1. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Unit 6 Communication in the Health Care Setting

2. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Chapter 15 The Patient as an Individual

3. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Patients as Individuals Patient well-being affected by attitude, expressed concern, and technical skills Individuals are complex –Cultural influences, personal experiences, and basic human needs all play role

4. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Philosophy of Individual Worth Every human being has worth Give same level of care regardless of patients’ circumstances –Some patients present very unique challenges More difficult than others

5. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dealing with Prejudice Prejudice –Negative feelings about people due to race, cultural background, appearance, etc. –Prevents seeing people as unique individuals –Leads to unfavorable judgments –Must identify own prejudices to deal with them

6. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question True or False: –Almost everyone has prejudices of some type.

7. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer True Although possibly unaware, almost all people have prejudices

8. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Meaning of Culture Culture includes the following: –Values and beliefs –Social organization –Family structure –Language –Religion –Everyday activities

9. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Purpose of Culture Provides guidelines for behavior Gives life predictability Provides means for people to live together in relative harmony

10. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Cultural Differences Customs vary among cultures –Differences can cause misunderstandings Approaches: –Appreciate different approaches to life –Learn about other cultures Especially those of likely future patients

11. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Cultural Differences Approaches: –Avoid assuming patients will always understand you –Remember that members of cultural groups may or may not practice certain customs

12. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Cultural Differences Approaches: –Be sensitive to possible cultural differences and patient needs –Ask appropriate questions to learn about patients

13. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dominant Culture Generally accepted foundational beliefs of society or country Examples of U.S. culture: –Importance of efficiency and punctuality –Shaking hands when meeting new people

14. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Subcultures Many subcultures exist in U.S. –Individuals may have customs different from dominant culture But never make assumptions about people based on appearance –Personal space Comfortable distance for conversation Varies among cultural groups

15. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question Comfortable personal space in the dominant culture of the U.S. is about ____. A.6 inches B.12 inches C.18 inches

16. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer C. 18 inches Comfortable personal space considered appropriate by dominant culture of U.S.: –Approximately 18 inches

17. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question True or False: –A new female arrives at Dr. Hendrick’s office wearing a long dress and a head covering. It is safe for the medical assistant to assume the patient is Muslim.

18. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer False Never safe to assume anything about patient’s culture based on appearance

19. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Major U.S. Cultural Groups African Americans Asian Americans European Americans Hispanic Americans Native Americans

20. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question Which of the following immigrant groups tends to retain their native language and customs? A.Young people looking for better economic opportunities B.Older adults escaping persecution C.Professionals who have skills in the U.S.

21. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer B. Older adults escaping persecution Older adults who feel forced to leave native countries tend to retain customs more than younger people

22. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question True or False: –Direct eye contact is a sign of sincerity for most cultural groups.

23. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer False Eye contact –Sign of sincerity in dominant U.S. culture However, many groups view as rude or aggressive

24. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Health Care Beliefs Vary widely among cultural groups Differences include the following: –Definitions of good health –Causes of disease –Methods of treatment

25. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Health Care Beliefs Traditional Western medicine –Practiced by most U.S. physicians –Focused on physical aspects of body –Employs scientific methods

26. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Religion and Health Care Religious and spiritual beliefs influence many health care practices –Shamans –Faith healing –Illness as will of God or punishment for sins –Prayer –Evil eye

27. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Harmony and Health Balance of body, mind, and spirit Growing interest in U.S. Basic belief of many cultures –Chinese concept of yin and yang

28. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Harmony and Health Body humor theory –Traditional Hispanic belief –Four fluids control body –Hot and cold disorders and treatments

29. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question True or False: –T’ai chi is a form of acupuncture that originated in China and is becoming accepted in the U.S.

30. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer False T’ai chi –Form of Chinese martial arts –Involves focusing mind and performing slow body movements

31. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Herbs and Plant Medicines Used for thousands of years Many used today Growing interest in U.S. in “natural” remedies –Not controlled by Food and Drug Administration (FDA) –Can be harmful

32. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Individual Needs Effectiveness of health care worker –Understanding and respecting individual differences Patients have different perceptions of health care setting

33. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Determining Individual Needs Observe patient’s behavior and ways of interacting with others Determine whether language barriers present Ask questions to learn individual preferences

34. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Determining Individual Needs Listen carefully to patient’s responses Some patients need more information than others –Explain what is being done and why

35. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question True or False: –It is appropriate to ask patients directly about their health care beliefs.

36. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer True Appropriate to ask patients questions about health care beliefs –Should be done in inquiring manner Rather than judgmental

37. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Maslow’s Hierarchy of Human Needs Developed by American Psychologist Abraham Maslow Human behavior motivated by efforts to meet needs Five categories of needs ranked in order of importance for human fulfillment

38. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Maslow’s Hierarchy of Human Needs Level 1: physiological –Food, shelter, and water Level 2: safety and security –Free from physical and psychological harm Level 3: love and affection –Friendships and intimacy

39. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Maslow’s Hierarchy of Human Needs Level 4: self-esteem –Opinion individual has of self Level 5: self-actualization –Achievement of full personal potential

40. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question True or False: –It is necessary to fully meet each need on Maslow’s hierarchy before moving up to the next level.

41. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer False Life is dynamic process –Not necessary to fully meet need category before moving to next level

42. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Maslow’s Hierarchy of Human Needs Illness and injury alter human needs Full recovery may involve moving up hierarchy Role of health care professionals: –Recognize patients’ needs –Help patients meet needs at each level

43. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Defense Mechanisms Responses to perceived threats to self- esteem –Provide relief from mental discomfort and anxiety –Commonly used at times of stress E.g., illness, injury

44. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Defense Mechanisms Compensation –Meet need through substitution Control –Use inappropriate control to make up for loss of control elsewhere Denial –Pretend something is not true

45. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Defense Mechanisms Displacement –Transfer feelings about one person to another Illness –Become ill for attention or to avoid situation Malingering –Pretend to be ill

46. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Defense Mechanisms Projection –See own weaknesses in others Rationalization –Explain behavior with socially acceptable reason Regression –Use inappropriate behavior for age

47. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Defense Mechanisms Repression –Keep unpleasant memories out of awareness Withdrawal –Refuse to communicate with others or participate in social activities

48. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question If the health care professional suspects a patient is displaying a defense mechanism to deal with fear, it is best to _____. A.Take action to reduce the patient’s fear B.Encourage the patient to be truthful and face the difficult situation C.Ignore the patient’s behavior

49. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer A. Take action to reduce the patient’s fear Usually best to try to understand patient’s fear and then seek ways to help alleviate it –E.g., provide information, offer to discuss it

50. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dealing with Loss Losses include: –Death of loved one –Independence –Physical ability –Good health Loss can significantly influence patient behavior

51. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dealing with Loss Health care professionals can help patients deal with loss –Recognize significance to individuals –Give patients opportunity to share feelings –Help patients explore ways to deal with loss

52. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Ways Individuals Deal with Loss Seek support from family and friends Find comfort in religion Draw on self-esteem Employ problem-solving techniques Use defense mechanisms Become angry or depressed