SCREENING FOR HEALTH,FITNESS AND WELLNESS part 1

2. SCREENING FOR HEALTH,FITNESS
AND WELLNESS

3. • SCREENING
• Screening refers to testing of a person or
group of people for the presence of
disease or pathology.
• It is essentially checking for pathology
when there are no symptoms of disease.

4. • Common screening activities include:
Screening for lifestyle factors leading to
increased risk for serious health
problems(e.g. amount of exercise ,stress
, weight etc)
Screening posture for scoliosis
Identifying high risk factors for
slipping , tripping or falling of older
adults
Performing pre work screenings to
identify risk factors in work place and
health status of potential workers.

5. • EXAMINATION
• Examination means a detailed analysis ,
inspection or study.
• It is a medical examination or clinical
examination by which a medical
professionals investigate the body of a
patient for signs of disease.
• Examination in physical therapy includes :
taking client’s history , performing specific
test , reviewing body systems for potential
pathology , professional judgement etc.

6. • The initial examination of a client
involves screening but also incorporates
specific tests and measures leading to
physical therapy diagnosis or referral to
another practitioner

7. EVALUATION
• It is a process in which a physical
therapist makes clinical judgements
based on data gathered during
examinations.

8. INTERVIEWING THE
CLIENT
• It includes:
Nonverbal communication
Verbal communication

9. NONVERBAL
COMMUNICATION
• It is communication between people
through sending and receiving
wordless clues.
• The interviewer must be a good listener
and have the ability to focus energy ,
attention and thoughts on what
individual is saying.
• Too much energy may be intimidating
and too less energy may suggest
disinterest.

10. • When interviewing a person , the
physical therapist needs to object a
positive demeanor or appearance
because 1st impression is highly
influential.
• Words have 7% impact on interpersonal
communication, Tone of voice has 38%
impact and Body language has 55%
impact message delivery.

11. • Interpersonal communication includes:
Eye contact
Body position
Proper distance
Gestures
Facial expression

12. EYE CONTACT
• It is the most common and
powerful nonverbal
behavior.
• Optimal eye contact:
• it involves looking
directly at the interviewee
when speaking or
listening , it conveys
sincerity and respect for
other person.
•

13. • Direct eye contact: It is not always
culturally appropriate.
• People in Latin America , Africa and
Asia may believe that direct eye contact
is sign of disrespect.
• Prolonged eye contact: it provides the
interviewee a sense of safety .
Uninterrupted eye contact may be too
personal.
• Avoiding eye contact: has negative
implications, may suggest guilt, fear
and dishonesty

14. • Steady eye contact without staring :
indicates interest in the individual and pupil
dilation indicates keen interest.
• Eye shift: indicates that the individual may
be processing or recalling information
• Darting eyes: indicates the person is excited,
worried or wearing eye contact lenses.
• Furrowing of brows: suggest that the
individual is perplexed or trying to avoid the
topic.

15. • Starring with eyes fixed on the object
or lowering the eyes down or away
indicates preoccupation with another
concern or discomfort discussing a
topic.
• Lack of eye contact: indicates
avoidance of interaction , respect ,
discomfort, embarrassment or
preoccupation with another concern

16. Which eye contact??

17. BODY POSITION
• During interview , both interviewer and
interviewee should be comfortably
seated with eyes at the same level and
shoulders squarely facing each other.
• Open body posture: arms relaxed at
both sides is more welcoming posture
• Closed body posture: arms crossed
over the chest is less welcoming.

18. • Stiff posture: indicates tension , anxiety
or concern.
• Steady movements: such as rocking or
squirming may suggest that the person
may be concerned, worried or anxious.
• Leaning forward: indicates eagerness,
attentiveness and openness to
communication.
• Slouched or stooped posture: indicates
sadness, ambivalence or unreception
• Good posture: reflects confidence and
interest of individual.

19. Good Posture

20. DISTANCE
• Distance between physical therapist
and interviewee is another key factor
for interpersonal communication
• Some individual feels comfortable with
physical proximity(one arm’s length)
while others may be offended
• E.g Southern Europeans believe that
touch is acceptable while north
Europeans expect little contact if any.

21. One arm’s length distance

22. GESTURES
• It is used to emphasize important points.
• Lack of gestures : signals anger or lack of
openness
• Gestures such as playing with clothing , hair
or jewelry are distracting
• Cultural differences are needed to be
considered.
• E.g. Taiwanese gesture to indicate “no” is to
lift one’s hand to face level, palm facing
outward, and moving it back and forth

23. Gestures

24. FACIAL EXPRESSION
• Incongruities between facial expression
and verbal expression are not
uncommon and confound interpersonal
communication E.g. if someone says
that he or she is fine but has a tense
expression, more questions should be
asked to elicit additional information.
• Wrinkling the forehead or speaking
with pursed or tight lipped mouth can
indicate tension

25. • Yawning : a sign of boredom or
tiredness
• Rolling the eyes: it is a dismissive
expression that has a negative effect on
communication

26. VERBAL
COMMUNICATION
• It is critical for eliciting responses
needed for medical history and
identification of health risks
• It is helpful to initiate the interview
using open, general questions to elicit
sincere behavior from interviewees
e.g. open ended question and closed
ended question

27. LEARN MODEL
• L:: listen with sympathy and
understanding to the client’s perception
of problem
• E:: explain your perception of problem
• A::acknowledge and discuss the
differences and similarities
• R::recommend a course of action
• N:: negotiate an agreement
• This model can be used to overcome
cultural communication barriers

28. • Throughout the interview , the
interviewer should summarize the
discussion in order to avoid any
misunderstanding
• Projecting professionalism and clinical
competence increases the sense of
assurance during the interview process
• Characteristics of professionalism
includes effective communication ,
professional appearance , respect and
displaying courteous behavior

29. • Academic degrees , clinical specialist
certifications , and professional
membership gives individual more
confidence
• A private area for the interview and
well organized space for screening
process further gives a positive
impression.

30. SCREENING FOR MENTAL
HEALTH
• Mental health problems include
depression , anxiety , fear or rage
• Depression is a psychosocial problem
affecting individual’s health , fitness
and wellness and ultimately their
quality of life
• Depression is more in females (12%)
than men(7%)

31. SCREENING FOR
SUBSTANCE ABUSE
• If alcohol abuse is suspected , several
screening tools available but CAGE
questionnaire is widely used
• C:: cut down on drinking
• A:: annoyance with criticism about drinking
• G:: guilt about drinking
• E:: use of alcohol as am eye opener
• This test takes about 1 minute to complete

32. SCREENING FOR
PHYSICAL ABUSE
• Physical , sexual and verbal abuse are prevalent in
our society for which screening is necessary
• The following 3 questions can be asked during
screening:
 Have u been hit, kicked , punched or hurt by
someone?
 Do u feel safe in current relationship?
 Is there a partner from previous relationship who is
making u feel unsafe now?
• Screening will be positive if the answer to these
question is “yes”.