Claustrophobia

On a musculoskeletal outpatient placement I was treating a lovely 70 year old man for his final review session before discharging him to community physiotherapy. It was my first time meeting the pt who was 4 months post NOF#. I showed the pt to a cubicle and closed all the curtains and gestured to have a seat. After a minute of talking to the patient about how he’d been since his last physio session he told me he was feeling a little claustrophobic.

I rearranged the curtains so that we were taking up 2 cubicles (lucky no one was using the cubicle next door).He felt a little better. The pt began to say how he’d been getting claustrophobic recently and has to go outdoors. I asked him if he got SOB, of whether it occurred after a cigarette, the answer was no. We talked about the claustrophobia for a minute trying to work out possible causes and then continued on with the session.

Just as I was about to start an objective on the pt he told me he still was claustrophobic. So we decided together to open up some of the curtains so he could see outside the cubicles. Once again he continued to be claustrophobic so we moved to a different cubicle that was right next to an exit door. I opened the door, opened all the curtains and had him facing so he could see the glass door and outside, with the wind coming in, as well as seeing the openness of the room inside. The patient felt much much better!!!I was relieved something had finally worked so he could feel relaxed and not panic. At the end of the session I recommended he speak to his doctor regarding the claustrophobia.The patient agreed.

I have learnt that it is never a waste of time making a pt feel comfortable and relaxed as it will ultimately influence their treatment sessions, concentration, ability to relax and enjoyment of coming to physio.

This scenario has shown me the need to think on the spot and be somewhat flexible when dealing with clients. It also illustrates the need to think about the pt as a whole and to expect the unexpected. The situation highlighted to me that not all pts feel they need privacy (by closing curtains) and are happy to have their treatment sessions in the ‘open’. If a similar situation came up with a claustrophobic pt I would ask them how they would prefer to have the environment set up and accommodate accordingly.