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Behavioral Medicine I > PA-PT Communication > Flashcards

PA-PT Communication Flashcards

1
Q

What is the most important factor in determining pt adherence to treatment plan and satisfaction with practitioner?

A

The interview. It is the keystone of satisfaction.

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2
Q

> 80% of Dx are based on…

A

the interview

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3
Q

How long is the average physician interview? Hope much time to pt get to tell their story on average?

A

6 min; 18s

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4
Q

What percentage of people get to finish their story when talking to their practitioners?

A

2%

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5
Q

What are the 2 health outcomes associated with interviewing?

A

Diagnostic accuracy and patient adherence

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6
Q

What are the 4 social outcomes associated with interviewing?

A
  1. satisfaction
  2. informed consent
  3. few complaints
  4. decrease in malpractice
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7
Q

What are the top 6 reasons for malpractice law suits?

A
  1. explanation of Dx inadequate
  2. explanation of Tx inadequate
  3. pt feels ignored
  4. not understanding pt/family perspective
  5. devaluing pt/family views
  6. rushing
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8
Q

What is the cycle of communication? What steps can this go wrong in?

A

spoke > heard > understood > agreed to > acted on; all of them

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9
Q

What stage of the communication cycle comes after understanding?

A

Agreeing to idea.

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10
Q

What percent of communication is verbally expressed through words?

A

~10%

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11
Q

Words, silence, sounds, tone, volume, and attitude are all examples of…

A

verbal communication

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12
Q

Body motions, use of space, touch, eye contact, use of time, posture, and locomotion are all examples of…

A

nonverbal communication

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13
Q

What do patient want from their practitioners?

A
  1. to be heard
  2. to be understood
  3. for their information to be retained
  4. for their information to be acted on
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14
Q

What are the goals of communication with your patient?

A
  1. elicit information to create tx plan
  2. provide pt with information to execute tx plan
  3. ensuring the pt is ABLE to execute tx plan
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15
Q

What are the 3 types of PA-PT partnerships discussed in class?

A
  1. Patient Centered
  2. Cross cultural
  3. Collaborative
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16
Q

How do PAs establish patient-centered partnerships? (Hint: 7 steps)

A
  1. listen
  2. validation
  3. explore painful areas
  4. examine own beliefs about right approach to clinical care in any given situation
  5. be sensitive and aware to outside influences on the patient
  6. be flexible and negotiate when it comes to making plans
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17
Q

How do PAs establish cross-cultural partnerships with pt? (3 ways)

A
  1. understand illness from perspective of the patient
  2. understand social context
  3. assist pt with understanding Dx and Tx
    - ex. explain a cavity is not a curse
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18
Q

How do PAs establish collaborative partnerships with pt? (6 ways)

A
  1. identifying problems together
  2. both resp. for solving problems and outcomes
  3. help pt make informed choices
  4. pt set goals
  5. teach problem solving skills and help pt accomplish goals
  6. PA works with interdisciplinary team
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19
Q

What are the 4 E’s required for effective PA

A
  1. Engaging
  2. Empathy
  3. Education
  4. Enlisting
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20
Q

The pt’s language is a language of ____.

A

experience; they want to tell a story; they are concerned with personal meaning of illness; they want to speak in response to open-ended questions.

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21
Q

The clinician’s language is a language of _____.

A

Medicine and science; they want to get Hx quickly, ask closed-ended question to get specific info.; and are looking to construct DDx

22
Q

Inviting the patient to tell a story; is an example of?

A

Developing rapport.

23
Q

What are the four ways you can help to develop rapport?

A
  1. open-ended questions
  2. invite pt to tell story
  3. listen actively; acknowledge the story
  4. summarize what you heard
24
Q

What do you think needs to be done to relieve the problem?

Is an example of what type of question.

A

Open-ended.

25
Q

Feeling sorry for someone is called…

A

Sympathy

26
Q

Putting oneself in another person’s shows is called..

A

Empathy

27
Q

Offering reassurance is…

A

Support; not empathy.

28
Q

The ability to intellectually identify with or vicariously experience the feelings, thoughts, and attitudes of another in order to gain understanding of their experience, is called…

A

Empathy

29
Q

You are faced with a pt who is a convicted felon. You do not feel empathy for this patient. Should the quality of care the pt receives differ from anyone else?

A

No.

30
Q

Assessing/judging a behavior and not the person is an example of showing…

A

empathy

31
Q

Reflecting on your understanding of a pt situation is an example of an…

A

empathic behavior

32
Q

Using the pt’s language so that they feel heard is an example of an…

A

empathetic behavior

33
Q

When is it appropriate to self-disclose? What type of behavior is this an example of?

A

Empathetic behavior; only when disclosing information purely benefits the pt

34
Q

What are 5 common barriers to expressing empathy in the healthcare setting?

A
  1. time
  2. energy
  3. control of interview
  4. burnout/can’t fix distress
  5. not PAs job
35
Q

What does the acronym OARS stand for and what does it relate to? (Which E?)

A

Empathy;

  1. Open Questions
  2. Affirmations
  3. Reflections
  4. Summary
36
Q

“I heard you say it is hard to fit in exercise now that you’re in PA school”, is an example of?

A

Reflection. Used in empathy.

37
Q

“You’ve had difficulty sleeping now for the last couple of weeks, your appetite is gone, and you’re not able to concentrate at work. Is that right?” Is an example of…

A

Summary. Used in empathy.

38
Q

When a pt transfers feelings towards other in their life onto their practitioner it is called…

A

Transference

39
Q

When a PA transfers feelings towards other onto the pt, involving personal biases, stereotypes and beliefs, it is called…

A

counter-transference

40
Q

What are the four things PAs need to educate their pt on?

A
  1. Dx
  2. Tx plan
  3. how to care for themselves
  4. how to navigate the healthcare system
41
Q

What percentage of pt want as much info from the clinicians as possible?

A

90%; pt cannot give informed consent if they do not have all the information they need.

42
Q

Health literacy effects _____.

A

Health outcomes; identify pt with low health literacy.

43
Q

Poor patient eduction leads to…

A

increased health system costs

44
Q

What method should be used to educate your patients?

A

Ask-tell-ask model

45
Q

Explain the components of the ask-tell-ask model.

A

Ask: what they know
Tell: what them about stuff they missed
Ask: for understanding with teach-back/show-me technique

46
Q

Asking a patient to explain or demonstrate how they will undertake a recommended treatment plan is called…..

A

Teach-back/show-me technique of determining patient’s understanding of treatment plan or interventions.

47
Q

During teach-back/show-me technique, your patient does not correctly explain the treatment plan. What do you do?

A

Re-teach the information in a different way.

48
Q

Limit the amount of information provided, and repeat it, is an example of a useful _________ strategy.

A

communication

49
Q

List 7 examples of communication strategies.

A
  1. slowing down
  2. avoiding jargon
  3. drawing pictures
  4. limit information provided and repeat it
  5. use teach-back technique
  6. allow questions
  7. include family
50
Q

What does enlisting the pt refer to?

A

inviting patient to be involved in decision making process.

51
Q

How can you enlist your patient?

A
  1. share decision making
  2. assess conviction and confidence
  3. identify/solve barriers
  4. Agree on simple plan and write it out
52
Q

What are the 5 questions a pt should be able to answer after an appointment?

A
  1. what health problems do i have and what do i do about them
  2. where do i go for tests, medicine, and appointments
  3. how do i take my medicine
  4. other info (what, how, when…)
  5. Next steps that need to be taken (next apt., place, phone numbers)

Behavioral Medicine I (5 decks)

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