Last Updated Jun 2011
Patient autonomy is a part of the patient’s bill of rights. Yet, it’s an ideal that is often difficult to attain. A study, Patient Participation in Physical Therapy Goal Setting, found that although physical therapists try to involve patients in goal setting, they often do not reach the full potential of patient participation. Fortunately, there are a variety of tools available to help physical therapists improve their clinical communication skills in order to enhance patient autonomy.
To achieve patient autonomy, the American Physical Therapy Association (APTA) encourages physical therapists to understand the goals and objectives a patient hopes to achieve from physical therapy. Stacey Zeigler, PT, DPT, GCS and Professor at Clarkson University, recently had the opportunity to present "Empowering Patient Autonomy for Outstanding Outcomes" at the APTA Combined Sections Meetings held in New Orleans in February. She defines patient autonomy as empowering the patient enough to make their own decisions in the treatment process without being unnecessarily influenced by the health care provider.
Ziegler believes physical therapists need an open dialogue with patients to develop a true understanding of what they hope to achieve through physical therapy. Once physical therapists understand why patients sought out physical therapy and what they hope to accomplish, physical therapists will be in a better position to help physical therapists achieve their goals.
A Few Tools Available to Help Enhance Your Clinical Communication Skills
One clinical communication tool physical therapists can use to communicate effectively with their patients is the Ozer Payton Nelson Method (OPN). Using a structured communication format, the OPN method encourages open communication. The OPN Method invites physical therapists to engage patients through all phases of care by providing suggested questions to ask and guidelines on when questions should be asked.
Another communication method designed to improve patient autonomy is the Four Habits Model. This communication technique is built upon a teaching and research framework. It uses a sequence of important communication behaviors from both the physical therapist and patient perspective. The Four Habits include: Invest in the Beginning, Elicit the Patient’s Perspective, Demonstrate Empathy and Invest in the End. Elements within the Four Habits Model include everything from ways to build patient rapport quickly to developing empathy towards a patient’s emotions.
Sometimes it’s necessary to evaluate the patient’s view on autonomy. This is where the Ideal Patient Autonomy Scale comes into play. The Ideal Patient Autonomy Scale features 14-items that can be answered on a five-point scale. This communication tool helps physical therapists gain a better understanding of a patient’s perspective.
The Ottawa Personal Decision Guide is designed for any health-related decisions. The guide helps simplify the decision making process by allowing patients to list the benefits and risks with each option available. It’s a useful supplementary tool when more than one medically reasonable option is available to a patient.
These are just a few of the clinical communication tools available to help enhance patient participation in their physical therapy treatment. Learn more about some of the communication tools and decision aids Zeigler recommends by listening to the full podcast. Her APTA presentation is also available for download at PTTalker.com.
Learn more about improving your clinical communication skills by listening to a podcast with Stacey Zeigler, PT, DPT, GCS at PTTalker.com.
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