Physiotherapy communication approaches in management of obesity and overweight

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Introduction

Aims

To provide final year physiotherapy students and newly qualified physiotherapy graduates with an online learning resource which aims to develop their knowledge and understanding of physiotherapy management approaches for people with overweight and obesity.

Learning Outcomes

By the end of this activity you will be able to:

1. Explain and describe some of the key contributing factors to overweight and obesity and critically evaluate how these factors impact physiotherapy practice.

2.  Appraise the relevant evidence to identify and summarise the role of physiotherapy in management and treatment of obese or overweight patients.

3. Critically evaluate the theories and evidence base for communication approaches to facilitate behaviour change in people with overweight and obesity.
 

Audience

Although this resource is aimed at final year physiotherapy students and newly qualified physiotherapy graduates, other health care students and professionals may find it useful, as well as anyone else interested in the subject.

Understanding Obesity

Obesity Quiz: How much do you know?

Please follow this link: https://www.onlineexambuilder.com/obesity-quiz-how-much-do-you-know/exam-42680

Definition of Obesity

Obesity is where an individual is carrying excess body fat which can increase the chances of developing secondary diseases.

Obesity can be measured by Body Mass Index (BMI) as shown:

BMI 25-29.9 – overweight
BMI 30-39.9 – obese
BMI 40+ - severely obese

However, to measure obesity more reliably waist circumference can also be measured where females as classed as obese is measuring over 80cm and males over 94cm. Fat percentages can also be calculated to give a truer measurement of obesity (NOO 2011; NHS 2014a).

Implications of Obesity

There are many implications of obesity worldwide. Obesity increases the risk of many long-term health conditions such as type 2 diabetes, heart disease, arthritis, hypertension, cancer, stroke, liver problems, respiratory problems, sleep issues, mental health disorders and overall may cause a reduced quality of life (Keenan et al. 2011). People with obesity also have an increased risk of falls (Fjelstad et al. 2008).
 
With the rising obesity epidemic and reduced staff, funding and resources within the NHS the demand on the health service is huge. This could ultimately lead to reduced quantity and quality of care. Obesity also contributes to wider financial problems such as more benefit outgoings and loss of output within the economy (Public Health England 2015).  In addition, obese patients have an increased recovery time which leads to an increased length of hospital stay which further adds more pressure on the health service due the increased demand for hospital beds. Therefore, there is an increased demand for bariatric equipment which with the reduced funding and resources within the NHS currently results in difficulty (CSP 2015b).

How can communication be used to facilitate behaviour change?

Motivational interviewing

Introduction 

Motivational interviewing (MI) is described as “a collaborative conversation style for strengthening a person’s own motivation and commitment to change” (Miller and Rollnick p. 12 2013)

Four processes in Motivational interviewing

1. Engaging
2. Focusing
3. Evoking
4. Planning

O.A.R.S Strategy

Open-ended questions
Affirmations
Reflective listening
Summaries

Example of use of O.A.R.S. Strategy

(Recording) Are you able to identify all parts of the strategy?

References

References will automatically be added here, see adding references tutorial.