Aimee Galick, Ph.D. & Beth Patrick, Ph.D.(c) Session #A5a Saturday, October 12, 2013 Empowering Female Patients in Multi-Disciplinary Settings Aimee Galick, Ph.D. & Beth Patrick, Ph.D.(c) Collaborative Family Healthcare Association 15th Annual Conference October 10-12, 2013 Broomfield, Colorado U.S.A. Collaborative Family Healthcare Association 12th Annual Conference

Empowering Female Patients in Multi-Disciplinary Settings Aimee Galick, Ph.D. & Beth Patrick, Ph.D.(c) CFHA 2013

Overview Intersection of female discourse & medical context. Overview of qualitative research findings from meta-data analysis of women’s experience of heart disease. Model for empowering female patients. Collaborative conversation about attendee’s experiences working with female patients. 1. understanding of women's gendered health and illness experiences based on the presenters' research examining women's experiences with illness, learn how they can empower female patients as health care professionals. We provide a culturally-relevant inter-disciplinary model that is straightforward, broad, brief, and easy to apply in a variety of encounters with female patients.

Traditional Female Discourses Less dominant/More submissive Less independent/More dependent Less rational/More emotional Less competitive/More cooperative Less objective/More subjective Less autonomous/ More responsible for giving care in relationships The idea of societal discourses, i.e., shared ways that members of a social community talk and think, provides a conceptual link between individuals and the larger society (Krolokke & Sorensen, 2006). Discourses give contextual meaning to experience. At any point in history there are dominant ideas that inform people of “socially acceptable” ways of thinking, feeling, and behaving in relation to the world and in certain situations. Being a “woman” thus influences how to acceptably relate to others, behave, and feel, as well as how others respond. For example, it is generally not socially acceptable for women to display anger in the same ways as men. Dominant constructions of femininity still influence women to focus on relationships and connection, which often means putting other’s needs ahead of their own (Loscocco & Walzer, 2013). People often view women as less independent, more submissive, more suggestive, less logical, less competitive, and less objective than men. At the same time, societal messages suggest that women are responsible for the giving of care in their relationships (Knudson-Martin, 2009).

Medical Context Hierarchical - Independence driven Biological focus Symptom relief Medical compliance Provider as expert Power process.

“When the doctor’s come into the room, they direct all of their comments and questions to my husband as if I’m not there” “I don’t know how to explain myself to the doctors... so instead, I let my husband do the talking...” “My (male) doctor encourages me to ‘just stop my anxiety’ and ‘get a grip of my emotions’ so that I can be a better candidate for a heart transplant” “I think my doctor was upset by my tears...I need to try harder next time to not cry in front of him” “If I ask for too much from my doctor I feel like I am labeled an ‘annoying woman’ or a ‘complainer’”

Brief Overview of Heart Study

Empowerment comes from feeling understood & having a voice in defining reality.

Case Example White female patient in her mid-60’s recently found out that she may be ineligible for health- promoting procedure. Presented as confident, organized, flexible Husband and daughter described her as someone who “just adjusts” to life challenges Concurrent Sessions - Period 5 Saturday, October 12, 2013 - 1:30 to 3:00 PM Over the past century medical discourse has become the dominant perspective on illness. Relational discourses, which carry less power, are frequently adopted by women and inform their thoughts, feelings, and behavior. Medical family therapy seeks to improve service delivery by bridging these competing systems of language with their differences in systemic power. The purpose of this interactive presentation is to facilitate participant's understanding of women's gendered health and illness experiences based on the presenters' research examining women's experiences with illness, and learn how they can empower female patients as health care professionals. We provide a culturally-relevant inter-disciplinary model that is straightforward, broad, brief, and easy to apply in a variety of encounters with female patients. Audience Level: All audiences Track: Clinical Care/Direct Practice At the conclusion of this presentation, participant will be able to:   Describe how women's illness experiences and interactions with family and healthcare providers are negatively impacted by dominant gender discourses.   Identify what women want in the treatment of illness based on findings from a qualitative meta-analysis.   Discuss what they can do as health care providers to empower women to manage behaviors, emotions, and family relationships.

Approach the conversation from a place of wanting to understand and connect with women When women operate from these themes they are less likely to make their health a priority, to comply with suggested treatments, and to get the help and support they need. Women and healthcare professionals are often unaware of how gender negatively impacts women’s behavior around health and illness. Introduce how these positive intentions can sometimes have a negative impact on the women and potentially family members and relationships Validate difficulties with illness specific to women Follow with a statement about how particular difficulties are specific to women, i.e. sometimes for women it can be difficult to have so much focus on the self because we/they are used to focusing on others. This often creates a space where women can either agree or disagree with the statement and voice her experience Use a strength-based approach to providing suggestions for improving care Tell women they deserve to be cared for by others using yourself as a positive model of this Strategize with women on how they can care for themselves and get their needs met from important others such as family, friends, or other health care professionals

How do you work to empower female patients?

Questions? Thoughts? Reflections? Aimee Galick, PhD, agalick@llu.edu Beth Patrick, PhD(c), epatrick@llu.edu