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Health Literacy

Strategies and techniques to support

training, exercises and self-management

CC-BY-SA 4.0 License, except the images 1 - 2

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Learning outcomes

You are able to:

  • describe strategies to teach clients different exercise types (verbal, images, videos,...)

  • support client’s self-management

  • check client’s comprehension of provided information using different techniques

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As health profesionals, PT's have a role in education and training patients.

  • Physiotherapy expertice  - Health condition knowledge

- Health promotion strategies

- Specific rehabilitation exercises

  • Leadership and mangement – Self management

[World Physiotherapie 2021;

World Confedaration of Physical Therapy, 2011]

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As health profesionals, PT have a role in education and training patients.

Physiotherapy expertice - Health condition knowledge

  • Contents:

  • Diagnosis
  • Pathophysiology
  • Natural course
  • Symptoms
  • Treatments
  • Risk factors
  • Psychosocial aspects

[World Physiotherapie 2021;

World Confedaration of Physical Therapy, 2011]

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As health profesionals, PT have a role in education and training patients.

Health promotion strategies

  • Contents:
  • Exercise
  • Nutrition
  • Avoidance of unhealthy behaviours
  • Lifestyle behaviour
  • Cognitive training

[World Physiotherapie 2021;

World Confedaration of Physical Therapy, 2011]

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As health profesionals, PT have a role in education and training patients.

Specific rehabilitation exercises

  • Contents:
  • Technique
  • Load
  • Repetitions
  • Duration

[World Physiotherapie 2021;

World Confedaration of Physical Therapy, 2011]

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As health profesionals, PT have a role in education and training patients.

  • Self-managment
  • Contents:

  • Symptoms control
  • Symptoms management
  • Stress control
  • Mental health education

[World Physiotherapie 2021;

World Confedaration of Physical Therapy, 2011]

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Strategies and techniques for exercises and training

Face-to-face sessions: Individual or in groups

Manuals

Booklets

Videos

Presentations

Flipcharts

Patient books

Web-based discussion forums (digital HL)

Communication and materials must be adequate to the patient’s HL level!

Written and visual materials:

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Checking comprehension

Teach-back method: Ask patients to explain health information in their own words or to demonstrate the correct use of performance of an exercise, device or task.

  • Use of open-ended questions.
  • Frame the query as a “test” of the provider versus a “test” of the patient.
  • Minimize any feelings of shame or embarrassment.
  • Use of plain language.

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Self-management

Self-management is a client's ability to deal with physical, psychological, and social consequences of a condition/disability and associated lifestyle adjustments, in coherence with the social environment.

[KNGF/ VvoCM, 2022]

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Self-management support

Self-management support is the systematic provision of education and support interventions to clients (and possibly their family and social network) so that clients can cope with the consequences of their illness/ condition in daily life (physical, mental and social area). �

[KNGF/ VvoCM, 2022]

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Factors that can influence self-management

Health literacy

Perception of the disease, condition or injury

Expectations of the therapy

Motivation

Behavior related to physical activity

Social support and guidance

Environmental factors

Factors specific to a disease or condition

Coping

[KNGF/ VvoCM, 2022]

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5 A’s to support self-management

Image 3. Five A‘s to support self-mangement. Picture by Pan American Health Organization 2013, p. 31

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Help patients break down goals into manageable steps. Have patients pick one specific step they are likely to do. Steps should be small and realistic to do over a short time (e.g., 1 week).

Fill out an action plan form. Use a form to outline exactly what the patient will do.

Image 4. Health Plan

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After making the action plan

Assess confidence

Identify barriers

Make a copy of the action plan

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Questionnaire/Self-reflection

Enabling self-management- I apply strategies adjusted to clients' level of health literacy to enable self-management

32. I assess barriers and facilitators related to therapy compliance (e.g. illness believes, shame, level of education, influence of the family, taboos, cultural influences etc.)

33. I involve the client in formulating personalized goals and action plans

34. I use the influence of the social context in a beneficial way

35. I check whether the follow up – plans for the subsequent sessions are understood and accepted

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Image 1. Five A‘s to support self-mangement. Picture Pan American Health Organization (2013, p. 31). Innovative care for chronic conditions: organizing and delivering high quality care for chronic noncommunicable diseases in the Americas. In: PAHO Washington, DC.

Image 2. Health Plan designed by by rawpixel, free license by freepik

All icons/pictograms from PowerPoint® for Microsoft 365 MSO (Version 2205 Build 16.0.15225.20172) 64 Bit )

References

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  • Koninklijk Nederlands Genootschap voor Fysiotherapie (KNGF) / Vereniging van Oefentherapeuten Cesar en Mensendieck (VvOCM). KNGF-richtlijn Zelfmanagement. Amersfoort/Utrecht: KNGF/VvoCM; 2022
  • World Confederation for Physical Therapy, Guideline: Clinical education components of physical therapist professional entry level education programmes. UK.; 2011.
  • World Physiotherapie. Physiotherapist educational framework. UK: World Physiotherapie; 2021. https://world.physio/what-we-do/education/physiotherapist-education-framework

Literature