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EBM Chapter Vocab > Chapter 3 > Flashcards

Chapter 3 Flashcards

1
Q

the study and use of communication strategies to inform and influence individual and community decisions that affect health . It links the fields of communication and health and is increasingly recognized as a necessary element of efforts to improve personal and public health.

A

health communication

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2
Q

what three interaction factors is effective health communication based on?

A
  1. the source
  2. the message
  3. the reciever
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3
Q

what influences the interaction between the information and the receiver regardless of whether it is from print media, broadcast media, websites, schools, community programs, family and friends, or healthcare professionals.

A

the source

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4
Q

T/F The content of the message for effective health communication should be delivered in plain language instead of professional jargon.

A

true

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5
Q

what is the last factor to be considered in effective health communication?

A

the receiver of the message

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6
Q

who recognized the patient center approach was essential to provision of quality health care?

A

Institute of Medicine

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7
Q

focuses on the health care provider as the expert and the interaction with patients revolves around the disease. The patient is expected to comply with the recommendations made by provider.

A

traditional health care model , the biomedical model

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8
Q

the patients role is transformed from a passive observer to an active participant in the decision making process. The goal of this interaction is to build a relationship on trust and respect where treatment and self management procedures are negotiated between the two collaborative parties

A

patient - centered health care

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9
Q

In patient centered health care, the the clinicians role moves from one of being an expert and making decisions for the patient to that of being a ________ and helping the patient make informed decisions.

A

facilitator

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10
Q

a health care professional who employs a patient centered approach values the patients ______ and_______.

A

right to autonomy and self determination

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11
Q

A federal law that mandates patient info privacy and security called the _________.

A

Health Insurance Portability and Accountability Act HIPAA

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12
Q

When was HIPAA enacted?

A

1996

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13
Q

HIPAA governs the disclosure of PHI. What is PHI?

A

privacy and portability of Protected Health Information (PHI)

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14
Q

Th process of care includes what 4 phases?

A
  1. Assessment
  2. planning
  3. implementation
  4. evaluation
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15
Q

when is health communication established? This is when the patients chief complain is explored by the provider. Data are gathered on the patients health status after reviewing history, interviewing the patient, and examination of the body.

A

Assessment phase

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16
Q

What are the two assessment topics that are to be addressed during the assessment phase of care?

A
  1. Patients understanding of the disease or condition

2. Self management procedures

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17
Q

What is the question assessing?

-What do you like or not like about brushing your teeth?

A

Self management procedures

-assessment phase

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18
Q

What is the question assessing?

What type of treatment have you had for cavities?

A

Patients understanding of the disease or condition

-assessment phase

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19
Q

the degree to which individuals have the capacity to obtain, process and understand basic health info and services needed to make appropriate health decisions and is critical to achieving the objectives set forth in Healthy People 2020 and more broadly, key to success of our national health agenda

A

Health literacy

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20
Q

application of number and measurements into daily tasks such as medication dosing

A

numeracy

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21
Q

T/F The lack of sufficient health literacy is a risk factor for positive health outcomes and presents significant barriers to health based on the shame associated with lack of skills.

A

true

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22
Q

T/F A recent systemic review confided an association between low health literacy and inferior use of the health care system (accessing emergency room care instead of preventative care)

A

true

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23
Q

LIkert scale -
0 =
4 -

A 
0 = always
4 = never
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24
Q

What was the best question to ask for determination of health literacy, with no added benefit as a result of asking the other two questions?

A
  1. How often do you find it challenging to fill out health forms by yourself?
    - chew & assocaites
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25
Q

a patient gets a 1 = “often” , what does this mean

A

having marginal health literacy

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26
Q

a patient get a 0 = “always” what does this mean

A

inadequate health literacy

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27
Q

what does the response “sometimes” = 2 mean?

A

some researchers found that at this point is where you define a patient has inadequate health literacy

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28
Q

How did Saker and associates findings differ from that of Chew et al?

