Chapter 4

Question 1

What are the 3 basic models of patient-physician relationship described by Szasz and Hollender?

Answer 1

• active-passive
• guidance-cooperation
• mutual-participation

Question 2

What are the five distinct communication patterns used in physician-patient relationships?

Answer 2

• narrowly biomedical
• expanded biomedical
• biopsychosocial
• psychosocial
• consumerist

Question 3

The ____-______ ___ model highlights the need to integrate the conventional understanding of disease with each patient’s unique experience of illness. It is considered a total-person approach to patient-problems.

Answer 3

patient-centered care model

Question 4

The patient-centered care mode has 6 interconnected components, which are:

Answer 4

1. Explore both the disease and the illness experience
   (4 key dimensions- )
2. Understanding the whole person
3. Finding common ground (priorities, goals and roles)
4. Incorporated prevention and health promotion
5. Enhancing the patient-physician relationship
6. Being realistic

Question 5

The patient-centered model focuses on four key dimensions of patients’ illness experience, they are:

Answer 5

1. what the patient believes is wrong with them
2. their feelings about being ill
3. impact of illness on their daily functioning
4. how they believe the physician should proceed

Question 6

A situation in which a patient is unable to participate or make decisions regarding their own health is known as the ______-_______ model of physician-patient interaction.

Answer 6

active-passive model

Question 7

A situation where the patient is seeking advice and answering the questions that the physician asks, while the physician is responsible for determining diagnosis and treatment, is indicative of the _______-_______ model of physician-patient interaction.

Answer 7

guidance-cooperation model

Question 8

The ______–________ model is a patient-physician relationship model that describes when the physician and patient make joint decisions about every aspect of care.

Answer 8

mutual-participation model

Question 9

There are 5 distinct communication patterns. The ________ pattern describes the patients seeking consultation from a physician. This pattern is preferred by physicians.

Answer 9

Consumerist pattern

Question 10

There are 5 distinct communication patterns. A balanced blend of biomedical and psychosocial communication between a patient and physician is known as the ______ pattern.

Answer 10

Biopsychosocial pattern

Question 11

There are 5 distinct communication patterns. Complete doctor talk, known as biomedical talk in conjunction with closed-ended questions is known as the ________ _______ pattern of communication between physicians and patients.

Answer 11

Narrowly biomedical pattern

Question 12

The ________ biomedical communication pattern is similar to the narrowly biomedical pattern, but with added emphasis on biopsychosocial elements.

Answer 12

Expanded biomedical

Question 13

The _______ communication pattern between physicians and patients is largely a biopsychosocial approach, with minimal biomedical communication.

Answer 13

collaborative (psychosocial) communication pattern

Question 14

When a physician matches a patients vocabulary, it is known as ___-________ communication.

Answer 14

non-discrepant

Question 15

When a physician explains biomedical issues using jargon, followed by layman explanations that the patient can understand, is known as __________ explanations.

Answer 15

multilevel explanations

Question 16

Failure to follow advice of a health professional is known as patient ___-________.

Answer 16

non-adherence

Question 17

There are seven methods to assess adherence. Name a few.

Answer 17

• Patients asks health professional
• Physician asks patient
• Patient asks other people, friends, family
• Physician monitors patient non-attendance
• Patient can count pills
• Patient/Physician can watch for treatment non-response
• Examine biochemical evidence (blood, saliva, etc)

Question 18

What are some reasons that a patient would report that they did not talk to their physician about their specific doubts or questions?

Answer 18

• It was not up to them to ask questions to express doubts, or behave as if their view was important (36%)
• Afraid of being less well thought of by the doctor (22%)
• Frightened of a negative reaction from the doctor (14%)
• Felt too flustered or hurried to coherently ask (27%)
• Doubted the doctor could tell them more right there (22%)
• Forgot, or were waiting until next time to ask (36%)
• Feared the truth (9%)

Question 19

Poor communication between physicians and patients is ( + / - ) correlated with patient adherence to treatment regimens.

Answer 19

negatively

Question 20

the degree to which patients carry out behaviors and treatments that physicians and other health professionals recommend, is known as _________.

Answer 20

adherence

Question 21

the failure to follow the advice of a health professional is known as ___-_________.

Answer 21

non-adherence

Question 22

when a patient intentionally modifies or supplements a recommend treatment regimen, it is known as ______ ____-________.

Answer 22

creative non-adherence

Question 23

Adherence can either increase or decrease with ____, depending on the specific illness, the timeframe, and the treatment regimen prescribed.

Answer 23

age

Question 24

Patient adherence improves as confidence in their physician’s ______ increases.

Answer 24

competence

Question 25

Improving patient adherence includes 3 strategies, they are:

Answer 25

educational strategies, behavioral strategies and social/emotional support.

