Chapter 9: Using health services and medication adherence Flashcards
Who uses health services?
average number of visits to the doctor per year is 5.5/ year. Females are more likely to have a health care provider than males.
What is the approx. time for medically necessary appointments?
21.2 weeks- longest ever recorded and wait time is increasing with time
What is the Canada health act?
all citizens have reasonable access to medically necessary health services without having to pay out of pocket (federal).Each province and territory pays its citizens medical bills and determines its own policy. Canada is the only universal health care plan that doesn’t cover prescription drugs
In terms of age groups, who is more likely to use health services?
young children and the elderly
In terms of Gender, who is more likely to use health services?
Women more than men (even if pregnancy is exlcuded)- could be because women get ill more often, or men are less likely to go get help
In terms of social class and culture who is more likely to use health services?
Non-aboriginal, non recent immigrants, people with High socioeconomic status
Whats the process of seeking medical treatment?
- Perceiving symptoms and responding to symptoms
- Deciding to seek treatment
- Actually seeing the medical practitioner
Whats involved in perceiving symptoms?
Noticing internal state/sensation, Labeling sensation, Little correspondence between perceived symptoms and actual physiological activity
Depends on: Individual differences (some people focus on internal states more (doesn’t make it more accurate))
Situational factors
and Beliefs and expectations
Whats involved in responding to symptoms?
- Even when people perceive symptoms, they do not always attribute them to illness
- Prior experience
- Expectations
- Emotions (if you’re fearful of what you might be told you might downplay it)
- Role of others & lay referral network
- Common sense model of illness: ideas and expectations about illness (Illness identity, Causes and underlying pathology, Timeline, Consequence)
What is lay referral network?
if you experience symptoms you ask other people for a referral of their experiences with similar symptoms, based on their responses you make a decision about whether or not to seek medical attention
What is treatment delay?
time between noticing a symptom and getting medical care
Delay can occur at various points: Appraisal delay, Illness delay: you think you might know what the illness is and you have to make a decisions about whether or not to seek medical treatment. Utilization delay, and Waiting to see a doctor
What is treatment delay affected by?
The presence and absence of pain
Other (non-illness related) factors like Life events (divorce may take up a lot cognitive and behavioural resources) and Perceptions of seriousness, susceptibility, barriers, benefits
What is hypochondriasis?
A tendency to worry excessively about health, excessively monitoring body sensations, frequently seeking medical treatment, making unfounded medical complaints even though a physician has told you its wrong. They are perceiving something. To be classified as a psychiatric disorder it has to be longer than 6 months and has to significantly impair functioning and cause stress.
What is secondary gain in terms of overusing health care services?
People who use health care services often bc they think people will behave better towards them if they are sick
What age group/gender tend to have a more active role in their health?
Women and younger adults tend to want more info/play an active role in their health
How can taking an active role in treatment decisions be beneficial?
Tend to recover faster, smoother
Greater adherence
What are some unhelpful practitioner behaviours?
Medical jargon
Baby talk and elderspeak (dumb down conversation- condescending)
Stereotypes
Gender of physician (female physicians’ tend to spend longer duration of time with patients than male physicians)
What are some patients behaviours?
Neuroticism, Anxiety
Knowledge, language, Attitudes
What is doctor centered care?
physician asks questions that require only brief answers (yes/no) and focus on the first problem the patient mentioned
What is patient centered care?
ask open ended questions such as “describe the situations when the pain occurs” that allow the patient to relate more info and new factors. Avoiding medical jargon and Patients participate in decision making
What benefits are associated with patient centered care?
Patient centered communication, Better recovery from their discomfort and concern, Better emotional health 2 months later and Fewer diagnostic tests and referrals
What is adherence?
degree to which patients carry out prescribed treatments and behaviours. Average non-adherence to advice=40% (range 20-80%)
What is adherence affected by?
Physician communication and style
Why dont people adhere?
Treatment might require: Lifestyle change i.e., exercise, nutrition, Complexity (Taking multiple pills with complicated instruction) Long duration (Adherence declines over time)
Side effects and giving up something else( If you take this pill you can no longer drink alcohol or weight gain)
