Week 7: Individualising Patient Communication Flashcards
What are the three different personal skills are required for effective patient communication:
- Content (clinical knowledge) skills are what HCPs communicate
- Process skills are how HCPs communicate
- Perceptual skills are what the HCP observes, thinks and feels
When providing a health service to patients, in addition to taking medical history and assessing the patient health needs, HCPs undertake the following communication steps:
- Understand the patient’s background / context for the service
- Learn & respect the patient priorities / concerns
- After taking medical history & assess patient needs, then decide what you need to let them know then tailor how you deliver the information for each patient
- Refine how to motivate the individual to act on your information
What are social determinants of health?
- Are the conditions in which people are born, grow, live, work & age
- These circumstances are shaped by the distribution of money, power & resources at global, national and local levels
Impact on Health Outcomes
- The ability to find, understand & apply information about health (i.e. health literacy)
- Health outcomes – such as cancer survival, oral health
- Risk factors of health such as physical inactivity & obesity, as well as the prevalence of multiple risk factors in an individual
- Life expectancy & self-assessed health status
- Access to healthcare
Impact on Smoking Rates
- There is a consistent inverse relationship between cigarette smoking & income level
- Increased risks of smoking-related harm begin before birth, with higher likelihood of pregnant women from low socioeconomic status backgrounds
Impact on Cardiovascular Disease (CVD)
Risk factors such as inactivity, high cholesterol levels & unhealthy food choices
What is the The CVD death rate statistically?
- For males in lowest socioeconomic areas was 1.52 times as high as for males in the highest socioeconomic areas
- For females, the disparity was 1.33 times as high
What happens with lower level of education?
- Fewer employment options
- Shift work
- Environmental risk
- Poor sleep patterns & weakened immune system
- Increase risk of heart disease
What happens with higher level of education?
- More employment options & higher income
- Influences physical health in a positive way
If people have been told something is not good for their health, why don’t they change their behaviours?
Why would people with the least amount of disposable money, spend the most on fast food and cigarettes?
- Level of education
- Unaware on the severity and risks involved
- Socioeconomic background
- Initially hard to break the cycle
What do Consumers Health Forum (CHF) do?
- National peak body representing the interests of Australian healthcare consumers
- CHF works to achieve safe, quality, and timely healthcare for all Australians and accessible health information & systems
What does Health Care Consumers’ Assoc. in ACT (HCCA) represent?
- HCCA works to improve quality and availability of health services, supports consumers to identify shared priorities about health, and represents these views to the ACT Government
- Principal health consumer advocacy organisation in the ACT
- Supported & developed health consumer perspectives and policy in the ACT for over 30 years
Why do we need health consumer ‘representatives’?
- To establish rules
- Provide a voice for all consumers on health issues
- Advocate for the health of all people
How can involving consumer representatives improve patient outcomes on an individual and community level?
- Improve health & wellbeing
- Quality of care
- Available healthcare resources
What is Health Literacy?
- The knowledge & skills required to understand and use information relating to health issues
- Nine million Australians (or 60 percent) of the population between the ages of 15 and 74 don’t have the basic knowledge & skills to understand and use information about their own health
What are the importance of Health Literacy?
- Poor health literacy results in:
- poorer health outcomes
- increased risk of an adverse event and
- higher healthcare costs
- Good health literacy
- Increases uptake of health-promoting behaviours
- Improved health outcomes
Individual & Environmental Factors Influence Health Literacy
Individual health literacy
- Make an effective decisions about health and health care, and take appropriate action
‘Overall’ Health Literacy
Understanding and being able to act on information about health & health care
Demands of the Health Literacy environment
- How easy or hard information it is to understand in the health industry
What are the components of Health Literacy?
- Communication skills
- Knowledge of health topics
- Culture
- Demands of the healthcare & public health system environment
- Demands of the particular situation/context
Describe Communication skills briefly which is a component of Health Literacy
- Adapting to specific context & situation
- Literacy skills
- Oral communication
- Comprehension
- Reflect on the words you use that might be ‘labels’
Describe Knowledge of health topics briefly which is a component of Health Literacy
People with limited, or inaccurate health knowledge may not:
- Recognise when they need to seek care
- Understand the relationship between lifestyle factors & health outcomes
Describe culture briefly which is a component of Health Literacy
Is the pattern of a person’s behaviour shaped by their language, thoughts, customs, beliefs, values and the groups to which a person belongs
Describe Demands of the healthcare & public health system environment which is a component of Health Literacy
People need to be able to read, understand, and complete complex forms
Describe Demands of the particular situation/context which is a component of Health Literacy
Health care is often associated with underlying stress or fear
Health literacy is often lower among:
- Older adults
- People with lower income
- People with limited education
- Minority populations
- People with limited English skills
How HCPs can improve Health Literacy?
- Provide information & services that are easy to understand, use and act on
- Be flexible & use a range of communication strategies to ensure patients understand their options
- Encourage patients to ask questions or ask for help & support
Low Health Literacy: what are the outcomes?
Individuals:
- May feel a sense of shame
- Are often uncomfortable and develop strategies to compensate / hide it
Health Literacy: Strategies for HCPs
- Communicate instructions appropriately
- Use visual aids
- Use ‘teach back’
- Minimise embarrassment
- Encourage patients to become advocates for service improvements
- Simplify language where possible
- Limit the amount of information provided
- Avoid distracters
- Provide context
- Be explicit
- Review / have the patient reflect
Define Cultural determinants of health
The protective factors that enhance resilience, strengthen identity and support good health & wellbeing
Define Cultural awareness
Raising the awareness and knowledge of individuals about the experiences and diversity of cultures that are different from their own
Define Cultural competence
To understand, communicate with, and effectively interact with people across cultures
Define Cultural safety
A state in which people are enabled and feel they can access health care that suits their needs, are able to challenge personal or institutional racism establish trust in services, and expect effective, quality care
What are the Reconciliation – 4 Rs
- Remember: the historic impact
- Reflect: critical reflection and respect lead to change in attitude and behaviours
- Recognise: the current situation
- Respond: from a position of collaboration & equality
How do you build with Indigenous Patients
- Greet the person with warmth & genuine friendliness
- Use non-threatening language & tone
- Ask where they come from
- Tell the person about yourself
- Explain the processes
- Ask how they feel about the processes discussed
Ahmed, a 67 year old refugee recently arrived from Somalia. Which of the following lists of factors would you expect to influence his health literacy ?
a) His experiences so far in finding and using healthcare services.
b) His ability to find, understand and act on health information
c) His skills and abilities communicating with his HCP
d) All of the above
