Patient Communication(physio)

Questions:Physio for patients.

1. In the past month, has your pain been bad enough to stop you doing many of your day-to-day activities?

2. In the past month, has your pain been bad enough to make you feel worried or low in mood?

3. Can you now (or could you ever) place your hands flat on the floor without bending your knees?

4. Can you now (or could you ever) bend your thumb to touch your forearm?

5. As a child, did you amuse your friends by contorting your body into strange shapes or could you do the splits?

6. As a child or teenager, did your kneecap or shoulder dislocate on  more than one occasion?

7. Do you consider yourself ‘double-jointed’?

History of the Present Condition.

8. how long the symptom has been present.

9. whether there was a sudden or slow onset of the symptom.

10. whether there was a known or unknown cause that provoked the onset of the symptom, for example:trauma or change in lifestyle that may have triggered symptoms.

11. whether the patient has sought any treatment already and, if so, what type of treatment and to what effect.

12. whether the patient feels the symptoms are getting better, worse, or staying the same.

13. How many and what type of pillows do you use? Is your mattress firm or soft?

14. Can you get back to  sleep, how long does it take, and what do you have to do?

The clinician may  ask the  following types of questions to elucidate psychosocial factors:

15. Have you taken time off  work in the  past with your pain?

16. How is your employer/coworkers/family responding to your pain?

17. Do  you  think  you  will  return  to  work? When?

18. What do you understand to be the cause of your pain?

19. What are you expecting will help you?

20. Do you expect to recover?

21. Do you feel you can control your pain?

22. What are you doing to cope with your pain?

23. Do you feel overwhelmed by the pain?

Night Symptoms. The following questions may be asked:

24.Do you have trouble falling asleep?

25.What position is most comfortable/uncomfortable?

26. What is your normal sleeping position?

27. What is your present sleeping position?

28. Do your symptoms wake you at night? If so,Which symptoms?

29. How many times in the past week?

30. How many times in a night?

31. How long does it take to get back to sleep?

Behaviour of Symptoms.

Aggravating Factors.

For each symptomatic area a series of questions  can  be asked:

32. What  movements, activities or positions bring on or make  the  patient’s symptoms worse?

33. How long does it take before symptoms are aggravated?

34. Is the patient able to maintain this position or movement?

35. What happens to other symptoms when this symptom is produced or made worse?

36. How do the symptoms affect function, for example. reaching, dressing, overhead activities, sport and social activities?

37. Does the patient have a feeling of instability in the shoulder?

Easing Factors.

For each symptomatic area a series of questions can be asked to help determine what eases the symptoms:

  • What movements and/or positions ease the patient’s symptoms?
  • How long does it take before symptoms are eased? If symptoms are constant but variable it is important  to  know what the baseline is and how long it takes for the symptoms to reduce to that level.
  • What  happens  to  other  symptoms  when  this symptom  is  eased?
  • Can you lie on the affected shoulder?
  • Do you agree that it’s not really safe for a person with a condition like yours to be physically active?
  • Have worrying thoughts been going  through your  mind  a lot  of  the  time?

50. Is  your  back  pain terrible  and  do  you  feel it’s never going  to  get  any  better?

51. Have you  not  enjoyed all  the  things you used to enjoy?

52. How  bothersome has  your  back  pain  been  in  the last  2  weeks?

53. What movements and/or positions ease the patient’s symptoms?

54. How long does it take before symptoms are eased? If symptoms are constant but variable it is important  to  know what the baseline is and how long it takes for the symptoms to reduce to that level.

55. What happens to other symptoms when this symptom is eased?

56. Have  you  had  time  off  work  in  the past  with  back pain?

57. What do you understand to  be the cause  of your back  pain?

58. If symptoms are constant: Does your thigh pain change when your back pain gets worse?

59. What are you doing to cope  with  your back pain?

60. If  there  is  a primary  and  a secondary symptom, what happens when  the  primary symptom  is produced  or  made worse?

61. How long does it take for symptoms to settle once they are aggravated?

62. Is the patient able to maintain this position or movement?

63. How do the symptoms affect function? For example, sitting, standing, lying, bending, walking, running, walking  on uneven ground, up  and down stairs, washing, driving, lifting and digging, work, sport and social activities.

64. Do you ever get your back pain without your thigh pain?

65. How long does it take before symptoms are eased? If symptoms are constant but  variable  it is important  to know what the baseline is and how long it takes for  the  symptoms to reduce to that level.

67. What else can you do to ease symptoms?

68. Do you have any difficulty getting to sleep (particularly related to your pain)?

69. If sleep is an issue, further questioning may be useful to determine management,  e.g.  positioning, advice regarding medication, hot/cold application.

70. What do you understand to be the cause of your pain?

71. Are you worried about the cause of your pain?

72. What does the future hold for you in relation to your pain?

Patients’ questions:

83. What can I expect on my first session?

84. What caused my pain/injury?

85. How long will it take to get better?

86. What can I do to assist my recovery?

87. What should I avoid?

88. Do I have to stop what I am doing now: training/gym sessions?