Chapter 9 & 10: health services Flashcards

1
Q

Placebos

A

inert substances or sham treatments

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2
Q

Psychosocial factors of symptom perception

A

expectations of the effect of a treatment drug, classical conditioning, specific phenomena like medical student’s disease and mass psychogenic illness, gender and cultural differences

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3
Q

Nocebo phenomenon

A

when patients taking an active medication perceive manufactured sensations or side effects that may not be the direct result of a drug; can be due to difference in vigilance and health worries

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4
Q

Placebo effect

A

ANY medical procedure that produces an effect due to its therapeutic intent (i.e. user’s beliefs and experiences about the intervention) rather than its specific nature (i.e. its actual physical or chemical properties)

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5
Q

What treatment typically creates a placebo effect?

A

prescribed medications and their pharmacological effects

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6
Q

Randomized controlled trials

A

measures the efficacy of a drug under optimal conditions, typically using a control group; susceptible to placebo effect

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7
Q

Factors that influence the placebo effect

A

pill color, size, branding, dosage, and price; description of the placebo as a stimulant or a depressant; kinds of placebo

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8
Q

How does pill color influence its placebo effect?

A

green and blue pills have sedative effects; red and yellow pills have stimulant effects; white pills are associated with pain meds

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9
Q

What characteristics of a placebo are more likely to produce a stronger effect?

A

injections rather than pills; capsules rather than tablets, higher dosage of pills; pills that are larger, branded, and priced higher; being given in a formal setting; provider’s warmth, confidence, empathy, and faith in treatment

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10
Q

Medical student’s disease

A

medical students incorrectly believe that they have contracted an illness that they have been learning about at one time or another

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11
Q

Mass psychogenic illness

A

widespread symptom perceptions across individuals (usually through chain reaction) despite tests show that symptoms have no medical basis in their bodies or in the environment

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12
Q

Commonsense models

A

cognitive representations of illnesses from the ideas and expectations we form about them

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13
Q

4 components of commonsense models

A

illness identity (name and symptoms): causes and underlying pathology; timeline or prognosis ideas; consequence (seriousness and outcomes)

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14
Q

Lay referral network

A

non-practitioners (e.g. friends, family) who provide their own information and interpretations regarding a person’s symptoms

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15
Q

What does the lay referral network do?

A

help interpret a symptom, advice someone to seek medical attention, recommend a remedy, recommend consulting another lay referral person

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16
Q

Who are frequent vs non-frequent users of health services?

A

children, women, older adults, advantaged groups; men in adolescence or early adulthood, marginalized groups, new immigrants

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17
Q

Iatrogenic conditions

A

health problems that develop as a result of medical treatment (e.g. wrong type or dose of medication, side effects or risks)

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18
Q

Sanctioning

A

when someone asks or insists that an ill person have their symptoms treated

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19
Q

Treatment delay

A

time that elapses between the first time a symptom is noticed and when the person enters medical care

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20
Q

3 stages of treatment delay

A

appraisal delay, illness delay, utilization delay

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21
Q

Appraisal delay

A

the time a person takes to interpret a symptom as an indication of illness

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22
Q

Illness delay

A

the time taken between recognizing one is ill and deciding to seek medical attention

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23
Q

Utilization delay

A

the time after deciding to seek medical care until actually using the health service or getting treatment

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24
Q

Alternative medicine

A

any practice that has purported healing effects but is not scientifically based; used in place of medical treatment

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25
Q

Complementary medicine

A

alternative medicine used in conjunction with conventional medical treatment

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26
Q

Complementary and alternative medicine (CAM)

A

unconventional treatments either used along with conventional treatments or used in place of them

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27
Q

Types of CAM

A

manipulative and body-based methods, natural products, mind-body interventions, energy fields, homeopathy, traditional Chinese medicine

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28
Q

Limitation of CAM

A

they have little to no scientific evidence of their safety and effectiveness in treating specific disorders

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29
Q

3 concerns about CAM

A

some CAM have harmful side effects; people are profiting from false claims about CAM effectiveness; people may forgo conventional medicine in lieu of CAM

30
Q

The worried well

A

people who are unnecessarily anxious about their health (in the absence of a related diagnosis) and tend to misuse health services

31
Q

Hypochondriacs

A

people who overuse health care even when there is no medical need to do so due to emotional distress, malingering, or symptom imagination

32
Q

Hypochondriasis or illness anxiety disorder

A

tendency of individual to worry excessively about their health, closely monitor bodily sensations, make frequent unfounded medical complaints, and believe they are ill despite reassurances by physicians that they are not

33
Q

When does hypochondriasis become a disorder?

