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ch5 definitions

Course Code
PSYC 365
David Cox

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Chapter 5: Communication in medical Settings
Patient delay -Period between an individual’s first awareness of a symptom and treatment for that symptom
Negative affectivity
(NA trait)
-Mood-related disposition (bad mood) greater proclivity to report symptoms than those with low NA trait in
absence of any objective differences in health status
-High NA trait = experience consistently higher levels of distress and dissatisfaction over time and across
different situations
-High hyper vigilant about their bodies and lower threshold for noticing and reporting subtle bodily
sensations + super concern about implications of such symptoms
Competition of cues -Internal symptoms likely t go unnoticed when individual is engaged in physical activity
-Consistent with finding that distraction can serve as useful short term coping method (sports competitions)
Lay referral system -Informal network of non-practitioners who offer their own interpretations long before any medical treatment is
sought (ex. Family, friends)
-Provide personal advice/view when someone mention symptoms, request ions an opinion or look sick
-Helpfulness varies, sometimes very helpful, but more often to recommend actions that worsen condition or
delay seeking appropriate and needed treatment
Patient delay -Period between an individual’s first awareness of a symptom and treatment for that symptom
Safer, Tharps, Jackson,
Leventhal study
-Identified stages of delay I seeking medical care
-Results: greatest pain = least delay; longer for patients who currently had other problem in their lives
(marriage), who read about their symptoms, older, waited for symptoms to go away
-Best predictor of illness delay was whether person had new symptom
-Likely see old symptom as normal and to tolerate it for long period
-Lengthy illness delay if imagine they were severely ill and negative consequences or if think can’t be cured 
-LIMITATIONS METHOD: cautious; 1. only include those who sought medical care (can’t generalize); 2.
Asked to recall and specify point which they first noticed symptom (inaccurate); should use prospective study
Delay by patients -Time between onset of symptoms and time of first medical consultation
Delay by providers -Delay between first medical consultation and start of treatment
-Do not seem to be associated with decreased survival in patients presenting with breast cancer
Total delay -Time between onset of symptoms and start of treatment
-2 main phases: 1. Delay by patients 2. Delay by providers
Active-passive model -Situation in which patients are unable to participate in their car or to make decisions because of their medical
-Ex. Coma, severe injury physician responsible for providing care and making decisions on patients behalf
-Communication in which the patient seeks advice from the physician and answers questions that are aced by
physician is responsible for determining diagnosis and treatment
-Physician responsible for the think and decision making
-Model likely to be followed if person had an infection or sprain
-Ex. Don’t ask questions because seem to be challenging physician authority, don’t know what the medicinal
would do (following orders)
-Health care model in which physician and patient make joint decisions about every aspect of care (diagnostic
tests to choice and implementation of treatment
-Assertiveness and active involvement on part of patient precursors of an effective partnership with the
-Ideal relationship
-Essentially foreign to medicine but 50 years later (now) it is not
Narrowly biomedical
communication pattern
-Biomedical talk, closed-ended medical questions, very little discussion of psychosocial issues (daily living,
emotions, social relations)
-Occurred in 32% of visits
Expanded biomedical
communicating pattern
-Numerous closed-ended medical questions and moderate levels of biomedical and psychosocial exchange
between physician and patient
-33% of visits
communication pattern
-Biological, psychological and social factors are all involved in any given state of health or illness
-Balance of psychosocial and biomedical communication
-20% of visits
communication pattern
-Substantial amount of psychosocial exchange between physician and patient
-8% of visits
-Preferred (collaborative model)
communication pattern
-Use of physician as a consultant who answers questions rather than being the one who asks them
-8% of visits
-Physicians especially satisfied with this approach these visits made good use of their time
-Patients moderately pleased
-Cohort usually younger patients engage
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