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83 Cards in this Set
- Front
- Back
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5 elements of communication
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words, symbols, method, context, environment
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words have these three meanings
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terminology (jargon and acronyms)
definition connotation |
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methods of communications
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verbal
written gesture physical |
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Context might include
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Biological, psychological, social, political, economic, religious, ethical, professional
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Environment could be
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geographical or physical
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barriers to effective communication
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ego involvement
differences in knowledge social status communicative purposes emotional distance one-way communication verbal manipulation language ambiguity |
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differences in knowledge could include...
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medical
personal cultural knowledge |
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emotional distance could result in
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dehumanization
distraction defense |
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one way communication would be described with these words
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tell
confront intimidate disconnect |
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verbal manipulation might have these 2 forms
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seduction
coercion |
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environment as a communication barrier could be due to
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noise
lighting traffic odor |
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biological barriers to communication might be developmental and include
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- comprehension
- auditory/visual function - method of expression |
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Pathological biological barriors to communication
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reception, processing, expression disorders like recessive aphasia
- neuro-psychological defects like dementia |
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Medical barriers to communication include
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instrumentation
medication |
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skills for effective communication
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- self-awareness
- self-assessment - listening (attending) - influencing |
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4 skills for effective communication include
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- self-awareness
- self-assessment - listening (attending) - influencing |
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Listening skills include
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- non-verbal cues
- questions (open & closed) - selective attention - reflection (content, feeling, meaning) |
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Some non-verbal cues
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Physical: space, posture and facial expression, movement, eye contact
Vocal: tone and inflection, volume, speed |
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"are you in pain today?" is an example of a ___ question
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closed question
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prompts, follow-ups and encouragement include:
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- could you be more specific?
- could you show me what you mean? - it would help me to understand if... - that's important information - let's return to that in a few minutes |
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Selective attention could include reinforcement, which is:
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paraphrasing, repetition or a follow-up question of a specific component of a response in order to focus or redirect the speaker
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"you said you have most of your pain in the morning. can you tell me more about that?" is an example of ____ and ___
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selective attention (via)
reinforcement |
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paraphrasing is not
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parroting
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reflection of content/reinforcement should emphasize
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key words or concepts
clarification and validation of the problem from the patient's perspective |
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you must make sure you hear ____
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what the patient wants to tell you
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- helping to focus and clarify a speaker's feelings
- gaining understanding of the speaker in a holistic sense - preserving own emotional status are aspects of this form of reflection of feelings |
Empathy
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Reflection of meaning could be
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-making explicit the speaker's interpretation of their experience
- frame of reference (perspective) |
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three things you want to reflect with re-enforcement/selective attention
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- content
- feelings - meaning |
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patient centered care requires respect for
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autonomy
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Motive-displacement
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it is no longer about us, we see the patient first
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3 care-giver dynamics of a caring relationship
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- motive displacement
- receptivity - engrossment |
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Receptivity could mean
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we ask questions to understand
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Engrossment means
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putting the patient's problem in the context of her life
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The question "What would you be doing if the pain were gone?" could help a PT determine...
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functional goals
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Adherence is slightly different in meaning than
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compliance
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five forms of information giving
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advice
suggestion opinion feedback logical consequences |
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when preparing to instruct a patient you must establish
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their baseline ability including:
developmental level educational level language background/training/experience |
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4 barriers to delivering Patient Education
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- patient's attitudes about illness
- "" passive role/attitude about PT - "" cognitive status - ""emotional status |
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persuasion
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- influencing for the purposes of changing attitudes
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Kelman's levels of Motivation for Change
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- compliance or adherence
- identification (rapport between therapist and client) - Internalization (internalizing the exercises or behaviors into patient's lifestyle) |
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Identification can be negative in this context
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when the patient is working to impress you but the therapy is ending
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5 levels of Proschaska's Model for Behavioral Change
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- precontemplation
- contemplation - preparation - action - maintenance |
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Pre-Contemplation implies
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parient is completely unaware of the need to change their behavior
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Contemplation
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Patient aware/can give lip service but has no intention of making change in next 6 months
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Preparation
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patient has understanding why, has made commitment to change, but has not taken action
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Action
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means patient is actively undertaking change
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Maintenance
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patient has been successful in making change and are avoiding relapse
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MEthod of confronting a patient safely:
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"I'm confused about..." or "help me understand..."
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personal power
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possession of control, authority or influence over another
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personal rights
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everyone entitled to act assertively and express themselves
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4 dimensions to health
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physical
social spiritual mental |
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WHO defines health as
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health is a state of physical, mental, and social well-being and not merely the absence of disease or infirmity
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according to Blakiston disease is
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a failure of the adaptive mechanism of an organism to counteract adequately the stimuli and stresses to which it is subject, resulting in disturbance in function or structure of any part of the body
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Medical model is ----
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reactive not proactive
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Illness, as definined by Barondess
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An array of discomforts and psychosocial dislocations resulting from interaction of a person with the environment. The environmental stimulus may be a disease but frequently is not
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Parson's Model, the Sick Role
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-- The non-responsibility of the individual for his or her condition ("something happens to me)
-- The exemption of the sick indivudual from normal task and role obligations - the recognition that being sick is undesirable and one should want to get well, -- the obligation to see out competent help |
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in 2030, one in ___ will be over the age of 65
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5
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health care expenditures are ~X% more for older people
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75%
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self-efficacy is
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the belief that one can effectively follow through and make behavioral change
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cultural competency is...
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a set of congruent behaviors, attitudes and policies that come together in a system, agency or among professionals that enable them to work effectively in cross-cultural situations
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4 elements of cultural competency
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- awareness of your own biases
- knowledge and understanding of other cultures - skill -- culturally appropriate - encounters -- culturally sensitive care |
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Low-context/individualistic applies to....
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Western society
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high concept/collectivist societies
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tend to be more in the east
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Concept of Face
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the sense of self-respect or self-esteem that people demonstrate in communicating with each other
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personalismo is the same as
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personal rapport
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somatization --
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reporting physical symptoms when psychologically stressed
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in 2030, one in ___ will be over the age of 65
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5
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health care expenditures are ~X% more for older people
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75%
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self-efficacy is
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the belief that one can effectively follow through and make behavioral change
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cultural competency is...
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a set of congruent behaviors, attitudes and policies that come together in a system, agency or among professionals that enable them to work effectively in cross-cultural situations
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4 elements of cultural competency
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- awareness of your own biases
- knowledge and understanding of other cultures - skill -- culturally appropriate - encounters -- culturally sensitive care |
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Low-context/individualistic applies to....
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Western society
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high concept/collectivist societies
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tend to be more in the east
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Concept of Face
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the sense of self-respect or self-esteem that people demonstrate in communicating with each other
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personalismo is the same as
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personal rapport
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somatization --
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reporting physical symptoms when psychologically stressed
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sociocultural influeces
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- biomedical markers
- service accessibility - service utilization - health care delivery systems - public policy and legislation - environment |
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biomedical markers are
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- genetics
- risk factors for predisposition to disease or impairment - normal change such as healing, aging, response to diseaseF |
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Medicare is overseen by what government system?
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Federal
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Medicaid is overseen by
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State government
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accessibility is
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the abilty to obtain needed, affordable, convenient, acceptable and effective personal health services in a timely manner
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utilization
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actual consumption of health services
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how is anxiety different from fear?
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anxiety is a common emotional response to something diffuse, unspecific, vague and fear is a reaction to a specific danger
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