Pharm Care/management Test 1 Set 2

Front 1

Why are consumers frequently dissatisfied with traditional western medical care? (2)

Back 1

1)skepticism
b)patients increasingly informed

Front 2

Is the purchaser of a prescription....(2)

Back 2

1)consumer
2)patient

Front 3

Role of Health Care Provider (3)

Back 3

1)treat sick
2)care offered primarily during acute periods of illness
3)not generally associated with wellness or prevention

Front 4

HC providers not generally being associated with wellness or prevention is reinforced via...(2)

Back 4

1)health insurance philosophy
2)active-passive role of patient

Front 5

Changing ppl to include "wellness behavior" is SLOW just look at rates of....(4)

Back 5

1)smoking
2)alcohol consumption
3)exercise
4)weight control

Front 6

Health care in US is a "SICKNESS" model meaning...

Back 6

early signs of chronic diseases are ignored until condition is critical

Front 7

When does CAD begin?

Back 7

as early as 7yo

Front 8

Health providers come into contact w/ patient only during sick periods b/c...(4)

Back 8

1)individual priorities (time)
2)limited resources ($)
3)screening not a priority for patients
4)reimbursement structure (insurance)

Front 9

Structure of health care system (2) and what this means

Back 9

1)reduction of acute conditions
2)shift to continuous treatment of chronic diseases

Consumers reqd to assume more active role in health care

Front 10

How do you make an informed consumer decision as a patient? (2)

Back 10

1)rely on advise of health professionals
2)use marketing model (access info to make purchase decision)

Front 11

Consumers are becoming active in health care process by gathering info via...(3)

Back 11

1)internet
2)DTC drug advertising
3)hospital stats

Front 12

Patient centered model of care shifts focus from...(2)

Back 12

body system/disease to person as a whole

biomedical to biopsychosocial

Front 13

In the Patient centered model of care consumer have greater satisfaction when...and ex

Back 13

treated as a person instead of a medical problem

don't ID patient during rounds by disease, ID by name

Front 14

_____ is the most patient centered care

Back 14

hospice

Front 15

3 Patient-Provider models of care

Back 15

1)active-passive model
2)Guidance-cooperative model
3)Mutual-Participation model

Front 16

Active Passive Model def. (3)

Back 16

1)active MD tells what to do
2)patient does it without really understanding why
3)like parent/infant

Front 17

Guidance Cooperative Model def. (2)

Back 17

1)like teacher/student
2)MD still in control but tries to make patient understand what is going on

Front 18

Mutual-Participation Model def. (2)

Back 18

1)MD and patient are equally powerful
2)happens a lot w/ chronic diseases

Front 19

Biopsychosocial model def. (4)

Back 19

Incorporates health and illness as a product of:
1)physical
2)social
3)emotional
4)psychological context

Front 20

Biopsychosocial model defines health as...

Back 20

complex set of variables more extensive than a set of clinical indicators

Front 21

Health Behavior Models fxn (2)

Back 21

1)help explain health behavior
2)assist in aiding patients to change their health behavior

Front 22

4 different Health Behavior Models

Back 22

1)Social Cognitive Theory
2)Theory of Reasoned Axn
3)Health Belief Model
4)Transtheoretical model of change

Front 23

Social cognitive theory model def. (2)

Back 23

1)first social-behavior model trying to explain health behaviors
2)our expectations influence our behavior

Front 24

Social cognitive theory expectations that influence behavior (2)

Back 24

1)outcome expectations
2)efficacy expectations

Front 25

Outcome expectations

Back 25

belief that certain behavior results in particular outcome

Front 26

Efficacy expectations

Back 26

own expectations that can accomplish behavior (we either think we can or can't do something)

Front 27

KEY to social cognitive theory (2)

Back 27

1)individuals perceptions of the expectations
2)efficacy expectations must match outcome expectations or it won't happen

Front 28

Social cognitive theory locus of control?

Back 28

1)what inspires one to do something or not

Front 29

External locus (social cognitive theory)?

Back 29

think it is outside of your control to change your health behaviors

Front 30

When did Health Belief Model occur (HBM)?

Back 30

started in 1950's w/ free immunizations

Front 31

HBM key

Back 31

likelihood that individual will take action or change behavior

Front 32

Use of HBM?