A

Both found that question 1 (how often do you find it challenging to fill out health forms by yourself) as the most effective question in determining health literacy, BUT ALL 3 WERE BENEFICIAL

  1. How often do you have problems learning about your health condition because of difficulty understanding written information.
  2. How often do you have someone (such as a family member, friend, caregiver or health care worker) help you read health materials?
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29
Q

Which of the following is a response that indicates inadequate or marginal health literacy to the question “How do you rate your reading ability?”?
Responses:
excellent, very good, good, okay, poor, very poor, or terrible.

A

okay, poor, very poor, and terrible ALL indicate inadequate or marginal health literacy

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30
Q

takes 3 minutes, reading and numeracy skills are evaluated by responses to 6 questions based on reading an ice cream food label

A

Newest Vital Sign instument

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31
Q

Newest vital sign instrument- what indicates a patient exhibits adequate level of health literacy

A

answer at least 4 questions correctly

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32
Q

Newest vital sign instrument - what indicates the possibility of a patient with limited health literacy

A

answer at least 2-3 questions correctly

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33
Q

Newest vital sign instrument - what is a strong indication of a marginal or inadequate health literacy level

A

answering one or none of the questions correctly

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34
Q

REALM-SF =

A

Rapid Estimate of Health Literacy in Medicine - Short Form

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35
Q

an assessment of reading ability that requires the patient to read seven words aloud, when patients do not know the word they reply “blank”

A

REALM-SF

- they are to only read the words they KNOW!

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36
Q

REALM-SF - what indicates a high school reading level?

A

7 correct

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37
Q

REALM-SF - what indicates a 7th - 8th grade reading level?

A

4-6 correct

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38
Q

REALM-SF - what indicates a 4th - 6th grade reading level?

A

1 - 3 correct

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39
Q

REALM-SF - what indicate a 3rd grade level?

A

zero correct

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40
Q

at the _____ level patents will experience difficulty reading most written patient education materials

A

7th to 8th grade reading level

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41
Q

at the _____ level might have problems reading prescription labels and required patient education materials designed for low literacy readers.

A

4th to 6th grade reading level

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42
Q

based on the 66 REALM-Long Form words, however the number of health words is reduced to 50. flash cards with spanish medical term printed on one side and two associated words on the back. The side with the term is shown to the patient, who is asked to correctly pronounce the word. Next the two associated words are spoken by the clinician, and the patient selects the one closest to the meaning.

A

The Short Assessment of Health Literacy for Spanish Adults (SAHLSA-50)

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43
Q

how is the patient scored using the SAHLSA-50

A

one point is received when the patient reads the correct word and pronounces it correctly and identifies the related word

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44
Q

a score of _____ using the SAHLSA-50 suggests adequate health literacy; ____ and less can indicate low health literacy

A

38-50; 37 & less

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45
Q

It is estimated that at almost ____ of the US population experiences at least one chronic disease

A

50%

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46
Q

____ was developed to influence individuals to take action to engage in healthy behaviors. The overall premise of this model is that people who perceive or believe that they are vulnerable to a disease and that their health is threatened will take action to prevent the threat and eliminate their vulnerability.

A

Health belief model

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47
Q

what year was the health belief model developed

A

1950’s

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48
Q

what are the 4 reasons that make patients take action toward healthy behaviors:

A
  1. they think they are susceptible to a health problem (perceived susceptibility)
  2. its serious (perceived severity)
  3. Believe that taking action by engaging in prevention or treatment will reduce the threat of the health problem (perceived benefits)
  4. Believe the benefits of taking action outweigh the barriers (perceived barriers)
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49
Q

What two models are helpful in understanding the stages of change in a patient changing to healthy behaviors? AND what do they promote?

A
  1. transtheoretical model
  2. the precaution adoption process model
    * They both PROMOTE the idea of chance as a PROCESS, not a SINGLE EVENT, depending on the patients readiness to change
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50
Q

patient is not willing or ready to change behavior within the next 6 months is what stage of the transtheoretical model?

A

precontemplation

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51
Q

patient is considering action to change behavior in the next 6 months is what stage of the transtheoretical model?

A

contemplation

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52
Q

patient is preparing for the change within the next month, and is partially engaged in changing the behavior is what stage of the transtheoretical model?

A

preparation

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53
Q

patient is actively engaged in changing the behavior in less than 6 months is what stage of the transtheoretical model?

A

action

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54
Q

patient has sustained the behavior change for more than 6 months is what stage of the transtheoretical model?

