Physiotherapy in palliative care– - Stockholms sjukhem

When the patient is in a late palliative phase losing bodily functions is to be expected. Thephysiotherapeutic activities in palliative care are often about keeping the functions. Goalschange when worsening occurs. Usual qualitative assessments of physical functions can thenbecome a confirmation of deterioration and will not give the patients feeling of support,security and expectations. (9)Patient Specific Functional Scale (PSFS) is an assessment instrument that grades the ability forthe patient to do important activities. It is important that the patient feels involved in thephysiotherapeutic activities and that it is positive. For physiotherapy in palliative care it isimportant to show the patients the resources they still have left.Visual Analog Scale (VAS) Borg-RPE scale or Borg-CR10 scale can be used when you want tomeasure the patient’s feelings of the symptoms. The intensity can be measured before and afteractivity treatment. For a patient in a late palliative stage of the disease with difficulty to judgetheir symptoms, the scale can be used verbally or ask questions that can be answered with a yesor no.Base of knowledgeAll care and treatment, including the physiotherapeutic, should be built on knowledge andclinical experience. Physiotherapists today strive to work in an evidence based way whichmeans integrating clinical knowledge, the patient’s unique situation and wishes with the bestpossible research evidence.Evidence based care means a systematic and conscious effort to provide care built on the bestavailable scientific evidence. Evidence here means the best available evidence, of effect orvalue of a treatment or other activity. The foundation for evidence based medicine is thesystematic over view of existing research results. The Swedish Council on Health TechnologyAssessment – SBU has the mandate of the Swedish Government to comprehensively assesshealthcare technology from medical, economic, ethical, and social standpointsScientific assessment in health care aims to identify interventions that offer the greatest benefitsfor patients while utilizing resources in the most efficient way. SBU is currently using fourlevels to grade evidence.Physiotherapy in palliative care – a clinical handbook Ulla Frymark, Lilian Hallgren, Ann‐Charlotte Reisberg 11