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Components of the Patient Interview
Client history Risk factors Clinical presentation Pain types/pain patterns Associated signs and symptoms of systemic disease Review of systems TERM 2
How to screen for the interview
DEFINITION 2 COMMUNICATION illiteracy -- health care literacy ESL -- interpreter courteous cultural differences TERM 3
Interviewing tools
DEFINITION 3 Appendix Disease specific assessments QOL, fall risk, shoulder pain, impairment ratings, breathlessness scales, VAS, BORG TERM 4
Chief Complaint
DEFINITION 4 why is the patient here? TERM 5
Red Flags during the interview?
DEFINITION 5 insidious onset -- is it really? symptoms out of proportion to the injury symptoms persist beyond expected time no position is comfortable
Signs to look out for in an interview
any physical, sexual or psychological attack including verbal, emotional or economic abuse previous history of many injuries or accidents history of fractures as 30% of women at fracture clinics have a history of intimate partner violence TERM 7
Indirect question for: "Were you hit, kicked,
choked, or pushed?"
DEFINITION 7 I see you have a bruise here. It looks like its healing well. How did it happen? TERM 8
Indirect question for: "Is there anything else
you would like to tell me about your
situation?"
DEFINITION 8 Are you having problems with your partner?Have you ever gotten hurt in a fight? TERM 9
Indirect question for: "Im concerned that your
symptoms may have been caused by
someone hurting you. Has anyone been
hurting you in any way?"
DEFINITION 9 You seem concerned about your partner. Can you tell me more about that? Does your partner keep you from coming to therapy or seeing family and friends TERM 10
Important points for the PT for abuse
DEFINITION 10 Use caution with hands-on techniques Our behavior may seem abusive Reporting Child -- law requires professionals to report suspected abuse spousal elder
Corticosteriods and the interview process
Suppress inflammation processesSide effects Local Weakness in tendonsJoint destruction Systemic GI , liver kidney, dysfunction TERM 17
Nutraceuticals
DEFINITION 17 Document the use of Herbs Supplements Vitamins Minerals Antioxidants TERM 18
Alcohol use and interviewing
DEFINITION 18 Alcohol affects many body systems, but the effects on the neurologic and musculoskeletal systems are of particular interest to PTs Alcoholic polyneuropathy Alcoholic myopathy Nontraumatic hip osteonecrosis Injuries from falls TERM 19
Importance of a client history
DEFINITION 19 use a history form for consistencyespecially remember to consider Age Gender Ethnicity Comorbidities (previous/present) ~ especially cancer Medications TERM 20
Screening for referral is based on what?
DEFINITION 20 Medical history ~ What they told you Clinical presentation ~ What you saw Associated signs and symptoms ~ What you asked about
Final question of an interview?
Is there anything else you think is important about your condition that we havent discussed yet?
