Unit 6

1. Unit 6 Communication in the Health Care Setting

2. Chapter 15 The Patient as an Individual

3. 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. Philosophy of Individual Worth • Every human being has worth • Give same level of care regardless of patients’ circumstances • Some patients present unique challenges • More difficult than others • Experiencing pain and anxiety

5. Dealing with Prejudice • Prejudice • Negative feelings about people due to race, cultural background, appearance, etc. • Prevents seeing people as unique individuals • Must identify own prejudices to deal with them • However, encourage positive health changes when necessary

6. Question • True or False: • Almost everyone has prejudices of some type.

7. Answer • True • Although possibly unaware of them, almost all people have prejudices

8. Meaning of Culture • Culture includes the following: • Values and beliefs • Social organization • Family structure • Language • Religion • Everyday activities

9. Purpose of Culture • Provides guidelines for behavior • Gives life predictability • Provides means for people to live together in relative harmony

10. 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. Cultural Differences • Approaches: • Avoid assuming patients will always understand you • Remember that members of cultural groups may or may not practice certain customs

12. Cultural Differences • Approaches: • Be sensitive to possible cultural differences and patient needs • Ask appropriate questions to learn about patients • Recognize there are many cultural sub-groups

13. 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. 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. Question • Comfortable personal space in the dominant culture of the U.S. is about ____ . • 6 inches • 12 inches • 18 inches

16. Answer • C. 18 inches • Comfortable personal space considered appropriate by dominant culture of U.S.: • Approximately 18 inches

17. Question • True or False: • A new female patient 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. Answer • False • Never safe to assume anything about patient’s culture based on appearance

19. Major U.S. Cultural Groups • African Americans • Asian Americans • European Americans • Hispanic Americans • Native Americans

20. Question • Which of the following immigrant groups tends to retain their native language and customs? • Young people looking for better economic opportunities • Older adults escaping persecution • Professionals who have skills in the U.S.

21. Answer • B. Older adults escaping persecution • Older adults who feel forced to leave native countries tend to retain customs more than younger people

22. Question • True or False: • Direct eye contact is a sign of sincerity for most cultural groups.

23. Answer • False • Eye contact • Sign of sincerity in dominant U.S. culture • However, many groups view as rude or aggressive

24. Health Care Beliefs • Vary widely among cultural groups • Differences include the following: • Definitions of good health • Causes of disease • Methods of treatment

25. Health Care Beliefs • Traditional Western medicine • Practiced by most U.S. physicians • Focused on physical aspects of body • Employs scientific methods

26. 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. 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. Harmony and Health • Body humor theory • Traditional Hispanic belief • Four fluids control body • Hot and cold disorders and treatments

29. 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. Answer • False • T’ai chi • Form of Chinese martial arts • Involves focusing mind and performing slow body movements

31. 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. 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

33. 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

34. Maslow’s Hierarchy of Human Needs • Level 4: self-esteem • Opinion individual has of self • Level 5: self-actualization • Achievement of full personal potential

35. Question • True or False: • It is necessary to fully meet each need on Maslow’s hierarchy before moving up to the next level.

36. Answer • False • Life is dynamic process • Not necessary to fully meet need category before moving to next level

37. 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

38. 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

39. 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

40. Defense Mechanisms • Displacement • Transfer feelings about one person to another • Acting out • Express difficult feelings by performing extreme behavior • Malingering • Pretend to be ill

41. Defense Mechanisms • Projection • See own weaknesses in others • Rationalization • Explain behavior with socially acceptable reason • Regression • Use inappropriate behavior for age

42. Defense Mechanisms • Repression • Keep unpleasant memories out of awareness • Withdrawal • Refuse to communicate with others or participate in social activities

43. Question • If the health care professional suspects a patient is displaying a defense mechanism to deal with fear, it is best to _____ . • Show interest in patient’s well-being • Tell the patient not to worry • Ignore the patient’s behavior

44. Answer • A. Show interest in the patient’s well-being • Demonstrate acceptance of patient’s feelings, listen, provide information as needed

45. Dealing with Loss • Losses include: • Death of loved one • Independence • Physical ability • Good health • Loss can significantly influence patient behavior

46. 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

47. 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

48. Individual Needs • Effectiveness of health care worker dependent on • Understanding and respecting individual differences • Patients have different perceptions of health care setting

49. Determining Individual Needs • Observe patient’s behavior and ways of interacting with others • Determine whether language barriers present • Ask questions to learn individual preferences

50. Determining Individual Needs • Listen carefully to patient’s responses • Some patients need more information than others • Explain what is being done and why