[libribook.com] Traumatic Scar Tissue Management 1st Edition
Others, however, view self care as work. For them, the regimen mightoccur a continuous struggle. Typically, the clients who are the mostsuccessful in self care are those who adopt and perform recommendedbehaviors until the behaviors evolve into habits (Ekman et al. 2000, vander Wal et al. 2010). Here we can see the importance of assisting theclient with finding selfcare measures that align with theirpreferences/values and ones they can more easily integrate into theirlifestyle.Certain patient-related factors can adversely impair self care, includingpsychosocial status (e.g. depression, anxiety, less social support, lower selfefficacy,less formal education, socioeconomic status), having a higher numberof symptoms, age-related changes (e.g. cognitive and sensory impairments,reduced functioning), lower health literacy and less health system experience (Niet al. 1999, Morrow et al. 2005, Morrow 2007, Dunbar et al. 2008, Moser &Watkins 2008).Those who are unable to make judicious decisions will have a more difficulttime engaging in good selfcare practices. Focused attention and workingmemory capacity are required to perceive and process information prior to theselection and execution of a course of action. Individuals with limited attentionand memory have diminished ability to understand and reflect and thus maystruggle with, or be unable to perform, self care; for example, those with severepsychiatric illness may have difficulty performing independent self care (Riegelet al. 2012).Likely more relevant to traumatic scar clients, situational influences on attentionand memory such as certain medications, sleep deprivation or emotional stresscan interfere with self care. In these situations, some degree of shared care,dependent care or community support may be needed (Lim & Dinges 2008,Naue 2008, Riegel et al. 2012).In addition to support from family, friends, social and support groups, anotherconsideration for improved client engagement in selfcare behaviors includes theuse of mobile technology for access to information or to reinforce anyself/homecare recommendations – technology considerations are covered inmore detail later in this chapter (Bodenheimer 2003, Zwar et al. 2006, Kennedyet al. 2013).
Strategies to Facilitate EngagementHow can we present, phrase or demonstrate a selfcare measure in a way that theclient will embrace it and engage, rather than view or interpret it as ‘one morething’ to add to their already long list of instructions from their healthcareprovider(s)? How can we inspire clients to invest, engage or buy-in? It has beenthe authors’ experience that the therapist’s level of commitment and interest in aclient’s wellbeing serves to inspire his/her own self-caring behaviors.Communication: Encouragement and EmpowermentEncouragement, an effective extrinsic motivator, serves to inspire and bolsterone’s confidence and stimulate engagement. Encourage your clients to takeresponsibility – and credit – for what they feel, learn and apply as a result oftheir work with you. The old adage applies: give someone a fish and they eat fora day, teach them to fish and they eat for a lifetime.Generating client interest in how their body works and how to best care forthemselves can facilitate improved self-sufficiency. Self-sufficiency furtherbolsters confidence and a sense of empowerment, culminating in heightenedengagement in selfcare behaviors.In order to function well, ongoing care may be the reality for some traumaticscar clients. However, self-management, as much as possible, is the ultimategoal, and therefore it is important to establish the MT as facilitator not fixer. Itserves no good purpose for any client to become dependent, as dependencyerodes empowerment.Although the healthcare provider is instrumental in identifying relevant selfcaremeasures, it is equally important to encourage clients to discover for themselveswhat they need to change or do to improve their situation.In terms of client self/home care, as professional guide or facilitator, thetherapist’s responsibility is to provide information or guidance in an objectivemanner. It is the client’s prerogative to make choices based on the informationthat has been provided – the very essence of informed choice.As healthcare professionals, MTs are required to fully inform clients aboutproposed plans so the client can make an informed choice about the course of
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Others, however, view self care as work. For them, the regimen might
occur a continuous struggle. Typically, the clients who are the most
successful in self care are those who adopt and perform recommended
behaviors until the behaviors evolve into habits (Ekman et al. 2000, van
der Wal et al. 2010). Here we can see the importance of assisting the
client with finding selfcare measures that align with their
preferences/values and ones they can more easily integrate into their
lifestyle.
Certain patient-related factors can adversely impair self care, including
psychosocial status (e.g. depression, anxiety, less social support, lower selfefficacy,
less formal education, socioeconomic status), having a higher number
of symptoms, age-related changes (e.g. cognitive and sensory impairments,
reduced functioning), lower health literacy and less health system experience (Ni
et al. 1999, Morrow et al. 2005, Morrow 2007, Dunbar et al. 2008, Moser &
Watkins 2008).
Those who are unable to make judicious decisions will have a more difficult
time engaging in good selfcare practices. Focused attention and working
memory capacity are required to perceive and process information prior to the
selection and execution of a course of action. Individuals with limited attention
and memory have diminished ability to understand and reflect and thus may
struggle with, or be unable to perform, self care; for example, those with severe
psychiatric illness may have difficulty performing independent self care (Riegel
et al. 2012).
Likely more relevant to traumatic scar clients, situational influences on attention
and memory such as certain medications, sleep deprivation or emotional stress
can interfere with self care. In these situations, some degree of shared care,
dependent care or community support may be needed (Lim & Dinges 2008,
Naue 2008, Riegel et al. 2012).
In addition to support from family, friends, social and support groups, another
consideration for improved client engagement in selfcare behaviors includes the
use of mobile technology for access to information or to reinforce any
self/homecare recommendations – technology considerations are covered in
more detail later in this chapter (Bodenheimer 2003, Zwar et al. 2006, Kennedy
et al. 2013).