assessment Parwin Yari MD ( Rehabilation specialist) Anne Carien - PowerPoint PPT Presentation

The 2nd European Polio Conference Amsterdam // 25-27 June 2014 Multidisciplinary one day rehabilitation assessment Parwin Yari MD ( Rehabilation specialist) Anne Carien Beishuizen ( Physiotherapist) Dorien Toor ( Occupational therapist) Liesbeth Eggink ( Medical social worker)

Content 1 How is the Multidisciplinary one-day Rehabilitation assessment achieved? P.Yari 2 Who is eligible to participate? P.Yari 3 How is the day organized? A.C Beishuizen, D. Toor, L. Eggink , P.Yari 2

Content 1 How is the Multidisciplinary one-day Rehabilitation assessment achieved? P.Yari 2 Who is eligible to participate? P.Yari 3 How is the day organized? A.C Beishuizen, D. Toor, L. Eggink , P.Yari 3

1- How is the Multidisciplinary one-day assessment achieved?  Post polio expertise centre  15,000 people in the Netherlands are registered as having poliomyelitis  Immigrants and foreign nationals with polio  In AMC 1/3 of all polio patients are foreign  Younger, more complex patients 4

1- How is the Multidisciplinary one-day assessment achieved? Initially, only diagnosis was performed In 2007 the first One-day assessment was organized 5

Content 1 How is the Multidisciplinary one-day Rehabilitation assessment achieved? P.Yari 2 Who is eligible to participate? P.Yari 3 How is the day organized? A.C Beishuizen, D. Toor, L. Eggink , P.Yari 6

2- Who is eligible to participate? Referral letter •  Rehabilitation specialist  Interview and physical examination  Additional tests - muscle MRI - x-ray - or gait analysis 7

2- Who is eligible to participate? • Criteria for participation • Goal of the session 8

2- Who is eligible to participate? Criteria for participation:  multiproblems  questions about managing symptoms 9 

2- Who is eligible to participate? Goal of the session  give insight into which factors lead to problems 10 

Content 1 How is the Multidisciplinary one-day Rehabilitation assessment achieved? P.Yari 2 Who is eligible to participate? P.Yari 3 How is the day organized? P.Yari , A.C Beishuizen, D. Toor, L. Eggink 11

3- How is the day organized? Two patients a month Questionnaire 12

3- How is the day organized? The most attention is paid to the main problem! Topic issues:  Reduction of pain, tiredness and overload  Improving fitness, exercise and sport  Advice on home and work adjustments  Advice on the use of walking aids  Social and emotional items - how to deal with physical complaints, with acceptance, with fear of being dependent and with concerns about the future 13

3- How is the day organized? Physiotherapist Occupational therapist Medical social worker Rehabilitation physican 14

Expert advice … that moves boundaries snapshots on my timeline 15

Physiotherapist  Preparations  Case history - patients needs!  Examination  Report and proposal for improvements

Physiotherapist Preparation: Medical history General information MRI muscles Muscle condition X-ray Joint problems Gait analysis Walking problems Questionnaire Patient’s needs Polio Problem List Patient’s main problems CISS questionnaire Coping strategies Daily activity list Daily activities

Physiotherapist Case History:  Exploration of the patient’s needs  The three main problems of the Polio Problem List

Physiotherapist Examination:  2 minute Walking Test  Submaximal Cycle Test  Joint Mobility  Observing Problem Activities and Transfers  Borg Scale/Rating of Perceived Exertion  6 minute Walking Test  Observing Effects of Walking Aids

Physiotherapist Report and proposal for improvement:  Outcomes of diagnostic tests  Recommendations for therapy

Physiotherapist Goals of the intervention: • Understanding the problems, origins and consequences • Finding a proper balance between physical capacities and physical activities

Occupational Therapist  Preparations  Case history - patients needs!  Examination  Report and proposal for improvements

Occupational Therapist Preparations: Medical history General information MRI muscles Muscle condition X-ray Joint problems Gait analysis Walking problems Questionnaire Patient’s needs Polio Problem List Patient’s main problems CISS questionnaire Coping strategies Daily activity list Daily activities

Occupational Therapist Case history:  semi-structured interview: COPM (Canadian Occupational Perfomance Measure) Activities which lead to overload, pain, Problems with daily living and work tiredness and/or unsafety situations? skills?  exploration of the physical and social environment

Occupational Therapist Examination:  Daily Activity List  Observations

Occupational Therapist Report and proposal for improvement:  Findings and conclusions  Recommendations for therapy Common goals for further therapy:  adjust heavy daily activities  advices for aids  improving sitting positions

Medical Social Worker  Preparations  Case history - patients needs!  Examination  Report and proposal for improvements

Medical Social Worker Preparations: Medical history General information MRI muscles Muscle condition X-ray Joint problems Gait analysis Walking problems Questionnaire Patient’s needs Polio Problem List Patient’s main problems CISS questionnaire Coping strategies Daily activity list Daily activities

Medical Social Worker The Goal :  To assess the social functioning of the patient.  To advice on the treatment and assistance.

Medical Social Worker Case History:  Exploration of the patient’s needs  The three main problems of the Polio Problem List  Balance in social functioning

Medical Social Worker Examination Focus during the consult:  the aid request  the findings, by using the CISS questionnaire (Coping Inventory for Stress Situations) and HADS questionnaire (Hospital Anxiety and Depressions Scale) - Task-oriented coping - Emotion-oriented coping - Avoidance-oriented coping

Medical Social Worker Advise:  Patient can cope the problem  Contact social medical worker/psychologist

Medical Social Worker Conclusion Most common request for aid :  Finding a balance in life.  The struggle in dealing with the limitations, that the patient has experienced for years.

Rehabilitation Physican Preparation: Medical history General information MRI muscles Muscle condition X-ray Joint problems Gait analysis Walking problems Patient ’ s needs Questionnaire Patient ’ s main problems Polio Problem List CISS questionnaire Coping strategies Daily activity list Daily activities 34

3- How is the day organized?  Team meeting without patient for 15 minutes  Team meeting with patient for 30 minutes - Further treatment necessary? 35

Orthosis 36

3- How is the day organized?  A full report is sent within 2 weeks  Telephone evaluation 37

Disclosure sheet Disclosure of speaker ’ s interest (Potential) conflict of interest None Potentially relevant company relationships in connection with event Sponsorship of research funding • Fee or other (financial payment) • Shareholder • Other relationships, i.e. • 38

Thank you for your attention! Questions? 39