Adherence/Non-Adherence; Bias/Implicit Bias & Social determinants Flashcards
The degree to which the use of a medication/treatment corresponds to the prescribed regimen
adherence in the context of medical care
Degree to which a patient does not follow a prescribed medical treatment/regimen
Can be intentional or nonintentional
non-adherence
non-adherence is preferred over the term:
why?
non-compliant
has a less judgmental tone
patient related factors for non-adherence
demographic factors
mental health/social support
disease factors
ethnicity, cultural, religious beliefs
education/ literacy level
socioeconomic status
health literacy
what are some demographic factors for non-adherence
Age, ethnicity/cultural beliefs, education, socioeconomic status, health literacy, language barrier
what are some mental health reasons for non-adherence
Untreated anxiety/mood disorders/addiction/personality disorders; cognitive difficulties (dementia)
what are some socioeconomic factors for non-adherence
patients do not have transportation/have to take bus(es) to get to an appointment; ability to take time off of work to go to an appointment
therapy related factors of non-adherence
Health Literacy
Route/Frequency of [medication] administration
Treatment complexity/Duration
Side Effects
Degree of behavior change required- do they think it is important???
Healthcare Provider/Health System Related Factors of non-adherence
Provider or Ancillary Staff/Patient rapport
Long waiting times
Accessibility of the building
the challenges of adherence
Chronic Conditions
Multiple Chronic Conditions
Risk of Mental Health Conditions (anxiety/depression) increases with each added chronic condition
Consists of attitudes and beliefs we have about a person or group of people
Can be negative or positive; not accurate
Examples: Racial or ethnic;
explicit bias
the behavior (not hiring women because they may want to start a family/get pregnant/not be available to work; unfair treatment to someone based on race/ethnicity/sexual and gender minority status/
discrimination
Attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner.
implicit bias
key factors of implicit bias
We ALL have them
They do not necessarily align with our declared beliefs
Implicit and explicit biases are related but different constructs
We generally tend to hold implicit biases that favor our own ingroup
The GOOD NEWS: Implicit bias is malleable
non-profit collaboration between international researchers interested in implicit social cognition –our thoughts outside our conscious awareness and control.
project implicit
what are actions to decrease implicit bias
Take you time!!! Feeling stressed or pressured can cause us to make decisions that are not necessarily how we truly want to act (auto drive)
See others as individuals rather than members of a certain gender, race, religion, or ethnic group.
Put yourself in their shoes – or position; this can help to develop empathy
Look for evidence against stereotypes –
Educate yourself – learn more about whatever group of people (race, culture/ethnicity, those with addictions)
KNOW this is a lifelong growth process!!!
social determinants of health for economic stability
employment
income
debt
medicals bills
support
social determinants of health for neighborhood and physical environment
housing
transportation
safety
parks
playgrounds
walkability
zip code/geography
social determinants of health for education
literacy
language
early childhood education
vocational training
higher education
social determinants of health for food
hunger
access to healthy options
social determinants of health for community and social context
social integration
support systems
community engagement
discrimination
stress
social determinants of health for the health care system
health coverage
provider availability
provider linguistic and cultural competency
quality of care
health outcomes from social determinants of health
mortality
morbidity
life expectancy
health care expenditures
health status
functional limitations
Everyone receives the same opportunities for health
equality
Recognizes different individual circumstances and provides the resources (e.g. and removes barriers) for each person to achieve their level of optimal health
equity
describes avoidable gaps in health outcomes; barriers that prevent individuals and populations from attaining maximum health
health inequity
how is health equity achieved
when everyone has a fair opportunity to attain their full health potential
health disparity exists when:
a health outcome is seen to a greater or lesser extent between populations.”** …and it is preventable.
Poverty and lack of access to resources are important risk factors for infant death and help to explain the differences seen among racial groups with a higher percentage living in poverty
health disparities
examples of health disparities
Chemical Plant Map
Household Income Map
Census tract life expectancy
Crime Map
nursing implications for SDOH
Social Justice and Advocacy
participation on committees, boards, and professional organizations
Know your resources
Ask the hard questions
Use The Nursing Process to provide the framework for integrating SDOH into patient care
Collaborative Practice
Be an active member of the interdisciplinary team
