Prior to sitting down with a patient, I spend time reviewing the Intake Functional Status Summary. For lack of a better description, I kind of want to be in their skin so to speak. As I continue sharing my clinical thinking, let me do a quick synopsis prior to sharing how I scan the report reviewing additional information. In Part 1, my little clinical alert flags began flashing. In Part II, I begin scanning the top of the report to grasp if I can clinically rationalize why I'm seeing such a difference in scores. In Part III, I focus on what it might be like to live in their skin performing various activities.
In my company settings, "patient history" is what is completed by patients vs "short history." So, after a patient completes the intake, this is what the Intake Functional Status Summary looks like. I like to do a quick scan to get a feel for what other factors may play a role during the patient's rehabilitation experience. What co-morbidities will influence my decision-making? Was the person an exerciser? If the patient has low back pain, what is the STarT Back Screening score? What items indicated fear in that screen? What is the patient's reported weight? (Key to know because depending on the weight, certain activities may not be performed on my equipment due to weight limitations.) Does pain level fluctuate? What are the intensities of the symptoms? Are there any odd pain referral patterns? What other health problems need to be considered when addressing the patient's current problem? How much diagnostic testing has been done? How many other professionals and treatments have been pursued?
All these additional questions are relevant to gain additional insight of the person's mindset. The information helps shape my communication style. If I know a person has had a lot of diagnostic testing and multiple treatments that have not been helpful, the person may have a higher amount of fear, frustration and anxiety. They person may not have had ample opportunity to discuss the current situation or time to interactively learn. I know my role will initially hear the person's story and focus on the positive. I also know that I have more of a simplistic style vs high tech with regard to diagnosis. Often times, in order for the patient to reach predicted outcomes, a whole new mindset needs to be created. That mindest of self-efficacy begins on day one and my role is to primarily gain the patient's trust and secondarily to help the patient believe in the positive that can become reality.
Until next time,