Patient Provider Relationships

Question 1

Factors that influence symptoms

Answer 1

Situational - medical students disease. Students learn about disease and then think they have it.
Personality- Hypochondriac
Stress
Mood

Question 2

Factors that influence interpretation of symptoms

Answer 2

Prior Experience: this happened to me before, I know what to do
Prevalance- UTI, common for females
Socio-demographic factors: Lower SES, don’t have time or insurance to go to factor
Expectations:
Seriousness of symptoms

Question 3

Illness representation/Schema * know this

Answer 3

Patients common sense belief about their illness 
5 components: 
- identity (label)
- consequences 
- causes
- duration 
- cure
Most GP know a little bit about a lot of things 

Also:
Internet and Lay referral network: input from friends/family

Question 4

Acute illness vs chronic illness vs cyclic illness * know this

Answer 4

Acute: Bacterial/Viral= short
Chronic: Long duration, multi factorial
Cyclic: Altering periods of activity. Ex. Migraines, Herpes

Question 5

Predictors of Health Service Users

Answer 5

Age: Infants & elderly cost a lot
Gender: women tend to use the system more
SES: Higher up on scale.
Culture: visible minorities more commonly visit physican but fewer specialist visits

Question 6

Misuse of Health Services

Answer 6

Physical symptoms trigged by psychological drivers
- Medical disorders perceived as more legitimate
Worried Well: constantly thinking they’re ill
Somaticiziers: complain about physical symptoms but know psychological is route of problem (treating physical isnt helping them)

Question 7

Delay Behaviour * Important (4 types

Answer 7

Living with 1+ potential serious symptoms without proper care
Appraisal, Illness, behavioural and medical delay

Question 8

Predictors of Delay Behaviour

Answer 8

• Elderly delay less than middle age
• frequency of occurrence(if you’ve had the symptom before)
• If Highly visible- more likely to seek help (hands and face)
• If its painful and impacting your life

Question 9

Treatment Delay

Answer 9

Occurs after primary visit because:

• Dont want to acknowledge it
• Curiosity satisfied by first visit
• Fear of symptoms and diagnosis

Question 10

HCP

Answer 10

Doctor, nurse, nurse practitioner, nutritionist

Anyone that is providing for your health

Question 11

Today’s Patient

Answer 11

Your perception of care- fancy offices.ipads
Patient consumerism
37 seconds after you walk into the doctors office they have made a diagnosis
- Internet common resource

Question 12

Structure of Health Care Delivery

Answer 12

1st: PHC provider
- they are gatekeepers- requires referral and not a lot of people even have a family doctor
2nd: Specialistics

Question 13

CAM

Answer 13

chiropractic, acupuncture, massage

More: women, middle age

Question 14

Holistic Approach * important

Answer 14

• Health is a positive state
• Not simply disease free
• Health education, self helping and self-healing

Question 15

Barriers to Care

Answer 15

• Poor communication
• Jargon
• Baby talk/ Elderspeak
• Sterotypes of patients: culture, sexism

Question 16

Treatment Non-Adherence

Answer 16

• When a patient does not follow prescribed treatment OR follows them for as long as they’re supposed to (antibiotics)
• Lifestyle (80% don’t adhere)

Question 17

Causes of Non-Adherence

Answer 17

Poor communication
Perceived Satistication- took this before and it didn’t work for me
Treatment reigmen- have t do it 3 times a day with food
Types of treatment: Medical>vocational> social/psych treatment

Question 18

Placebo Effect **

Answer 18

• Non active vehicle given in place of a drug
• Medical drug directly impacts and attacks pain receptor, placebo you think its going to reduce that anxiety and lowers symptom- makes you feel better.
  Over time- participants are responded better to placebos as well as the active medicine
  (1985-20% placebo, 2000-30% placebo ) that responded

Question 19

Other Factors to consider with Placebo Effect

Answer 19

• Interaction with health care provider/researcher= they make you think this medication is truly going to help you
• Patient characteristics= are you optimist vs pessimist. Anxious people show higher placebo effect.
• Physical appearance of the placebo ** this is critical

Single blind- doctor knows and can bias results through cues.

Double Blind- neither knows