Chapter Nine: Patients, Providers, and Treatments Flashcards
Def: Nurse Practitioners
affiliated with physicians in private practice, they see their own patients.
Responsibilities for Nurse practitioners:
Provide routine medical care
Prescribe treatment
Monitor progress of chronically ill patients
Explain disorders & their origins, diagnoses, prognoses, & treatments
Advanced-Practice Nurses includes:
certified nurse midwives, clinical nurse specialists, certified nurse anesthetics.
Responsibilities for advanced-practice nurses:
Some obstetrical care & births
Cardiac or cancer care
Administering anesthesia
Def: Physician’s assistants
educated in 2 year programs in medical schools teaching hospitals.
Responsibilities for physician’s assistants:
Perform many routine health care tasks.
Def: patient consumerism
being provided with choices, cooperating & participating in the development & enactment of the treatment plan.
Having considerable expertise abt their health issues
Types of Health Care Plans
Health Maintenance Organization (HMO)
Preferred-Provider Organization (PPO)
Point of Service Plan (POS)
Traditional Indemnity Plan
Def: Health Maintenance Organization (HMO)
managed care bc employer pays an agreed-on monthly rate.
Employees can then use services at no additional cost
Def: Preferred-Provider Organization (PPO)
Network of drs offers plan members a discounted rate.
Enrollers must choose form these practitioners
Def: Point of Service Plan (POS)
Administered by insurance companies or HMOs
Lets members go to drs & hospitals out of the network for a price.
Def: Traditional Indemnity Plan
Patients select their own drs & hospitals & pay a fee for service basis.
They don’t need a referral to see a specialist.
Changing structure of the health care delivery system can ________ patient provider communication bsc it results in colleague ___________.
undermine, orientation
Def: patient-centered care
providing patients with info.
Involving them in decisions regarding care
Consideration of psychosocial factors
Technical quality of care & the manner in which care is delivered are _________.
unrelated
Medical office is an ________ setting for effective communication.
unlikely
Def: Role of provider (communication)
extract significant info quickly from the patient.
Patient & provider aren’t always on the same page.
Provider Behaviors that contribute to faulty communication:
Inattentiveness
Use of jargon
Baby talk
Nonperson treatment
Stereotypes of patients
Patients’ contributions to fully communication:
Poor education & understanding
Patient’s inability to present their complaints effectively.
Neurotic patients exaggerate their symptoms
Ability to follow treatment guidelines declines bc of ________
old age.
Misunderstanding the provider’s _______ on factors that the patient considers to be incidental
Causes them to pay ________ attention and believe that the provider has not made the right diagnosis
emphasis, little
Interactive Aspects of the Communication Problem:
Lack of opportunity for feedback to the provider
Difficulty in knowing when a relationship has been established with a patient
Learning is fostered more by positive than by negative feedback
Dissatisfied patients…
Are less likely to comply with treatment recommendations
Are more likely to turn to alternative services that satisfy emotional rather than one’s medical needs
Are less likely to obtain medical checkups
Are more kiley to change drs and file formal complaints.
Adherence rates _____ depending on the treatment recommendations
vary
Measuring adherence:
Asking patients abt their adherence yields artificially high estimates
Researchers draw on indirect measures of adherence which can be biased.
Good communication is highest in patients when:
Clear, jargon-free explanation is received
Instruction are asked to be repeated
Instructions are written down
Unclear recommendations are singled out & clarified
Instructions are repeated roe than once.
Treatment regimens…
Qualities of the treatment regimen influence adherence
Nonadherent patients cite excuses.
Creative nonadherence
Def: Creative nonadherence
Modifying & supplementing a prescribed treatment regimen.
Why do ppl sue?
Faulty communication can lead to malpractice litigation bc many suits are due to medical incompetence but discretionary malpractice suits can be due to faulty communications.
Typically patients want: to find out what happened to them, an apology, to know that the mistake won’t occur again.
Training providers communication:
Simple behaviors that are seen as warm & supportive
Nonverbal communication
Training patients abt good communication:
Teaching skills to elicit info form physicians
Listing one’s own questions ahead of time
Probing for barriers to adherence:
Barriers can be discovered by talking to the patient.
Breaking advice into manageable subgoals that can b monitored
Rate of adherence instreases if lifestyle changes are prescribed
Structure of the hospital depends on the health ________ under which care is delivered
program
Def: cure
performing treatment action that has the potential to restore patients to good health.
Def: care
orientation of the nursing staff
Def: core
ensuring the smooth functioning of the system.
Role of Health Psychologists
Diagnosis of patients & assessment of patients’ level of functioning.
