Patient practitioner relationships Flashcards
Describe what the parson’s sick role cycle is?
- Patient temporarily excused from normal role
- Patient not responsible for own illness
- Patient must want to get better
- Patient must cooperate with competent help
What were the issues associated with Parsons sick role model?
- Patients are not always as passive as they are in the sick role cycle- severity of illness plays role- doesn’t take into account patient belief
- The model is biased for a medical professional
- Model cannot be applied to chronic conditions that do not improve no matter the degree of patient co-operation
In the present day, what does patient centred care mean?
- Listening to patient fully and addressing their concerns
- Exhibiting care and compassion- fully engaging in other agreeable behaviours to improve patients psychological, physiological and functional outcomes at all times
What is the three function model for a medical interview? And in the latter phase, what is expected?
- Data gathering phase
- Rapport development phase
- Educational and motivational phase
- Practitioner also works to resolve any areas of conflict to negotiate agree meant on therapeutic outcome
Describe the CALGARY- CAMBRIDGE approach to consultations? (IMPORTANT)
- Initiating session (establish the initial reason for consultation)
- Gathering information (exploring problem and understand the patients perspective)
- Building structure to the consultation
- Building relationship (appropriate non-verbal cues, developing trust and involving patient)
- Explanation and planning
- Provide correct amount and type of information
- Aiding accurate recall and understanding of information
- Gaining shared understanding by incorporating patients perspective
- Shared decision making - Closing the session
- Forward planning and appropriate closure
What is the general calgary cambridge consultation approach?
- Initiate session
- Gather information
- Provide structure
- Build relationship
- Explain and plan
- Close the session
What are the three dimensions of power sharing in the medical model?
- Who sets goal of visit? (doctor, patient or both)
- Whether patient’s values are explored (assumed by doctor, jointly explored or unexamined)
- Functional role of doctor (guardian, advisor or consulting technician)
What is the power like in a mutual relationship and describe what the patient visiting doctor scenario will be like?
- Power is balanced
- Purpose visit negotiated
- Patients values explored and doctor plays advisory role to guide patient’s decision
What is the power like in a paternalistic relationship and describe what the patient visiting doctor scenario will be like?
- Doctor holds onto the balance of power
- Controlling agenda for visit
- controlling goals and outcomes
- Acting as a guardian without explicitly exploring patients interests
What is the power like in a consumerist model and describe what the patient visiting doctor scenario will be like?
- Patients set the goals and agenda
- Making the decisions
- Determining the outcomes
- Doctor becoming a more technical consultant
What is the model that is preferred under the patient centred model of care?
Shared decision making care
What is shared decision making?
- Two way exchange of information between practitioner and patient and includes discussion of preferences for health states, therapeutic options and outcomes
- Finally they both come to a mutual decision and engage in this plan of action
What are some of the steps to ensure full patient involvement?
- recognising and clarifying problems
- identifying potential solutions
- discussing open and uncertainties
- Providing information about potential benefits, harms and uncertainties of each option
- Checking understanding and reactions
- Agreeing course of action
- Implementing chosen treatment
- Arranging follow up and evaluating the outcome
