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Patient Care 2 - Exam 2 > Cultural Competency > Flashcards

Cultural Competency Flashcards

1
Q

You treat pts not

A

teeth

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2
Q

Teeth do not walk into you office

A

Patients do

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3
Q

___________ is the most important tool in dentistry

A

Communication

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4
Q

Benefits of a good relationship with pt

A

More likely to follow our recommendations, pay bills on time, refer others to your practice, reduces anxiety, less likely to sue

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5
Q

Don’t we know how to communicate?

A

Matter of how effective we are
Dentists consider communication 1 of 3 most important factors in delivery of care
About 1/2 of all dentists feel they received only fair or poor training in dental school

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6
Q

Dental school

A
  • Often human behavior and motivational techniques not taught in dental school
  • Often taught that simply providing info is enough to change pts behavior (not true and need to motivate pt)
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7
Q

Communication and Litigation

A

68-70% of medical litigation cases cited communication as the primary cause

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8
Q

Outcomes of good communication

A

Build trust, reduce anxiety, increase pt satisfaction (increase your satisfaction), better pt assessment (better treatment plan and dental care)

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9
Q

Non-verbal communication

A

Perception, Vocal, Nonverbal perception

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10
Q

Perception

A

What’s perceived, not necessarily what transpired.
Delivery - how words are spoken (vocal quality, tone, pitch, emphasis, vol, pause, inflection)
Emotion - perception of compassion and empathy
Body language - Stance, posture, gesture, use of space

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11
Q

Vocal/Hearing

A

Pitch, rate, pause, emphasis, inflection.

Americans least favorite mode

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12
Q

Nonverbal perception

A

Facial/emotional - eye contact and smile

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13
Q

Smile

A

Fake (“social”) smile vs genuine (“Duchenne”)
Genuine involves the eye muscles
Men not as good distinguishing the two

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14
Q

Facial Feedback Hypothesis

A

Feedback, from the facial muscles to the brain plays a key role in determining the nature and intensity of emotions that we experience

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15
Q

Unconscious personal habits

A

Vocal/healing
Facial/emotional
Kinetic/body language

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16
Q

Vocal/healing

A

DON’T DO THESE

  • uh
  • you know
  • right? ok?
  • Clearing throat
  • Monotone
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17
Q

Facial/emotional

A 
Eyebrows
Fiddling with 
- glasses
- hair
- beard
- earrings
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18
Q

Kinetic/body language

A 
Spinning the pen/pencil 
foot tapping thing 
fingernails - tapping 
rocking 
hand gestures
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19
Q

What do I do with my hands?

A

Folded, behind back, akimbo, and fig leaf

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20
Q

The greeting

A

Hello - short pause.
I’m ________ - offer hand for shake/elbow bump/really nice smile
Weight balanced on both feet
Eye contact

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21
Q

Nonverbal

A

Appropriate space - arm’s length
Eye contact
Eye level
smile

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22
Q

Roadblocks to good listening

A

Office distractions

Beware of bias

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23
Q

Beware of bias

A
  • Listen with an open mind
  • Look for shakes of grey
  • FOCUS - don’t not get distracted
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24
Q

Office distractions

A
  • Multi-tasking
  • Reviewing chart
  • Staff interruptions
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25
Q

Nonverbal that promote conversations: the dentist

A

Same eye level, lean slightly forward, don’t cross arms

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26
Q

Verbal communication

A

Open-ended questions
Use Mr. Mrs. or Ms. unless they ask you to do others
Don’t rush
Give the pt a chance to talk
Anything that you would do differently in photo?

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27
Q

Verbal that inhibit conversation

A

Rushing to diagnose - let the pt be a part in the decision making
Asking closed-ended questions

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28
Q

Negative dentist attitudes

A

Arrogance, sarcasm, high pressure marketing - most pt can tell when this is happening, don’t push tx

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29
Q

As an educator

A 
Dont just lecture - "I know you are going to yell at me - do I look like someone who would yell?"
Find out what they already 
Then fill in missing info
Use memorable sound "bites"
NEVER use jargon 
Keep it brief 
Check pts/parents understanding
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30
Q

Know the person

A

What they like, what they do in life, just like getting to know a neighbor

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31
Q

Be respectful

A

Never assume you know what’s best for the pt (composite vs amalgam)
Find out what their preferences are

