Week 3 - Patient Practiciner Relationships Flashcards
Relationships and use of health care services
- Liner
- 0 to 5 and 45+ yrs increase significantly
- Gender differences (females more likely 20-40yrs)
5 Factors affecting illness reporting
1= INTERNAL FOCUS - socially isolated notice
2= SENSITISERS - seek info
3= EXTERNAL FOCUS - busy lives , don’t notice
4= REPRESSOR - ignore symptoms + health
5= MOOD - more pos report less illness , more neg report more
4 Types of Misuse of Health Service
1 = DELAY BEHAVIOUR - time for individual to decide they’re ill
2= ILLNESS DELAY - recognising symptoms and seek treatment
3= UTILISATION DELAY - decking medical attention and doing it
4= SCHEDULING DELAY - between making appointment and getting seen
How does malingering contribute to overuse of health service?
- Emotional gain (munchausen)
- Practical gain ; access to meds , free from responsibility , sick leave
3 Factors encouraging us to visit a practitioner
1 = PERSISTANCE OF SYMPTOMS - last longer
2= CRITICAL INCIDENT - sudden change in symptoms / sign
3= TREATMENT EXPECTATIONS - GP can make a difference or not
Types of Consults
- Depends on illness whether dr or patient centered
- eg breast cancer patients (benign = patient , malignant = dr) max choice of correct decision or responsibility if wrong [ Beaver et al]
Factors affecting Consultation Success
- Traditionally dressed doctor had highest raiting [McInstry et al]
- Non verbal factors such as eye contact , age , gender , situational
- 4x more powerful as verbal communication [Argyle]
Define Primacy Effect
Extra importance given to the first piece of information heard by physician
- interprets later info to fit immediate diagnosis
How does Patient knowledge effect diagnosis
- Known malinger may not get accurate diagnosis
- Embarrassing symptoms may not get reported
- [Robinson and West] genital clinic where more reported sensitive data to computer than a dr
