Health Psychology Chapter 9
Terms in this set (67)
What is involved in patient consumerism?
-Being prepared with choices
-Cooperating/participating in the development & enactment of the treatment plan
-Having considerable expertise about their health problems
What can result in patient dissatisfaction in managed care?
Changing structure of the health care delivery system can undermine patient-provider communication
What else can be a result?
What is patient-centered care?
-Providing patients with information
-Involving them in decisions regarding care
-Consideration of psychosocial issues
Technical quality of care and the manner in which care is delivered are...
How is the setting of a medical office?
Medical office is an unlikely setting for effective communication
What is the role of the provider?
Extract significant information quickly from the patient
(Patient & provider are not always on the same page)
What is shown when it comes to provider behaviors that contribute to faulty communication?
-Use of jargon
-Stereotypes of patients
How are some patients contributions to faulty communications?
-Patients inability to present their complaints effectively
-Neurotic patients exaggerate symptoms
At an older age...
Ability to follow treatment guidelines declines
What are some attitudes patients have toward symptoms?
-Misunderstanding the providers emphasis on factors that they consider to be incidental
-Paying little attention
-Believing that the provider has made an incorrect diagnosis
What are interactive aspects of the communication problem?
-Lack of opportunity for feedback to the provider
-Difficulty in knowing when a relationship has been established with a patient
-Learning is fostered more by positive than by negative feedback
What would dissatisfied patients do?
-Less likely to comply with treatment recommendations
-More likely to turn to alternative services that satisfy emotional rather then medical needs
-Less likely to obtain medical checkups
-More likely to change doctors and file formal complaints
What is it when there is non adherence to treatment regimens?
-Patients do not adopt the behaviors and treatments their providers recommend
-Adherence rates vary depending on the treatment recommendations
How could you measure adherence?
-Asking patients about their adherence yields artificially high estimates
-Researchers draw on indirect measures of adherence which can be biased
Adherence is highest in patients when?
-Clear, jargon-free explanation is received
-Instructions are asked to be repeated
-Instructions are written down
-Unclear recommendations are singled out and clarified
-Instructions are repeated more than once
Adherence is influenced by...
Qualities of the treatment regimen
Non adherent patients cite...
What is creative non adherence?
Modifying and supplementing a prescribed treatment regimen
When training providers what can be taught?
-Simple behaviors that are seen as warm and supportive
When training patients what can be done?
-Skills to elicit information from physicians
-Thinking own questions ahead of time
What can be done for probing for barriers to adherence?
-Barriers can be discovered by talking to the patient
-Breaking advice into manageable sub goals that can be monitored
-Rate of adherence increases if lifestyle changes are prescribed
What is the Information-Motivation-Behavioral Skills Model of Health Behavior?
What is the structure of the hospital?
-Depends on the health program under which care is delivered
What is the cure structure of a hospital?
Performing treatment action that has the potential to restore patients to good health
What is the care structure of a hospital?
Orientation of the nursing staff
What is the core structure of a hospital?
Ensuring the smooth functioning of the system
What is the role of a psychologist?
-Diagnosis of patients and assessment of patients level of functioning
-Pre- and post surgery preparation and pin control
-Interventions to increase medication and treatment compliance
-Teach appropriate self-care after discharge
-Diagnosis and treat psychological problems
What is the impact of hospitalization on the patient?
Patients are required to entrust themselves completely to strangers in an uncertain environment
(may result in problematic psychological symptoms)
Patients who have been prepared are:
-Less emotionally distressed
-Able to regain their functioning more quickly
-Able to leave the hospital sooner
How are Hospitalized children?
-Hospitalization can be hard on children
-Environment can be lonely and isolating
-May become socially withdrawn
-Dependency fostered by bed rest and reliance on staff can lead to regression
How can preparing children for medical interventions be beneficial?
