PPwOA Week 3 Cue Cards

This set of flashcards covers key concepts from the lecture on communication in health care, therapeutic relationships, ISBAR handovers, and the physical examination process including subjective, objective, observation, functional movement assessment, active vs passive movements, end feel, movement diagrams, and accessory movements.

Why is effective communication in health care different from everyday life?

Because health-care communication requires specialized verbal, nonverbal, and written skills to build a therapeutic relationship, understand patient experiences, and improve outcomes, with poor communication linked to adverse outcomes.

What is the transactional model of communication?

A model where communication involves establishing a relationship, simultaneous sending and receiving, and ongoing processing to create mutual understanding.

What is person-centered care?

Care that places the person at the center, focusing on their experiences, needs, goals, and involving them in shared decision making.

What does mutual understanding mean in therapeutic encounters?

A shared understanding between the client and health professional that underpins the therapeutic relationship and person-centered care.

What is rapport in healthcare?

A positive, genuine connection that enhances collaboration, engagement in therapy, and achievement of client-centered goals.

What does ISBAR stand for?

Identify, Situation, Background, Assessment, Recommendation; a standardized mnemonic for verbal and written handovers.

What are open questions used for in interviews?

They allow detailed information, give the client control over disclosure, and typically begin with how, what, or can you tell me about…

What are closed questions used for?

They provide discrete, short information (e.g., yes/no) and are useful for screening or when communication is difficult.

What are probing questions used for?

To elicit more detail about a topic, often triggered by what has already been discussed or by nonverbal cues.

What are clarifying questions for?

To ensure understanding and reduce assumptions, promoting mutual understanding.

Why should leading questions be avoided in assessment?

Because they direct the client to a particular answer and can bias information.

What is the subjective assessment in physiotherapy?

Gathering information from the client about beliefs, concerns, expectations, and goals to inform clinical reasoning.

What is an asterisk sign in physical examination?

The most important physical examination finding for a patient, marked with an asterisk to guide reassessment.

What are P1 and P2 in symptom provocation?

P1 is the onset or increase in pain during testing; P2 is the maximum pain the patient can tolerate.

What is the importance of effective communication in health care?

Effective communication fosters patient trust, improves adherence to treatment plans, enhances patient safety, and leads to better quality of care and overall health outcomes.

What are the key principles that guide person-centered care?

Respect, empathy, understanding the patient's unique perspective, involving them in shared decision-making, and tailoring care to individual needs and values.

What is the primary focus when taking a patient's history of the present condition during a subjective assessment?

To gather detailed information about the onset, mechanism, behavior (e4-hour pattern), aggravating/easing factors, and severity of the client's current symptoms.

What are some examples of abnormal end feels and what might they indicate?

1. Empty: Pain occurs before resistance, indicating severe pathology (e.g., acute inflammation, psychological causes).
2. Spasm: Involuntary muscle contraction before end range, indicating acute protective response (e.g., instability, fracture).
3. Springy Block: Rebound or 'boggy' feel at end range, indicating internal derangement (e.g., meniscus tear).
4. Pathological Hard: Bone on bone where it shouldn't be (e.g., severe osteoarthritis, loose body).
5. Pathological Soft: Boggy, spongy feel where it shouldn't be (e.g., synovitis, edema).

What is the difference between active and passive physiological movements?

Active movements are produced by the patient’s voluntary muscular effort; passive movements are performed by the clinician.

What is overpressure in ROM testing?

Applying end-range, pain-free pressure after the patient achieves pain-free active ROM to assess end range and non-contractile structures.

What is end feel?

The quality of resistance felt at the end of passive joint movement (e.g., bony, muscular, soft tissue end feels).

What is a movement diagram?

A visual map showing the relationship between signs (felt resistance, end feel) and symptoms to guide interpretation and treatment.

What are R1 and R2 in movement diagrams?

R1 is the initial resistance felt during an accessory movement; R2 is the maximum resistance; they help define joint mobility and impairment.

What are accessory movements?

Joint plays such as roll, slide, and spin that enable physiological movements but cannot be voluntarily controlled.

Why is observation important in functional assessment?

It reveals habitual or protective movement patterns, posture, skin changes, and muscle contours that inform the exam.

What are the three overarching aims of effective communication in healthcare?

1. Creation of a therapeutic relationship: Building rapport, trust, and empathy.

2. Exchange of information: Understanding patient experiences and providing clear explanations for shared decision-making.

3. Achieve patient outcomes: Improving patient satisfaction, adherence to treatment, and overall health status.

What is the difference between empathy and sympathy in healthcare communication?

Empathy is the ability to understand and share the feelings of another person by putting oneself in their shoes to feel with them. It fosters deeper connection and trust. Sympathy is a feeling of pity or sorrow for someone's misfortune, without necessarily sharing their emotional experience.

What is trustworthiness in healthcare communication?

Trustworthiness is the degree to which a patient believes a health professional is reliable, truthful, competent, and has their best interests at heart. It is crucial for building a strong therapeutic relationship and encouraging patient engagement.

What information is included in the 'Background' section of an ISBAR handover?

Relevant patient history, such as diagnosis, medical history, current medications, allergies, and recent interventions.

What information should be detailed in the 'Assessment' section of an ISBAR handover?

The health professional's clinical assessment of the patient's condition, including vital signs, physical findings, and current treatment responses.

What is the purpose of the 'Recommendation' section in an ISBAR handover?

To clearly state what action is suggested or required for the patient's ongoing care, such as further investigations, treatments, or monitoring.

What are the four main stages of communication in a clinical encounter?

1. Initiating the session: Establishing rapport, identifying reasons for the encounter, and setting objectives.
2. Gathering information: Eliciting patient's perspective, history, and conducting relevant assessments.
3. Explanation and Planning: Providing information, discussing options, involving the patient in shared decision-making, and formulating a plan.
4. Closing the session: Summarizing, clarifying the plan, safety-netting, and arranging follow-up.

What does the 'I' in ISBAR refer to?

Identify, which involves stating your name, role, and the patient's name and location to ensure clear recognition of all parties involved in the handover.

What does the 'S' in ISBAR refer to?

Situation, which involves providing a concise statement of the immediate problem, why the patient is being discussed, and their current status relevant to the handover.