What is the role of the PT in feelings of "Hope"?

To provide a mindset of realistic but strong motivation.

How do PT facilitate patient adjustment to loss?

What are the 6 Psychosocial Adaptation Strategies

1. Cognitive Reformation

2. Emotional and practical support

3. Counseling

4. Support Groups

5. Bereavement Services

6. Hope

In order to grieve effectively, people need to integrate their __________ into their lives.

losses

3 Things a Culture Does

1. Defines a paramater of social relationships

2. Provides paradigms that explain how the universe is ordered.

3. Provide a guide to differentiate one social group from another.

Name the 3 Coping Skills

Appraisal-focused (focused on meaning)

Assess + mentally practice

Define and reframe

Dent or avoid Emotion focused (feeling)

Control Emotions

Problem focused (action)                               Release Emotions

Collect info  Accept + Surrendor

Build Support

Act 

Develop measures of success

Primary v Secondary Losses

1

Condition Specific

Congenital and Perinatal

Key Points to Consider

Family support extremes

Acceptance of condition or awareness of disabilities

Feelings of jealousy towards siblings

2

Condition Specific

Adults with DD Key Points to Consider

Social Support

Friends are caregivers

Needs are addressed but wants independence 

3

Condition Specific

Sudden Onset Disability Key Points

A sense of loss of control

Overwhelmed and Denial 

4

Condition Specific

Acute or Rapid Progressive Disease Key Points

(Example = cancer)

- Sense of Hope

5

Condition Specific

Age- Related Disability Key Points

Significant decrease in functional status

Social support

Ability to cope

Mental Health

Positive Attitude

5 Styles of Managing Conflict

1. Avoidance          (Ignore conflict exsists)              ------------

2. Accommodation   (Cooperative approach)             lose-win

3. Competition       (Power driven aggressive)        win or lose

4. Compromise       (Something 2 work for both)     lose-lose

5. Collaboration       (Assertive and Cooperation)    win-win 

*Compromise = midway between competition and accomodation

*Mediation (mentioned in reading) neutral 3rd party facilitates process. 

2 Main types of Grief and subdivisions

Anticipatory 

Conventional 

Acute            (sense of realization of loss)

Chronic         (sense of grief that lasts)

Delayed      (shocked and denial)

Suppressed   ( loss that stays with a person)

As a PT what are some potential causes for loss

Patient discharge

Death

Decrease in patient function

Coworker

Referrals and motivation

Money and documentation

Loss of liscense

Loss of coverage

All types of losses include....

Sudden (TBI) Primary

Gradual (ALS) Secondary

Anticipated (Cystic Fibrosis) Chronic

Uncertainty (MS) Age

Total (death)

Permanent (SCI)

Temporary (Guillan Barre)

Acute

Communication occurs at 4 levels

1. Intrapersonal level              (Own thought process and interpretation of info)

2. Interpersonal level              (How you communicate with other persons)

3. Small group discussion      (How to interact with a group of people)

4. Organizational Communication 

*risk of error increases w/ higher # of people to communicate    with

3 Different types of Communication

1. Verbal   Verbal

2. Non- Verbal   Vocabulary

3. Written   Paralanguage

Active Listening  (3 step framework)

Non-Verbal Written *Restatement

Facial Expressions Exercise Program *Reflection

Touch Documentation *Clarification 

Spatial Distances Electronic

Distracting Behaviors         Media

Respect

Approach a person, group, idea or object with regard or esteem

Values

Deeply held attitudes and beliefs of truth, beauty, or worth of a person, object, action, or idea.

*Personal

*Professional

*Societal

Bias

A preformed thought or judgement.

Caregiver's Needs

Information/ Education

Trust

Advocacy

ID of resources

Support

Relief

Definition of Conflict

Involves tension or disagreement between 2 or more opposing forces

4 Areas of conflict between a health care provider and patient

• Native culture of health care provider
• Culture of the majority of health care system
• Native culture of the client
• Medical culture of the client

Sources of Conflict for a PT include...

Content= Time, resources

Psychological= Patient, patient family, trust, respect

Procedural= Policies, chain of command, decision making

ICF stands for....

International Classification Function

The ICF Model 

Family Health Systems Approach

1. Interactive Process           Questions, communication
2. Developmental Process Overall dev. health based on age/gender norm
3. Coping Process Deal with situations
4. Integrity Process History on how things are dealt
5. Health Process Health status life style

Top 10 Effective communication Strategies

Speak on their level Encouragement/ Positive Attitude

Active Listening Addressing patient effectively

Speak Clearly 

Proper facial expression

Posture

Eye Contact

Ask Follow up Questions

Resolution to conflict

Levels of Conflict

1) Personal (within an individual)

2) Interpersonal (2 or more individuals)

3) Intragroup (members within a group)

4) Intergroup (Two or more groups, depts, org)

Strategies for Adapting and Accepting Changes in Body Image

1) Communication

2) Education and Support

3) Emphasizing Capabilities

4) Life's Activities 

*set realistic goals

Factors that influence how a person responds to changes in body image

Prior loss

Nature of current loss

prognosis of treatment recovery

patterns of development

family and cultural values, beliefs, attitudes

personal control 

sin + stigma (loss is punishment)

social support

Body Image includes how people _______ and how they ______ they look.

-look

-think

The concept of sexuality includes....

1. Gender Identity

2. Attractivenes

3. Sexual Attitudes and Beliefs

4. Sexual Behaviors and practices

Healthy Sexuality Requires 3 things

1. Freedom from psychological problems that could negatively

    effect sexual function.

2. Freedom from disease and illness that interfere with physical

    aspect of cultural function.

3. Ability to enjoy and control sexual behavior in a manner 

    consistent with personal and societal ethics. 

4 Step approach to Sexual Education

1. Initiate a program of self learning.

2. Raise consciousness of member of team.

3. Become comfortable discussing issues of sex with pts.

4. Document topics discussed and create a plan.

5 Barriers to Effective Communication

1. Role uncertainty

2. Sensory Overload

3. Physical Appearance

4. Voice and Word Choice

5. Language Barriers

Definition of Culture

"The sum of beliefs, practices, habits, likes, dislikes, norms, customs, rituals that we learned from our families"

*Learned not inherited

*Determines how we interact with the world.

Three Core Sets of Skills in order to deliver culturally competent care

1. Self-Awareness

2. Knowledge of other cultures.

3. A skill in delivering care.

7

Common Cross-Cultural Differences

1. Time

2. Activity Orientation/ Environmental Control

3. Use of space

4. Social Organization

5. Communication

6. Poverty

7. Health Beliefs and Practices

Examples of "secondary cultures"

Geographical Location

Income

Religion

Age

Education

Appearance

Ethnocentrism

Belief the ones cultures thoughts, beliefs are the best and right way.

People first Language

Putting the person first before a disease or condition.

Examples

Person who has Parkinson's disease

Person with Alcoholism

Survivor of domestic violence

5 Stages of Grieving

Denial

Anger

Bargaining

Depression

Acceptance

Integrative Theory of Bereavement 

Shock

Awareness of Loss

Conservation and withdrawl

Healing 

Renewal

Tasks of Mourning

Accept reality of loss.

Experience pain associated with grief.

Adjust to circumstances created by loss.

Emotionally relocate person who has died and progress with life.

Infants Need

Respect and Consistency

*Touch, soothe if crying

Toddlers need

Respect and Security

*Allow mother to be present

Children need

Respect and Relating

*Share Interests

Adolescents need

Respect, Autonomy, Relating

*Involve in decision process

Adults need

Respect, ID, Intimacy

*Address with title

Older Adult needs

Respect Integrity

*proper title, time