Introduction to PPC

Question 1

žProcesses by which verbal and nonverbal messages are used to create and share meaning.

Answer 1

Communication

Question 2

Creating shared meaning is what kind of perspective?

Answer 2

Constitutive perspective (The perspective and meanings of each person may be very different, therefore it is important to create shared meaning)

Question 3

Which perspective doesn’t work for creating shared meaning? What does it mean?

Answer 3

Information-exchange perspective: communication as a tool to transfer information

Question 4

Example of creating shared meaning?

Answer 4

Pain scale from 0-10

Universal facial expressions break social, cultural barriers to create shared meaning

Question 5

972 study found that out of 800 visits to a peds emergency clinic, 26% of the parents did not tell the doctor their _____.

Answer 5

Primary concern

Question 6

In the 1972 study, why didn’t 26% of parents reveal their primary concern to their providers? Why is this happening still?

Answer 6

Doctors didn’t encourage them to disclose

Doctors felt patients were making them play a guessing game rather than being direct

This is still happening as of 2002, WHY??

Communication barriers!

Question 7

Patients must be able to tell their __1__ to their providers and providers must have a goal of obtaining the most complete story possible, and to achieve this must understand the __2__ and the __3__, the __4__ and the __5__ aspects of each interaction.

Answer 7

1) story
2) language
3) emotions
4) verbal
5) non-verbal

Question 8

Our own accounts of illness. Often involves the because factor.

Answer 8

žNarratives

Question 9

Patients reveal certain things because they are important to their illness experience.

Answer 9

Self-disclosure

Question 10

—Providers _____ in order to encourage patients to do so, but also to build rapport and establish _____.

Answer 10

Self-disclose; shared meaning

Question 11

Feedback, paraphrasing
—“So what you’re saying is…”

Answer 11

Active listening strategies

Question 12

Elicit more information

Answer 12

Open-ended questions

Question 13

Name the 18 outside influences that affect shared meaning/communication

Answer 13

1. Race
2. Gender
3. Culture
4. Environment
5. Family
6. Friends
7. Beliefs about health
8. Attitudes about health
9. Past health
10. Past healthcare
11. Family history
12. Media
13. Education
14. Insurance
15. Religion
16. Politics
17. Self-efficacy
18. Health literacy

Question 14

žWithout shared meaning, it is difficult for both parties to? (3 things)

Answer 14

1. Be satisfied with the interaction
2. Have all of their questions answered
3. Achieve the desired goals and have the best outcome

Question 15

žDescribe the Biomedical Model of Medicine.

Is shared meaning a goal in this model?

Answer 15

• —Scientific methods to deduce what is wrong and come to a diagnosis
• Relies on Facts
• —Patient is a “case” to be fixed

Shared meaning is NOT a goal

Question 16

Describe the žPaternalistic Model of Medicine.

Is shared meaning a goal in this model?

Answer 16

• —Doctor knows best, tells patient what to do
• —Doctor may not present all alternatives

Shared meaning is NOT a goal in this model.

Question 17

There is a power-imbalance between a physician and a patient. This power imbalance is partly result of _____. Example?

Answer 17

Cultural expectations

Example: Western cultures believe doctors are scientific experts

Question 18

—Medical schools have traditionally taught docs to _____ or the patient may ramble.

Answer 18

Keep it short and to the point

Question 19

—In a 2001 study only about 2% of doc talk was devoted to _____ and _____.

Answer 19

Partnership building and supportive communication.

Question 20

—Less than 7% of patient talk was devoted to _____ and _____ – patients rarely assert themselves, unless doc encourages them to.

Answer 20

Asking questions and being assertive

Question 21

—Process of steering talk away from certain subjects

Answer 21

Blocking

Question 22

—Process whereby an individual treats another individual as if they are inferior by withholding information, speaking down to them, ignoring their feelings, etc.

Answer 22

Patronizing behaviors

Question 23

žThe prerogative granted to providers to withhold information from patients if they feel that disclosing the information would do more harm than good.

Answer 23

Therapeutic privilege

Question 24

Describe Patient-Centered Care.

Answer 24

• žActive involvement by patients and families/caregivers
• Shared and informed decision-making

Question 25

Establishes patients and caregivers as peers who openly discuss health options and make mutually satisfying decisions. Working together as partners.

Answer 25

Patient-Centered Communication

Question 26

“Theorists” speculate patients will become more active under 3 conditions:

Answer 26

1. They are well informed about medical matters
2. They are assertive about asking for info, set agendas, and participate in decisions
3. They make rational choices (even when that choice is to not be compliant).

Question 27

žWell informed patients save the system _____ because they maintain their health more effectively.

Answer 27

Money

Question 28

_____ is one of the biggest factors in shared meaning, patient-centered care, shared and informed decision making, and _____.

Answer 28

žHealth literacy; health outcomes

Question 29

We need to study PPC from both _____ and _____ in mind.

Answer 29

• An information-exchange perspective
• With shared meaning

Question 30

žNo one is always _____-oriented or _____-centered or _____ at all times. Just not doable/possible.

Answer 30

Physician; patient; engaging in collaborative communication

Question 31

žThe most effective communicators (whether provider or patient) are able to _____ and _____ as the situation demands it.

Answer 31

Aapt and mix different communication strategies