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3 key factors that create a need for screening:
- side effects of medications
- visceral pain mechanisms
Reasons for Medical Screening
- Direct access: Therapist has primary responsibility or first contact.
- Quicker and sicker patient/client base.
- Signed prescription: Clients may obtain a signed prescription for physical/occupational therapy based on similar past complaints of musculoskeletal symptoms without direct physician contact.
- Medical specialization: Medical specialists may fail to recognize underlying systemic disease.
- Disease progression: Early signs and sxs are difficult to recognize, or sxs may not be present at the time of medical examination.
- Patient/client disclosure: Client discloses information previously unknown or undisclosed to the physician.
- Client does not report sxs or concerns to the physician because of forgetfullness, fear, or embarrassment.
- Presence of one or more yellow (caution) or red (warning) flags.
- diaphoresis (unexplained perspiration)
- night sweats (can occur during the day)
- pallor (paleness)
- dizziness/syncope (fainting)
- weight loss
Physical Therapist Role in Disease Prevention
- Primary Prevention: stopping the process(es) that lead to the development of disease(s), illness(es), and other pathologic health conditions through education, risk-factor reduction, and general health promotion
- Secondary Prevention: early detection of disease(s), illness(es), and other pathologic health conditions through regular screening: this does not prevent the condition but may decrease duration and/or severity of disease and thereby improve the outcome, including improved quality of life
- Tertiary Prevention: providing ways to limit the degree of disability while improving function in patients/clients with chronic and/or irreversible diseases
- Health Promotion and Wellness: providing education and support to help patients/clients make choices that will promote health or improved health. The goal of wellness is to give people greater awareness and control in making choices about their own health.
Elements of Patient/Client Management
- Examination: history, systems review, and tests and measures
- Evaluation: assessment or judgment of the data
- Diagnosis: determined within the scope of practice
- Prognosis: projected outcome
- Intervention: coordination, communication, and documentation of an appropriate treatment plan for the diagnosis based on the previous four elements