Please enable JavaScript.
Coggle requires JavaScript to display documents.
Health Care Services (Factors affecting QUALITY of communication (Provider…
Health Care Services
-
Results of Poor communication
- varies, depending on the treatment recommendations
~ ST antibiotic regimens = 1/3 fail
~ Appointment for modifying preventive health behaviours = 50-60% skip
~ Behaviour change recommendations = >80% fail
~ Prescribed meds = 85% fail
-
Low adherence
- depressed ppl
- low IQ
- lack of time/ $$
- disorganized families
Can lead to creative nonadherence = modify own treatment regimen
e.g. take smaller doses to make meds last longer
-
-
Hospital Setting
Structure
- depends on the health program under which care is delivered
- high occupational segregation - lack of communication between the different vocations = potential source of conflict, ambiguity in functioning, burnout
3 goals of Hospital Functioning
- CURE = physician's responsibility, through performing any treatment action that has potential to restore patients to good health
- CARE = nurse staff; humanitarian side of medicine - keep the patients' emotional and physical state in balance
- CORE = administration - ensure smooth functioning of system and flow of resources, services, personnels
goals are not always compatible - conflicting demands
Interventions to ^infoIrving Janis (1958): studied if something could be done to reduce stress that patients experience before and after operations
- group patients according to level of fear before operations
- studied how well patients understood and use info provided
Highly fearful
- remain anxious after surgery
- many negative side effects
- too absorbed with fears to process preparatory info adequately
Moderately fearful
- coped best
- vigilant enough to develop realistic expectations
Minimally fearful
- unfavorable reactions after surgery
- insufficiently vigilant to understand and process info
Patient Consumerism
in the past: physician's authority used to be accepted without question/ compliant
now: patients have adopted consumerist attitudes rather than just being passive recipients
Reasons for change:
1) presented with multiple choices
- having a choice = empowering + need to have information before making a decision
2) patient needs to be actively engaged in treatment regimen
- full cooperation and participation
- have expertise about their own illness
Placebo effect = any medical procedure that produces an effect in a patient because of its therapeutic intent
- complex, psychological mediated chain of events that has physiological effects
- facilitated by norms surrounding treatment regimes
Strong placebo effects:
- warmth, confidence, empathy, competence, reassurance providers
- how much the provider believe in the treatment
- patients with high need for approval/ low self-esteem, highly anxious
- settings with medical formality
- shape, size, color, taste and quantity
- precise instructions
Nocebo effect = phenomenon where info about potential adverse effects of a condition/ treatment may produce those adverse effects
- power of the mind to harm us
Adherence is highest when
- patient receives clear, jargon-free explanation of etiology, diagnosis, treatment reccomendations
- patient asked to repeat instructions
- instructions are written down
- repeat instructions >1x
qualities of treatment regimen affect adherence
- short-term, simple, does not interfere with desirable activities, not troublesome
- when advice is perceived as "medical" (take meds) vs. "vocational" (relax from work)
Placebo response is so strong that all drugs have to be evaluated against a placebo before it can be marketed