Health Comm Test 3 (ch. 5-8)

hirschmann's ethnography of medical interns

the constant exposure to emotional situations helps create the detachment, doesn't take very long

who do you think should be held responsible in the cedars sinai case? why?

the nurse should be sued, when administering a drug to anyone you need to double and triple check the labels and what you are giving them.

how are our social networks likely to change as we age? why?

we lose friends gain new ones over support

what do you think of the blowing the whistle case study? why do you think substance abuse is higher than normal among health care providers?

- they have more access to it

how is a sense of normalcy related to social support?

- things are comfortable, predictable, and familiar. --requires cooperation --the normalcy of a condition depends on others to enact

what are some tips for avoiding and handling medical mistakes?

-establish trust -invite feedback -respond to complaints and requests as quickly as possible -show that you care -create realistic expectations -put it in writing -dont be shy about getting referrals -dont forget the family -own up to small mistakes

in what ways can people be oversupportive? what are the likely outcomes of different types of oversupport? name 5 tips for assuring that sure social support efforts are effective

-excessive and unnecessary help -outcomes= overhelping, overinforming, overempathizing -tips= dont overwhelm distressed indv., be careful with humor, call if you need me isnt usually helpful, just say something gentle if dk what to say, adapt a no strings attached approach

what are some communication strategies for supportive listening? for allowing emotional expression?

-focus on the other person -remain neutral -concentrate on feelings -legitimize the other persons emotions -summarize what you hear

what are some of the business aspects of medicine that frustrate caregivers and contribute to burnout?

-hassles over reimbursement -medical liability -being overworked - and feeling overwhelmed by regulations and policies

describe the principles of the theory of health as expanded consciousness. what is the role of the explicate order? the implicate order? what role do nurses play in helping people cope with health episodes

- a health crisis is not necessarily negative or undesirable. instead health events are integral parts of life that provide opportunities for growth and change -explicate order= made up of tangible elements of our existence -implicate order= comprising patterns beneath the surface

what are some strategies for avoiding burnout as a caregiver?

-hold daily debriefings with yourself -resist the urge to put off the good stuff -be mindful about what makes you happy -design your own time pie -seek the company of people whose presence replenishes you

what guidelines do you suggest when deciding who gets medical care? (box 6.2)

-how important or urgent is the treatment, look at who has the most life to live

what do you think of the transformation at virginia mason cancer center? do you think other medical centers could do a better job than they currently do at accommodating patients and limiting wait times? are there other processes youd like to see improved?

- having entertainment during wait periods, more eye appealing walkways etc. = good idea -yes

what did you learn from the case study "language barriers in a health care emergency" (box 6.5)

-in public places such as hospitals we should be prepared to accommodate all cultures especially if there is a solid population of that culture within the area.

what are some expectations regarding care for family members in thai culture?

-it is a sons duty to take care of the their elderly parents. -everyone in family must view body before it is put into a casket.

what are some tips for communicating with patients who are children?

-lett he children set the tone -pay attention -go easy on medical terminology -talk about illness as something normal

name and describe some of the role sets that patients and caregivers play. how is each role set described likely to affect health communication

-machine/mechanic -child/parent -believer/spirtualist -consumer/provider -partners

what are some promising options for bridging the language gap?

-medical interpreter law -language programs for caregivers - role play scenarios

in your opinion is there such a thing as a good death? if so, how would you describe it?

- wouldnt say good vs bad death would call it peaceful vs painful death.

how does role theory help to explain the initiation process in which caregivers in training are reminded of their status as novices?

-Role theory= social roles are defined by unique sets of rights, responsibilities, and privileges. -trainees are given pop quizzes and scut work (chores nobody wants)

what does the term transcendent experience mean? can you think of examples from movies or your own experiences?

-awareness that one's circumstances exist within the framework of something more meaningful than one might previously have imagined. ----we spend so much time stressing over grades and earning points, but in the grand scheme of things it doesnt matter as much as we think, most jobs dont even look at your gpa

what factors contribute to stress and burnout among caregivers? does high stress always lead to burnout? why/why not?

-burnout= emotional exhaustion, depersonalization, reduced sense of accomplishment -causes= conflicting demands (dbl blind situations), control of emotions (detachment), perceived communication deficits, excessive workloads, perceived appreciation -stress is considered a major cause of burnout

what is compadre? what should health professionals know about hispanic culture in regard to compadres?

-close friends of the family -they should treat them with respect to avoid insulting the entire family

describe some of the cultural beliefs and practices of arabs and muslims. how might these influence health communication

-collectivist culture -prayer mandated 5 times a day -daytime fasting mandated during ramadan -modesty -no pork no alcohol -left hand not used for eating or drinking -male/female contact boundaries -fertility is important -burying people on the same day of death

discuss the importance of personalismo, respeto, and confianza in traditional hispanic cultures. how might these ideas influence health communication ?

