Session 9 Flashcards
Why is there an interest in patients views?
Patient satisfaction important. Humanitarian. Growth of consumerism. Emphasis on accountability - secures legitmacy. NHS act 2006
What does the health service ombudsman do?
Undertakes independent investigations into complaints
that the NHS has not acted properly or fairly or has provided a poor service. Provides the ultimate, independent view of what has happened.
How can patients views be investigated?
Indirectly – Patient complaints or Ombudsman’s reports
Directly – Qualitative methods (interviews, focus groups, observations) or Quantitative methods (questionaires - anonymous, less staff training, cheap)
What is PALS?
Patient Advice and Liaison Services - offer confidential advice, support and information on health related matters (complaints, NHS questions, concerns)
What can cause dissatisfaction?
Interpersonal skills - no reassurance/advice/patient doesn’t convey concerns
Content of health care - waiting times, health outcomes,, inconvenience
What are possible challenges in responding to dissatisfaction?
Sometimes patients’ views may not be reasonable or
rational
Difficult to locate responsibility and/or know what to do
Difficult to know how much resource should be diverted to satisfying issues that give rise to complaints
What are the sociological approaches to understanding the patient-professional relationship?
Functionalism - emphasises consensus and reciprocity
Conflict theory - emphasises conflict
Interpretivism/Interactionism - emphasises the meanings
that people ascribe to social situations and how they’re
conducted
Patient-centred/partnership models - emphasise
partnership
Describe the functionalist approach to understanding the patient-professional relationship and its criticisms
On the whole lay people don’t have the technical competence to remedy their situation. The sick person is placed in a state of dependence. The sick person should want to get well.
Assumes patient is incompetent. Doesn’t explain why things go wrong.
Describe the conflict approach to understanding the patient-professional relationship and its criticisms
The doctor holds bureaucratic power - they have a monopoly on definitions of health and illness. Patient has little choice but to submit.
However patients aren’t always passive (non-compliance)
Describe the interpretive/interactionist approach to understanding the patient-professional relationship
Focuses on the meanings that both parties give to the interaction. Interested in patterns of order. Unwritten rules govern conduct of all parties
Describe the patient centred approach to understanding the patient-professional relationship
No decision about me without me. Triple diagnosis, holistic view. Finds common ground on problem and management plan. Egalitarian.
What can a patient contribute to a decision making process?
Their concerns and priorities, personal perceptions of costs and benefits of alternative interventions, judgements about the severity of their health problems and trade-off issues of survival at cost of quality of life
Describe the difference between explanatory and aspirational models of the doctor-patient relationship
Explanatory - explain the way the doctor-patient relationship works and what can go wrong
Aspirational - how the doctor-patient relationship ideally should be
What is a complimentary therapy?
Any medical system based on a theory other than orthodox science of medicine
What are reasons for uses of complimentary therapy?
Persistant symptoms, Adverse reactions to conventional treatment. May feel they received little time and attention.
