Test 1 Review Flashcards
What were the findings of the Report to Nation on Cancer in the Poor?
- poor face barriers, and often don’t get treatment
- poor may make extreme sacrifices
- fatalism is prevalent among poor
- poor experience greater pain and suffering
How did healthcare navigation start?
the American Cancer Society released the Report to Nation on Cancer in the Poor, whose findings sparked the beginning
Who started healthcare navigation, where, and why?
Dr. Freeman, oncologist at Harlem Hospital in New York. he wanted to eliminate barriers to timely care, mainly for breast cancer patients
Barriers Dr. Freeman stated:
financial, communication and information, medical system, and emotional (fear and distrust)
What were the outcomes of Dr. Freeman’s model?
increased early stage diagnosis and treatment, and increased survival rate
- 6% Stage 1 diagnosis to 41% in Stage 0 or 1
- 5 year survival rate from 39% to 70%
What is the discovery-delivery disconnect?
disconnection between what we know and what we do-results in unequal treatment
-ex) provider knows patient needs treatment but doesn’t give the treatment because the patient can’t pay
What kinds of people perform navigation?
- professional (nurses and social workers)
- paraprofessionals (tumor registrars and community health workers)
- laypeople (community leaders and cancer survivors)
disparity
a great difference, such as the difference between healthcare for richer and poor
fatalism
mindset that the outcome will be bad regardless, so they don’t need to get treatment
continuum of care
linear progress of patient throughout healthcare system with overlapping phases
6 Phases of Continuum of Care
- Education and Outreach
- Screening
- Diagnosis and Staging
- Treatment
- Survivorship
- End of life
Roles that navigators address
- access to care needs
- emotional and practical concerns
- patient and family concerns
- being involved throughout continuum of care
5 A’s of Quality of Care
- Accessible-removing structural and cultural barriers to care
- Affordable-ensure people have insurance and free/low cost programs
- Available-map location and identify contacts for cancer services and advocate for services to fill gaps
- Appropriate-establish culturally competent services and staff
- Accountable-assure sustainability, quality, and responsiveness of services
+ understandable-provide education to improve knowledge, attitudes, and practices
Health literacy is the strongest predictor of what?
health status
Factors that affect health literacy
culture, language, age, literacy skills, etc
How many affected worldwide?
90 million
National Assessment of Adult Literacy
- 2003 study
- 1st large scale literacy study
- found 12% adults at proficient
- 3 domains of study explored
- 4 levels of health literacy found
3 domains explored in NAAL study
- Clinical
- patient forms
- Preventative
- following guidelines for preventive services
- Navigation
- understanding what insurance pays and getting to appts.
4 Levels of health literacy
- below basicc
- basic
- intermediate
- proficient
Red flags to limited health literacy
- making excuses
- asking no questions
- resistance
- often missing appts. and tests
- not taking meds or treatments
Ask Me 3
- 3 things every patient should know before leaving
1. Diagnosis-What is my problem?
2. Treatment-What do I need to do?
3. Context-Why is this important to me?
How to create shame-free environment
- attitude of helpfulness, caring, and respect
- ask open ended questions
- listen and smile
- provide confidential assistance
What are some ways to make patient friendly documents?
- short and simple with limited medical language: “living room”
- bullet points and white space
- focus on 1 to 3 key pts.
- emphasize what patient should do, not what they shouldn’t
Listening strategies
- active voice: subject of sentence acts on verb
- congruence: making your verbal message and nonverbal actions match
- empathy: ability to understand and share feelings of another person
Barriers to communication
- giving advice
- agreeing
- general statements or cliches
- defensiveness
- changing the subject
- disrespecting
- transference
4 Problem Areas/Boundaries in forming professional relationships with your providers
- touch
- self disclosure
- gifts
- contact with client outside of work
How patient coaching helps people reach their goals
it gives the patient knowledge and reassurance of their confidence, and this helps them make an informed decision on their own