-core values and principles -personalismo= warm friendly relationships rather than impersonal - respeto= respectful and deferential behavior toward people of greater age and social status -confianza= the openness and trust among members of one's intimate circle

why might caregivers adopt a life at all costs perspective? what are the potential disadvantages of such a perspective?

-death is considered failure, and frightening, and could mean a lawsuit criticism or bad reputation -may be against persons wishes, prongling painful illness/life

do you have an advance-care directive? why or why not?

-describe in advance the medical care a person wishes to receive (or not) if he or she becomes too ill to communicate. -no, im fairly young in age but my family and i have all agreed about basic decisions about who would make decisions for whom

how do ageist assumptions affect health communication? describe communication accommodation theory

-discrimination based on a negative view of aging -CAT- **people tend to mirror each other's communication styles to display liking and respect. -convergent (use similar gestures, tone vocab) divergent (use diff communication styles) over accommodation may set a spiraling process in motion

describe some of the cultural beliefs and practices of asians and pacific islanders. how might these influence health communication?

-don't openly contradict one another - patients dont take part in treatment decisions -touching and eye contact may be seen as overly personal and overly familiar -reluctant to say much about their health histories

what factors contribute to the popularity of holistic medicine? what are the potential adv. and disadv.?

-more providers, more research dollars, more payment possibilities ADV. -simple principles, closer relationships, low cost/low tech, models more directed to health maintenance DISADV -some substances not well researched, swindling, lack of communication with traditional health care practitioners.

what role does hospice play?

-organization that provides support and care for dying individuals and their families. -palliative care (designed to keep person as comfortable and fulfilled as possible NOT design to cure illness)

what two frustrating dichotomies do people with disabilities often face?

-people tend to either treat their disabilities as the most important thing about them or self consciously to avoid the issue entirely -people with disabilities are often cast "either as heroic super crips or as tragic, usually embittered and angry, unfortunates worthy of pity or charity

describe the three phases of conceptualization that children experience as they mature

-prelogical conceptualization (2-6) (illness from monster or sun) -concrete-logical conceptualization (7-10) (external causes directly relate to internal manifestations) -formal- logical conceptualization (11+) (can understand complex influences we cant see)

what factors are linked to caregiver satisfaction?

-reasonable workload -feel a sense of personal satisfaction -respected

what are some explanations of why people of different races seem to achieve different health outcomes?

-receive different care -distrust -high risk -lack of knowledge -limited access -ineffective patient caregiver communication

how is social support linked to health and longevity? what are some of the reasons for the link between social support and health?

-social support = people helping people -buffering hypothesis= when we encounter potentially stressful experiences in which case knowing that other people are there for us and can cushion us for when we go through hard times. -benefits even when we dont encounter some kind of harmful agent or stress

describe 5 reasons misunderstandings might occur between patients and caregivers of different socioeconomic status

-socioeconomic status -gender -sexual orientation -race -age -ability/disability

what are some tips for bonding with patients when time is limited? which of these do you consider most important? why?

-start strong -dont interrupt -empower patients -dont end the visit before you ask if the patient has other questions or concerns **the last one for sure so it still allows the patient to feel a part of it.

in the case of willie king, who do you believe should be held responsible for amputating the wrong leg? why? who should be sued? pay the medical bills?

-surgical staff should be held responsible for writing down the incorrect leg -hospital should be sued - hospital should pay medical bills

what are some tips for communicating effectively with people who have diabetes

-talk to people with disabilities directly, not to their interpreters or companions -remember to identify yourself to sight impaired persons -treat adults with disabilities as adults -sit down when talking to someone in wheel chair -relax -dont insist on helping

what are some communication techniques for dealing with difficult patients?

-treat complaints as opportunities -empower team members to handle problems before they grow -invest in patient relationships -show empathy -display curiosity -try a little humor

what abilities are considered when assessing health literacy? how prevalent is low health literacy in the US? what are the consequences?

-understand the language in which information is conveyed -have access to reliable and relevant information -be interesting in health related information -have the social skills to discuss health matters with others -have adequate hearing and/or vision to get the information -understand how to apply the information -be willing and able to put health information to effective use

describe three tips for improving communication between patients and caregivers of different socioeconomic or literacy status

-what is my main problem? -what do i need to do? -why is it important fr me to do this?

how might time constraints affect patient care giver communication? how do you respond to some physicians argument that they must limit patients input so they can keep exams within a particular time limit? how can patients help this?

-when time is short supply, expediency may seem like the only alternative to turning away people in need. -caregivers can seem rushed and impatient, so quick short responses if any at all. -patients can make the most from the caregivers at the entry levels

what are the implications of regarding illness as a curse?