-Children equally benefit with preparation as adults
-Results in less problem behaviors
-Parents can undertake preparation
-Presence of parents during stressful medical procedures can be helpful
What is Complementary and Alternative Medicine (CAM)?
Diverse group of therapies, products, and medical treatments
-Represents a vast and unevaluated aspect of care
What is the National Center for Complementary and Alternative Medicine (NCCAM)?
Created to evaluate the usefulness and safety of CAM
What is Holistic Medicine?
Approach to treatment that deals with the physical, psychological, and spiritual needs of the person
How does Traditional Chinese medicine work?
Based on the idea that a vital force qi flows throughout the body
-Strives to affect the balance yin and yang
What is Ayurvedic medicine?
Goal is to balance among the body, mind, and spirit.
What are some treatments for Ayurvedic medicine?
Use diet, exercise, massages, herbs, oils, spices, and various minerals
What is Homeopathy?
Interprets disease and illness as caused by disturbances in a vital life force
What is the treatment for homeopathy?
Use diluted preparations
What is Naturopathy?
Central tenet is that the body can heal itself through diet, exercise, sunlight and fresh air
How do Dietary Supplements work?
Contain nutrients in amounts that are as high or higher than levels recommended by the United States Institute of Medicine's
How does prayer work?
Spiritual beliefs have been tied to better health practices, health, and longer life
What is Acupuncture?
-Long, thin needles are inserted into designated areas of the body
How does Acupuncture work?
-Used to control pain
-Triggers the release of endorphins which reduces the experience of pain
-Theoretically influence the areas in which a patient is experiencing a problem
What is Yoga?
Breathing techniques, posture, strengthening exercises, and meditation
What does Yoga treat?
-Chronic pain, bronchitis, symptoms associated with menopause
-Mental and physical ailments related to stress, including anxiety and depression
What is Hypnosis?
State of relaxation which can alone help reduce stress and discomfort
Effects of hypnosis may be due to the composite effects of what?
What does Meditation do?
-Variety of therapies that focus and control attention
-Helpful for managing pain
-Effective treatment for certain functional disorders
What is Guided Imagery?
Patient is instructed to conjure up a picture that he or she holds in mind during the experience of discomfort
What does guided imagery do?
-Meditative procedure that has been used to control discomfort related to illness and treatment
What is Chiropractic medicine?
Performing adjustments on the spine and joints to correct misalignment.
(Believed to prevent and cure illness)
What is a massage?
Manipulation of soft tissue
What can a massage do?
-Reduces stress and is believed to boost immune functioning
-Flushes waste out of the system
-Used to control stress and pain
Who uses CAM?
-People who are not successfully treated by traditional medicine
-People who face delays in receiving medical care and cannot afford high costs of medical care
-Used more by white people than by minorities
What is the evaluation of CAM?
-Difficult because they are highly individualized
-Importance of CAM is derived from the fact that many people use it
What is Integrative medicine?
combination of alternative medicine with conventional medicine
What is the placebo effect?
Medical procedure that produces an effect in a patient because of its therapeutic intent
(Included in many effective treatments)
What does the effectiveness of a placebo depend on?
How a provider treats the patient How much the provider seems to believe in the treatment
How are the effects strengthened?
When the provider gives reassurance to the patient that the condition will improve
What are some characteristics of those who show strong placebo effects?
-Have high need for approval
-Have low self-esteem and are persuadable
What are some situational determinants of placebo effects?
-Setting that is similar to medical formality
-Shape, size, color, taste, and quantity of the placebo
-Treatment regimens that seem medical and include precise instructions
Placebo effect is facilitated by...
Norms that surround treatment regimens
Why are placebos effective?
People believe that drugs work
What is the Double-Blind Experiment?
One group of patients are given a drug to cure a disease or alleviate symptoms and another group is given a placebo
What would be the measure of the drugs effectiveness in the double-blind experiment?
Difference between the effectiveness of the drug and the effectiveness of the placebo