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32
Q

Be accommodating

A

Make sure the pt is comfortable

Be flexible to ensure pt acceptance

33
Q

Know pts feelings toward dental care

A

Always ask about previous dental experiences

  • what they liked, what they didn’t
  • how can you make this visit comfortable for them?
34
Q

Being seen

A

Talk at eye level
Acknowledge facial and body expressions
Eliminate physical barriers

35
Q

Being Heard

A 
Use pts language 
- don't use medical/dental jargon 
Give feedback
Ask for feedback 
Invite pt to tell their story 
- listen for feelings, values, and thoughts
36
Q

Being accepted

A

Avoid scolding or judging

- if you must judge, judge the behavior, not the person

37
Q

Careful what you say!

A

ADA surveyed malpractice claims
Critical comments made by dentists to pt about another dentists work are among the most common factors contributing to malpractice allegations

38
Q

Establish a starting routine (helps with anxiety)

A

Small talk, tell them where they can put their personal belongings, seat them in the pt chair

39
Q

The introduction (“need and greet”)

A 
Introduce yourself
Call you pt by name (Mr. Mrs)
Smile
Make eye contact 
Sit at eye level 
Don't turn away, swivel in chair, lean in doorway, etc.
Actively listen and don't interrupt
40
Q

Pt visits

A

66% don’t see DDS regularly

- higher among - certain ethnic groups, low-income groups, less educated

41
Q

Why do ppl avoid the dentist?

A 
Fear 
- #1 reason
- unknown 
- known 
High cost 
- lack insurance 
Lack of providers in some areas
42
Q

Strongest predictors of dental anxiety (in order)

A

Attitude towards dentists
Check-up frequency (more frequent - less anxiety)
Satisfaction with mouth
Avg # filled surfaces (more fillings = less anxiety)
Gender (Females > males)
Annual income

43
Q

Anxiety

A

A nervous disorder characterized by a state of excessive uneasiness and apprehension typically with compulsive behavior or panic attacks

44
Q

Reasons for dental anxiety

A

“the injection”

  • painful injection
  • not getting numb
  • the fact of being numb
  • needle phobia
45
Q

Reasons for dental anxiety

A

sights, sounds, smells (alcohol, cloves, fear)

46
Q

Reasons for dental anxiety

A

Choking - afraid of swallowing instruments or other harmful substance
Gagging
suction

47
Q

Reasons for dental anxiety

A

Painful - dentist is there to hurt them
Embarrassment - my teeth can’t be saved, scared of “lecture”, being judged
Parents - bad experience in younger yrs, influence kids, kids will follow by example
Money - high cost, what is he/she gives me the wrong treatment? Don’t high pressure them

48
Q

Initial contact questions

A

How long since your last dental visit.
What kind of past tx? How was it? How did it feel?
Do you have any concerns about receiving dental tx? - opens the door for pt to talk freely

49
Q

Behavioral signs

A 
Fidgeting with hands or objects 
Sitting on edge of chair leaning forward 
Rapidly thumbing through magazines 
Pacing 
Restless 
Startled rxn to noises
Rapid head movement 
Repetitious hand/leg and foot movements
50
Q

Physiological Signs

A 
Perspiration 
- forehead
- heads
- palms
- upper-lip
- under-arms
Cardiovascular - BP and HR
Respirations - rate and depth
51
Q

Good ideas to reduce anxiety

A 
Explain procedures before starting 
Give specific info during procedures
Give reassurance 
Give the pt some control 
Provide distraction 
Build trust 
Show personal warmth
52
Q

Patients perceptions of a good dentist

A 
Assured me that they would prevent pain
Was friendly 
Didn't rush
Was calm 
Gave moral support 
Asked if I was nervous 
Made sure I was numb 
Don't let them see you sweat under ur mask
53
Q

Ways to reduce anxiety in children

A

Tell
Show
Do

54
Q

Vision impairment

A

Does not always mean total blinds. Most so-called “blind” persons ha e some usable vision

55
Q

If a blind person seems to need help - offer it

A

Identify yourself, and make it clear ur talking to him or her. If your help is accepted, don’t push or pull. Let the person take ur arm and follow your body motion

56
Q

Go ahead and use words like “see” and “look”

A

there are NOT reasonable substitutes

57
Q

It may be tempting to pet a guide dog, but that dog has an important duty and should not be distracted from it.

