Week 11 Flashcards
Key objective for any society, including any work or educational environment
Trying to achieve equality, fairness and justice
Avoid discrimination, unconscious bias and micro aggressions
Treating others with respect and offer support other students, staff and patients
What is unconscious bias
How a person thinks can depend on their life experiences and sometimes they have beliefs and views about other people that might not be right and reasonable
When a person thinks:
Better of someone because they believe they’re alike
Less of someone because that person is differently to them
This means they could make a decision influenced by false beliefs or assumptions sometimes called stereotyping
Unconscious bias, stereotyping and discrimination can be based on:
One of the 9 protected characteristics by the law (Equality act)
Other characteristics not protected by the law e.g. class (socioeconomic background), body shape , where people grew up etc
2010 Equality Act
Protected characteristics are:
Age
Disability
Gender reassignment
Marriage and Civil partnership
Race
Religion or belief
Sex
Pregnancy and maternity
Sexual orientation
Age protected characteristics
Being treated unfairly because of your age or because you’re part of a particular group
E.g. limiting job offer to applicants under 30
Age limitation is sometimes allowed but has to be justified example- assuming that a 90 year old immobile and physically fragile patient does not have mental capacity to consent to their own medical treatment
Disability protected characteristics
A person has a disability if they have a physical or mental impairment, and the impairment has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activity Must be substantial and long term
Some impairments are automatically treated as a disability. People are covered if they have:
Cancer, including skin growths
A visual impairment
Multiple sclerosis
A HIV infection
A severe long term disfigurement
E.g.being refused position because of mentioning in job interview that you suffer with depression or other mental health illness
Gender reassignment
A person proposing to undergo, is undergoing or has undergone a process for the purpose of reassigning the persons sex by changing physiological or other attributes of sex
Protection to transsexual people
Gender reassignment is a personal process rather than a medical one you dont undergo medical treatment or be under medical supervision to be protection under the equality act as a transgender person
Marriage and civil partnership protected characteristics
Sex or sexual orientation of the people in marriage or civil partnership is irrelevant
E.g. a nurse showing surprise and smirking that’s you are in same-sex marriage
Race. Protected characteristics
Race includes: colour, nationality, ethnic or national origins
Religion or belief. Protected characteristics
Religion means any religion and a reference to religion includes a reference to a lack of religion
Belief means any religious or philosophical belief and a reference to belief includes a reference to a lack of belief
A philosophical belief is a non-religious belief and includes things like humanism, secularism and atheism
Sex. Protected characteristics
Reference to a man or woman
Reference to persons who share a protected characteristic is a reference to persons of the same sex
Pregnancy and maternity. Protected characteristics
Counts as pregnancy discrimination if you’re treated unfavourably because you:
Are pregnant; have a pregnancy-related illness; are on maternity leave
The protected period runs from start of pregnancy to end of maternity leave
This applies so far only to women, so men cannot be discriminated under Equality Act for being on parental leave
E.g. hospital withdrawing their offer of FY placement after you disclose you will need maternity leave
Other biases and discriminations not covered by equality act
Class, socioeconomic background or wealth
Body shape
Other body features
Food drink preferences and allergies
Certain names and local associations
What school you went to
Intersectionality
Discrimination and prejudice can occur across multiple characteristics
Multiple discrimination can be greater
Patient compliance/adherence
Adherence refers to the following:
Preventative health behaviour
Keeping medical appointment
Self care actions
Taking medication as directed
Insistence on discharge against medical advice (lack of adherence)
Parents administering medication to children
Non-adherence
Describes the failure of a patient to follow recommend health behaviours and treatment advice given by a clinician
Non-adherence focuses better on a collaborative clinician patient relationship and shared decision making
What affects patient adherence
Treatment- while patients comply with one treatment, they may not comply with another
Condition
Beliefs
Good predictor of long term adherence is adherence at entry
Complex regimens have low adherence
Intrusive treatments have lower adherence
Expense decreases adherence
Adherence for asymptomatic conditions generally poorer
Fear of side effects
Confusion
Don’t understand treatment process
Doctors underestimate patients comprehension level
When do patients comply (adhere)
Ley’s model of compliance (1981,1989)
Understanding
Satisfaction —> compliance
Memory ^
Stanton’s model of adherence 1987
Doctor communication
Increased knowledge and satisfaction
Patients beliefs locus of control perceived social support
Adherence
Information- motivation- strategy model (Martin 2010)
Information- patients do not understand what they are supposed to do
Motivation- patients are not motivated to carry out their treatment recommendations
Strategy- patients do not have a workable strategy for following treatment recommendations
Information
Communicate info effectively to patients
Build trust and encourage patients to participate in decision making and to be partners in their own healthcare
Have patients share why and how they’re to carry out their treatment recommendations.
Listen to patients concerns and give them full attention
Motivation
Help patients to believe in the efficacy of the treatment
Elicit, listen to and discuss negative attitudes towards treatment
Determine the role of the patients social system in supporting or contradicting elements of the regimen
Help the patient to build commitment to adherence and to believe that they’re capable of doing it
Strategy
Assists in overcoming practical barriers that stand in the way of patients effectively carrying out a course of action
Identify individuals who can provide concrete assistance
Identify resources to provide financial aid or discounts
Provide written instructions/ reminders
Sign a behavioural contract
Link to support groups
Provide electronic reminders or follow up phone calls
Empowerment and self care
What is health promotion
The process of enabling people to increase control over and to improve their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions
