Chapter 7 Flashcards
factors related to using and misusing health services
4
- perception
- interpretation
- lay referral network
- going online
Perceiving symptoms
2 ways of perciving symptoms
Individual Differences in the extent to which they attend to their state
* Eg: lv awareness, sensitivity
* Doesn’t mean their more accurate (could overestimate symptoms)
Environmental and social factors
* Environmental: other people reporting symptoms
* Psychological: expectations, negative emotions
Interpreting symptoms
2 ways of perciving symptoms
Prior Experiences
* Can help or hinder people’s interpretations of symptoms
Common Sense Model of illness
* Illness identity (name, symptoms).
* Causes and underlying pathology.
* Timeline or prognosis.
* Consequences (seriousness, effects, outcome).
lay referral network:
definition & examples
Getting advice from others before deciding to seek medical attention
* Symptom interpretation
* Advice about seeking care
* Recommended remedy
* Recommend talking to someone else
Going online
3 influsences of going online
The worried well
* People who are unnecessarily anxious about their health in the absence of a related diagnosis.
* Misuse health services
Self diagnose
* Using health related information online
Doctor TV shows:
* ⅓ -½ of the recommendations made were based on good science
sociocultural factors in using health services
4
- gender
- SES
- Indigenous experiences
- stigma
who has more difficulties in acessing health care
- Women
- LGBTQIA+
- Immigrants
- Low income canadians
Misgendering in health services
- Associated with more negative emotions, less identity strength, higher felt trans stigma
- Affecting mental health of individuals & limit future engagement with health care system
Low SES & immigrants in health services
Longer wait times in hospitals
Being indigenous in health services
3 problems
Language & culture as key barriers
- Canada’s health care system poorly equipped for addressing and accommodating the unique cultural needs of Indigenous people.
- Practitioners are also poorly educated on the social and economic determinants of Indigenous peoples’ health.
Lacking transportation & childcare services & service in area
Racism, discrimination, stigma
Stigma in health services
- Being diagnosed to a stigmatised disease → interfere with the use of health services
- Disabilities: Often excluded from healthcare initiatives
- effects treatment & prevention
Disabilities in health services
- stigma
- incorrects assumption about health & health care needs
- excluded from health care initiatives
Health is a Human Right
- the highest attainable standard of health as a fundamental right of every human being.
- right to control one’s health/body and the right to a health system that offers equal opportunity to attain health
patient-centred communication
definition and what does it give us
= Care providers try to see the problem and treatment as the patient does (empathy), and in so doing enlist the patient’s cooperation
role of empathy in provider burnout
2
Compassion Fatigue
- Emotional exhaustion due to frequent/difficult patients.
burnout
Burnout
definition & 3 main components involved
Condition that results from chronic work strain
1. Emotional Exhaustion
2. Depersonalization
3. Low Sense of Personal Accomplishment
adherence/compliance
Definition & Avg adherance rate & what is adherance seen the least in
- the extent to which a patient follows medical advice or instructions
- Average (overall) rate of adherence is 60%.
- Low adherence to recommended lifestyle
is empathy bad?
no. Negative correlation between empathy & burnout
what is the right kind of empathy
Name & defintion
Clinical empathy:
- Understanding inner experiences & perspectives of the patient as separate individual & communicating this to them
How to enhance patient adherence
Make it SIMPLE
Simplify regimen.
Impart knowledge.
Modify patient beliefs.
Patient communication.
Leave the bias.
Evaluate adherence.
key psychosocial factors in the hospital setting
4
- Being Hospitalized
- Coping in the Hospital
- Preparing Patients for Procedures
- Monitors Vs blunters
how can being hospitalized have negative aspects
- Limits privacy
- Restricting activity
- High degree of dependency on others
- Stressful events
What are the types of coping in hospital settings
2 & the different types
Problem-focused coping:
- When patients believe they can do something about the problem
Emotion-focused coping:
- When patience perceive no control
- Blame Common, Associated with poor adjustment than self-blame
- Helplessness Due to low control. Affecting future perceptions of situations that can be controlled
- Denial, rumination, catastrophizing
How could different ways of preparing patients for procedure help
how & different types of control
Behavioural control:
* Reduce discomfort/promote recovery during/after the medical procedure
* Actions: special breathing/coughing exercises
Cognitive control:
- Knowing how to focus on benefits of medical procedure rather than unpleasant
Informational control:
- Gaining knowledge about event/sensation/what to expect
Monitors vs Blunters
why they imporant to differentiate. who are they? how to keep motivated
People vary in how much health-related information they desire.
monitor
- Concerned & worried about issue → seek information
- To motivate: Provide messages that include detailed information about risks & strategies.
bulnters
- Overwhelmed by threatening information → avoid information
- To motivate: Keep messages short, succinct, non-threatening, and in simple terms
key factors in patient satisfaction
6
- Technical quality of treatment/care
- Quality of interaction with practitioner
- Sense of autonomy and informed consent
- Communication
- Coordination and communication among care providers.
- Support and planning for leaving the hospital
- physical space
- Food
Does patient satisfaction predict good health outcomes
5
- Reduced hypertension
- Fewer complications after surgery
- Reduced mortality
- Improved patient compliance/adherence
- Improved use of health services
Varieties of CAM:
Manipulative & body-based methods
* chiropractic care, massage therapy, and reflexology
Natural products
- herbal products, vitamin and mineral supplements, and other dietary supplements
Mind-body interventions
- progressive muscle relaxation, meditation, yoga
Homeopathy
Traditional chinese medicine
CAM (Complementary and Alternative Medicine
- Alternative medicine = practice that alleged healthing effects but not scientifically based
- Complementary medicine = alternative medicin used in conjunction with conventional treatment
Concerns on CAM
search
What leads to the use of CAM?
search
Placebo:
= any medical procedure that produces an effect in a patient because of its therapeutic intent and not its specific nature, whether chemical or physical
Randomised Clinical Trials (RCTs)
- measure the efficacy of a drug under optimal conditions; typically using a control group
- placebo effect is especially problematic to RCTs, as it causes confusion about the underlying causes of any observed effects. If a new drug is observed to have an effect, it is unclear how much of that effect is due to the placebo effect, which is assumed to occur with any treatment
Factors affecting placebo effect:
- Placebo Characteristics
- Setting that has the trappings of medical formality will induce stronger placebo effects than will a less formal setting.
- Providers who exude warmth, confidence, and empathy get stronger placebo effects than do remote and formal providers
- provider’s faith in the treatment
- Being told that they ‘could’ have an effect (aka can still have effect even when knowing they’re placebo)
*
Why placebo happens:
Effect of time
* People just improve with time
Confirmation bias
* Focusing on improving because they’re looking for improvements
Expectations
* Thinking that taking medicine will work
Pharmacological conditioning
* Associating treatments with improved symptoms
Human connection
* empathy/warmth making us feel better
