Exam 3 Flashcards
Integrated patterns of human behavior
Culture
The tendency to believe that what people do reflects who they are
Fundamental attribution error
Fundamental attribution error is also called
Correspondence bias or attribution effect
Over-generalized belief about a particular category of people
Stereotypes
Negative attitude or feelings based on stereotype towards category of people and its individual numbers
Prejudice
Negative and unequal treatment of individuals based on their group membership
Discrimination
PAUSE
Pay attention, acknowledge, understand, search, execute
When is PAUSE used
Culturally responsive care
Attitudes, knowledge, and skills that allow integration and translation of knowledge about various cultures into the practice of pharmacy
Cultural Competence
Acknowledgement of one’s own barriers to true intercultural understanding
Cultural Humility
Platinum rule
Treat others as they would want done to them
Unconscious attribution of particular qualities to a member of a certain social group
Implicit Bias
The ability to provide care to patients with diverse values, beliefs, and behaviors and to tailor that to the needs of the patient
Cultural Competence
What determines health and differences in health
Social determinants, time, endowments
Endowments
Something given and cannot be changed (Genetics)
Health disparity
Difference as a result of factors other than clinical appropriateness and patient preference
Discrimination
Differences as a result of bias
Health Difference
Clinical appropriateness and need, patient preference
Donabedian framework
Structure of care and process of care leads to health outcomes.
Interventions should target structures and processes to improve outcomes and decrease disparity
Iron trianlge
Quality of care, cost containment, access to care
Can only pursue two of the 3 dimensions without the third being sacrificed
Equality
Equal opportunity
Equity
Equal outcome
In health and health care what is the opportunity and what is the outcome
Health care is the opportunity, health is the outcome
Stereotype
Exercise our mind
Prejudice
Exercise our emotions
Discrimination
Exercise our will
Ideas of professionalism given to pharmacy
Law, code of ethics, specific knowledge, formalized institutions to pass on knowledge
Social object of pharmacy
Optimizing drug therapy
4 outcomes that improve patient quality of life
Cure of disease, reduction/elimination of symptoms, arresting/slowing of disease symptoms, preventing disease or symptoms
5 causes of patients non-quality of life
Inappropriate prescribing, delivery, behavior by patients, monitoring, and patient idiosyncrasy
Most important cause of patient non-quality
Inappropriate monitoring
Pharmaceutical care
Responsible provision of drug therapy for the purpose of achieving definite outcomes that improves a patients quality of life
Components of the Communication accommodation theory (CAT)
Approximation, interpretability, emotional expression, discourse management, interpersonal control
Approximation
speech patterns
Discourse management
Asking questions, taking turns, non-verbals, listening
Interpersonal control
Patient centered/shared decisions, balance of power
Health literacy
Ability to perform tasks related to function in the health care environment
Components of health literacy
Reading, writing, numeracy, speaking, listening, understanding concepts
What can help with health literacy?
SILS, REALM, teach back, open ended questions, plain language
REALM
Rapid estimate of adult literacy in medicine
SILS
Single item literacy screener
State of complete well-being includes physical, mental, social, spiritual
Health
Objective phenomenon/pathology characterized by altered or abnormal functioning
Disease
Subjective phenomenon including physical and social state
Illness
Ability to meet obligations and roles as defined by others as a result of disease or illness
Sickness
Theory
Things you can observe and how those are inter-related
Purpose of a theory
Useful for understanding, planning, implementing, evaluating
Kleinman model
Explanatory model of illness
Kleinman model elements
Severity, timing and mode of onset, pathophysiology, natural history (Course), etiology (cause), treatment
Reaction to illness
Denial, action, emotion
Reaction to abnormality
Hide/mask or seek fix
Health behavior
Activity by a person who believes self health
Health belief model domains
Perceived susceptibility, severity, benefits, barriers
Health belief model elements
Demographic/psychosocial variables, perceived threat, decisional balance, cues to action, likelihood of taking action
Patient Centered Care
Identifying and responding to patients ideas and emotions regarding their illness and reaching common ground regarding treatment
Biomedical model
Better treatment, but patient is in a passive role and health is considered absence of disease
4 habits model
Invest in the beginning, elicit patient’s perspective, demonstrate empathy, invest in the end
When is the 4 habits model used
Patient centered care
Framework for understanding the stages individuals progress through toward adopting and maintaining health behavior change
Transtheoretical model/stages of change
5 stages of change
Pre-contemplation, contemplation, preparation, action, maintenance
RULE
Resist the righting reflex, understand your patient’s motivations, listen to your patient, empower your patient
OARS
Open ended questions, affirming reflective listening, summarizing
Self expressed language that is an argument for change to the healthy behavior
Change talk
SOLER
Face Squarely or at an angle, open posture, lean forward, eye contact, relax
Primary non-adherence
Not starting the prescription
Secondary non-adherence
Anything after the script has been picked up
Medication non-persistence
Prematurely stopping medication, secondary
Impact of non-adherence
30-50% of people are non-adherent, expensive, causes 125,000 deaths
Direct assessment of medication
Lab values, sensors, direct observation
Indirect assessment of medication
Interview, self-report, pharmacy record, med counts
Dimensions of non-adherence
Health care or system factors, patient related factors, therapy related factors, condition related factors, social and economic related factors
DRAW actions
Simplify regimen, organize medications and refills, understand, educate, motivate, reduce cost, address cognitive issues, follow up
Self-deception
Problematic assumption regarding respect, judgement of meaning applied by self to action/comment by other
Suicide statistics
44,193 die annually 1 Million attempts each year, 10th leading cause of death, 2nd for our age range
Suicide best practices
Ask directly, listen and support, validate feelings, connect resources
