Part II Ch 4-8 Flashcards
1
Q
Communicating with someone in a way that doesn’t disparage or put down the other person or their actions, whether or not you disagree
A
tactfulness and diplomacy
2
Q
Showing consideration for other people’s feelings and needs
A
courtesy
3
Q
To be completely yourself when dealing with others in all of your words and actions
A
genuineness
4
Q
When you are genuine in human interactions, you do not just go through the motions, but you ____ fully
A
engage
5
Q
To open up, or show something about one’s self
A
appropriate self-disclosure
6
Q
Self-disclosure is best used when it does these 2 things
A
- shows another person that you have had experiences similar to theirs
- it has significance because it allows you to show empathy for what that other person is feeling as a result of their experience
7
Q
What 4 things you should avoid re: self disclosure?
A
- telling a story about yourself simply for the sake of telling a story about yourself
- telling a story that is not about you but about the problems of someone else the patient doesn’t know
- one-upping the patient by trying to outdo their story
- removing the focus in any way from the patient
8
Q
To be able to stand up for what you believe is right without any undue anxiety about what others may think of you
A
assertiveness
9
Q
_____ communication uses clear and direct language while remaining relaxed and respectful
A
assertive
10
Q
_____ communication uses confrontational and even sarcastic language, while maintaining a tense and often superior attitude
A
aggressive
11
Q
Communication that advances the patient’s well-being and care
A
therapeutic communication
12
Q
HCPs should avoid giving easy reassurance because the patient has the right to feel any way they may feel and such reassurance ____ the patient’s feelings
A
diminishes
13
Q
HCPS should avoid giving easy reassurance because it may give ____ in the face of a negative outcome
A
false hope
14
Q
Approving or disapproving of the patient can falsely give the patient the impression that a _____ exists between them and their HCP
A
power relationship
15
Q
Agreeing/disagreeing with a patient is an ineffective communication behavior because it turns the discussion of the patient’s health into a matter of the patient’s being ____
A
right or wrong
16
Q
Prying is distinct from encouraging discussion; HCP with effective communication skills will understand how to strike the balance between ____ and ____
A
pushing too hard and helping a patient open up
17
Q
Defensive HCPs inappropriately changes the terms of the relationship from patient/provider to _____
A
attacker/defender
18
Q
T or F. Patients may not understand why they have acted a certain way; to ask them for their reasons can inhibit, confuse, or even anger them
A
T
19
Q
Cliches can cause the patient to feel that the HCP is giving a _____ response
A
mechanical, thoughtless
20
Q
Ineffective coping behavior: overemphasize a certain trait or behavior in one area because they believe they must make up for what they perceive as a deficiency, or failure, in another
A
compensation
21
Q
Ineffective coping behavior: patient attempts (unconsciously) to reject or deny the existence of feelings, needs, thoughts, desires, or even facts
A
denial
22
Q
Ineffective coping behavior: when it is impossible for the patient to accept ownership of certain thoughts, feelings, needs, desires; attributes them to a more acceptable substitute–someone or something outside of themselves
A
displacement
23
Q
Ineffective coping behavior: patient attempts to disconnect the emotional significance of certain ideas or events from those ideas or events
A
dissociation
24
Q
Ineffective coping behavior: patient mimics the behavior of someone else in order to conceal their own natural behavior
A
identification
25
Ineffective coping behavior: patient projects onto another person or object their own feelings, as if the feelings originated in the other person or object
projection
26
Ineffective coping behavior: using false reasoning to justify inappropriate or unacceptable behavior, hoping to make the behavior tolerable
rationalization
27
Ineffective coping behavior: unconsciously returning to immature, or even infantile, behaviors or thoughts
regression
28
Ineffective coping behavior: patient simply puts out of their mind painful or difficult thoughts, feelings, ideas or events
repression
29
Syndrome where a patient may feel anxiety just because they are present in a medical practice
white coat syndrome
30
T or F. If conflict with a coworker is serious (sexual harassment, quality of patient care concerns), you should speak with the other party first before involving a supervisor
F; involve a supervisor immediately
31
