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Behavioral Dynamics > Exam 1 (Lecture 3, 4, 5, 6) > Flashcards

Exam 1 (Lecture 3, 4, 5, 6) Flashcards

1
Q

**What are the seven patient factors that are barriers to eliciting patient concerns?

A

Time
Embarrassment
Language barrier
Intimidated
Deaf (Sensory barriers)
Trust
Mental handicaps

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2
Q

**What are the 8 provider factors that are barriers to eliciting patient concerns?

A

Time
Hypocrisy
Provider bias/prejudice
Cultural differences
“Frequent fliers”
Keeping your composure
Personal or emotional conflicts
Patient being inattentive

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3
Q

What are the two portions of the HPI, are the _____ and _____

A

patient centered and clinician centered

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4
Q

What are some nonverbal sources of communication that often fall in the patient centered HPI?

A

nonverbal cues
physical characteristics
autonomic changes
accoutrements (clothing, jewelry, makeup)
environment
self

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5
Q

The empathy skill NURS, what does it stand for?

A

Naming
Understanding
Respecting
Supporting

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6
Q

**What is one important question that needs to be asked during the social context of the HPI?

A

Does it affect your ADLs?

Job function
Daily activities
Hobbies
Family

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7
Q

In the patient education section, what are some key points to cover?

A

Assessment of patient understanding
Communication at patient level
Tailor your education for each patient:
Self-management education

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8
Q

What are some benefits of shared decision making?

A

More likely to feel secure in the healthcare setting
Stronger commitment to recover
Improved perception of the quality of care
Better self-efficacy and patient responsibility for their outcomes
Improved self-management
Better adherence to care plans
Strengthens provider-patient bond

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9
Q

What are some disadvantages of shared decision making?

A

Patient may not desire to make decisions or feel comfortable making decisions
Patient misunderstanding may lead to incorrect decisions
Possible association with increased costs and services in hospitalized patients

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10
Q

**What are some patient factors that are barriers to ending the visit?

A

Failure to comprehend education
Continuous questions
Casual conversation
New complaint at end of encounter
Family members

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11
Q

**What are some provider factors that are barriers to ending the visit?

A

Poor flow of patient encounter
Lack of proper communication with patient
Failure to “enforce” the end of the visit
Casual conversation

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12
Q

Name some skills that define someone as a “good communicator”

A

Effectively listens to others
Understands and uses nonverbal communication appropriately
Manages stress well
Emotionally aware of others
Effective verbal expression of thoughts

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13
Q

What is the “fast food” rule?

A

Whoever is the “hungriest” gets to talk first
Repeat their message sincerely
Remember mirroring!

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14
Q

Oftentimes what does an incomplete history equal ?

A

incomplete data to make decisions

A lot of times, this leads to costly and UNNECESSARY testing!

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15
Q

What are some common patient reasons as to why they did not adhere to the care plan?

A

disagreed with treatment
cost
instructions were too difficult to understand
went against their personal beliefs
did not understand

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16
Q

Name some factors that affect patient satisfaction

A

expectations
communication
control
decision-making
time spent with patient
clinical team
referrals
continuity of care
dignity

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17
Q

What is the root cause in the majority of malpractice causes?

A

poor communication

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18
Q

What is a quick summary of the biopsychosocial model? Who was it proposed by?

A

Interrelation of biological, psychological, and social factors that all contribute to the presence or absence of disease

George Engel

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19
Q

Hereditary (Genetics)
Anatomic
Molecular
Gender
Age
Ethnicity

All fall under what Biopsychosocial Factors category?

A

Biological

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20
Q

Temperament
Personality
Motivation
Emotion
Attention
Cognition

All fall under what Biopsychosocial Factors category?

A

Psychological

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21
Q

Family
Society
Culture
Environment
Spiritual
Economic

All fall under what Biopsychosocial Factors category?

A

Social

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22
Q

What is the the triple overlap of the Biopsychosocial model?

A

mental health

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23
Q

What are the 5 core values of the provider-patient relationship?

A

attentiveness
support
partnership
respect
empathy

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24
Q

Name some forms of nonverbal communication

A

kinesics (facial expression)
proxemic
paralanguage
autonomics
appearance

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25
Q

____ are specific, deliberate movement

A

gestures

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26
Q

_____ are communication through touch

A

haptics

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27
Q

____ space around individual

A

proxemic

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28
Q

____ is nonverbal speech. Name some things it includes

A

paralanguage

Pitch
Tone
Volume
Speed
Rhythm
Emphasis

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29
Q

____ physiologic changes caused by autonomic nervous system

A

autonomic

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30
Q

____ Patient’s body is engaged, relaxed and in an open posture

A

Safe Pattern

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31
Q

_____ Patient’s body is engaged but has increased tension - response of “attack” or “retaliation” due to feeling unsafe

A

Fight Pattern

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32
Q

_____ Patient’s body is not engaged and has increased tension, as in preparing for “flight” - response of “guarding” or “pulling away” due to feeling unsafe

