He is divorced and at the end of the day, he likes to sit in front of the TV and “have a few beers.”

Small Group Activity: Instructions

Divide into 3 groups of 5

Use the assigned method to attempt to change the patient’s behavior

Consider the pros and cons of your assigned method

Problem solve in your group and prepare to present in class

Motivation Defined

A psychological construct that arouses an individual to take the actions needed to achieve a goal

Adherence

Degree to which clients follow treatmentMeasured by factors such as

Clinic attendanceDegree of adherenceClient self-reportsClinician’s assessment

Factors Affecting Motivation & Adherance

Locus of ControlSelf-EfficacySelf-EsteemSocial Determinants of Health

Locus of Control

Julian Rotter (1960s)Dynamic theory based on life experiences

Influenced by culture and family Internal Locus of Control: believe that they can influence what will

happen to them (increased self motivation) External Locus of Control: believe that what happens to them is a

result of outside influences/events

Internal

External

Self-Efficacy

A phenomenon of a client’s perception of reality Sense of competence and ability Related to how successful people believe they can be in accomplishing a

task

Self-Judging: Positive and negative perceptions influence therapeutic outcomes

Bandura introduced concept in 1977

A strong sense of self-efficacy relates to increased adherence

Self-Efficacy is a dynamic concept, it can be improved!

Self-Esteem

How people feel about themselves Do they accurately assess self-worth in comparison to others? Do they take pride in their abilities?

Clients with strong self-esteem Tend to have higher motivation to be actively involved in their

care Believe they are in control of their own lives

Social Determinants of Health

Race/ethnicityLiteracyEducationIncomePlace of residenceCommunity resourcesSocial support (see next slide)

Social Support

Patients who are supported have Greater optimism Less depression Less anxiety Improved quality of life Higher self-esteem Greater adherence to treatment

Factors That Affect Clients’ Motivation and Adherence

Locus of ControlSelf-EfficacySelf-EsteemSocial Determinants of Health

Other Factors That Affect Clients’ Motivation and Adherence

Psychological state Depression Anxiety Feelings of inferiority Shame Guilt Denial Fear

Other Factors That Affect Clients’ Motivation and Adherence

CultureHealth and health care historyPractical concerns

Other Factors That Affect Clients’ Motivation and Adherence

Health care professionalCongruency of clinician and client goalsCompatibility with clients’ attitudes, beliefs, values,

style of self-regulationLevel of knowledge and skillAbility to

Empathize with clients’ needs Individualize treatment plan

Barriers to Effective Motivation and Adherence

KnowledgeReadiness to changeCongruence/shared goalsPragmatic problemsIllness parametersDepression/hopelessnessSelf-efficacyLocus of control

Promoting Motivation and Adherence

Clients tend to be motivated to strive towards goals That are important and relevant to them That they believe/hope are possible

Clients tend to adhere to programs that are Not too difficult Not too costly Not too time consuming Are consistent with their health belief system

Strategies to Enhance Motivation and Adherence

Modifying health behaviors Health Belief Model Transtheoretical Model for Health Behavior Change (Stages of

Change) Motivational Interviewing

Strategies to Enhance Motivation and Adherence

Education and empowermentClient-centered careGoal settingFeedback and follow-upPeer support groupsFunctional programsPrimary and secondary control-enhancing strategiesCollaboration

Client-Related Barriers to Collaboration

Non-adherenceImpairments and disabilitiesLack of interest in collaborationPerception that clinician has lack of timeUncertainty regarding success of treatment

Clinician-Related Barriers to Collaboration

Inadequate knowledge about how to collaborateUnwillingness to relinquish/share powerPaternalistic perspectiveFailure to consider pre-morbid lifestyle and history

Strategies for Improving Collaboration

Client-centered care Ask clients to identify questions and problems in their own

words Facilitate open dialogue Educate clients about how to be active participants

Upcoming Assignments

See handout for revised due dates of Research Project Assignments

Thank You letter to Christi Anderson due THIS Thursday at 2:30pm

Go RANGERS!!!