Doc1A Midterm 1

Question 1

Culture

Answer 1

• set of learned and shared beliefs, values, traditions, languages, and norms applied to social interactions and interpretation of experiences
• cultures are dynamic
• cultures are created across many dimensions of identity

Question 2

dimensions of identity that play into culture formation

Answer 2

• race
• ethnicity
• class
• age
• gender
• sexual orientation
• other social categories

Question 3

Culturally Effective Care relates to

Answer 3

• health disparities

* communication skills

Question 4

cultural competence

Answer 4

a set of congruent behaviors, attitudes, and policies that come together in a system, agency or among professionals that enables effective work in cross-cultural situations

Question 5

structural competence

Answer 5

• recognize structures that shape clinical interactions
• observe and imagine structural interventions
• develop structural humility

Question 6

physician is a good communicator leads to

Answer 6

2.16 times better patient adherence

Question 7

RESPECT model

Answer 7

• Respect
• Explanatory model
• Social context
• Power
• Empathy
• Concerns
• Trust

Question 8

R of respect model

Answer 8

• active listening posture
• non-verbal and verbal encouragement
• summarizing/paraphrasing

Question 9

E of respect model

Answer 9

•ask about patient’s explanatory model:
“what are you most worried could be causing your symptoms?”
“what do you think might solve this problem?”

Question 10

S of respect model

Answer 10

•ask about social context of illness/problem:
“how is this affecting your life?”
“what gives your strength to face your illness?”

Question 11

P of respect model

Answer 11

•Share power
“is there anything else you’d like to talk about today?”
•Limit interruptions
•sit

Question 12

E of respect model

Answer 12

•show empathy

NURS!

Question 13

C of respect model

Answer 13

•ask about concerns/fears

Question 14

T of respect model

Answer 14

•trust, team-building, therapeutic alliance

Question 15

NURS

Answer 15

• name emotion
• seek to understand the reason for emotion
• respect/validate
• offer support

Question 16

5 step interviewing

Answer 16

1. set stage for interview
2. obtain CC and other current concerns/ agenda setting
3. open HPI
4. continue patient-centered HPI
5. transition to doctor-centered phase of interview
   * conclude with summary, change to change or add, give instructions (ie wait here)

Question 17

subjective data in patient hx

Answer 17

• patient’s story

* symptoms obtained in history from CC through ROS

Question 18

objective data in patient hx

Answer 18

• what you discover in physical exam
• lab studies
• imaging studies

Question 19

elements of complete medical history

Answer 19

• CC
• HPI
• PMH
• PSH
• Meds
• Allergies
• FHx
• SHx

Question 20

seven dimensions of a symptom

Answer 20

LOCATES
•Location
•Other associated sx
•Character (quality)
•Aggravating/Alleviating factors
•Timing
•Environment (setting)
•Severity

Question 21

Location

Answer 21

• exact location

* does it radiate or change location

Question 22

Timing

Answer 22

• onset
• constant/intermittent
• recurrent
• duration
• frequency

Question 23

family hx

Answer 23

• parents, siblings, grandparents

* age of onset for FHx

Question 24

social hx

Answer 24

• occupation/work setting
• habits - tobacco, alcohol, drugs
• diet
• exercise
• relationship/support