A

Flight Pattern

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33
Q

_____ - Patient’s body is not engaged; the person is overwhelmed with excessive input and is withdrawn, unable to mount a response

A

Withdrawal Pattern

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34
Q

Name 4 common body patterns found in a clinical setting

A

safe
fight
flight
conservation-withdrawal

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35
Q

Define sexuality

A

Encompasses thoughts, feelings and behaviors connected with sexual gratification and reproduction

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36
Q

_____ individual with genetic, hormonal, and/or physical features
of both male and female at once

A

intersex

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37
Q

we all start out _____ during the early stages of fetal life

A

anatomically female

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38
Q

______ Innate sense of feeling male, female, some combination of both male and female, neither, or an alternative such as third gender

A

gender identity

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39
Q

What does gender identity relate to ?

A

psychological aspects of behavior related to masculinity and femininity

40
Q

____ how one presents one’s gender to others

A

gender expression

41
Q

_____ discrepancy between assigned (biological) gender and gender identity

A

Gender discordance (dysphoria)

42
Q

_____ Gender discordant people who make changes to their perceived gender and/or anatomic sex in order to conform with their gender identity

A

transsexual (older term is transgender)

43
Q

____ a person whose gender identity, gender expression, and biological sex all align (e.g., man, masculine, and male)

A

cisgender

44
Q

_____ a person who is not cisgender

A

transgender

45
Q

_____ a person whose gender identity is neither masculine nor feminine, is some combination of both, or is fluid

A

Nonbinary/Genderqueer

46
Q

What are the 4 steps in the sexual response sequence?

A

Desire
Excitement
Orgasm
Resolution

47
Q

What phase of the sexual response?

_____ characterized by sexual fantasies and desire to have sexual activity

A

Phase 1: Desire

48
Q

What phase of the sexual response?

_____ brought on by psychological OR physiological stimulation OR combination
subjective sense of pleasure

A

Phase 2: Excitement and arousal

49
Q

What phase of the sexual response?

_____ peaking of sexual pleasure; releasing of sexual tension; rhythmic contraction of perineal muscles and pelvic reproductive organs

A

Phase 3: orgasm

50
Q

What phase of the sexual response?

____ disgorgement of blood from genitalia (detumescence); subjective sense of well-being and relaxation

A

Phase 4: Resolution

51
Q

Name 3 hormones that lead to increased sexual desire

A

dopamine
testosterone
estrogen

52
Q

_____ also increases vaginal lubrication, blood flow to female genitalia, and fullness/engorgement of female genitalia

A

Estrogen

53
Q

Name 2 hormones that lead to decreased sexual desire

A

Serotonin and progesterone

increased levels in the brain = decreased desire

54
Q

sexual desire for males is commonly ____ stimuli

sexual desire for females is commonly ___ stimuli

A

physical

psychological

55
Q

What is the sexual dysfunction that is associated with the desire phase?

A

hypoactive sexual desire disorder; sexual aversion disorder

56
Q

What is the sexual dysfunction that is associated with the excitement phase?

A

female sexual arousal disorder; male erectile disorder

57
Q

What is the sexual dysfunction that is associated with the orgasm phase?

A

orgasmic disorder, premature ejaculation

58
Q

What is the sexual dysfunction that is associated with the resolution phase?

A

postcoital dysphoria, postcoital headache

59
Q

Sexual dysfunction is frequently associated with _____

A

other psychiatric syndromes

60
Q

______ Deficiency or absence of sexual fantasies, desire for sexual activity

A

Hypoactive sexual desire disorder

61
Q

_____ characterized by an aversion to, and avoidance of, genital sexual contact

A

sexual aversion disorder

61
Q

What are some treatment options for hypoactive sexual desire disorder and sexual aversion disorder?

A

therapy
Serotonergic drugs - flibanserin (Addyi)
Melanocortin agonists - bremelanotide (Vyleesi)
Testosterone + estrogen

62
Q

What is the serotonergic drug that is associated with hypoactive sexual desire disorder and sexual aversion disorder?

A

flibanserin (Addyi)

63
Q

What is the melanocortin agonist drug that is associated with hypoactive sexual desire disorder and sexual aversion disorder?

A

bremelanotide (Vyleesi)

64
Q

_____ dysfunction with lubrication-swelling response of sexual excitement, can be persistent or recurrent, partial or complete. What is the treatment

A

Female sexual arousal disorder

consider therapy referral
Testosterone
Bupropion (Wellbutrin) : is associated with SSRI use
Sildenafil (Viagra)

65
Q

What are some factors that play a role in male erectile disorder?

