Unit 2 exam Flashcards
Health
-a state of complete well being
-includes physical, mental, social
-not mearly an absense of disease/infirmity
Disease
-objective phenpmenon/professional construct
-characterized by altered or abnormal functioning of the body
-pathologic change in the structure or function of the body or mind
Illness
-subjective/lay construct
-physical and social state
-response of the person to a disease
-abnormal process in which the person’s level of functioning is changed
Sickness/sick role
-excused from social/normal role responsibilities
-rights: not responsible for the condition, inable to meet obligations
-result of disease/illness
-seeks advice/permission from scientific source
cultural and contextual factors influencing health and illness
-social: lifestyle drugs, big Pharma advertising
-economics: health insurance
-culture: low blood pressure
-
Explanatory mode
- perspective and belief about their illness and treatment
-helps understand patient’s perspective
-ask what, why, how, who questions
Western medical model/biomedical
-mechanistic
-prone to malfunction
“tune up”
Suchman’s medul of illness phases
-symptom experiance
-assumption of the sick role
-medical care contact
-dependent patient
-recovery
Common sense medel of illness
-identity
-cause
-timeline
-consequences
-cure/control
Activity and passivity: Szasz and Hollenders Model of care
-No interpersonal communication
-Patient listens to provider
-Like in emergency situation or parent/infant relationship
guidance -cooperation: Szasz and Hollenders Model of care
-Patient is capable of interpersonal communication
-Still independent on professional
-Like parent/adolescent relationship
Mutual participation: Szasz and Hollenders Model of care
-Both patient and provider are powerful and independent
-Adult to adult relationship
The consumer model of Care
-Great patient autonomy
-Emphasize patient right
-Patient is an informed and skeptical of care
The patient centered model
-Focus on the whole person vs just the body
-Open ended questions
-Patient’s feedback
-Patients have greater satisfaction
Biopsychosocial Model
-A shift in western medicine
-Biomedical medel era
-nfectious disease was major killer
-Biopsychosocial model:
Chronic diseases is major killer, Considers poverty, where you live, pollution
Describe the pharmacists’ role in patient treatment decisions
-use of self care
-Lay people believe some problems are ‘doctorable’
-help seeking behavior
-OTC meds
-Persription meds
pasive acceptors
take med with no questions
active acceptors
-evaluates medication to address concerns
acrive modifiers
modify their regimen (drink alcohol)
rejectors
don’t take medication
Health disparities
a difference in the health achievements of individuals and groups
-just a difference
Health inequity
-differences in health that are unnecessary and avoidable, consider unfair and unjust
-affected by social, economic, and enviormental conditions
Health equity
highest level of health for all people. Full and equal access to opportunities
Describe who is most at risk for health disparities
-most prominant with racial and ethnic disparities
-Also includes
Geography
Income
Education
Health literacy
English proficiency
Gender
Disability
Sexual orientation/gender identity
occupation
Major causes of health inequities in the US
-social determinants: education, income, employment
-enviormental hazards
-healthcare access and preventative health services
-root cause is structural rasicism
Major areas of health inequities in the US
-health outcomes: complications
-mortality: death rates
-morbitity: potentially preventable hospitilizations
-behavioral risk factors: opiod abuse, adolesant pregnancy and childbirth, cigarette smoking
Evidence of health inequalities
-life expectancy at birth by race and gender
-life expectancy at birth by location
-suicide rates
-life expectancy declined
obesity by area
Specific Areas of Inequity Relevant to
Pharmacists
-vaccine coverage: ower influenza vaccination coverage observed for non-Hispanic Blacks and Hispanics
-Illicit and prescription drug-related deaths: highest in Black and Hispanics
-cardio disease: black women
-obesity: lower in whites than black and hispanic adults
-Asthma: higher in children and women
-pregnancy
-cigarette smoking: indigenious and poor populations
-Diabetes: education and age and location
healthcare disparities
Differences in quality of care received by racial and ethnic minority group and non-hispancic whites who have equal access to care
causes of healthcare disparities
- Not one simple cause
-How healthcare systems are organized: Policies and practices
-Professional interpretation/translation
-Provider’s bias, prejudices, and uncertainty when treating patients
sources of healthcare disparities
-Healthcare system: Cultural or linguistic barriers, Fragmentation of healthcare systems, Types of incentives to contain costs, Where marginalized populations tend to receive care
-Clinical encounter
Describe several pieces of evidence of disparities in healthcare
-How physicians interact with minorities
-English proficiency and physician language
-What influences black americans beliefs about diabetes
Barriers to accessible and quality healthcare
-income
-education
-availibility of health insurance
-limited english proficiency
-availibility of a usual source of care
-race and ethnicity
Quality Priority Areas
- Patient Safety
- Person-Centered Care
- Care Coordination
- Effective Treatment
- Healthy Living
Proposed solutions to solving healthcare
disparities
-diversity in the workplace
-reducing bias
-upstream intervensions
-collaboration
Evolution of healthcare disparities
Existence of disparities → Reasons→ Solutions
Determinants of health
-Personal, social, economic, environmental, and biological factors which
determine the health status of individuals
Social determinants of health
conditions in which we are born, grow, live,
learn, worship, and work that contributes to health
What factors make the biggest contributions toward health
Social and economic factors such as employment and social support
components of the SDOH framework
behaviors,
biological factors, social support, socioeconomic factors, education, health
system etc
HiAP
-ocuses on SDOH and strengthens the capacity of the
community can eliminate inequities/advance equity
Pharmacists can address SDOH
-risk factor SDOH
assessments, provision of innovative social need services, working with
community health workers/patient navigators
WHat reduces interview effectivness
-double/multiple questions
loaded
-leading
-double negative question
Describe the stages of interviewing patients
-opening
-exploration
-closure
Identify strategies to establish rapport with a patient
-responsive to patients
-active and passive paticipation
-appropriation cues
-show respect for patient’s experiance
Describe assessing patient’s unvoiced agendas and their
implications
Solicit a patient’s agenda by first understanding their concerns and
priorities
