Treatment Considerations in Disasters and Conflicts

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Introduction[edit | edit source]

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Education[edit | edit source]

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Self-Management[edit | edit source]

Self-management, incorporating active involvement of in decisions about treatment and shared responsibility has become more part of rehabilitation for individuals with long term neurological conditions. Understanding what it is and why it is becoming such a key element of the rehabilitation process are important to ensuring your treatment has patient involvement and is patient focused. Read the following resources on Self Management.[1][2]

Self-management is a model of care in which patients are encouraged to use strategies and learn skills to manage their own health needs [3]. Patients are active participants and take responsibility for their own health care behaviours, a notion that is lost in the medical model and passive therapies [4]. Recently, the WHO defined 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.”[5] Lorig et al (2003)[6]. explain that “wellness” from self-management requires attention in three key domains: the medical, behavioural, and emotional elements of a person’s life. They recognise that physiotherapists do not have extensive training in each domain, but they stress that physiotherapists’ expertise in exercise therapy, pain management, and healthy lifestyles promotion enables the profession to play a key role in supported self-management.

According to Phillips (2012) [7], a person needs to learn a range of skills to manage the biological, mental, emotional, and social impacts of their condition, including the effects of physical inactivity on health. This is termed the “biopsychosocial approach.” The following diagram depicts the range of strategies available to support the use of self-management:

Promoting Independence[edit | edit source]

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. PFA 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

Peer Support[edit | edit source]

Peer means the group of people who have faced the same kind of trauma. During the assessment, if the patient feels comfortable being with the peer group, the therapist can offer the option to the patient.[5] Many patients may have little knowledge regarding their pain experience as some pain might be due to emotional suffering and central sensitization.[8]Peer support might provide emotional support and it can be provided face to face, in a group, or via the internet as per the patient's choice.[9]

Condition Specific Treatment[edit | edit source]

Fracture[edit | edit source]

Peripheral Nerve Injury[edit | edit source]

Read more here about Nerve Injury Rehabilitation

Burns[edit | edit source]

Read more here about Post-burn Rehabilitation and Rehabilitation of Hand Burn Injuries

Amputations[edit | edit source]

Read more here about Amputee Rehabilitation and Interdisciplinary Management of the Amputee

Acquired Brain Injury[edit | edit source]

Read more here about Physiotherapy Management of Traumatic Brain Injury and Interdisciplinary Management of Traumatic Brain Injury

Spinal Cord Injury[edit | edit source]

Read more here about Physiotherapy Management of Individuals with Spinal Cord Injury and Interdisciplinary Management in Spinal Cord Injury

Resources[edit | edit source]

References [edit | edit source]

  1. Mudge, S. et al, Who is in Control? Clinicians’ View on their Role in Self-management Approaches: A Qualitative Metasynthesis , BMJ Open, 2015
  2. Jones, F. Chapter 19: Self-management , in Stokes, M. &s Stack, E., Physical Management for Neurological Conditions, Churchill Livingstone, 2013.
  3. 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.
  4. Harding V, Watson PJ. Increasing activity and improving function in chronic pain management. Physiotherapy. 2000 Dec 1;86(12):619-30.
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  6. Lorig KR, Holman HR. Self-management education: history, definition, outcomes, and mechanisms. Annals of behavioral medicine. 2003 Aug 1;26(1):1-7.
  7. Phillips J. The need for an integrated approach to supporting patients who should self manage. Self Care. 2012;3:33-41.
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