L31 - Living with uncertainty Flashcards
• 1. Infer situations that generate uncertainty for patients • 2. Describe the relationship between uncertainty and stress • 3. Recognize the impact diagnoses of unknown etiology and/or of a non-treatable nature have on both patient and doctor • 4. Reflect the roles of stereotypes in influencing such circumstances • 5. Infer strategies that can reduce or avoid negative impacts of uncertain and/or non-treatable conditions on both patients and practitioners.
On the basis of perceived resources and perceived demand, what is perceived appraisal?
judgement a person makes of how well their perceived available resources can meet the perceived or anticipated demands
In term of perceived demand and perceived resources, when will there be stress
Perceived demand > Perceived resources
When will the stress be worse (list 3-4 situation)
High or unclear threat
Ambiguity in indicators of threat onset
Marginal control
Weak beliefs about personal control
How will stress affect us? (4 effects)
Impaired immune function
Raised CVS reactivity
Subject anxiety/ depression
Impaired decision making
What is stereotyping in healthcare basis
oversimplified expectations about others based on one or more characteristics and over-extended to all who have such characteristics. e.g. “elderly”
What is the up side and down side of stereotyping
Helps minimise uncertainty but raise risk of error, prejudice and discrimination
What kind of information is given on the basis of shared decision making
Explanatory
Preparatory
How are uncertainties reduced
Clear, honest information Shared decision making Reassurance of continued supportive Dr/ Pt relationship Second opinion/ group decision making Clear delineation of responsibility
How do you demonstrate Supportive Dr/Pt relationship
Recognise pt. may have expertise
Provide guidance but respect patient’s preferences
Encourage questions
Empathy, not sympath or defensiveness
Policy for seeing same doctor on each visit
Honesty
Mr Chui has to receive endoscopy, he is quite anxious. Before the surgery, the gastroenterologist explained to him step by step the procedures of the endoscopy. He also told him how it would feel like. The man felt much better and less anxious. This can be explained by A. Confidence in the doctor B. Increased control by reducing anxiety C. Generalized increased control D. Predictability E. Assurance
C/D ?
I personally think it is D
This is the Preparatory part in the shared decision making. I think the patient is anxious because of the uncertainty in the procedure, hence by providing information, it increases the predictability.
