Unit 6 Communication in the Health Care Setting

Chapter 15 The Patient as an Individual

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

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

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

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

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

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

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

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

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

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

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

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

Question Comfortable personal space in the dominant culture of the U.S. is about ____. A.6 inches B.12 inches C.18 inches

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

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.

Answer False Never safe to assume anything about patient’s culture based on appearance

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

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.

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

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

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

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

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

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

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

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

Question True or False: –T’ai chi is a form of acupuncture that originated in China and is becoming accepted in the U.S.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Question True or False: –It is appropriate to ask patients directly about their health care beliefs.

Answer True Appropriate to ask patients questions about health care beliefs –Should be done in inquiring manner Rather than judgmental