Lecture 9 - Patient-Provider relationships Flashcards

1
Q

what is Nurse practitioner -

A

=Trained in traditional nursing and has additional education in health assessment, diagnoses, and management of injuries and illness
ì Can order tests and prescribe drugs
ì Responsibilities include providing routine medical care, prescribing treatment, and attending to the chronically ill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what does a nurse have an impact on -

A

=1. On patient outcomes

2. On satisfaction with health care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what was the traditional patent-provider relationship -

A

=ì Authoritarian ì Unequal

ì Dominance hierarchy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the ‘new’ patent-provider relationship -

A

=ì Open
ì Equal
ì Reciprocal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the three main barriers to Effective Communication -

A

=setting, structure of health care system and changes in physician’s role

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the barrier ‘setting’ to Effective Communication -

A

=1. Patients sick, in pain

  1. Need for many questions
  2. Time pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the barrier ‘Structure of Health Care System in Canada’ to Effective Communication -

A

=1. GPs are entry point, no specialists

2. Many do not have GP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the barrier ‘Changes in Physician’s role’ to Effective Communication -

A

=1. More interdisciplinary teams (more equality)

  1. Patients asking for more involvement
    - > Physicians dominance, autonomy, authority challenged
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are some Problematic Communication ì Behaviours

A
- =• Not listening
• Jargon
• Babytalk and elderspeak
• Nonperson treatment
• Stereotyping and disparaging language
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

explain Not Listening -

A

=ì Only 23% of patients finished explanations before diagnosis
ì Physician interrupted within 18-22 seconds
ì Physicians knew they were recorded!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

why is Using Jargon an issue? -

A

=Many patients do not understand this language

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

why is jargon still used -

A

=habitual, cultural (hospital cultural), to educate the patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is elder-speak -

A

=Baby Talk for older adults
ì Using overly familiar terms to address elderly patients, such as
“dear” or “sweetheart”
ì Using pronouns “we”, “us”, and “our” in place of “you” ì Answering questions for the older adult
ì “You would like to have your bath now, wouldn’t you?” ì Talking for the older adult
ì You had a great time with your family today, I saw. And you were watching ‘Gone with the Wind’, which you love. Right?”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are consequences of elderspeak -

A

=agist, takes away agent; learned helplessness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

why does elder speak happen -

A

=it is well intended but shouldn’t happen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is Nonperson Treatment -

A

=Depersonalizing the patient
ì Not talking to the patient during an exam
ì Not talking to the patient in the presence of other providers
ì Not knowing the patient’s name

17
Q

what are consequences of Nonperson Treatment - =dehumanizes person, makes them uncomfortable
why is Nonperson Treatment done -

A

=culture of hospital, bad bedside manners

18
Q

why is stereotyping an issue in the hospital setting -

A

=doctors assume that an individuals issue could be one thing and disregards everything else

19
Q

explain what is included in Other Potential Barriers: Patient Characteristics -

A
=ì Certain personality traits 
ì Anxiety
ì Knowledge
ì Education
ì Language proficiency
20
Q

explain the differing concerns of patients and providers -

A
=Patient 
ì Pain
ì Symptoms interfering with activities
Provider
ì Underlying disease
 ì Severity
 ì Treatment options
21
Q

Why it is Difficult for Practitioners to Change Some Maladaptive Communication Behaviours? -

A

=ì Little feedback from patients
ì If the patient does not return, it is unclear what it means

essentially few opportunities for practitioner to learn

22
Q

what are some options for Improving Patient-Provider Communication -

A

=ì Teaching providers patient-centred communication

ì Teaching patients how to elicit information from providers

23
Q

what are the three types of Treatment Adherence -

A

=adherence, non-adherence and creative non-adherence

24
Q

explain adherence -

A

=Following a prescribed behavioural and/or treatment regimen

or routine

25
explain Non-adherence -
=Patients don't adopt behaviours and treatments their | providers recommend
26
explain Creative non-adherence -
=ì Patients modify or supplement a prescribed treatment regimen (e.g., adjusting dosages, supplementing treatments) ì May be a patient's attempt to reassert control over their illness and its treatment.
27
what are some diseases with high adherence -
=ì HIV ì Arthritis ì Gastrointestinal disorders ì Cancer
28
what are some diseases with low adherence -
=ì Pulmonary disease ì Diabetes | ì Sleep disorders
29
what are the Causes of Non-adherence -
``` =Many 'valid' reasons ì Faulty patient-provider communication is the greatest cause of non-adherence to treatment! ì Forgetting ì Memory overload ì Side-effects ì Not agreeing with the treatment ì Does not believe in the treatment's effectiveness ì Uses other ways to treat it ```
30
how many patients cannot repeat what they need to do within minutes of discussing it! -
=1/3
31
how to Improving Adherence -
=Establish effective & empathic communication 1. Improve patient understanding 2. Improve patient satisfaction 3. Provide patient with space to make a decision 4. Provide patient with written information about what they agreed on
32
what is The Placebo Effect and why does it work -
=when patients just believe they are being treated | it works because of psychological and physiological effects
33
who responds most to The Placebo Effect -
=ì Big Five Factors and placebo responding ì People scoring high in extraversion were more likely to experience placebo effects
34
what makes the placebo effect strong -
=provider behaviours (- Confidence and competence - Expressing faith in treatment) Settings that have medical formality Appearance of placebo (shape, size, colour, quantity) Regimens hat seem medical (precise instructions)
35
what are the ethics of placebo -
=ì Placebos cannot be used in regular medical care | ì Placebos unethical in clinical trials when an effective treatment exists