Initially enacted to protect workers in the US from being denied health insurance coverage when changing jobs
HIPAA: Health Insurance Portability and Accountability Act
32
Workers could change jobs with the confidence that their health insurance would not have to be interrupted between jobs or at the start of a new job
portability
33
Rule that protects patients' rights by ensuring the privacy of patients' health information
HIPAA privacy rule
34
Your healthcare organization must have policies and procedures that comply with either the state or federal law, whichever is ____
stricter
35
States policies and procedures by which patient health information may be disclosed
Notice of Privacy Practices (NPP)
36
Health orgs must have patients sign this document
Acknowledgement of Receipt of Privacy Practices
37
The use and disclosure of health information are permitted only for TPO; expand
treatment, payment, healthcare operations
38
TPO: includes activities like accreditation, employee training, and quality control
operations
39
4 exceptions to TPO
1. court orders
2. workers' compensation cases
3. statutory reports
4. research
40
Used to properly diagnose the patient's condition and develop the appropriate treatment plan; done by obtaining a thorough and accurate medical history
patient interview
41
3 functions of the medical interview
1. information gathering
2. relationship building
3. patient education
42
2 common approaches to the patient interview
1. primary care provider-only approach
| 2. team approach
43
Approach where the patient relates their medical history only once
primary care provider-only approach
44
Approach where the patient is interviewed more than once
team approach
45
____ approach is time consuming but may result in a more thorough and complete medical record
team
46
Primary interviewees are usually the patients themselves but may also be ____
family members, spouses, etc
47
___ questions quickly provide a great deal of objective information about the patient
closed questions
48
____ questions establish therapeutic communication and relationship between patient and HCP
open
49
Avoid using questions that begin with ____
why
50
Avoid ____ questions which are likely to prompt or encourage the patient to provide what they perceive is the desired answer
leading
51
Statements that involves obtaining information from the patient without the patient feeling questioned; often starts with "tell me about..."
indirect statements
52
Interview where the HCP controls the dialog; may interrupt the patient and may prevent the patient from continuing to express all of their concerns
HCP-centered interview
53
Interview where HCP uses "continuers" expressions that encourage the patient to reveal all of their concerns at the beginning of the interview
patient-centered interview
54
3 elements of the patient-centered interview
1. open-ended questions
2. indirect statements
3. specific closed questions
55
The American Academy on Physician and Patient suggests "PEARLS" during a patient-centered interview; expand
```
Partnership
Empathy
Apology
Respect
Legitimization
Support
```
56
PEARLS: conveys that the HCP and the patient are in this together
partnership
57
PEARLS: expresses understanding and concern for the patient
empathy
58
PEARLS: acknowledges that the HCP is sorry that the patient had to wait, that the procedure was painful, that the lab tests will take several days to process, and so on
apology
59
PEARLS: acknowledges the patient's suffering, anxiety, fear, etc
respect
60
PEARLS: acknowledges that the patient may be angry, frustrated, depressed, etc
legitimization
61
PEARLS: conveys that the HCP will be there for the patient and not abandon them
support
62
The interviewer should sit approximately ____ from the patient and maintain a relaxed but attentive posture
an arm's length
63
____ questions help to eliminate ambiguous responses or confusion on the part of the patient
direct
64
Another important aspect of listening is being aware of what the patient has ____ of their verbal response
left out
65
HCPs should ____ the implied; derive a conclusion about what the patient really means
verbalize
66
Primary goal of an interview is to identify the patient's ____
chief complaint
67
Interviews should focus on, or ____, specific symptoms or important medical information that will facilitate reaching an accurate diagnosis
pinpoint
68
Many children are able to contribute substantially to the patient interview by the age of __ or __ years but must be verified by a guardian
5 or 6 years
69
When interviewing adolescents, avoid ___ that would tend to elicit brief responses or silence
closed
70
Discussing a patient with an unauthorized individual is a violation of the patient's privacy and can turn into an ___ and ___ issue
ethical; legal