Back 32

to understand the success or failure of health behavior change via susceptibility and severity

Front 33

Susceptibility (HBM)

Back 33

PERCEPTION of individual risk

Front 34

Severity (HBM)

Back 34

PERCEPTION of seriousness of disease if untreated

Front 35

Additional factors in HBM (2) (and ex of each)

Back 35

1)PERCIEVED benefits (will change/eliminate condition)
2)PERCIEVED barriers (compliance/SE's)

Front 36

Decision to change health behavior in HBM depends on...(2)

Back 36

1)indivial perception of risk and severity
2)likelihood of action after weighing perceived benefits/barriers

Front 37

Modifying factors of HBM (8)

Back 37

1)age
2)education
3)race/family
4)personality
5)social status
6)reference groups
7)peer pressure
8)prior experiences

Front 38

Influences in health behavior in HBM (2)

Back 38

1)cues to axn like commericals and seeing what's happening to others
2)self-efficacy/confidence in ability to act

Front 39

To quit smoking (steps in relation to HBM) (5)

Back 39

1)believes that he is susceptible to (-) effects
2)recognizes severity of risk
3)recognizes potential benefits
4)Wonder if barries will be too great
5)wonders if will get support of family members

Front 40

HBM doesn't...

Back 40

help to change ppl; just to understand them

Front 41

Transtheoretical model of change
a)fxn
b)developed by...and why?
c)theory behind it
d)people must...

Back 41

a)meant to help change ppl; not just to understand them
b)Prochaska; other models didn't explain why behavior change worked in some and failed in others
c)behavior change not just set of perceptions & factors
d)go thru set of states before behavior change occurs

Front 42

TTM Core Constructs (5)

Back 42

1)Five Stages of Change
2)10 Processes of change
3)Decisional balance (pros vs. cons)
4)self-efficacy
5)temptation to relapse

Front 43

TTM 5 Stages of Change to healthy behavior

Back 43

1)precontemplation
2)contemplation
3)preparation
4)action
5)maintenance

Front 44

TTM Precontemplation Stage (4)

Back 44

1)No thought of change
2)unmotivated
3)demoralized
4)wont act for next 6 months

Front 45

TTM Contemplation Stage (4)

Back 45

1)Beginning/intending to change within next 6 months
2)know benefits of change but be aware of costs
3)easy to get stuck in this stage due to behavioral procrastination
4)NO plan for action (nor are they ready for plan of action)

Front 46

TTM Preparation Stage (5)

Back 46

1)Take axn in immediate future
2)ready to change
3)have plan of action
4)taken big step/axn in past year
5)Do action-oritented programs (like weight watchers)

Front 47

TTM Action Stage (2 and 1 ex)

Back 47

1)made OVERT modifications to lifestyle within last 6 months
2)greatest risk @ this stage is relapse
3)must stop smoking cant like switch to low tar cigs

Front 48

TTM Maintenance Stage (3)

Back 48

1)Change process not as frequent in action stage
2)6months-5years
3)focus on relapse prevention

Front 49

According to TTM interventions by health professionals should be...and 2 ex why

Back 49

STAGE SPECIFIC

Cant tell diabetic how to use a glucose monitor if in precontemplation stage

Compliance monitors also useless for ppl in PC and C stages

Front 50

Goals of intervention of a PC or C patient (4)

Back 50

1)assist in motivation
2)promote awareness
3)focus on pros of changing
4)more of a coach and less of an instructor

Front 51

DTC advertising has resulted in....

Back 51

patients coming to MDs wanting a specific Rx medication

Front 52

Choosing a cholesterol drug boils down to 3 questions

Back 52

1)will it get cholesterol low enough
2)will patient tolerate it
3)can patient afford it

Front 53

What % of patients with high cholesterol will lose weight, change diet and exercise to control it?

Back 53

MINORITY

Front 54

Most common side effect from cholesterol meds...