A

Distracting a guide dog can potentially put the person in harms way

58
Q

Interacting with ppl who are blind/low vision

A

when your leaving say so

59
Q

Avoid presumptions about a person physical abilities

A

You don’t know what this persons physical abilities are. Just bc someone is in a wheelchair it does not mean that they are paralyzed or that they are incapable of taking a few steps

60
Q

Greet a wheelchair user the same as you would anyone

A

Extend your hand, even if they have limited use of their hands or an artificial limb. Generally, its appropriate to offer to shake hands regardless of their condition

61
Q

Speak directly to the person who uses the wheelchair

A

If someone is accompanying that persons DO NOT talk to the companion about the person in the wheelchair. If you are going to continue a conversation for a while, suggest you go somewhere where you can take a seat so that the person does not lift their head to look at you.

62
Q

Power chair - learn locations of accessible ramps, doors and parking

A

Look for them throughout campus, in case you are asked or are giving directions

63
Q

Offer to help when appropriate

A

Knowing when to offer a helping hand can be tricky. Remember that bc a person uses a wheelchair, this does not necessarily mean that he or she is in need of assistance. If you see a situation where they can use ur help, ask, do not move the wheelchair without permission

64
Q

Get the person’s attention before speaking

A

Call out the person’s name; if that is not successful, a tap on the shoulder a wave, or another visual signal usually does the trick

65
Q

Identify who you are

A

Introduce yourself or show your name badge or business card

66
Q

Ask about communication strategy

A

Ask if it would be helpful to communicate by writing or by using a phone to type back and forth

67
Q

Speak slowly and clearly

A

but do not yell, exaggerate, or over pronounce. Exaggeration and overemphasis of words distorts lip movements, making lip reading more difficult

68
Q

Look directly at the person when speaking

A

avoid turning away to write on a board or pull something from a file

69
Q

Maintain eye contact with deaf person

A

Eye contact conveys the feeling of direct communication. Even if an interpreter is present, continue to speak directly to the deaf person. He/she will turn to the interpreter as needed.

70
Q

Invisible disabilities

A

Learning disabilities
ADD/ADHD
Psychological disabilities
Many chronic medical conditions

71
Q

Self check: comfort with different populations

A

How do you communicate with an elder?
Child?
Someone from another culture?

72
Q

What can we do?

A

Be aware of bias, learn to listen, learn to elicit pts perspective

73
Q

A lifelong learning process of increasing awareness, knowledge and skills

A

Valuing diversity, learning about your own culture and other cultures, avoiding stereotypes, gaining cultural experiences, engaging with your local communities

74
Q

Cultural factors that can affect oral health care

A

Eating habits and diet preferences
What healthy teeth and gums look like
Perception of time
Gender roles

75
Q

Health Literacy

A

The ability of the pt to process and use medical information - read handouts, navigate websites, etc.
Associated with education and race/ethnicity
Not associated with age and gender
Need to make sure ur communication is appropriate for the pt - language reading level, etc.

76
Q

Using qualified interpreters

A

Get on “same pg” before entering the room
Position yourself and interpreter
Address pt, not interpreter
Confirm understanding and agreement with pt
Document interpreter’s presence

77
Q

What not to do

A

Do not use unqualified interpreters - more likely to make mistakes, may breech confidentiality, may lead to misdiagnosis or tx.
Do not ask the interpreter to perform tasks out of his/her role
Do not say anything you do not want to pt to hear

78
Q

What not to do

A

Do not use unqualified interpreters - more likely to make mistakes, may breech confidentiality, may lead to misdiagnosis or tx.
Do not ask the interpreter to perform tasks out of his/her role
Do not say anything you do not want to pt to hear

79
Q

Kleinman’s Questions

A

What do you think has caused your problem?
Why do you think it started & when it did?
What do you think your sickness does to you? How does it work?
How severe is ur sickness? Will it have short or long course?
Groups can have vastly different notions of health and disease.
What kind of tx do you think u should receive? What are the most important results you hope to revive from this tx?
What are the CC of ur sickness has caused for you?
What do you fear most about your sickness?

Patient Care 2 - Exam 2 (3 decks)

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