Week 1 Human Behavior Flashcards
Chapter 1: Evolving Models of Health Care
Summarize the WHO’s definition of health
A state of physical, social, and mental well-being
Chapter 1: Evolving Models of Health Care
Explain how disease, sickness, and illness differ
disease – is the manifestation of impaired bodily functions
sickness - refers to those behaviors manifested by an individuals who feels ill or believes that he or she is
illness – the totality of the patient’s experience, how that patient feels behaves, and perceives his or her condition
Chapter 1: Evolving Models of Health Care
Define and provide examples of direct and indirect health risks
direct risks (reckless driving, smoking)
indirect risks (high fat diet, not exercising)
Chapter 1: Evolving Models of Health Care
Summarize the extensions of the modern health care model and thus, the broadened role of physicians
Biopsychosocial model recognizes that (1) multiple determinants in the development of disease and the resultant illness process and (2) that there is a hierarchical organization of biological and social systems
Health is determined by multiple etiological variables, continuously interacting via complex mechanisms, and interdependent process.
Chapter 1: Evolving Models of Health Care
Describe how primary prevention differs from secondary prevention
primary – practices to protect, promote, and maintain health
secondary – immunizations and medical surveillance
Chapter 1: Evolving Models of Health Care
Explain why the biomedical model is too specific
Post-Flexnerian (focused on bio) medical education and practice became heavily biomedical and partly lost sight of the broader human and social context of disease and health care.
Chapter 1: Evolving Models of Health Care
Summarize the BPS(S) model
Biological, Psychological, Social, and Spiritual Science
Chapter 1: Evolving Models of Health Care
Summarize qualities of the Integrated Sciences Model
Psychosocial and biological phenomena are viewed as interdependent and functionally interactive
Stress is challenge to homeostasis
Disease is a byproduct of the failure of the stress response system
Chapter 1: Evolving Models of Health Care
Describe the importance of integrated assessment and multimodal treatment
Assessment should involve a detailed exploration of the differential and interactive contributions of biological, behavioral, cognitive, cultural, and environmental risk factors
Multimodal treatment plan addresses multiples variables in a treatment plan such as biological, behavioral, cognitive, cultural, and environmental.
Chapter 34: The Physician-Patient Relationship
Summarize the responsibilities and rights of physicians, including situations in which physicians can refuse to perform certain procedures
Physician has a responsibility to inform the patient, to the best of this or her ability, regarding the nature of the disorder, probably course if untreated, and available and recommended treatments.
Listen to patient’s concerns, address them sensitively, and respect the patient’s decisions even though the physician may disagree
Use the authority in the best interest
Chapter 34: The Physician-Patient Relationship
Defin: informed consent
Informed consent in an open communication process between the patient and physician that results in the patient approving or not approving a medical intervention or course of action
Chapter 34: The Physician-Patient Relationship
List the limits of confidentiality when working with patients
HIPAA
Patient’s info cannot be shared with anyone, except those who are directly involved in patient’s care.
Chapter 34: The Physician-Patient Relationship
Describe the difference between transference and countertransference
Transference refers to the beliefs, expectations, and perceptions from previous relationships that influence current life experience.
Countertransference refers to inappropriate reactions the physician has to a patient.
Chapter 34: The Physician-Patient Relationship
Factors that influence patients’ adherence to treatment recommendations
Language and Cultural Differences
Age Effects
Gender Effects
Other Factors
Physician-Patient Relationships Factors the illness warrants treatment the treatment is effective the cost of treatment is reasonable given the benefits the treatment is feasible
Factors
The complexity of the regimen
The persistence of symptoms
The frequency and quality of contact with the physician
Chapter 35: The Medical Encounter
Define rapport and ways to maximize rapport between a physician and patient
State of mutual confidence and respect between two people
Chapter 35: The Medical Encounter
Describe how a physician should respond to patient emotions, including sadness and anger
Sadness: be comfortable with emotion in order to allow the patient to be comfortable expressing it; show respect
Angry: remain calm and listening reflectively, and encouraging the patient to discuss what is causing the anger are likely to diffuse the situation
Chapter 35: The Medical Encounter
Summarize pros and cons of open-ended questions, focused questions, and closed-ended questions. State what kind of question can elicit the maximum amount of information in the minimum amount of time.
Open-ended questions elicit the maximum amount of information in the minimum amount of time.
Focused questions narrow the area to be explored
Closed-ended questions prompt specific responses and are appropriate for clarifying details
Chapter 35: The Medical Encounter
Describe the types of questions that should be avoided
Compounds questions – complicated
Leading question – prompt patient to give specific response
Chapter 35: The Medical Encounter
List potential sources of error in clinical decision making
The provider’s theoretical and personal biases
Diagnosis by formula (preconceived categorizing)
Optimism and Pessimism
Too many hypothesis (rule out the least likely hypothesis)
Oversimplification (may require more complex explanation)
Reorganizing the abnormal (defining normal)
Provider-patient interaction
Mistaking correlation for causation
How writing about a stressful experience affects arthritis and asthma patients?
Asthma patients in experimental group had 19.4% improvement in lung function
Arthritis patients in experimental group had a mean 28% reduction
Possible cortisol effect on immune system
Limitations include few diseases, and short study time
How does the social support affects?
Longer survival
Possible social support, medical compliance, placebo, better use of resource, pain management
* Patients were not informed about possible outcomes
How does the psychological stress affect susceptibility to the common cold?
Rates of respiratory infection and clinical colds increased in a dose-response relationship with stress
How do social ties affect the common cold?
More social ties (resulted in fewer colds, less mucous, better ciliary clearance, and less virus
Explain complexity of a disease.
Diseases are generated, experienced, defined and ameliorated within a social world. Disease is a complex domain of human experience, involving explanation, expectation and meaning.
Assessing:
Psychological aspects of disease
Social aspects of disease
Spiritual aspects of disease
(Psychological) The importance of meaning and illness story?
Does your illness mean anything?
Why do you think you got sick?
How did this change you?
Did your symptom precede or follow a meaningful life event?
(Social) How might being sick have an impact on
Family, Work, Money, Friends, Fun
Will you lose opportunities in life because of this?
(Spiritual) Is there something about your spiritual beliefs that might make a difference in your medical care?
FICA
FICA addresses spiritual issues with patients.
F: Faith and belief
Do you consider yourself spiritual or religious…do you have spiritual beliefs that help you cope with stress…if “no”, what gives your life meaning?
I: Importance
What importance does your faith or belief have in your life? Have your beliefs influenced how you take care of yourself in this illness? What role do your beliefs play in regaining your health?
C: Community:
Are you part of a spiritual or religious community? Is this of support to you and how? Is there a group of people who you really love or who are important to you?…churches, mosques, temples…can be support systems.
A: Address in care:
How would you like me, your health care provider, to address these issues in your healthcare?
