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18 Cards in this Set
- Front
- Back
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5 stappen bij een medisch consult |
1.Opbouwen van de relatie 2.Reden van aanwezigheid achterhalen 3. Conducts physical or verbal or both examination 4. the doctor, or the docter and the patien, or the patient (in that order of propability) considers the condition. 5. The docter, and occasionally the patient, considers further treatment or further investigation. |
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Key elements for a successful interview |
1. having a good knowledge of research ormedical information and being able to communicate this to the pationt. 2. achieving a good relationship with the patient 3. establishing the nature of the patients medical problem. 4. gaining an understanding of the patients understanding of their problems 5. engaging the patient in any decisionmakingprocess / treatment choices, for example, are discussed witht the patient. 6. Managing time so that the consultation does not appear rushed. |
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Professional centered approach |
arts controle, arts besluit, patient passively accepts. |
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Patient centered approach |
Identifies and works with patients agenda as well as their own, the arts actively listens to the patient and responds appropriately, the patient is an active participant in the process. ''shared decision making'' onbevooroordeeld |
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all issues takin into account in elwyn consultation approach |
1. explore patients ideas about nature of problem and potential treatments. 2.Identify how much information the patient would prefer, and give them this much 3. Check understanding of potential treatment options and expectations and concerns in them 4. acces the patient's decision-making preference and adopt their preferredmode. 5. Make, discuss or defer decisions 6. arrange follow-up |
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Attitudes en consult? |
Interfereert het professionele contact, obesitas-->lui 15% medicijnstudenten homofoob. Tunnelvisie, invloed op communicatiestijl, uitgangspunt motiverende gespreksvoering. |
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Shared decision making |
Niet in alle gevallen, voornamelijk bij equipoise (weet niet welke het beste is) |
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Attitudes |
mini evaluaties, goed voelen, acc waarn, bij horen. |
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3 vormen adherence |
Compliance, concordance en adherence (indiv omg meegenomen) |
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Wat wordt er vaak gebruikt in de patient centered approach? |
Motivational interviewing (motiverende gespreksvoering) |
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5factoren irt therapietrouw |
1.patientgerelateerd(leeft, cult, pers), 2.conditie ger(Perc ernst,sympt,progn) 3.Behandeling ger.(aard beh, bijeff, kosten) 4.SE fact(oplniv, soc isol, toegang tot kosten behandeling(verzekering) 5. Systeem ger. (communicatie met arts over beh, alternat beh att.) |
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Training omgaan met attitudes |
Bewustwording, waarop is hij gebaseerd?, herformuleren. |
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Breaking bad news |
1. In person 2. Find out what patientknows 3. Find out what patient wants to now 4. Share, start with a warning shot and smallinf in simple language 5. Respond to patients feelings 6. Plan and follow-through,planning next steps, summarising what has been said. |
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3 ways to diagnose illnesses |
Hypothesis testing(best one), pattern recognition, opinion revision(based on rules of thumb) |
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Number of factors to influence heuristics in diagnosing |
Availability, representativeness, potential 'pay off': least cost and most benefit' |
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Sub optimal use of medication? |
Social factors(drug use, low social support), psychological factors(anxiety and depression), treatment factors(misunderstanding). |
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What helps to maximise appropiate use of medication? |
Concordance, maximise understanding, max memory (summing up). |
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Improving adherence |
(standard care, action plans, coping plans.) - Self control strategies, relapse prevention (high risk situation), Motivational strategies (stepwise progression social support), and make change habitual. |