A

maintenance

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55
Q

the precaution adoption process model differs from the transtheoretical model.
What is the first stage?

A

first stage is when the patient is unaware of a health issue

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56
Q

what is the second stage of the precaution adoption process model?

A

when he or she gains awareness but is NOT engaged to change

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57
Q

What is the 3rd stage of the precaution adoption process model?

A

characterized by the patient realizing that he or she has a decision to make as to whether to take action

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58
Q

stages _____ result when the patient has made a decision as to whether or not to take action int he precaution adoption process.

A

4 & 5

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59
Q

what is the stage 4 of the precaution adoption process model?

A

decision not to take action

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60
Q

what is stage 5 of the precaution adoption process model

A

decision to take action

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61
Q

stages ____ and ____ are similar to those of the transtheoretical model.

A 
stage 6 (acting)
stage 7( maintenance)
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62
Q

identify the stage of change-

are you aware that you have an infection in your gums resulting in redness and bleeding?

A

unaware of health issue

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63
Q

are you interested in learning how to reduce the infection and prevent it from coming back?

A

unengaged by the health issue

64
Q

are you interested in flossing your teeth once a day?

A

contemplation

65
Q

have you decided to floss your teeth once a day in the near future?

A

decision to act

66
Q

are you flossing several times a week?

A

action

67
Q

are you consistently flossing on a daily basis?

A

maintenance

68
Q

provides a visual means for patients to a sees their willingness to change their behaviors and an opportunity for the clinician to actively engage the patient in the change process; a visual analog scale that ranges from 0 to 10

A

readiness ruler

69
Q

on a readiness ruler what does the higher number mean?

A

the higher the number the patient selects, the more willing he or she is to make a change

70
Q

readiness ruler -

never think about it

A

0-1

71
Q

rr - sometimes think about it

A

2-3

72
Q

rr - i have decided to eliminate an unhealthy behavior or engage in a healthy behavior

A

4-6

73
Q

rr - i am already eliminating an unhealthy behavior or engaging in a healthy behavior

A

7-8

74
Q

rr - m behavior has chained to eliminate an unhealthy behavior or engage in a healthy behavior

A

9-10

75
Q

using the readiness ruler, how does a clinician learn about the motivation for behavioral change?

A

asking questions to why the patient did not place the mark farther to the left side

76
Q

using the readiness ruler, how does a clinician elicit barriers to behavioral changes?

A

finding out the reasons why the patient did not mark the ruler further to the right

77
Q

in what patient centered communication strategy is the patient asked for suggestions to overcome the perceived barriers and implement concrete actions for changing behaviors.

A

readiness ruler and the series of questions

78
Q

beliefs about _______ determine an individuals confidence in his or her ability to make a behavioral change by taking action and overcoming barriers.

A

self efficacy

79
Q

Self efficacy is one of the behavioral factors of the ______ theory; it proposes that behavioral factors; cognitive factors (knowledge, expectations, and attitudes); and environmental factors including social norms and interactions with other individuals, determine human behaviors

A

social cognitive theory

80
Q

when should you ask questions to make the patient aware and believe that he or she is susceptible to a health problem

A

patient is not aware that he or she has a health problem or potential health problem (unaware of health issue)

81
Q

what patient should you ask questions to make the patient believe that the health problem is serious; discuss the benefits of taking action to change heath behaviors and the risks of not changing

A

patient is not willing or ready to change behavior within the next six months (unengaged in the issue)

82
Q
  • guide patient to understand that the benefits of taking action outweigh the barriers
  • provide positive feedback on the patients willingness to consider a behavioral change
  • educate the patient on alternatives to change (various tobacco cessation products)
  • encourage and motivate the patient to make an action plan
A

patient is considering action to change behavior in the next 6 months (contemplation)

83
Q
  • provide positive feedback on the patients attempts to make changes to support development of self-efficacy
  • assist patient in making an action plan consists of goals, actions (using small - step approach), and target dates
A

patient is preparing for the change within the next month and is partially engaged in changing (decision to act)

