Patient-Practitioner Relationships

Question 1

What does the Sick Role by Parson state (4)?

Answer 1

Parson’s Sick Role

1. Patient temporarily excused from normal role
2. Patient not responsible for own illness
3. Patient must co-operate with competent help
4. Patient must want to get better

Question 2

Describe FIVE criticisms of Parson’s sick role

Answer 2

1. Too rigid of a model
2. Not all patients are passive
3. Passivity depends on character and severity of condition
4. Some interventions require physically intrusive procedures e.g surgery
5. Biased in favour in medical profession

Question 3

What does Patient-centered care advocate?

Answer 3

1. Listening to the patient fully.
2. Exhibiting care and compassion
3. Engaging in agreeable behaviour to improve the patient’s psychological, physiological and functional outcomes all at the same time.

Question 4

Patient centered care (think holistic) encourages…

Answer 4

focus on the patients and their concerns rather than merely diseases and their assessment.

Question 5

What is the Three Function Model for the medical interview?

Answer 5

Model by Cohen-Cole and Bird. It advocates:

1. Data gathering phase
2. a rapport-development phase
3. an educational and motivational phase

In the last phase practitioner also works to resolve any areas of conflict to negotiate an agreement on therapeutic outcome.

Communication, empathy and involvement are prioritised over authority and paternalism.

Question 6

Describe the 6 steps of The Calgary-Cambridge Consultations

Answer 6

1. Initiating session - establishing rapport and reason for consultation
2. Gathering info - exploring problem and understanding from patient perspective
3. Providing structure to consultation
4. Build relationship - developing rapport and involving patient
5. Explanation & planning - providing correct amount and type of info, shared decision making
6. Closing the session - forward planning and appropriate closure

Question 7

Which model did Emanuel and Emanuel (1992) come up with?

Answer 7

The power sharing dimensions to characterise the share of power.

Question 8

Paternalistic Relationship

Answer 8

Doctor is in power.

Doctor acts as a guardian

Question 9

Mutual Relationship

Answer 9

Power is balanced

Doctor plays advisory role

Question 10

Consumerist Relationship

Answer 10

Power is with patient

Doctor acts as consulting technician

Question 11

What does the Health Foundation report state on shared-decision making? 8 points

Answer 11

1. recognising and clarifying the problem;
2. identifying potential solutions;
3. discussing options and uncertainties;
4. providing information about potential benefits, harms and uncertainties of each option;
5. checking understanding and reactions;
6. agreeing a course of action;
7. implementing the chosen treatment;
8. arranging follow-up;
   and evaluating the outcome

Question 12

What are Decision Aids and give an example?

Answer 12

They help shared decision making.
e.g videos, leaflets, structured counselling.

Most decision aids share the following three features:
1. providing facts about the condition, options, outcomes and probabilities;

2. clarifying patients’ evaluations of outcomes that matter most to them;
3. guiding patients through a process of deliberation so that a choice can be made matching their informed preference.