-wrath of good being or malice of an evil being (hiv/aids is wrath again homos) -for when rational explanations dont make sense

have you experienced the death of a loved one? how did it compare to the process described in a long goodbye to grandmother?

-yes - took place while away in college, total opposite experience

are you concerned that if you have a genetic profile, the information might be used against you? why or why not? are you interested in knowing your genetic profile? why/why not?

-yes because it may determine if or when they treat me -so so, i'm afraid to know but it could benefit my health to know because possible preventatives can be taken

have you ever felt that an animal was a good friend? why/why not? do you think animal companionship affects your coping ability?

-yes, comfort, unconditional love, reduce anxiety - companionship helps coping ability

describe the provisions of the HIPAA. what are the the implications for health communication?

-you can access your medical records -any other access to your records must be authorized by you -you must get a copy and sign off on the privacy policy of the organization -they cant see your contact or other information to anyone, but they can accept money from others to send the information directly to you

describe forms of nurturing support and give an example of each from your own experience

1)esteem support --help someone feel valued --supportive listening 2)emotional --acknowledge and understand what someone feels --allowing emotional expression 3)social network --work in support groups --facilitating group work

what are two types of action facilitating support? give an example of each from your own experience

1)performing tasks -- instrumental support (lending money to help pay a bill) 2) collecting information --personal information (experience), searching online, magazines, newspapers --too much info may not help coping

what are the adv and disadv of the way that professional caregivers are typically socialized?

ADV -prepares students for practice (intensity, emotional control, endurance) -establishes chain of command thinking -bonds the cohort -rite of passage DISADV -makes practitioners stoic, self sacrificing, susceptible to burnout- not healthy emotionally -can make the practitioner his/her own authority; less likely to listen to others -may identify more with the cohort and other practitioners than with patients

sleep deprivation

Any significant loss of sleep, resulting in problems in concentration and irritability

compare the birth experiences of carol bishop mills and her husband with those of kate and chris. what do you learn from these examples

CBM- was told all positives about baby then was gently told she may have down syndrome. K&C-first thing told was doc was sorry that baby had downs and made it sound like the end of the world and ashamed of the little boy. **tone and attitude mean everything

how do easterners and westerners typically regard health and wellness? what elements of each perspective appeal to you? why?

East -health is constant dynamic process of balance, the forces in balance are physical, social, supernatural (aim to restore and maintain harmony) West -health is a functional state, affected by "outside" forces like viruses or bacteria, and/or a "wearing out of the parts" that happens with age. (aim to take care of the villains, compensate for the worn out parts)

describe the provisions of the family and medical leave act of 1993

guarantees that people can take up to 12 weeks off work to care for ailing family members, seek medical care themselves, or bring the new children into their families. *doesn't require employers to pay workers during this time though and doesn't apply to all companies or all employees

what are the strengths and weaknesses of the organic approach? what are the strengths and weaknesses of the harmony approach?

ORGANIC -physical indicators, evidence based medicine. Problems= illness thats not easily observed is seen as not "real", if not sick then perfectly healthy. HARMONY -overall well being, balance, healing vs curing. Problems= relies on evidence that is difficult to observe or measure, may be a problem w/assertion trying to preserve harmony.

describe pivotal points in the history of racial and gender acceptance in health care in the united states?

RACE -1963 black MDs couldn't practice in the south -1990s jocelyn elders became first black surgeon general

what are the adv. of interdisciplinary teamwork? the challenges? what communication strategies do experts suggest?

adv -apply multiple perspectives to a problem, blurs the line between departments and present new opportunities, reduces costly oversights disadv, -takes time -groupthink -health professionals from different disciplines often have very different ideas about health

describe the idea of yin, yang, and qi and how they influence traditional chinese ideas about health care.

balance of yin and yang allows qi (central life energy) to flow correctly

how can an emphasis on prevention lead to prejudice against ill people?

can cause shame, guillt, isolation not realistic to be 100% all the time

what are some of the reasons that discussion of sexual orientation is important yet challenging in medical transactions?

important because it helps patients feel comfortable. challenging because of discrimination and fear of social rejection.

do you think affirmative action should be maintained or abolished as a factor when selecting students for caregiver education programs, why?

maintained- adds diversity, allows minorities to achieve their goals and dreams that their socioeconomic status and race wouldn't typically allow.

what does Bohm suggest as the best way to overcome the problematic nature of the typical thought process?

not by ignoring diversity but by embracing it

what is your opinion of the right to die issue? (box 8.5) why?

people should be allowed to choose to end their lives when in the situation between a peaceful or painful death.

what are the implications, both good and bad, of focusing extensively on science during caregiver education?

socialization hidden curriculum isolation identity in limbo BUT- makes group closer, organization