Chapter 10 The consultation and beyond Flashcards

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1
Q

five phases of doctor-patient encounter

A

1: establishing relationship
2: find reason for patient’s attendance
3: verbal or physical examination
4: consideration of condition of symptom
5: consideration further treatment

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2
Q

6 factors for good consultation

A

1: good medical knowledge
2: achieving good relationship
3: establishing nature of problem
4: realizing patient’s level of understanding for their own condition
5: engaging patient in decision-making
6: managing time - should not seem rushed

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3
Q

what shift has been visible in the paradigm of doctor-patient consultation

A

form professional-centered to patient centered, including them in the decision making process

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4
Q

Elwyn’s consultation approach
- define choice, opinion, decision

A

choice- patient knows what treatment options are available
opinion- providing more detailed information about opinions
decision- supporting the work of considering the preferences and deciding what is best

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5
Q

give a reason why many patients leave the decision process completely up to the doctor

A

this way they don’t take any responsibility and avoid a difficult decision

(interestingly people who paced highest emphasis on their own health, were least likely to want to be included in decision-making process)

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6
Q

what healthcare do people feel more free to express their emotions to - doctors or nurses

A

nurses - more time, more involved in holistic care

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7
Q

SPIKES model what is it for?

A

breaking bad news
setting up interview
perception of patient about their own state
invitation of patient to actually talk about diagnosis
knowlegde and info for patient
emotions are adressed and helped
strategy and summary - clear treatment plan

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8
Q

reasons why people forget to take their medication?

A

forgetting
treatment regimen is too complicated to cope with effectively
social factors
treatment factors
family factors

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9
Q

how to maximize medication use in patients

A

achieving concordance
- provide info in understandable way
- listen and respond to patient in way that encourages decsion-making process

maximize understanding
- appropriate language
- patient prepares questions before setting

maximizing memory
- visual aids
- written info or audiotapes
- emphasize and repeat essential info
simplify language

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10
Q

name the methods of interventions trying to maximize medication taking adherence

A

reminders
convenient scheduling
provide info
reinforcement
family therapy
self-monitoring

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11
Q

reasons for non-adherence to behavior change

A

pain, discomfort
lack of clarity
lack of motivation
lack of time
other diseases
illness representations
self-efficacy

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