Treatment Considerations in Disasters and Conflicts: Difference between revisions
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Patient education has been defined as, "any set of planned activities designed to improve a patient's health behaviours, health status, or both." <ref name="Louw & Puentedura">Louw, A, Puentedura, E. (2013). Therapeutic Neuroscience Education. Teaching patients about pain. A guide for clinicians. Minneapolis. Orthopedic Physical Therapy Products.</ref> These activities aim to facilitate the patient's knowledge base in order to help them make sense of their condition and guide them towards effective, ongoing self-management by developing skills such as problem solving, decision making, resource utilisation, action planning, self-tailoring, self-monitoring, which all requires a positive patient-rehabilitation professional partnership. | Patient education has been defined as, "any set of planned activities designed to improve a patient's health behaviours, health status, or both." <ref name="Louw & Puentedura">Louw, A, Puentedura, E. (2013). Therapeutic Neuroscience Education. Teaching patients about pain. A guide for clinicians. Minneapolis. Orthopedic Physical Therapy Products.</ref> These activities aim to facilitate the patient's knowledge base in order to help them make sense of their condition and guide them towards effective, ongoing self-management by developing skills such as problem solving, decision making, resource utilisation, action planning, self-tailoring, self-monitoring, which all requires a positive patient-rehabilitation professional partnership. | ||
Self-management is a model of care in which patients are active participants in their own health care who are encouraged to use strategies and learn skills to manage their own health needs, and take responsibility for their own health care behaviours <ref>Oliveira VC, Ferreira PH, Maher CG, Pinto RZ, Refshauge KM, Ferreira ML. Effectiveness of self‐management of low back pain: Systematic review with meta‐analysis. Arthritis care & research. 2012 Nov;64(11):1739-48.</ref> <ref name="HARDING">Harding V, Watson PJ. Increasing activity and improving function in chronic pain management. Physiotherapy. 2000 Dec 1;86(12):619-30.</ref>. The World Health Organisation (WHO) define self- management as “the ability of individuals, families and communities to promote health, prevent disease, and maintain health…..to cope with illness and disability with or without the support of a health-care provider.”<ref name=":0" /> | Self-management is a model of care in which patients are active participants in their own health care who are encouraged to use strategies and learn skills to manage their own health needs, and take responsibility for their own health care behaviours <ref>Oliveira VC, Ferreira PH, Maher CG, Pinto RZ, Refshauge KM, Ferreira ML. Effectiveness of self‐management of low back pain: Systematic review with meta‐analysis. Arthritis care & research. 2012 Nov;64(11):1739-48.</ref> <ref name="HARDING">Harding V, Watson PJ. Increasing activity and improving function in chronic pain management. Physiotherapy. 2000 Dec 1;86(12):619-30.</ref>. The World Health Organisation (WHO) define self- management as “the ability of individuals, families and communities to promote health, prevent disease, and maintain health…..to cope with illness and disability with or without the support of a health-care provider.”<ref name=":0" /> Self-management, incorporating active involvement of the patient and their support networks in decisions about treatment and shared responsibility, has become a recognised aspect of all rehabilitation and is a vital aspect of treatment in disaster and conflict settings given that patients often have reduced access to or time with rehabilitation professionals, with follow up often limited or delayed secondary to constrained health systems and damaged health and community infrastructure. <ref>Mudge, S. et al, [https://members.physio-pedia.com/wp-content/uploads/2016/02/Who-is-in-control.pdf Who is in Control? Clinicians’ View on their Role in Self-management Approaches: A Qualitative Metasynthesis] , BMJ Open, 2015<div class="researchbox"></div></ref><ref>Jones, F. Chapter 19: Self-management , in Stokes, M. &s Stack, E., [https://members.physio-pedia.com/wp-content/uploads/2016/02/Stokes-Chapter-19-Self-management.pdf Physical Management for Neurological Conditions], Churchill Livingstone, 2013.</ref><ref>Lorig KR, Holman HR. Self-management education: history, definition, outcomes, and mechanisms. Annals of behavioral medicine. 2003 Aug 1;26(1):1-7.</ref> | ||
Educating patients and caregivers on self-management and providing them with clear guidance on any restrictions and signs of complications, advice and exercises, and explaining how to progress and what to do if they don’t make progress is hugely important within disaster and conflicts, this can be even more important when patients are awaiting definitive management, as pre-operative education can make post-operative care much easier.<div class="researchbox"> | |||
== Promoting Independence == | == Promoting Independence == | ||
