Lecture 7 Flashcards
Using Health Services
Malingering
lying, saying you are sick to get secondary gains
steps to using health care services
- Perception - detecting or perceiving symptoms
- Interpretation - interpret symptoms as potentially threatening
- Decision - decide that medical attention or health care is needed
Stages of delay
Things that may hold people back from using health care
- Appraisal - time that it takes before you interpret it as a problem
- Illness - time you live with the illness before you decide to use health services
- Utilization - the time between when you decide you should see health services and when you actually see them
The ‘worried well’
Those who are unnecessarily anxious about their health in the absence of a related diagnosis. These ppl tend to misuse health services
Lay referral Network
Before people decide to seek medical attention for their symptoms, they typically get advice from friends, relatives or co-workers who may: help interpret a symptom, give advice about seeking care, recommend a remedy, recommend talking to someone else
What groups report difficulties accessing health care services?
Women
LGBTQIA+
Indigenous ppl
Immigrants
Low income canadians
Those reporting poor health
How is gender related to health services use?
Both women and gender non-conforming people report more difficulties accessing and using health services
Misgendering and its impacts
Misgendering occurs when a person is addressed or describing using language that does not match their gender identity
Within the health care system this can significantly affect the mental health of trans and nonbinary individuals and limit future engagement with the health care system
How are indigenous people affected when it comes to health care?
Language and culture have been cited as key barriers
Lack of transportation and childcare services; lack of services in the area
What barriers to accessing health care do ppl with disabilities face?
They persist many incorrect assumptions about health care needs
Ppl with disabilities often are excluded from health care initiatives
What are some things the patient can do that may be problematic or impede communication?
Wait too long to see a doctor
Be a passive consumer, not listen
Insist procedures are unnecessary
Express too much concern
Describe symptoms inaccurately
Omit or falsify information
Insist on procedures or medications that are unnecessary
Fail to follow recommendations
Monitors and how to motivate them
More concerned and worried about the issue and are seeking information
To motivate them you need to provide messages that include detailed information about risks and strategies
Some things the practitioner can do that may be problematic
Not listen, ignore
Focus on only the first problem mentioned
Ask only yes or no questions
Depersonalize patient
Use too much medical jargon
Use baby talk
Blunters and how to motivate them
Overwhelmed by threatening information
To motivate them, keep messages short, succinct, non-threatening and in simple terms
Patient Centred Communication
Care providers try to see the problem and treatment as the patient does, and in doing so enlist the patient’s cooperation
Is empathy bad for the provider?
Empathy can lead to compassion fatigue which is emotional exhaustion due to frequent/difficult patients
Empathy can also lead to burnout
3 components of burnout
- Emotional exhaustion
- Depersonalization
- Low sense of personal accomplishment
Clinical Empathy
Understanding the inner experiences and perspectives of the patient as a separate individual and communicating this to them
Factors related to patient satisfaction
Technical quality of treatment and care
Quality of interaction with practitioner
Sense of autonomy and informed consent
Communication
Coordination and communication among care providers
Support and planning for leaving the hospital
How does the physical space of health care services affect patient satisfaction?
Single bed hospital rooms result in better physical and mental health outcomes for patients
Reliable benefits associated w having a window in one’s room and having a view of nature specifically
Patient experiences w hospital food play a significant role in overall ratings of satisfaction with care
How is patient satisfaction associated with good health outcomes
Reduced hypertension
Fewer complications after surgery
Reduced mortality
Improved patient compliance/adherence
Improved use of health services
Alternative Medicine
Any practice that has purported ealing effects but is not scientifically based; used in place of medical treatment
Complementary Medicine
Alternative medicine used in conjunction with conventional medical treatment
Types of CAM (Complementary and alternative medecine)
- Manipulative and body based methods (ex. Chiropractic care)
- Natural products (ex. Herbal products, vitamin and mineral supplements)
- Mind-body interventions (ex. Progressive muscle relaxation, meditation, yoga)
Concerns about CAM
Some have harmful side effects
People are profiting from false claims about CAM effectiveness
People may forgo conventional medicine in lieu of CAM
Placebo effect
Any medical procedure that produces an effect in a patient bc of its therapeutic intent and not its specific nature, whether chemical or physical
Randomized Clinical Trials
Designed to measure the efficacy of a drug under optimal conditions; typically using control group
The placebo effect is especially problematic to RCTs as it causes confusion about the underlying causes of any observed effects. IF a new drug is observed to have an effect, it is unclear how much of that effect is due to the placebo effect, which is assumed to occur with any treatment
Placebo characteristics
The shape, size, colour, taste and quantity of a drug influences its effectiveness: the more a drug seems like ‘medicine’, the more effective it will be
Green and blue pills are associated w sedative effects
Yellow and red are associated with stimulant effects
White pills are associated with pain meds
Capsules are considered more effective than tablets
Provider Characteristics: Placebo
Providers who exude warmth, confidence, and empathy get stronger placebo effects than do remote and formal providers
The providers faith in the treatment is another influence on the effectiveness