Pre and postsurgery preparation & pain control
Impact of hospitalization on patients:
Patients are required to entrust themselves completely to strangers in an uncertain environment. Can result in problematic psychological symptoms
Patients have been prepared are:
Less emotionally distressed
Able to regain their functioning more quickly
Able to leave the hospital sooner
Hospitalization can be hard on _____
kids
Environment can be _____ and isolating for kids
lonely
Kids who are hospitalized may become socially ____________.
withdrawn
Dependency fosters by bed rest & reliance on staff can lead to _______ on kids.
regression
Kids _______ benefit from preparation as adults
equally
Preparing kids for medical interventions:
Results in less problem behaviors after hospitalization
Parents can undertake preparation
Presence of parents during stressful medical procedures can be helpful.
Def: Complementary & Alternative Medicine (CAM)
Diverse group of therapies, products, & medical treatments
Represents a vast & reevaluated aspect of care.
Origins of CAM:
Holistic medicine
Def: Holistic medicine
Approach to treatment that deals with the physical, psychological, & spiritual needs of the person.
Traditional Chinese medicine…
Based on the idea that a vital force, qi, flows thru the body.
Strives to balance the forces of yin & yang.
Def: ayurvedic medicine
Balancing among the body, mind, & spirit by means of diet, exercise, message, herbs, oils, spices, and various minerals.
Def: homeopathy
Interprets disease & illness as caused by disturbances in a vital life force.
Treatment includes diluted preparations
Def: naturopathy
Central tenet is that the body can heal itself thru diet, exercise, sunlight, & fresh air.
Dietary supplements & health….
Contains nutrients in amounts that are as high or higher than levels recommended by the United States Institute of Medicine’s (USIM) daily recommendations.
Prayer & health….
Spiritual beliefs have been tied to better health practices, better health, & longer lifespan.
Def: acupuncture
Long, thin needles are inserted into designated areas of one’s body.
Needles theoretically include the areas in which a patient is experiencing an issue.
Used to control pain
Triggers the release of endorphins, which reduces the experience of pain
Def: yoga
Includes breathing techniques, posture, strengthening exercises, and meditation.
Yoga can treat…
Chronic pain, bronchitis, & symptoms associated with menopause
Mental & physical ailments related to stress, including anxiety & depression.
Cancer-related fatigue.
Def: hypnosis
State of relaxation.
Relaxing alone can help reduce stress & discomfort.
Effects of hypnosis may be due to the composite effects of:
Relaxation
Reinterpretation
Distraction
Drugs
Def: meditation
Variety of therapies that focus & control attention
Helpful for managing pain
Effective treatment for certain functional disorders
Def: guided imagery
Meditative produce that has been used to control discomfort related to illness & treatment.
Patient is instructed to conjure up a pic that they hold in their mind during the experience of discomfort.
Used to induce relaxation
Def: Chiropractic medicine
Performing adjustments on the spine & joints to correct misalignments.
Believed to prevent & cure illness.
Def: osteopathy
Drawn on the body’s ability to health issues.
Seeks to facilitate healing using manual & manipulative therapy
Def: massage
Manipulation of soft tissue
Reduces stress & is believed to boost immune functioning.
Flushes waste out of the system
Used to control stress & pain.
Who uses CAM?
Ppl who aren’t successfully treated by traditional medicine.
Ppl who face delays in receiving medical care & cannot afford high costs of medical care.
Used more by white ppl than by any other race.
Evaluate CAM:
Difficult bc they are highly individualized.
Importance of CAM is derived from the fact that many ppl use it.
Def: Integrative medicine
Combo of alternative medicine with conventional medicine.
Def: placebo
medical procedure that produces an effect in a patient bc of its therapeutic intent. INcluded in many effective treatments.
Effectiveness of a placebo varies depending on:
How a provider treated the patient
How much the provider seems to believe in the treatment.
Effects are strengthened when the provider gives reassurance to the patient that he condition will improve
Ppl who show stronger placebo effects are:
Those who have a high need for approval.
Have low self-esteem & are persuadable
Are anxious.
Situational Determinants of Placebo Effects…
Setting that is similar to medical formality
Shape, size, color, taste, & quantity of the placebo.
Treatment regimens that seem medical & include precise instructions
_________ effect is facilitated by ______ that surround treatment regiments. Each way in which treatment will be enacted.
Placebo, norms
Placebos are effective bc ppl believe that the drugs ______.
work
Double-blind technique with the placebo effect:
One group of patients is given a drug to cure a disease or alleviate symptoms, & the other group is given the placebo.
Measurements of the diff between the effectiveness of the drug & the effectiveness of the placebo