A

Available sex partner
History of consistent sexual activity
Absence of vascular disease

66
Q

If you have a young/middle aged male with ED what is the likely cause?

A

psych problem

67
Q

What is important to determine in a male with ED?

A

can he get an erection some of the time (masturbation/morning)? or just with a specific partner?

some of the time points to psych as the cause

68
Q

What are some pelvic complaints that are associated with female orgasmic disorder?

A

Endometriosis, pelvic floor dysfunction, pelvic organ prolapse, uterine fibroids
Childbirth or miscarriage/abortion
Atrophy of genital tissues

69
Q

What is the treatment for male orgasmic disorder? What is likely the cause?

A

therapy, dopamine agonists (experimental)

Rigid, puritanical background
Unconscious guilts
History of abuse

70
Q

How is premature ejaculation usually diagnosed?

A

man regularly ejaculates before or immediately after entering his partner

71
Q

____ is the second most common complaint among men with sexual disorders

A

premature ejaculation

72
Q

premature ejaculation can be helped by using the ________ or ____

A

squeeze technique

consider an SSRI

73
Q

_____ recurrent or persistent genital pain occurring in either men or women before, during, or after intercourse

A

Dyspareunia

74
Q

_____ involuntary muscle constriction of the outer 1/3 of vagina. What is one helpful technique?

A

vaginismus

Dilation: dilating vaginal opening with patient’s fingers or with graduated dilators (PT with pelvic subspecialty may help)

75
Q

What pt population is vaginismus most common in?

A

highly educated women, high socioeconomic groups

76
Q

Name some common causes of dysparenia in women

A

Inflammation, infection, or scarring of external genitalia

Thinning of vaginal mucosa and/or reduced lubrication

Endometriosis

Leiomyomas (uterine fibroids)

Chronic cystitis (UTIs, Interstitial cystitis)

77
Q

Name some common causes of dysparenia in men

A

Peyronie’s Disease (abnormal fibrous penile tissue)

78
Q

Name some psych medications that can affect sexual function

A

Antipsychotics → decrease dopamine

Antidepressants (SSRIs, SNRIs, and TCAs) → increase serotonin

Anti-anxiety agents → May improve sexual function in persons inhibited by anxiety, but certain agents may increase serotonin

79
Q

Anticholinergics may produce ____ and ____ leading to sexual dysfuntion

A

dry mucous membranes and impotence

80
Q

What is the criteria for diagnosing sexual dysfunction

A

Experience the disorder 75-100% of the time

Have experienced the disorder for at least 6 months

Have significant distress due to the disorder

Not have another factor that could better explain symptoms (e.g. nonsexual mental disorders, relationship distress, etc.)

81
Q

Female hypoactive desire dysfunction and Female arousal dysfunction merged into a single syndrome _____

A

Sexual interest/arousal disorder)

82
Q

Dyspareunia and vaginismus were merged into a single syndrome called _____

A

Genitopelvic pain/penetration disorder

83
Q

____ sexual arousal not associated with psychological desire. **What is it believed to be the root cause?

A

Persistent Genital Arousal Disorder

Believed to be defect in sensory nerves

84
Q

What is the treatment for Persistent Genital Arousal Disorder?

A

SSRIs, psychotherapy, topical or injected
anesthetic agents

85
Q

____ achievement of arousal by exposing genitalia to strangers

A

exhibitionism

86
Q

_____ consists of recurrent cross-dressing in a heterosexual man

A

tranvestism

87
Q

____ attaining arousal watching an unsuspecting person or people

A

voyeurism

88
Q

____ inflicting pain upon the sexual object as a means of arousal

A

sexual sadism

89
Q

_____ erotic pleasure being achieved by being humiliated, enslaved, or physically bound or restrained

A

Sexual masochism

90
Q

_____ erotic fantasies and sexual urges or behavior involving non-living objects (i.e., female undergarments)

A

fetishism

91
Q

_____ sexual arousal derived from touching or rubbing against a nonconsenting person

A

frotteurism

92
Q

What is the treatment for paraphilias?

A

pharmacotherapy (if evidence for its use) and psychotherapy

93
Q

What is a heterogenous fishbowl?

A

Central sub-group discusses the topic, while a larger outer group observes and offers silent support, varied points of view on an issue are all represented in the center group

94
Q

What is a homogenous fishbowl?

A

Central sub-group discusses the topic, while a larger outer group observes and offers silent support

everyone in a particular class/point of view sits in the center group and states their points first, then the groups change out for each point of view

95
Q

What are good qualities in a good team leader?

A

Open communication/good communication

Having good motives for being the leader

Organized

Seeing themselves as equal to others on the team, not better than others

96
Q

What are some qualities of a good team participant?

A

Actually participate/willing to work

Flexible

Different/diverse backgrounds

Involves others in decisions

Behavioral Dynamics (16 decks)

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