Chapter 1: Psychosocial Considerations

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Chapter 1: Psychosocial Considerations
2015-03-03 22:57:35
Psychosocial Considerations
NPTE: Chapter 1
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  1. Malingering
    • Symptom magnification syndrome
    • Defined as behavioral response where displays of symptoms control the life to the patient, leading to functional disability
    • May be psychological advantages to illness (pt may feel protected from threatening world, uncertainty or fear about future, social gain, reduces stressors)
    • PTs need to recognize symptoms and respond o patient
    • Emphasize regaining functional outcomes, not pain reduction
  2. Tests to Evaluate Malingering
    • Hoover Test: involves the therapist's evaluation of the amount of pressure the patient's heels place on the therapists hands when the pt is asked to raise one LE while in supine position¬†
    • Burn's Test: requires the patient to kneel and bend over chair to touch floor
    • Waddell's Signs: evaluate tenderness, simulation tests, distraction tests, regional disturbances, and overreaction (can be predictive of functional outcome)
    • Functional capacity evaluations: used to evaluate psychosocial as well as physical components of disability
  3. Secondary Gain
    • Usually some type of financial gain for staying ill (workers comp, larger settlement for injury claims)
    • Frequently seen in clinics that manage industrial injuries
    • May not want to return to work for various reasons associated with the work environment (stress, disliking coworkers)