84
Q
  • provide positive feedback on engaging in health behaviors to support self efficacy
  • provide an opportunity for the patient to revise the action plan (actions and target dates)
  • suggest additional strategies to maintain momentum of change (social support, reminders on sticky notes)
A

action - patient is actively engaged in changing behavior in less than 6 months

85
Q
  • provide positive feedback not eh behavior change and completing the action plan
  • suggest additional strategies to sustain the change
  • in case of a relapse, the patient develops a new action plan
A

maintenance - patient has sustained the behavior change for more than 6 months

86
Q

requires healthcare providers to use their knowledge of current practice standards. When prodders are unsure of how to proceed, the evidence based process is followed to determine th emost effective care in order to make the best recommendations to the patient

A

planning phase of the patient care

87
Q

what is the goal of the planning phase of patient care

A

patient and provider to be partners and negotiate self management behaviors as well s the type of treatment and length of care and evaluation decisions
**here negotiation is paramount

88
Q

A healthcare provider needs to develop a comprehensive treatment care plan that includes what?

A
  1. self management strategies to decrease disease and conditions and strategies to monitor, maintain, or improve health
  2. diagnostic tests
  3. teratment - interventions , services and alternative care
  4. length of care - # of visits, length of visits, time between visits
  5. evaluation of care
  6. estimated cost for all aspects of care
89
Q

once the care plan is developed, the clinician presents the case and begins ________. explaining existing conditions related to the patients chief complaint however it is an ethical responsibility to educate the patient on ALL findings from the assessment

A

informed consent

90
Q

the next part of the informed consent is ______. procedures focus on monitors an existing disease (diabetic patients testing their blood glucose levels), taking medications and other interventions to maintain or improve a disease or condition (dietary considerations and exercise for pre diabetic patients), and managing the emotions that accompany the illness

A

self management

91
Q

small changes are preferred over multiple behavioral modification to help establish patients ______ or their belief theta they are able to make change

A

self efficacy

***target date : patient action plan using a small step approach

92
Q

what is the next aspect of the informed consent process after self management

A

to present to the patient the recommend treatment plan as well as alternative interventions and the consequences of not receiving care

  • # of appointments & follow up care explained
  • the recommended services and their purposes are explained
  • prognosis, potential benefits, potential risks, and consequences of nonintervention
  • estimated cost
93
Q

what is most important during presenting the recommend treatment plan during the informed consent process?

A

most important is giving patients the opportunity to ask questions.

94
Q

T/F Infomed consent is best when the patients signature is written next to his or her decisions for treatment or nonintervention. Note that the patients reasons for declining care should also be documented

A

true

95
Q

T/F on an informed consent form there an be near the bottom an opportunity to rate the clinician on various aspects of his or her clinician. Or you can develop a form to have this done separately using CATs or PubMed database or Google.

A

true

96
Q

encompasses the actions of the clinician and patient take to maintain or improve health. be honest. explain all procedures. When a procedure has the potential to be uncomfortable convey to the patient that you want to know when she is experiencing pain in order for you to minimize that experience

A

implementation phase of care

97
Q

a set of congruent behaviors, attitudes, and policies tha tome together in a system, agency, or amount professionals that enables effective work in cross-cultural situations -

A

defined by Office of Minority Heath - the way healthcare professionals to recieve education in culturally and linguistically competent care

98
Q

What is CLAS

A

National Standards for Culurally and Linguistically Appropriate Services

99
Q

standards 1-3 of CLAS address what?

A

culturally competent care

100
Q

standards 4 -7 of CLAS address what?

A

mandates for language access services for healthcare organizations receiving federal funds

101
Q

standards 8-14 of CLAS address what?

A

the structure and policy of the healthcare organization to support the previous seven standards

102
Q

during implementation phase of care, patient education is important , ____ of the information will be retained. therefore supporting material during the explanation will increase retention to ____.

A

20%; 30%

103
Q

patient provider communication is enhanced when the practitioner is stationed at ____ level as patient.

A

eye

104
Q

Active listening should be followed by phrases such as “what i hear you saying is”… “let me see if i understand what you are saying” . This is an example of _______.

A

summarizing

105
Q

What are the 3 steps to a useful strategy for educating the patient?

