Effect of Stay in Hospital on Patients Flashcards
Identify the main physical health hazards of hospitalisation.
- Bed rest
* HCAI
Identify the effects of hospitalisation on adults.
- unfamiliar hospital environment
- entering the role of a patient
- loss of control
- depersonalisation
- institutionalisation
Identify specific effects of hospitalisation on children.
- separation distress
- illness misconceptions
- faulty representation
What are the main consequences of increased bed rest on health ?
Decreased muscle mass and increased body fat (decreased fitness and functional ability, which can result in loss of independence for elderly patients)
How can the risk of HAIs be reduced ?
By the implementation of hospital infection control guidelines
Why is the hospital environment problematic for patients ?
- unfamiliar environment
- privacy is often limited
- wards can be stressful places to stay (not conducive to recovery)
- staff wear uniforms
- a patient may interact with up to 30 members of staff in a day
- many objects in the environment are unfamiliar
Describe the issue of “entering the role of a patient” in hospital stays.
Loss of familiar social roles from work and home results in the patient ‘role’:
•wear night-clothes during the day
•allowing parts of their body to be examined •little control over timing of meals, visits or when the main lights go out
What do doctors as being “good” patients ? “bad” patients ? Which of these categories is more likely to make a better recovery ?
“Good patients” are perceived as being passive, not demanding much time etc. when in fact “Bad patients” (those asking questions, complaining etc.) understand their situations better and therefore are likely to make a better recovery.
Explain the issue of “loss of control” associated with hospital stays.
-Restrictions are placed upon patients:
•therapeutically desirable restrictions (better for recovery)
•organisationally desirable (e.g. everyone gets lunch at the same time)
-As a result of these restrictions, reactance (feeling of anger when patient feels restrictions are unnecessary, and hospital staff often on receiving end of reactance)
-Patients can have an internal, or external recovery locus of control (measured through a recovery locus of control scale, RLOC) following a hospitalisation. Internal locus means they feel they control their recovery, whilst external locus means they feel their recovery is in the hands of the doctors etc.).
Patients with internal loci make better recoveries (since they know their behavior controls their recovery, more likely to adhere to treatment, carry out physiotherapy).
-Inpatient episodes can be used to boost a patients perception of self control
Give an example of what a patient with an internal recovery locus of control might say.
It’s what I do to help myself that’s really going to make all the difference
Describe an experiment performed to test the effectiveness of internal loci of control.
- Hysterectomy patients under general anaesthesia.
- Audio therapeutic suggestions and statements designed to reinforce the internal locus of control (e.g. it’s what you do that controls your recovery) played along with blank tape, because cortical audio evoked responses are not abolished by most general anaesthesia (so their cortex was still processing the information)
- When compared with a control group, they had shorter periods of bedrest following the operation, and a better recovery.
Identify and define some the forms of control which may be lost in the process of a hospital stay ?
Behavioural control: perceived ease or difficulty of performing the particular behavior.
Cognitive control: How patient thinks about hospital experience they are having.
Decision control: perceived ease or difficulty of making decisions.
Informational control: perceived awareness of the information to assist them in increasing recovery or making decisions.
Give examples of ways to aid patients in increasing the different forms of control which may be lost in a hospital stay. What is the benefit of improving these forms of control in hospital ?
Behavioral control: Teach patient to turn over in bed without pulling stitches, physiotherapy
Cognitive control: Encourage patient to focus on positive aspects of hospitalization
Decision control: Shared healthcare
Information control: Helping patient get reliable information from reliable sources
Improving these forms of control (i.e. preventing the patients losing them) can aid recovery.
Define depersonalisation. Give an example of something a doctor might stay when depersonalising a patient. What is the problem with depersonalisation?
When your patient is treated as though he or she were either not present or not a person
“The stomach ulcer in bed nine”
Depersonalisation can reduce patient satisfaction in care.
Why does depersonalisation occur ?
1) a way of distancing the doctor from the fact that the body they are treating belongs to a thinking and worried person (helps them not be emotionally involved)
2) may help practitioners deal with patients deteriorating or dying
3) overworked, stressed and tired doctors may lead to less personalised care