Healht psy lec

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    Patient-Provider Behaviors

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    Describe patient and provider factors thatcontribute to faulty communication and non-adherence to treatment

    Describe what complementary and alternative

    medicine (CAM) is and why testing itseffectiveness is difficult

    Learning Objectives

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    True of meNot true of me

    I like going to the doctor for check ups

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    Before, physicians authority was accepted

    without question or complaint

    Now, patients are more involved in theirhealth care

    Patients are presented with choices Patients are actively engaged in their treatment

    regimen

    Patient Role in Health Care

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    Communication does not always go smoothly

    Consequences Nonadherence to treatment recommendations

    Initiation of malpractice litigation

    Factors that influence communication Setting

    Provider behaviors

    Patient behaviors

    Nature of Patient-ProviderCommunication

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    Inattentiveness

    Jargon

    Baby talk

    Nonperson treatment (depersonalization)

    Stereotypes of patients

    Provider Contributions to FaultyCommunication

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    Personality

    Anxiety level

    Patient attitudes towards symptoms

    Patient Contributions to FaultyCommunication

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    Providers rarely receive feedback

    When a patient doesnt return:

    The treatment may have led to a cure

    The treatment may have failed, but the patient gotbetter anyway

    The patient may have gotten worse and gone elsewhere

    The patient may have died

    Feedback is essential for the providers

    Interactive Aspects ofCommunication

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    Nonadherence to treatment regimens

    Antibiotic regimens

    33% fail to comply

    Behavior change (e.g., stop smoking, follow a diet)

    80% fail to comply Prescription medications

    85% fail to adhere completely

    Results of Poor Patient-ProviderCommunication

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    Causes of adherence:

    Good communication

    Type of treatment regimen Followed for a short time

    Are simple

    Require less frequent dosage

    Dont interfere with other desirable activities

    Adherence

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    Teaching providers how to communicate Simple courtesy rules

    Greet patients

    Address them by name

    Explain the purposes of procedures

    Nonverbal communication skills Forward lean

    Direct eye contact

    Practice communication skills

    Improving Patient-ProviderCommunication

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    Teaching patients how to communicate

    Teaching patients skills for eliciting informationfrom physicians

    List questions before the visit

    Improving Patient-ProviderCommunication

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    Hospitalization can be difficult for children

    Preparing children is beneficial

    Showing them a film of another child after surgery

    Relaxation training

    Preparing Children for MedicalInterventions

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    Teach nurses and parents behaviors

    Do use: Distraction

    Coping advice

    Dont use: Reassurance

    Empathy

    Apology

    Nurse and Parent Training inPostoperative Stress (N/P-TIPS)

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    Non-traditional medical approaches used in

    addition to or instead of traditional medicine

    Top 5 CAM therapies:

    Prayer 43%

    Natural products (herbs, vitamins, and minerals) 17.7%

    Deep Breathing 12.7%

    Meditation 9.4%

    Chiropractic and Osteopathic 8.6%

    Complementary and AlternativeMedicine (CAM)

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    Others: dietary supplements, acupuncture,

    yoga, hypnosis, massage

    Insufficient evidence to evaluate theeffectiveness of most CAM therapies

    Highly individualized

    Multiple CAM therapies are often used

    CAM

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    Compared:

    Providers referral of CAM therapies Child use of CAM therapies

    Providers recommended 26 of the 32 optionsmore often than children were using them

    Deep breathing exercises Massage Pet therapy Dietary supplements

    Pediatric CAM Use

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    Questions?

    Thank you