71
The degree to which individuals have the capacity to obtain, process, and understand basic health info and services needed to make appropriate health decisions
health literacy
72
Health literacy requires basic ____ skills and knowledge of ___ issues
literacy; health and medical issues
73
Only __% of adults have proficient health literacy
12%
74
Populations that frequently experience low health literacy
1. older people
2. racial and ethnic minorities
3. people without a high school diploma
4. people with low incomes
5. non-native speakers of English
6. people with chronic disease
75
4 elements of plain language
1. organized info so that the most important points are delivered first
2. info broken down into understandable chunks
3. language that is simple with clearly defined medical terminology
4. use of the active voice
76
Language barriers can cause an increased use of ____ tests and increased rates of _____
diagnostic; hospitalizations
77
3 disadvantages in using family members as medical interpreters
1. unfamiliar with complex medical information
2. more likely to incorrectly translate words and phrases
3. loss of patient confidentiality
78
Employ _____, that is, ask the patient to repeat important instructions or information in their own words
teach back
79
Tell a visually impaired patient that you will be ____ them before you do so; never surprise them with needles, cold stethoscopes or other medical objects and devices
touching
80
When providing instructions, be descriptive when conveying info that would be _____ to patients with normal vision
visually obvious
81
T or F. Do not attempt to guide a visually impaired patient without asking
T
82
When dealing with visually impaired patients, walk with the patient ____ you and the service dog
between
83
Lower case "deaf" is used when referring to the ____ while uppercase "Deaf" is used when referring to a ____
audiologic condition; particular group of individuals who share a language
84
Patients who were born ____ deaf are likely to communicate using ASL; not based on English and uses a different sentence structure and grammar
bilaterally
85
T or F. If a deaf patient doesn't understand, never say "it's not important" as this is dismissive and disrespectful to the patient
T
86
T or F. Focus on deal patients as opposed to friends or family members; they have lost their ability to hear, not their individuality, dignity or intellectual competence
T
87
2 types of confusion
1. delirium or acute confusion
| 2. dementia or chronic confusion
88
Many patients with dementia experience heightened confusion later in the day, also called ____
sundowning
89
3 objectives of patient education
1. changing health outcomes
2. improving health status
3. improving patient compliance
90
T or F. Patient education involves more than the transfer of information
T
91
Estimates of patient noncompliance range from ___% to ___%
50 to 90%
92
3 steps in the approach to patient education
1. assessment of the patient
2. design of the instruction
3. selection of teaching strategies and resources
93
To determine the type of instruction needed for a particular patient, 4 categories of variables must be assesses
1. contexts for the education
2. patient demographics
3. patient learning styles
4. information and content to be included in the teaching session
94
Refers to the medical condition that creates the need for the instruction
situational context
95
Refers to the environment in which the instruction will take place
instructional context
96
Certain characteristics of the patient that may influence their response to the instruction
patient demographics
97
3 types of learners
1. visual
2. auditory
3. kinesthetic
98
Learners respond well to pictures, diagrams, anatomic models, and literature
visual learners
99
Learners prefer to be engaged verbally with the use of questions and answers or discussion
auditory learners
100
Learners learn by physical demonstration of a task or technique by the HCP followed by the practice of the technique by the patient
kinesthetic learners
101
Final component of the assessment phase; determines what info should be included in the teaching session for the particular patient
content analysis
102
Content analysis focuses on what info is ___ rather than redundant, irrelevant, or simply interesting
essential
103
HCP must distinguish between ____ and ____ information
need-to-know; nice-to-know
104
In designing instruction, HCP should begin by establishing _____
behavioral objectives
105
Behavioral objectives are ____ and ____ behaviors that result from the instruction
specific; measurable
106
Final step in the development of instruction
selection of which strategies and resources to use with a particular patient
107