A
  1. tell the patient what you are going to tell them (orients and prepares the patient for what he or she is going to hear)
  2. tell them
  3. summarize what you told them (reinforces the info presented during the second step)
106
Q

used to verify the patients understanding of self management procedures; the patient is asked to teach the procedure back to the practitioner by demonstrating the use of equipment or explaining medication dosing

A

teach back method

107
Q

what are the 4 questions in the text that should be addressed when the patient is using the teach back method to verify their understanding of the self management procedure.

A
  1. what is it
  2. why do i use it
  3. how do i do it
  4. when do i do it
108
Q

T/F there are many factors that influence the patients adherence to self management procedures such as physical, emotional, comprehension ability, and remembering.

A

true

109
Q

at the end of the appointment ______ needs to be discussed as outlined on the treatment plan.

A

follow up care

110
Q

during this phase of care the healthcare provider communicates with the patient to determine his or her progress with the intervention and uses subjective info and objective info to measure outcomes based on tests.

A

evaluation phase - the intervention is evaluated at the next appointment or after a series of appointments

111
Q

T/F The patients successes need to be celebrated, the failures should not be emphasized.

A

true

112
Q

T/F When selecting patient education materials plain language should be used, abbreviations and acronyms are commonly used today are will be easier for the patient to read.

A

FALSE!!!!!

plain language should be used BUT NO ABBREVIATIONS OR ACRONYMNS ARE USED

113
Q

T/F When selecting patient education material, the wording should be in plain language and should be positive rather than negative.

A

true

114
Q

T/F When selecting patient education material, it is important that the literacy level is appropriate for the patients level, which should be determined by the clinician during the planning process of care.

A

FALSE! assessment process of care

115
Q

What level is used of ready to read materials used for patient education materials?

A

4th -6th grade level

116
Q

When selecting patient education material, it is important that the content be “specific” for the target population. What are the 5 specificities the material should include?

A
  1. age
  2. gender
  3. role (parent, caregiver, etc)
  4. culture
  5. language
117
Q

sponsored by the National Library of Medicine and the Institutes of Health (NIH).

A

Medline Plus

118
Q

What is the first, second, and third tabs on Medline Plus homepage?

A

Health Topic, Drugs and Supplements, Videos and Cool Tools

119
Q

how are health topics organized on MedlinePlus website?

A

organized by the name of the disease or condition

120
Q

What would a patient find if they selected the second tab, Drugs and Supplements, tab on MedlinePlus website?

A

information about prescription and over the counter medications, herbal therapies, and dietary supplements

121
Q

T/F MedlinePlus has materials in languages other than English and also has easy to read materials for low health literacy patents. It also contains a link to a medical dictionary.

A

true

122
Q

sponsored by National Health Information Center: a searchable database of health topics and also provides access to other databases that consumers can use to locate physicians and other providers and healthcare centers

A

Healthfinder.gov

123
Q

T/F Heathfinder.gov features self-management tools like health calculators, online checkups to determine the risk for certain diseases, planners for physical activity, and menus.

A

true

124
Q

a relatively new website for consumers to access summaries on clinical effectiveness research published in systematic reviews; maintained by National Center for Biotechnology Information Systematic Reviews

A

PubMed Health

125
Q

T/F PubMed Health is better suited to patients with a high level of health literacy

A

true

126
Q

tools, usually electronic, that are useful to the practitioner while treating a patient. These products contain synthesized evidence similar to the Cochrane Library.

A

point of care products (or resources)

  • UpToDate
  • MD Consult
127
Q

T/F UpToDate requires a subscription to have access.

A

FALSE- patient education materials available without a subscription

128
Q

T/F The “basics” educational material are written at a lower health literacy level than the “beyond the basics” materials.

A

true

129
Q

On the UpToDate website the patient homepage is a search bod where a word or phrase can be entered to locate relevant information on diseases, conditions, tests, diagnosis and self management, symptoms, interventions, and medications. What must u do to search?

A

use quotation marks around a phrase

130
Q

point of care product - with free access to patient education materials. 4 tabs.al materials can be customized with information from the healthcare provider.