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According to Unicef, psychosocial well-being can be seen as the state of being or doing well of an individual in different aspects of life, including having supportive social relationships, access to basic survival needs and economic and environmental resources and physical, intellectual, emotional and development needs being addressed. <ref>Unicef. Key Practice: Psychosocial Support. Available from: https://www.unicef.org/uganda/key-practice-psychosocial-support (Accessed 2 March 2022).</ref> | According to Unicef, psychosocial well-being can be seen as the state of being or doing well of an individual in different aspects of life, including having supportive social relationships, access to basic survival needs and economic and environmental resources and physical, intellectual, emotional and development needs being addressed. <ref>Unicef. Key Practice: Psychosocial Support. Available from: https://www.unicef.org/uganda/key-practice-psychosocial-support (Accessed 2 March 2022).</ref> | ||
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‘Psychosocial support’ then refers to the actions that address both the psychological and the social needs of individuals, families and communities and helps them to deal with the situation in which they find themselves, and help them to build resilience, and rebuild their life and involves a range of care and support interventions offered by caregivers, family members, friends, teachers, rehabilitation workers, and community members on a daily basis, and may extends to care and support offered by specialised psychological and social services where required.{{#ev:youtube|_h0L6u68tbI|250}} <div class="row"><div class="col-md-6 col-md-offset-3"><div class="text-right"><ref>Hamanitarian Capacity Building..Psychosocial Support. Available from: https://youtu.be/_h0L6u68tbI[last accessed 28/02/22]</ref></div></div></div> | |||
== Peer Support == | == Peer Support == | ||
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Introduction[edit | edit source]
Education and Self-Management[edit | edit source]
Patient education has been defined as, "any set of planned activities designed to improve a patient's health behaviours, health status, or both." [1] These activities aim to facilitate the patient's knowledge base in order to help them make sense of their condition and guide them towards effective, ongoing self-management by developing skills such as problem solving, decision making, resource utilisation, action planning, self-tailoring, self-monitoring, which all requires a positive patient-rehabilitation professional partnership.
Self-management is a model of care in which patients are active participants in their own health care who are encouraged to use strategies and learn skills to manage their own health needs, and take responsibility for their own health care behaviours [2] [3]. The World Health Organisation (WHO) define self- management as “the ability of individuals, families and communities to promote health, prevent disease, and maintain health…..to cope with illness and disability with or without the support of a health-care provider.”[4] Self-management, incorporating active involvement of the patient and their support networks in decisions about treatment and shared responsibility, has become a recognised aspect of all rehabilitation and is a vital aspect of treatment in disaster and conflict settings given that patients often have reduced access to or time with rehabilitation professionals, with follow up often limited or delayed secondary to constrained health systems and damaged health and community infrastructure. [5][6][7]
Educating patients and caregivers on self-management and providing them with clear guidance on any restrictions and signs of complications, advice and exercises, and explaining how to progress and what to do if they don’t make progress is hugely important within disaster and conflicts, this can be even more important when patients are awaiting definitive management, as pre-operative education can make post-operative care much easier.
Promoting Independence[edit | edit source]
After a traumatic injury, people need rehabilitation assessment and interventions that take account of any pre-existing conditions and focus on helping them regain optimum function and independence as quickly as possible within the environment in which they will be discharged to. A person’s ability to participate in everyday activities in their home and community environments may be significantly disrupted both as a result of the disaster or conflict itself with damaged and destroyed infrastructure, poor access to essential services and crowded living conditions or as a result of the specific injury, which may require them to change their routines or daily activities have to be relearned or managed differently, or may require assistance from others for personal tasks such as showering, dressing and grooming as well as domestic and community tasks. What is considered best practice may be different given the impact of the setting on the individual, and you need to always ensure you consider not only their specific injuries but the environment they have to live within.
