I am currently on my cardiopulmonary placement where I came across a young male patient who had pneumonia and required physiotherapy. This normally would have been straight forward by doing ACBT’s plus cough/huff, however this person did not speak very good English. Not speaking English is hard enough when you’re trying to ask the patient for information, but it is even more complicated when you want them to actually do a task.
My main problem for this patient was trying to explain the ACBT procedure with a breath hold at the end. It seemed every time I got them to take a deep breath in, they found it difficult so would just stop! I couldn’t seem to make them understand that they were required to take the ‘biggest’ breath in and hold. After about 5 minutes of demonstrating and trying to explain to the patient, I just tried my best to do the ACBT’s with what the patient had understood.
Questions raised from this treatment session, included; is it benefitting the patient to do a technique slightly incorrect? Or is it more beneficial to find an interpreter or changing your physiotherapy treatment session to something that the patient may understand.
Looking back on my treatment session, I think for this particular patient ambulation whilst deep breathing would of been more beneficial, as it is easier to demonstrate than ACBT’s and the patient is still getting some benefit from it.
IF IN THE SAME SITUATION AGAIN I WOULD STILL TRY TO EXAPLAIN/DEMONSTRATE THE MOST BENEFICIAL TECHNIQUE TO THE PATIENT. IF THAT FAILED I WOULD TRY THE SECOND MOST OPTIMAL TECHNIQUE. IF FAMILY MEMBERS ARE AROUND I WOULD CONSIDER GETTING THEM TO INTERPRET TO THE PATIENT, HOWEVER IN MY SITUATION THERE WAS NO FAMILY AVAILABLE.
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It's frustrating when there's no one around who can interpret.
Maybe a spirometer might have helped...? I know they're not an amazingly effective treatment tool, but maybe that visual feedback of raising two balls rather than one might have worked. Maybe the patient knew there was a discrepancy between your demonstration and their attempt, but presumed that their health status would prevent them from trying to copy properly... in which case taking them for a walk to watch a fellow sick patient do ACBTs (if you had a friendly pt who didn't mind) might show them it's not impossible... if not, they've been up for a walk anyway!
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