A

MD Consult

131
Q

what are the tabs on MD Consult

A
  1. 1st tab = searchable database for diseases, conditions, and interventions
  2. 2nd tab = database for medications; it can be searched by drug classification as well as by generic or brand names
  3. 3rd tab = information by medical specialty
  4. 4th tab = patient educaiotn materials in spanish
132
Q

Two point care products that require a subscription to access patient education materials

A

PERC = Patient Education Reference Center

& Essential Evidence Plus

133
Q

point care product that has materials in 15 languages besides english

A

PERC

134
Q

this can be searched by disease or condition or symptoms, such as back pain or headache. the info provided for diseases and conditions relates to an explanation of the disease or condition, tests and diagnosis, interventions, medications, a glossary, and resources.

A

Pri-Med Patient Education Center

*Harvard Med School in partnership with Medical Group Management Association and Pri-Med Point of Care

135
Q

T/F Interactive tools to enhance learning in the form of quizzes, games, and risk assessment calculators are available on Pri-Med Patient Education Center.

A

true

136
Q

website that is a great source of ufo and fun activities related to the health of children, teens, and parents

A

KidsHealth

137
Q

what does the process to assist with the development of a resource that will meet patients needs?

A

assessment, planning, pilot testing, evaluation, and improvement

138
Q

during this phase of creating patient education media, the target population is assessed to learn about its literacy levels, cultural aspects of health, specific health needs, and the type of media used most often.

A

first step, assessment

139
Q

if you cannot survey or interview patients, or talk to a health care professional to complete the assessment phase of creating patient education media, what could you do?

A

consult the Centers for Disease Control and Prevention website named “Audience Insights”
- resources are provided on how to design educational materials that communicate more effectively with populations such as moms with children at home, tweens, teens, boomers, and Hispanics

140
Q

during the second step of creating patient education media: planning involves deciding on desired objectives. What are the 3 types?

A
  1. Conginitive objectives ( change in knowledge)
  2. affective objectives (changes in attitudes)
  3. psychomotor ( changes to motor skills)
141
Q

After the 3 objectives have been decided on, the practitioner must use an evidence based approach to planning the content of the resource. How can you do this?

A

outline

142
Q

Once the outline of the media is done, what is next?

A

reviewed by a web designer or information technologist for feedback

143
Q

the third step of creating pt education media , ______ which involves testing the resource with members of the target population. It can be done through the use of surveys or a focus group after the sample audience has read or viewed the materials.

A

pilot testing

144
Q

what are the 5 key points of the questions that should be included in the survey or focus group?

A
  1. was objective 1 met? *list each objective separately
  2. was info easy to understand
  3. were there words u did not understand
  4. were the visual aids easy to understand
  5. what can we do to make this info better
145
Q

when does the evaluation step begin in the process of creating patient education media.

A

when he practitioner carefully scrutinizes the feedback from the pilot testing and plans changes to the resource. The final step is to make improvements to the draft and create the final version

146
Q

the use of technology to communicate info to improve health and health serves. examples include: online health info, online self management tools, online support groups, online communication with health care professionals, and online access to health records.

A

E-health

147
Q

what are the benefits to consumers and their support people by using E-health.

A

management of chronic diseases, access to info to make informed decisions about their health, and improved communication with healthcare providers and organizations

148
Q

to gain attention to this national initiative, to motivate individuals and organizations into action and to create partnerships to increase access to e-resources

A

vision for e-health

149
Q

what are the two publications by the CDC that are useful for healthcare providers who are interested in sussing media for health messages

A

The health communicators social media toolkit

& CDC’s Guide to Writing for Social Media

150
Q

can be scanned by an iPhone; health promotion app

A

Quick Response Codes (QR)

151
Q

articulate the framework for promoting health at the personal, family, and community keels for students in pre-k, elementary school, and high school.

A

National Health Education Standards (NHES)

152
Q

what are the eight standards of the NHES divided into? the age groups

A

prek - 2nd grade
3rd-5
6-8
high schol

153
Q

T/F The NIH modules consist of 6 lessons to be presented over a 2-3 week period

A

true

154
Q

The NIH modules instructional design follows the ______.

A

5E model

Engage, Explore, Explain, Elaborate, and Evalulate

155
Q

T/F The CDC do NOT recommend a single presentation in one grade level as an effective means to promote healthy behavior.

A

true

- a school district should develop a health curriculum form elementary school through high school

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