Patient Empowerment

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Patient Empowerment  

The recognition of a patient’s powerlessness or sense of powerlessness is where empowerment begins. The patient asking for help is challenged by a lack of self-efficacy to manage their recovery. The suffering of those in need of healthcare and rehabilitation exemplifies this relationship between patient / client and physical therapists, which is where the facilitation of empowerment begins. Empowerment as a process requires self-mastery and the ability to transcend through suffering by challenging adversity.

Empowerment Defined

Empowerment is the expansion of freedom of choice and action. It means increasing one’s authority and control over the resources and decisions that affect one’s life: when we exercise real choice, we gain increased control over our lives and are able to change ourselves.

Empowerment may be defined as a complex experience of personal change.

We have defined the process of empowerment as the discovery and development of one’s inherent capacity to be responsible for one’s own life.

Patient empowerment is defined as helping patients discover and develop the inherent.

Suffering

Suffering is an existential frustration associated with an unavoidable experience that threatens existence and loss of personal autonomy. Suffering is commonly associated with pain. People in pain frequently report suffering when they feel chronic, dire, out of control, overwhelming, or unknown. However, pain by itself does not cause one to suffer. The perception of the pain and how it demands more of the person than they can manage better defines the nature of suffering.

Locus of Control

Suffering is associated with powerlessness. Powerlessness is thought to come from a loss of internal and or external locus of control. Internal locus of control is the perception of one’s control over personal competence and motivation. Outside the parameters of the perception of personal competence and motivation is the external locus of control. High internal locus of control is the foundation for creating intrinsic motivation that leads to self-efficacy. Intrinsic motivation and self-efficacy are both mediated by competence, autonomy, and locus of control.

Intrinsic Motivation

Intrinsic motivation is shaped by the perception of self-competency. Self-competency begins with recognition that a new skill is needed to achieve a positive outcome. Successful attempts and acquisition of new skills and completion of tasks provide reinforcement of competency. The reinforcement and continued momentum fuel motivation, which remains a conscious decision to continue creating a cycle that proves to be autonomous.

Self-efficacy

Self-efficacy is the actualization of one’s own competency with their skillset to achieve an established outcomes with a reliance of interaction with their environment. Self-efficacy takes active competency over that which is perceived as controllable and resourceful to the person.  

Therapeutic Alliance

The therapeutic alliance (TA) refers to a sense of collaboration, warmth, and support between a client and their practitioner. TA is associated with a combination of emotional flexibility, interpersonal communication, and trust. Building trust through communication creates patient/practitioner collaboration and builds a relationship that inspires personal motivation toward the goals of therapy. Goal flexibility is centered around the needs of the patient and allows for appropriate modifications that support those needs. TA enables the physical therapist to transfer knowledge and power to the patient / client and enables the patient to receive the transferred knowledge and power. Patient education emphasized with empathy that is directed toward personal choices and ideas help patient empowerment.  

Patient interview

Goal directed physical therapy is insufficient for sustainable and comprehensive recovery. Patient empowerment begins with patient education and ends with the active participation of the patient in their physical therapy. Empowerment takes place with the transcendence and sustainable management of the patient’s impairment or dysfunction by the patient giving the autonomy and authority over their own rehabilitation and life.

This interview was conducted with Ellen who demonstrates empowerment by her resilience, self-efficacy and her positive mindset. Ellen had a level of self-efficacy prior to her being diagnosed with Parkinson's that has enabled Ellen to transcend her diagnosis. Ellen was able to push outside of her comfort zone and engage in a HIIT/CrossFit research program at the Arkansas College of Health Education. The variability and intensity of the program along with the group dynamic has lead Ellen to empowerment. We recently interviewed a research participant that is in a Parkinson’s study involving high intensity CrossFit workouts. This participant was handpicked by the researchers as someone who exemplifies empowerment.

References

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