Psychological Support[edit | edit source]
Psychological first aid (PFA), describes a humane, supportive response to a fellow human being who is suffering and who may need support and involves the following themes:
- providing practical care and support, which does not intrude;
- assessing needs and concerns;
- helping people to address basic needs (for example, food and water, information);
- listening to people, but not pressuring them to talk;
- comforting people and helping them to feel calm;
- helping people connect to information, services and social supports;
- protecting people from further harm
Psychosocial Support[edit | edit source]
Disasters and conflict put significant psychological and social stress on individuals, families and communities, and can impose significant stress and hardship. The term ‘psychosocial’ refers to the dynamic relationship between the psychological dimension of a person, including their internal, emotional and thought processes, feelings and reactions and the social dimension of a person, which includes their relationships, family and community network, social values and cultural practices.
According to Unicef, psychosocial well-being can be seen as the state of being or doing well of an individual in different aspects of life, including having supportive social relationships, access to basic survival needs and economic and environmental resources and physical, intellectual, emotional and development needs being addressed. [8]
‘Psychosocial support’ then refers to the actions that address both the psychological and the social needs of individuals, families and communities and helps them to deal with the situation in which they find themselves, and help them to build resilience, and rebuild their life and involves a range of care and support interventions offered by caregivers, family members, friends, teachers, rehabilitation workers, and community members on a daily basis, and may extends to care and support offered by specialised psychological and social services where required.Peer Support[edit | edit source]
Peer support occurs when people share their personal knowledge, experience, emotional, social or practical help with each other. Peer support comes from people who have faced the same kind of experience, trauma or injury. Peer support offers an environment where a person can feel that they are being listened to as a person and not as a patient and can offer a different and unique perspective to the medics and rehabilitation professionals as peers have that “lived experience”, they can relate to the person in a way that only someone who has “been there and done that” can.
Peer support is commonly used in situations where a person has undergone a life-changing injury such as a spinal cord injury, traumatic brain injury or amputation and can take a number of forms including peer mentoring, reflective listening (reflecting content and/or feelings), or counselling and can be provided face to face, individually or in a group based setting, or in some instances has also been provided through telehealth.[10] Peer support can be utilised not only for the person who has had the injury, but can o=also include peer support for family members and care givers.
Resources[edit | edit source]
References [edit | edit source]
- ↑ Louw, A, Puentedura, E. (2013). Therapeutic Neuroscience Education. Teaching patients about pain. A guide for clinicians. Minneapolis. Orthopedic Physical Therapy Products.
- ↑ Oliveira VC, Ferreira PH, Maher CG, Pinto RZ, Refshauge KM, Ferreira ML. Effectiveness of self‐management of low back pain: Systematic review with meta‐analysis. Arthritis care & research. 2012 Nov;64(11):1739-48.
- ↑ Harding V, Watson PJ. Increasing activity and improving function in chronic pain management. Physiotherapy. 2000 Dec 1;86(12):619-30.
- ↑ Cite error: Invalid
<ref>tag; no text was provided for refs named:0 - ↑ Mudge, S. et al, Who is in Control? Clinicians’ View on their Role in Self-management Approaches: A Qualitative Metasynthesis , BMJ Open, 2015
- ↑ Jones, F. Chapter 19: Self-management , in Stokes, M. &s Stack, E., Physical Management for Neurological Conditions, Churchill Livingstone, 2013.
- ↑ Lorig KR, Holman HR. Self-management education: history, definition, outcomes, and mechanisms. Annals of behavioral medicine. 2003 Aug 1;26(1):1-7.
- ↑ Unicef. Key Practice: Psychosocial Support. Available from: https://www.unicef.org/uganda/key-practice-psychosocial-support (Accessed 2 March 2022).
- ↑ Hamanitarian Capacity Building..Psychosocial Support. Available from: https://youtu.be/_h0L6u68tbI[last accessed 28/02/22]
- ↑ Cite error: Invalid
<ref>tag; no text was provided for refs named:2
