1 Patient Centredness Flashcards
Q: Define a patient-centred interview.
A: An early defnition = “understanding the patient as a unique human being” has evolved over the years
into more sophisticated measures.
A PCI is one in which the interviewer identifes, acknowledges and responds to the patient in a way that encourages the patient to participate and ensures that their own agenda becomes part of the consultation process.
Q: List advantages of the patient centred interview to clinicians. (5)
A: • allowing basic medical tasks to be accomplished
• informative, (providing both technical information and
expertise and recommendations for behaviour in a way that is understandable and motivating)
- facilitative, (in that all the patient’s concerns are likely to be established)
- responsive (to the patient’s emotional needs and concerns);
• participatory (so that patients have a responsible and
authentic role in the decision making).
Q: Describe at least two different models of patient-centred consultations.
A:
Q: Identify appropriate communication behaviours used in patient-centred consultations.
A:
Q: Identify attitudes commensurate with patient-centred
interviewing.
A:
Q: What is central concept of clinical communication?
A: patient-centred approach
Q: What is the patient centred approach in contrast with?
A: paternalism, or doctorcentredness, where doctors dominate the agenda setting, goals and decision-making in regard to information and services, where the medical condition is defined in biomedical terms and where the patients’ voice is largely absent.
Q: List advantages of the patient centred interview to patients. (5)
A: In consultations that demonstrate PCI, the clinician:
- Explores the patient’s main reason for the visit, concerns and need for information
- Seeks an integrated understanding of the patient’s world – that is, seeing them as a whole person with emotional needs and facing real life issues
- Finds common ground on what the problem is and mutually agrees on management
- Enhances prevention and health promotion
- Enhances the continuing relationship between the patient and the doctor
Q: What are the key outcomes of Patient Centred Interviewing? (5)
A: • Improve diagnostic efficiency • Increase patient satisfaction • Increase concordance/adherence with treatments • Improve recovery • Reduce the number of symptoms
Q: What is a common misconception in the use of patient centred care?
A: that being patient centred means responding to every whim of the patient, thereby increasing expenses to the health care system
Q: What are the 6 PCI classifications?
A: 1. Allow patients to express their major concerns
- Seek patients’ specific requests
- Elicit patients’ explanations of their illnesses
- Facilitate patients’ expressions of feelings
- Give patients information
- Involve patients in developing a treatment plan
Q: What are the benefits shown with allowing patients to express their major concerns?
A: Patients who were encouraged to express more of their concerns were more satisfied and more likely to comply with treatment.
same patients were more likely to recall what the doctor told them and felt more committed to the doctor’s view of the diagnosis and treatment.
Q: In a study, patient agendas were classed as symptoms, diagnosis theories, illness fears, wanted and unwanted actions, self treatment and emotional and social issues. What were some of the poor outcomes associated with? What do patients need in order for better healthcare to be conducted?
A: unvoiced agenda items.
Patients and their needs must be more fully present in the consultation
Q: Why is separating fact from opinion in consultations important? (not saying “I know exactly what you mean”, but rather “I think I understand what you mean”)
A: a way helps individuals to express themselves whilst respecting it might be different for others
Q: Emotional distress among patients in primary care often goes unrecognised during the consultation. Roter et al (1995) explored the effects of communication training on the process and outcome of care associated with emotional distress in patients. What did this randomised control trial find?
A: that patients reported a reduction in emotional distress up to six months after a consultation with a physician who had received (the intervention)
