Chapter 10 Flashcards
1
Q
how have hospitals evolved over time?
A
Started as places to house all less-fortunate members of society, then began to become medically specialized, then developed a positive reputation and attracted patients from all social classes -> now admit millions of people per year and perform a wide variety of functions
2
Q
organizational structure of hospitals
A
- Board of trustees
- Administrators (take care of day-to-day business)
- Medical staff:
- Medical Director/Chief of Staff
- Attending physicians
- Residents (recent med school graduates)
- Nurses
- Allied workers (ex. Physical therapists, lab technicians)
- Orderlies
3
Q
2 roles of hospitals
A
- Coordinating patient care: caring for someone often involves wide array of personnel with different specialties
- Health Hazards: protecting patients and staff from excessive exposure to chemicals, ensuring correct patient and body part is receiving surgery, reducing exposure to disease (ex. Nosocomial infection, contracted while in hospital)
4
Q
the impact of the “bottom line” of hospitals
A
- Hiring too few nurses -> impacts quality of care
- Designed to treat people quickly (acute care)
5
Q
factors that influence relations with hospital staff
A
- Psychosocial issues of patients: anxiety & worry (often stemming from lack of information); depersonalization (not treating patient like a person)
- Burnout among healthcare professionals: Burnout (psychosocial and physical exhaustion resulting from chronic exposure to high levels of stress and little personal control) is very high in healthcare professions (can be reduced though mixing up tasks and support groups)
6
Q
sick-role behaviour (good vs. bad patients)
A
- Physicians say “Good patients” are passive, cooperative, uncomplaining, and stoic
- “Problem patients” are uncooperative, emotional, dependent, etc., often because they’re seriously ill
- Problem patients who are not seriously ill may be engaging in reactance (angry responses when they feel controlled)
7
Q
types of coping processes in hospital patients
A
- Problem-focused coping: patient asking for medication to reduce pain, reading info about health problem, etc.
- Emotion-focused coping: patients who believe they can do nothing to change a stressor usually rely on this coping method (ex. Denial, seeking social support, etc.)
- Cognitive processes:
- Attributing blame (blaming self or others leads to poor adjustment)
- Assessing personal control (learned helplessness)
8
Q
3 ways to help patients cope
A
- People hear and understand messages while anaesthetized, even if they can’t remember them -> hospital staff should remain positive and give constructive suggestions to patients during surgery
- Providing hospitalized patients with psychological counselling
- Sharing a room with someone who is recovering from a similar procedure
9
Q
psychological preparation for surgical and non-surgical procedures
A
- enhancing patients’ sense of control
- Behavioural control: being able to reduce discomfort during or after procedure (ie. Breathing exercises)
- Cognitive control: focusing on benefits of procedure, not its unpleasant aspects
- Informational control: gaining knowledge about events and/or sensations to expect during or after the procedure
- If there’s no way for patient to behaviourally control their experiences, information and cognitive control are especially helpful
10
Q
coping styles and preparation for treatment
A
- Some patients use avoidance strategies (denial), some use attention strategies (seeking detailed info about situation)
- Some people who use avoidance strategies actually do better in certain situations (ex. Blood donation)
- Preparation for medical procedures is most effective when its content is matched to the coping needs of the person (ie. If you’re an avoider, it’s better for you not to get much info)
11
Q
hospitalization in childhood
A
- Early years:
- Immobilization in hospitals can be very stressful
- Separation distress: caused by being away from parents in unfamiliar setting -> can have long-lasting effects post-hospital stay (ie. Child becomes clingy and dependent)
- School age:
- Typically are better able to cope with some aspects of hospitalization
- 4 aspects of hospitalization become difficult for kids as they get older:
- – Reduced personal control
- – Increased cognitive abilities allow for more worrying
- – Feeling lonely and worrying about status in friend groups
- – More embarrassed by exposing bodies to hospital staff
12
Q
how to help children cope with hospitalization
A
- Prepare them beforehand:
- Explain why they’re there, let child ask questions, read book about hospital, explain routines, be calm and confident
- At least one parent should remain with child when admitted until they’re settled into the room
- Leaflets, presentations, and hospital tours
- Using puppets to demonstrate medical procedures
- Training in coping skills and relaxation
- Video/film presentation about their procedure (ex. “Ethan Has an Operation”)
13
Q
effectiveness of informational strategies for kids vary based on
A
- Age: children younger than 7 profit from info presented shortly before the procedure, older children prefer info presented days before
- Experience: info is likely to make kids more anxious if they’ve had difficult experiences with procedures before
- Coping: less benefit for kids who use avoidance strategies
14
Q
3 psychological characteristics of burnout
A
- Emotional exhaustion: feeling drained of emotional resources and unable to help others on a psychological level
- Depersonalization: lack of personal regard for others; treating people like objects, having little concern for their needs, and developing callous attitudes towards them
- Perceived inadequacy of professional accomplishment: feeling low in self-efficacy and falling short of personal expectations for work performance
