Introduction_to_Health_CareHarounMitchell_Introduction_to_Health

Introduction to Health Care

Haroun/Mitchell, Introduction to Health Care, 5th Edition. © 2021 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Unit 6

Communication in the Health Care Setting

Chapter 15

The Patient as an Individual

Patients as Individuals

Patient well-being affected by attitude, expressed concern, and technical skills

“People don’t care how much you know until they know how much you care.”

Individuals are complex

Cultural influences, personal experiences, and basic human needs all play role

Philosophy of Individual Worth

Every human being has worth

Give same level of care regardless of patients’ circumstances

Some patients present unique challenges

More difficult than others

Experiencing pain and anxiety

Empathy provides foundation for understanding others

Dealing with Prejudice (1 of 2)

Prejudice

Negative feelings about people due to race, cultural background, appearance, etc.

Also called “bias”

Prevents seeing people as unique individuals

Dealing with Prejudice (2 of 2)

Must identify own prejudices to deal with them

Many incorporated into our belief systems

Taken for granted

Implicit Bias

Bias that is outside consciousness

Difficult to identify and overcome

Studies reveal extensive implicit bias in health care

Affects patient outcomes

Question 1

True or False:

Almost everyone has prejudices of some type.

Answer 1

True

Although possibly unaware of them, almost all people have prejudices

Overcoming Bias (1 of 2)

Examine responses to others

Imagine individual as opposite of stereotype

Try to see person as an individual

Practice empathy

Overcoming Bias (2 of 2)

Associate with people of different groups

Reframe interactions with patients to ones between equals

Not necessary to agree with all beliefs of others

Especially if harmful to their health

Meaning of Culture (1 of 2)

Values and beliefs

Social organization

Family structure

Language

Meaning of Culture (2 of 2)

Religion

Everyday activities

Economic status

Sexual orientation

Purpose of Culture

Provides guidelines for behavior

Gives life predictability

Provides means for people to live together in relative harmony

Dominant Culture

Generally accepted foundational beliefs and behavior of society or country

Examples from U.S. culture:

Importance of efficiency and punctuality

Having a firm handshake

Individuals and Culture

U.S. population increasingly diverse

Some groups no longer considered to be minorities

Different levels of integration into maintain U.S. culture

Recognize differences but do not make assumptions

Dealing with Cultural Differences (1 of 2)

Appreciate different approaches to life

Learn about other cultures

Especially those of future patients in your area

Avoid assuming patients will always understand you

Remember that members of cultural groups may or may not practice certain customs

Dealing with Cultural Differences (2 of 2)

Be sensitive to possible cultural differences related to patient needs

Ask appropriate questions to learn about patients

Recognize there are many cultural sub-groups

Examples of Cultural Differences

Personal space

Comfortable distance for conversation

About 18 to 24 inches in U.S.

Closer in some cultures, farther away in others

Use of touch

Varies greatly

Gender issues

Question 2

Comfortable personal space in the dominant culture of the U.S. is about ____ .

A. 6 inches

B. 12 inches

C. 18 inches

Answer 2

C. 18 inches

Comfortable personal space considered appropriate by dominant culture of U.S.:

Approximately 18 inches

Question 3

True or False:

A new female patient arrives at Dr. Hendricks’ office wearing a long dress and a head covering. It is safe for the medical assistant to assume the patient is Muslim.

Answer 3

False

Never safe to assume anything about patient’s culture based on appearance

Question 4

True or False:

Direct eye contact is a sign of sincerity for most cultural groups.

Answer 4

False

Eye contact

Sign of sincerity in dominant U.S. culture

However, many groups view as rude or aggressive

Traditional Western Medicine

Practiced by most U.S. physicians

Focuses on physical aspects of body

Employs scientific methods

Treatment must be proven safe and effective

Illness attributed to factors that can be measured and explained

Cultural Variations Definitions of Health

Absence of disease

Balance of body energy

Harmony with nature

Integration of body, mind, and spirit

Cultural Variations Sources of Good Health

Nutritious food, good hygiene

Gift from ancestors

Will of God

Reward from God

Good luck

Cultural Variations Causes of Illness

Imbalance of body energy

Demons and spirits

Punishment for sins

Microbes and resulting infection

Will of God

Cultural Variations Treatment Methods

Acupuncture

Pharmaceutical drugs

Prayer

Surgery

Lifestyle changes

Rituals and ceremonies

Religion and Health

Religious and spiritual beliefs influence many health care practices

Shamans

Faith healing and prayer

Illness as will of God or punishment for sins

Prayer

Evil eye

Harmony and Health (1 of 2)

Balance of body, mind, and spirit

Growing interest in U.S.

