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Chapter 9

Chapter 9 health notes.docx

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Department
Psychology
Course
PSYC 3170
Professor
Gerry Goldberg
Semester
Winter

Description
Patient-Provider Relations Notes  Nurse practitioner: is a registered nurse (RN) who has an additional education in health assessment, diagnosis, management of all illnesses and injuries  order tests and prescribe drugs o Work with physicians in private practice but also provide care in public clinics such as nursing homes; emphasize prevention o Advanced proactive nurses- autonomasly and collabritvly o Complement rather than replace other health care providers  Physician assistants: are skilled health care team members who perform a wide range of medical services o Their duties: medical histories, physical examination, diagnosis, and treatment o Physician assistances will become more popular in the future o Main employer of assistants is the candian military forces o  We often judge technical quality on the basis of the manner in which care is delivered. o A warm, confident and friendly provider is judged better than someone who is unfriendly o Uncertainty kills liking  Patient consumerism- Another factor in which where there is a heavy influence on patient-provider interactions is the patient’s increasing desire and need to be involved in the decisions that affect their health  Increasing emphasis on maintaining and achieving good health in Western societies has contributed to patient consumerism in recent years o More proactive role in managing their health o Practitioner must have patients full cooperation o Patient must plan for better health and that will ensure commitment o Modify lifestyles such as no smoking and exercise o Ppl who see health under ones control liely to alter it positively  The internet is also used in the patients being more proactive in their treatment  Patient has more expertise about their illness especially when it is chronic or returning  The relationship between patent and provider is changing in the ways that make better communication essentials  Setting: o Unlikely source for good comms; likely interupted o is in a practitioners office for 12-15 mins o Provider has to extract information quickly o Difficulties: patient uses over the counter remedies that mask the symptoms o And they think that some symptoms are more important that the practitioner’s knowledge of symptoms Structure of health care delivery system  Primary are health care facilities and coordinates the provision of the services that are delivered to ensure community of care (family doctors)  Secondary health care: need to record any necessary tests or procedures that are passed along to primary physician o Gatekeeper systems is receiving specialized care or tests require referrals from physicians o Even having a regular physician  may not have time to see them or have a referral because of the few physicians and many people o The long wait for consultation can be stressful and frustrating for patients o Add to this even a longer wait for specialized care such as for cardiac or cancer care o Ontario one of the lowest ratios; Canada is lowest to primary health care o STUDY: primary care users in southwestern Ontario had a primary physician majority had to wait and could not get an appointment o CAM –complematary and alternative medicine o Chiro, massage, acupuncture o Socio demographic affects usage of cams o Cam=consumersit approach o Consultations are longer,  Changes are occurring in the health cares system  More women and becoming doctors and increase acceptance of contemporary and alternative therapies  Responsibly that were before only for doctor now change to other doctors and patients  Holistic health: the idea that merely is a positive state to be actively achieved not merely the absence of disease, has gained a strong foothold in Western medicine  Viewpoint both spiritual and physiological influences on health and patients responsibility for achieving health and curing illness  Emphasizes self-help, health education, and self-healing  Changes alter relationship between provider and patient making more open, equal and reciprocal (emotional contact) Provider behaviors that contribute to faulty communication  A problem between practitioner and patient is not listening o Beckham and Frankel (1984): studies 74 office visits, 23% patients could finish their explanation, 69% physicians interrupted (directing to a disease), patient can only talk for 18-22 seconds o This is not good because it can leave out important information  The use of jargon and technical language is another factor in poor communication o Physicians have sued medical jargon for a very long time o Also can be contributed by the technical training and may forget that patients are not ad expertise as they are  Physicians may underestimate patients understanding and may use baby talk to them o This includes overly simple explanations coupled with infant zing baby talk that make the patient feel like a helpless child  Depersonalization of the patient is another problem that impairs the quality of the patient-practitioner relationship o This may be done to keep the patient quiet when an explanation is being told or when there is a test being conducted o May be employed when the practitioner is stressful to keep the patient quiet and them concentrating o The worriedness of docs has impacts on the patients level of anxiety; heart disease  Communication erodes when patients have a disease that practitioners do not want to treat  Negative stereotypes also play a role in the way that the practitioner views the patient o First Nations: practitioners seem then as quiet and passive, drunk, or angry ; must be culturally effective o Same ethnicity as practitioner and patient has the most satisfaction and better results o Negative perceptions of the elderly o Sexism is another problem o Females more q’s more care o Foster more disclosure o Both gender however like males docs o Physicians also prefer healthier people over sick ones Patient’s contributions to faulty communication  1/3 cant repeat diagnosis  Several factors contribute to the faulty communication of provider-patient o Neurotic patients: exaggerated picture of their symptoms o Anxiety makes it difficult to focus their attention to process incoming information  Some patients unable to understand information about their case o Low SES have the least amount of communication with the doctors o As people age the number of medical problems increase and the way that they present their communications effectively and follow treatments decreases o Patients who receive a clear explanation of disorder or t
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