Back 54

muscle aches that stop when medication is halted

Front 55

How do you progress thru the TTM stages of change? (3)

Back 55

1)covert and overt activities
2)guides for intervention programs
3)independent variables needed to move from one stage to next

Front 56

10 independent variables in the TTM processes of change

Back 56

1)consciousness-raising
2)dramatic relief
3)environmental reevaluation
3)self-reevaluation
4)self-liberation
5)social liberation
6)counterconditioning
7)stimulus control
8)contingency management
9)helping relationships

Front 57

Which TTM processes of change encompass PC to C

Back 57

consciousness raising

Front 58

Which TTM processes of change encompass P to A (2)

Back 58

social liberation
dramatic relief

Front 59

Which TTM processes of change encompass C to P

Back 59

self-reevaluation

Front 60

Which TTM processes of change encompass A to M (4)

Back 60

environmental reeval
counterconditioning
stimulus control
contingency management

Front 61

Which TTM processes of change encompass P to M

Back 61

self-liberation

Front 62

Which TTM processes of change encompass ALL of them

Back 62

helping relationships

Front 63

Dramatic reliefs entails...(2)

Back 63

1)emotional experience
2)role playing

Front 64

Self-reeval entails...

Back 64

assessments of self-image w/ and w/o condition

Front 65

Environmental reeval entails...

Back 65

effect on one's social environment

Front 66

Self-liberation entails...

Back 66

belief and commitment to act

Front 67

Social liberation entails...

Back 67

increase in social opportunities

Front 68

Counterconditioning entails...

Back 68

learning healthy behaviors to substitute unhealthy

Front 69

Stimulus control entails...

Back 69

remove cues for unhealthy behavior

Front 70

Contingency management entails...

Back 70

consequences for taking steps in certain directions

Front 71

Helping relationships entails...

Back 71

support of family/friends

Front 72

What is the decisional balance of change? (and when does this happen)

Back 72

weighing pros and cons of changing

@ each stage of processes of change

Front 73

To progress thru processes of change what has to happen w/ decisional balance?

Back 73

Pros must increase and cons must decrease

Front 74

Relationship b/w stage and decisional balance for an UNhealthy behavior

Back 74

Pro's incrase initially then decrease

Front 75

Relationship b/w stage and decisional balance for a healthy behavior

Back 75

pro's increase then stay that way

Front 76

Self-efficacy? and 3 ex

Back 76

Situation specific confidence ppl get when able to cope w/ high-risk situations w/o relapse

1)go to party w/o drink/smoke
2)avoid binge eating @ buffet
3)continuing meds when adverse event occurs

Front 77

Temptation is caused by? and 3ex

Back 77

intensity of urges to go back to specific habit in the middle of a difficult situation

1)emotional distress
2)cravings
3)positive social situations

Front 78

Relationship b/w stage and both self-efficacy and temptations

Back 78

Temptation has to go down for self-efficacy to go up

Front 79

In which model does a person weigh perception of risk in addition to their percieved severity if they get the condition?

Back 79

health-belief model

Front 80

In the TTM consciousness raising is considered a part of:

Back 80

process of change

Front 81

Schlering-Plough & Merck are planning a combo pill of...

Back 81

singular
claritin

Front 82

____ is the name of the clinics being setup in CVS's

Back 82

MinuteClinic

Front 83

____ services are used to unsnarl medical bills (4)

Back 83

1)SmartMedicalConsumer
2)MedBillManager
3)RevolutionHealth
4)Quicken Medical Expense Manager

Front 84

President Bush's plan for increasing the # of ppl w/ health insurance

Back 84

Give tax breaks to ppl who buy their own health insurance; making it more affordable for them

Front 85

What % of children diagnosed as bipolar are thought to have been misdiagnosed?

Back 85

50%

Front 86

In the netherlands their healthcare is becoming more like america's in that...
a)individuals must...
b)insurers must...
c)empolyers must...

Back 86

a)buy insurance or pay penalty
b)offer coverage to all comers
c)DO NOT have to offer any coverage

Front 87

In the massachusetts plan
a)individuals must..
b)insurers must..
c)employers must...

Back 87

a)buy insurance or pay penalty
b)may limit coverage for pre-existing conditions
c)must offer coverage or pay penalty

Front 88

In the proposed california plan
a)individuals must...
b)insurers must..
c)employers must..

Back 88

a)buy insurance or pay penalty
b)offer coverage to all comers
c)offer coverage or pay penalty

Front 89

Medco Health solutions just bought ____ so that it could...

Back 89

PolyMedica

offer diabetic medical supplies

Front 90

Medicare is now offering to pay for what in order to prevent certain diseases?

Back 90

more screening tests and immunization in order to save money by preventing certain diseases