Question 26

Providing prompts and reminders to increase patient motivation to adhere to their treatment regimen is an example of a ___________ strategy

Answer 26

behavioral strategy

Question 27

Reading information from a pamphlet to help one adhere to their treatment regimen is known as an __________ strategy.

Answer 27

educational strategy

Question 28

__________ contracting is when a patient and health professional negotiate a series of treatment activites and goals as well as rewards based on the patient fulfilling the activities.

Answer 28

Contingency contracting

Question 29

______ and ________ support can provide much-needed motivation for patient adherence, particularly when the regimen is long term or requires lifestyle changes.

Answer 29

Social and emotional support

Question 30

Poor physician-patient communication; complexity and duration of a regimen; age, gender, cultural background of the patient; and affective characteristics of the physician, are factors associated with ___-________.

Answer 30

non-adherence

Question 31

What are some Health-Related resources available on the Internet?

Answer 31

• medical articles and reports
• medical services
• health initiatives and health promotion
• surveys
• support

Question 32

Principles used to assess quality in Health-Related Websites include : (8 principles)

Answer 32

1. Authority - advice from medically trained
2. Complementarity - support not replace Dr. relationship
3. Confidentiality - confidential data?
4. Attribution - sources of data, claims provided
5. Justifiability - claims have balanced evidence
6. Transparency of Authorship - contact addresses provided?
7. Transparency of Sponsorship - organizations contributing funding are identified
8. Honesty in advertising - advertising policy described? available?

Question 33

Sources of patient dissatisfaction with physician-patient interactions are:

Answer 33

• physicians not being prepared for the consultation
• physicians rushing the consultation
• physicians underestimating the seriousness of the reported symptoms

Question 34

Withholding/falsifying information, not seeking the needed information during a consultation, and forgetting what was told, are 3 behaviors of _________ that contribute to faulty communication.

Answer 34

patient

Question 35

Convenience and increased options for patients are 2 potential benefits of ______ as a means of physician-patient communication.

Answer 35

email

Question 36

4 potential issues of using email as a means of physician-patient communication are:

Answer 36

• confidentiality
• quality of communication
• cost (of secure servers) and workload concerns
• email guidelines are lacking in clarity and specificity

Question 37

________ physicians spend more time with patients, ask more questions, engage in more psychosocial communications than the opposite gender of physicians.

Answer 37

Female

Question 38

Patients preferring same-sex physicians is an example of social ___________.

Answer 38

social concordance

Question 39

____-concordant consultations are less hurried, consist of more psychosocial discussion and visits are perceived as more satisfactory by patients.

Answer 39

Race-concordant

Question 40

6 Factors associated with adherence include:

1. whether patients are required to change longstanding _______.
2. _______ of the regimen.
3. ____-_______ of the regimen.
4. _____ of patients
5. Cultural _______ toward western biomedicine
6. Perceived level of care, respect and _________ of the prescribing physician.

Answer 40

1. Habits
2. Duration
3. Side-effects
4. Age
5. Attitudes
6. Competency

Question 41

5 Steps to Improving Adherence includes:

1. _____ patients about the important of adherence.
2. Providing _______ and _________ as cues.
3. _______ the regimen so it fits the patients lifestyle
4. _________ contracting
5. _______ support for adherence.

Answer 41

1. Educate
2. prompts and reminders
3. Tailoring
4. Contingency
5. Social Support

Question 42

Patients do not see physicians only because of symptoms, it is also about:

• Personal ______ of the symptom
• ______ created by symptoms and context.

Answer 42

• context

- emotions

Question 43

A research-based, psychosocial approach to interacting with patients, grounded in empirical support, includes six beliefs:

1. Patients do not see physicians only because of ________
2. Patients usually have more than one ________
3. Allowing patient to tell their story is ________ helpful.
4. Allowing patient to tell their story is ________.
5. Patients dont want everything fixed, they mostly want the physician to know about _____.
6. Patients dont feel the physicians ________ and care until it is demonstrated.

Answer 43

1. symptoms
2. problem
3. diagnostically helpful
4. therapuetic
5. them (who they are as a person)
6. compassion

Question 44

Why is Patient-Centered Practice Important?

1. improved patient ______ of physician instructions.
2. improved medication ________.
3. fewer tests and ______ needed.
4. ______ health outcome for patients.
5. Less ________ of physicians.
6. Lowered risk of _________ lawsuits.
7. Greater patient and physician ___________.

Answer 44

1. recall
2. adherence
3. referrals
4. Better health outcome
5. switching
6. malpractice
7. satisfaction

Question 45

The 5 Main types of health-related information on the Internet are:

1. Medical ______ and _______.
2. _______, products and diagnostic tools.
3. Health ________.
4. _______ and general statistics.
5. _______ (e.g. peer groups)

Answer 45

1. Medical articles and reports
2. Services, products, and diagnostic tools
3. Health promotion
4. Surveys and general statistics
5. Support