WEEK 1: Relational approach to cultural and social considerations in health assessment, The interview, The complete health history Flashcards
what are the 3 levels of inquiry in a relational approach?
Intrapersonal (what the patient is feeling and what is influencing you), Interpersonal (considers experience of patient getting examined) and Contextual (considers circumstances influencing assessment)
what are the two lenses used in a relational approach?
- Meaning and Interpretation: called a hermeneutic phenomenological lens and considers how the patient attributes meaning to the circumstances and how they are interpreting the event.
- Power: called a critical lens and considers various aspects of power between health care providers and patients as well as power structures within society.
what is gender filter?
where some health care treatments overlook, misdiagnose or may be misunderstood based on gender.
what is decolonizing filter?
understanding how bias, stereotypes, culture, social determinants such as poverty, education level or geographic location may be influencing the client.
what are health inequities?
differences in the distribution of health outcomes between populations that are unnecessary, avoidable, unfair, and unjust.
mention the 3 practice imperatives while conducting health assessments.
Practice imperative 1: Conduct culturally safe health assessments
Practice imperative 2: Pay attention to the social and economic contexts of patients’ and families’ lives
Practice imperative 3: Intentionally work to build trust and create safety
what is subjective data?
what the patient says about themselves
list the milestones of a successful interview
- Gather complete, accurate data
- Establish rapport and trust
- Awareness of implicit bias
- Share information with pt. about their health state
- Build rapport for a continuing therapeutic relationship
- Look for opportunities to engage in health promotion and illness prevention
- Social Determinants of Health
what is the contract between patient and examiner?
the interview
what are the factors to consider in the contract (the interview)?
- Time and place
- Introduction and explanation
- Purpose
- Length
- Expectations
- Presence of others
- Confidentiality
- Costs
facilitating the interview involves awareness of?
- How social and professional positioning affects pt. perception.
- How you communicate.
- How thoughts, judgements, emotions, and physical proximity can influence the assessment.
the process of communication involves?
- Sending
- Receiving
- Attending to power differentials
- Recognizing Implicit Bias
- Communication skills (* Unconditional positive regard
- Empathy
- Active listening)
what should always be done about the physical setting?
- Ensure privacy
- Minimize interruptions
- Attention to the physical environment
- Taking notes
- Electronic clinical documentation
what are the challenges of note taking?
- Impedes eye contact
- Shifts attention away from patient
- Interrupts patient’s narrative flow
- Impedes observation of nonverbal behaviour
- Can be threatening during discussion of sensitive issues
what are the benefits of electronic clinical documentation?
- Can minimize redundancy
- Helps stay focused on patient and convey active listening