American Academy on Physician and Patient suggests an ____ framework to determine what a patient already knows and what they think about the issue
ask-tell-ask
108
In instructing patients, add ___ behaviors instead of eliminating ___ behaviors
new; old
109
Kinesthetic instruction is beneficial in these 3 instances
1. use of inhalers
2. use of walkers
3. use of glucomenters
110
HCP comes from an understanding of ____ the illness from which the patient suffers, and the patient comes from an experience of the ____ of the illness
what causes; symptoms of the illness
111
HCP needs to develop an understanding of the complex diversity that will characterize society as well as a strong cultural sensitivity, also called
cultural competence
112
The knowledge and interpersonal skills that allow providers to understand, appreciate, and work with individuals from cultures other than their own; involves an awareness and acceptance of cultural differences; self awareness; knowledge of the patient's culture; and adaptation of skills
cultural competence
113
Model that defines cultural competence as the process in which HCP strives to achieve the ability and availability to effectively work within the cultural context of the client; process of becoming culturally competent, not being culturally competent
the volcano model
114
5 steps in the volcano model process
1. cultural awareness
2. cultural knowledge
3. cultural skill
4. cultural encounter
5. cultural desire
115
Volcano model step: looking closely and honestly at your own biases toward other cultures; includes an awareness that racism and other forms of discrimination exist in healthcare delivery
cultural awareness
116
Volcano model step: seeking thorough understanding of attitudes and beliefs of other cultural ethnic groups; as well as health conditions and diseases that exist among them
cultural knowledge
117
Volcano model step: accurate understanding the cultural details surrounding the patient's presenting problem; physically assessing the patient within the context of their culture
cultural skill
118
Volcano model step: actively seeking face-to-face encounters with members of other cultures in order to better understand the HCP's own beliefs about their cultures; prevents stereotyping
cultural encounter
119
Volcano model step: desire of the HCP to become more culturally knowledgeable and skillful; genuine want instead of merely a need to fulfill a job requirement
cultural desire
120
Model describing a range of six points on a scale of cultural competence
The Cultural Competence Continuum
121
6 points in the cultural competence continuum
1. cultural destructiveness
2. cultural incapacity
3. cultural blindness
4. cultural precompetence
5. cultural competence
6. cultural proficiency
122
The Cultural Competence Continuum point: attitudes, policies, structures, and practices by a system or organization that are destructive to members of a cultural group; openly hostile/racist behavior
cultural destructiveness
123
The Cultural Competence Continuum point: inability of an individual or institution to respond effectively to the needs and interests of culturally and linguistically diverse groups; afraid to hire POC because of white customers
cultural incapacity
124
The Cultural Competence Continuum point: viewing and treating all people from different cultures as if they were the same
cultural blindness
125
The Cultural Competence Continuum point: level of awareness by people or institutions of their capacity for growth in responding effectively to culturally and linguistically diverse groups; recognizing the need to cultural train employees
cultural precompetence
126
The Cultural Competence Continuum point: demonstrates an acceptance and respect for cultural differences
cultural competence
127
The Cultural Competence Continuum point: high regard for diverse culture and use this ethical stance as a foundation to guide their endeavors
cultural proficiency
128
6 universal facial expressions
1. happiness
2. sadness
3. fear
4. anger
5. disgust
6. surprise
129
14 standards are organized by these 3 themes
1. culturally competent care
2. language access services
3. organizational supports for cultural competence
130
3 categories with varying levels of stringency within the CLAS framework
1. mandates
2. guidelines
3. recommendations
131
CLAS: current federal requirements for all recipients of federal funds
mandates
132
CLAS: activities recommended for adoption
guidelines
133
CLAS: suggested for voluntary adoption
recommendations
134
T or F. Do unto others doesn't necessarily hold in cross cultural communication
T
135
When communicating with limited-english speakers, speak ___ not ____
slowly; loudly
136
T or F. When an interpreter is present, look at the patient, not the interpreter
T