Basic belief of many cultures

Chinese concept of yin and yang

Harmony and Health (2 of 2)

Body humor theory

Traditional Hispanic belief

Four fluids control body

Hot and cold disorders and treatments

Question 5

True or False:

T’ai chi is a form of acupuncture that originated in China and is becoming accepted in the U.S.

Answer 5

False

T’ai chi

Form of Chinese martial arts

Involves focusing mind and performing slow body movements

Herbs and Plant Medicines

Used for thousands of years

Many used today

Growing interest in U.S. in “natural” remedies

Not controlled by Food and Drug Administration (F D A)

Can be harmful

Human Needs

Considering needs a useful approach for understanding human behavior

Considers patients as individuals within cultural framework

Maslow’s Hierarchy of Human Needs (1 of 4)

Abraham Maslow theorized that human behavior is motivated by efforts to meet needs

Model used for many years to better understand patients

Assumptions being questioned today, but may still be useful for general consideration of human behavior

Maslow’s Hierarchy of Human Needs (2 of 4)

Level 1: physiological

Food, shelter, and water

Level 2: safety and security

Free from physical and psychological harm

Level 3: love and affection

Friendships and intimacy

Maslow’s Hierarchy of Human Needs (3 of 4)

Level 4: self-esteem

Opinion individual has of self

Level 5: self-actualization

Achievement of full personal potential

Question 6

True or False:

It is necessary to fully meet each need on Maslow’s hierarchy before moving up to the next level.

Answer 6

False

Life is a dynamic process

Not necessary to fully meet need category before moving to next level

Maslow’s Hierarchy of Human Needs (4 of 4)

Illness and injury alter human needs

Full recovery may involve moving up hierarchy

Role of health care professionals:

Recognize patients’needs

Help patients meet needs at each level

Defense Mechanisms (1 of 5)

Responses to perceived threats to self-esteem

Provide relief from mental discomfort and anxiety

Commonly used at times of stress

E.g., illness, injury

Defense Mechanisms (2 of 5)

Compensation

Meet need through substitution

Control

Use inappropriate control to make up for loss of control elsewhere

Denial

Pretend something is not true

Defense Mechanisms (3 of 5)

Displacement

Transfer feelings about one person to another

Acting out

Express difficult feelings by performing extreme behavior

Malingering

Pretend to be ill

Defense Mechanisms (4 of 5)

Projection

See own weaknesses in others

Rationalization

Explain behavior with socially acceptable reason

Regression

Use inappropriate behavior for age

Defense Mechanisms (5 of 5)

Repression

Keep unpleasant memories out of awareness

Withdrawal

Refuse to communicate with others or participate in social activities

Question 7

If the health care professional suspects a patient is displaying a defense mechanism to deal with fear, it is best to _____ .

A. Show interest in patient’s well-being

B. Tell the patient not to worry

C. Ignore the patient’s behavior

Answer 7

A. Show interest in the patient’s well-being

Demonstrate acceptance of patient’s feelings, listen, provide information as needed

Dealing with Loss (1 of 2)

Losses include:

Death of loved one

Independence

Physical ability

Good health

Loss can significantly influence patient behavior

Dealing with Loss (2 of 2)

Health care professionals can help patients deal with loss

Recognize significance to individuals

Give patients opportunity to share feelings

Help patients explore ways to deal with loss

Ways Individuals Deal with Loss

Seek support from family and friends

Find comfort in religion

Draw on self-esteem

Employ problem-solving techniques

Use defense mechanisms

Become angry or depressed

Treating Patients as Individuals

Effectiveness of health care professional dependent on understanding and respecting individual differences

Patients have different perceptions of health care setting

Learning About Patients (1 of 2)

Observe patient’s behavior and ways of interacting with others

Determine whether language barriers present

Ask questions to learn individual preferences

Learning About Patients (2 of 2)

Listen carefully to patient’s responses

Some patients need more information than others

Explain what is being done and why

Question 8

True or False:

It is appropriate to ask patients directly about their health care beliefs.

Answer 8

True

Appropriate to ask patients questions about health care beliefs

Should be done in inquiring manner

Rather than judgmental

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