A

when it lasts for at least 6 months, causes significant emotional distress or functional impairments

34
Q

Somatic symptom disorder

A

when hypochondriasis is accompanied by perceived physical symptoms

35
Q

Factitious disorder

A

repeatedly and intentionally acting as if one is sick, sometimes even inducing symptoms

36
Q

Practitioner behavior that can impede communication with the patient

A

doctor-centered diagnosis; using too much medical jargon, baby talk, elderspeak, and overly simplistic explanations; expressing negative stereotypes

37
Q

Doctor-centered diagnosis style

A

physician focuses on the first problem mentioned by the patient, is inattentive, asks questions that only require brief answers, depersonalizes the patient (e.g. no eye contact, cold emotion)

38
Q

Patient-centered diagnosis style

A

physician try to see the problem and treatment as the patient does (empathy) e.g. asks open-ended questions, avoids medical jargon, and allows clients to participate in some decision-making

39
Q

Rational nonadherence

A

nonadherence to a treatment regimen that is deliberate and has valid reasons, regardless of whether they are medically sound

40
Q

Psychosocial factors affecting adherence

A

attention, memory, planning, conscientiousness, negative emotions (e.g. stress and depression), self-efficacy, social support

41
Q

Chronic care model

A

focusing on either reversing a chronic condition or slowing its progress (i.e. secondary and tertiary prevention)

42
Q

6 features of the chronic care model for primary prevention

A

organization of care, clinical information systems, delivery-system design, decision support (e.g. training staff), self-management support, community resources

43
Q

Depersonalization

A

when practitioners treat patients as if they are not present or not a person (e.g. having a cynical attitude)

44
Q

Compassion fatigue

A

emotional exhaustion due to frequent or difficult patients

45
Q

Burnout

A

state of psychosocial and physical exhaustion that results from chronic work strain and little personal control

46
Q

3 components of burnout

A

emotional exhaustion, depersonalization, low sense of personal accomplishment

47
Q

2 possible explanations for the negative correlation between empathy and burnout

A

empathy makes work more meaningful; burnout causes a decline in the capacity for empathy

48
Q

Clinical empathy

A

understanding the inner experiences and perspectives of the patient as a separate individual and communicating this to them

49
Q

2 coping processes used by patients

A

problem-focused (e.g. asking for pain medication) and emotion-focused coping (e.g. seeking social support)

50
Q

2 cognitive processes in coping

A

attributing blame to oneself or others, assessment of personal control

51
Q

Traits of a good patient

A

passive, cooperative, uncomplaining, stoical, attentive in discussions with medical staff

52
Q

3 types of control that can be given to a patient

A

behavioral, cognitive, informational

53
Q

Behavioral control

A

performing certain actions to reduce discomfort and promote recovery during or after the medical procedure

54
Q

Cognitive control

A

focusing on the benefits of the medical procedure and not its unpleasant aspects

55
Q

Informational control

A

learning about the events/sensations to expect during or after the medical procedure

56
Q

2 coping styles of patients

A

avoidance and attention

57
Q

2 approaches used by psychologists to assess emotional adjustment

A

diagnostic interviews (the gold standard) and questionnaires

58
Q

Diagnostic interviews

A

a structured conversation with a set of questions the psychologist/psychiatrist asks the client

59
Q

2 types of questionnaires

A

one that focuses on a single disorder and one that screens clients for a variety of emotional difficulties (e.g. minnesota multiphasic personality inventory)

60
Q

Millon behavioral medicine diagnostic (MBMD)

A

self-report test that assesses psychosocial factors (e.g. coping style, negative health habits) and decision-making issues relevant to a patient

61
Q

What groups report more difficulties in accessing health services?

A

women, indigenous people, immigrants, low-income Canadians

62
Q

Barriers to accessing healthcare

A

language and culture (key barriers), lack of transportation and childcare services, lack of services in the area (e.g. Indigenous reserves), racism, discrimination, stigma

63
Q

Cultural barriers for indigenous peoples to accessing healthcare

A

lack of resources in addressing and accommodating their unique cultural need; lack of education on social and economic determinants of their health

64
Q

Monitors vs blunters

A

more concerned about the issue so they seek information; overwhelmed by threatening information so they avoid it

65
Q

How do you motivate monitors?

A

provide messages that include detailed information about risks and strategies

66
Q

How do you motivate blunters?

A

keep messages short, succinct, non-threatening, and in simple terms

67
Q

3 main factors related to patient satisfaction

A

technical quality of treatment/care, quality of interaction with practitioner, sense of autonomy and informed consent

68
Q

3 key factors in patient satisfaction according to the CIHI

A

good communication with patient, coordination and communication among care providers, support and planning for leaving the hospital

69
Q

Good health outcomes related to patient satisfaction

A

reduced hypertension, fewer post-surgery complications, reduced mortality, improved patient compliance, improved use of health services

70
Q

What physical features of a hospital room result in better health outcomes?

A

having a single-bed reduces infection and improves privacy; having a window with a view of nature improves satisfaction, reduces anxiety and pain