Continuity of care is important in order to improve patient outcomes because it takes time for the benefits of exercise to accrue. Unfortunately, it is not uncommon to lose a patient after one or two sessions. 20% of patients drop out after their third visit and another 20% quit by their seventh. Physical therapy can be a challenge for patients to do.
Here are three steps therapists can take to provide a successful path for their patients' treatment:
#1 - Be a Good Host
Relatedness, also known as belonging, is the first step in helping patients feel comfortable with their treatment. If you were hosting a party with your closest friends, what would be the purpose of this party? Your goal would be to ensure that your guests have the best time possible! This is the environment we should strive to create. It might be helpful to ask yourself, “Am I making my patients feel well-cared for?”
#2 - Be Clear
Competence is another driver of personal motivation. We can promote competence by providing a clear structure for our patients’ goals. Sometimes we forget to remind patients of their progress. Tell your patient that moving from a 5 to 10-pound weight was a big step towards achieving their goals. Communicate the little things as they are big steps in the right direction.
#3 - Be Interested
Autonomy is the final driver for intrinsic motivation. Autonomy means you are choosing to do something, to be a better version of yourself. When autonomy is not being respected, it feels like you are being controlled. This may be the trickiest step to implement in physical therapy. Sometimes, a patient needs to adhere to a strict plan.
This is where your clinical reasoning can really shine. Let’s say it’s time in your treatment plan to progress to loaded exercises. These exercises are painful and it’s clear from conversations with your patient that they are apprehensive. Adherence to a home exercise program seems highly unlikely and that will hinder outcomes. So what can we do to better your patient’s outcome?
Do we need to push patients’ into pain, when we know it’s infringing on their autonomy and might contribute to them quitting? Maybe if there’s pain with an overhead press, add a squat to overhead press in order to dissociate the painful movement. Is your patient a basketball player? Attach more meaning to the exercise and press a basketball overhead. Whatever fun exercise you can come up with, gain feedback and gauge your patient’s reaction to ensure their autonomy is being respected.
By using these three steps, we can try our best to help our patients maintain their course of physical therapy.
