Setting Realistic Goals with Pelvic Health patients
Managing Expectations: Setting Realistic Goals with Pelvic Health Patients
As pelvic health physiotherapists, one of our core responsibilities is to guide our patients through their rehabilitation journeys with empathy and understanding. Managing expectations and setting realistic goals are critical components of effective treatment. Let’s explore how to navigate these conversations with patients and ensure they’re in the driver’s seat of their own physio journey.
Understanding Personal Circumstances
Before setting any goals, it’s vital to have an in-depth understanding of your patient’s personal circumstances. This includes their daily routines, responsibilities, physical capabilities, and emotional state. Start by asking open-ended questions like:
“Can you walk me through a typical day for you?”
“What are some challenges you face in finding time for exercises?”
“How are you feeling about your current condition and the treatment plan?”
These questions can help paint a complete picture of the patient’s life, allowing you to tailor the treatment plan to their specific needs and capabilities.
The Importance of Realistic Goals
Setting realistic goals is a cornerstone of successful treatment. Unrealistic expectations can lead to frustration and disengagement, while achievable goals can motivate and encourage patients.
We have all heard about SMART goals - goals that are Specific, Measurable, Achievable, Relevant, and Time-bound. However within this, instead of setting an end-point goal like “perform three sets of pelvic floor exercises daily for four weeks”, start with smaller steps.
Break down larger goals into smaller, manageable steps with shorter time-frames to completion. This approach can prevent patients from feeling overwhelmed and allows for celebrating small victories along the way. Your first goal may be something along the lines of ‘purchase Movicol and bring it to the clinic next week to discuss’.
Conversations About Barriers
Engage in honest conversations about potential barriers to implementing home exercise programs or other strategies. Many patients face obstacles such as time constraints, lack of motivation, carer duties or physical issues. Addressing these barriers upfront is important for you to be aligned with your patients and strengthen the therapeutic alliance so you are both aiming for the same thing.
Example Dialogue
Physio: “I understand you’re very busy with work and taking care of your children. How do you feel about finding time for the exercises we discussed?”
Patient: “It’s tough. I usually don’t get any time for myself until late at night.”
Physio: “That’s completely understandable. Maybe we can reduce the number of exercises, so you can do during the day, perhaps while you are at work, while the kids are napping or even involving them in a fun way etc…? ”
When you decide upon a solution, it can be helpful to run it through the ‘confidence scale’ by asking: “How confident are you that you can implement this program/strategy?” Ask your patient to rate their confidence on a scale of 0-10. This simple question can reveal a lot about their perceived barriers and readiness for change.
Example Dialogue
Physio: “On a scale of 0 to 10, how confident are you that you can do these exercises daily?”
Patient: “I’d say about a 4.”
Physio: “That’s helpful to know. What do you think would help increase your confidence?”
Empowering Patients: The Driver’s Seat
As physiotherapists, our natural inclination is to solve problems for our patients. However, true success in therapy comes when patients take control of their own health. This philosophy aligns closely with insights from our psychologist colleagues, who emphasize the importance of patients being active participants in their therapy.
Tips for Empowering Patients
Education: Provide patients with the knowledge they need to understand their condition and the rationale behind each exercise. This empowerment can enhance their commitment to the treatment plan.
Collaboration: Involve patients in setting their own goals. Ask them what they hope to achieve and work together to establish a realistic plan.
Support: Offer continuous support and check-ins, but resist the urge to micromanage. Encourage self-monitoring and reflection on their progress.
Practical Advice for Managing Expectations
Set Clear Expectations Early: From the first session, communicate what patients can realistically expect from therapy. Be honest about the time and effort required and the potential outcomes.
Regular Reassessment: Frequently revisit and adjust goals as needed. Progress in pelvic health can vary, and being flexible with goals ensures they remain relevant and attainable.
Celebrate Small Wins: Recognize and celebrate even the smallest improvements. This positive reinforcement can boost motivation and keep patients engaged.
Conclusion
Managing expectations and setting realistic goals with pelvic health patients is a delicate balance of empathy, communication, and empowerment. By understanding their personal circumstances, addressing barriers, and ensuring they are actively involved in their treatment, we can help patients achieve meaningful progress. Remember, our role is to guide and support them on their journey, but ultimately, they need to be in the driver’s seat for therapy to truly make a difference.