Patient Behaviour

Why Patients Act the Way They Do

Patient behaviour can be influenced by Parsons' theory, emotions, grief, comorbid illnesses, coexisting stress factors, and cultural factors.

Parsons' Theory: “the sick role”

developed by Talcott Parsons in 1951

• unspoken agreement b/w society and the sick person

• based on the concept that a sick individual is not a productive member of society

• the sick individual is released from obligations and responsibilities and not held accountable for their illness

sick person rights

• exempt from normal social roles

• not held accountable for illness

Sick person Obligations

• should try to get better

• seek assistance from qualified healthcare professionals

Health-Seeking Behaviour

• actions taken to seek help or healthcare

• influenced by individual and social factors

Factors Affecting Health-Seeking Behaviour

• personality type

• gender

• age

• social support

• cultural norms

• role within the family

Triggers for Seeking Healthcare

• new or alarming symptoms

• symptoms that interfere with daily activities

• disruption of social roles and interactions

• receiving permission from someone else

Kübler-Ross Model of Death and Dying

Model introduced in 1969 describing five stages of grief

5 stages of grief

1. denial

2. anger

3. bargaining

4. depression

5. acceptance

• stages do not always occur in order

• some people never reach acceptance

Applications of the Grief Model

Originally developed for terminally ill patients but also applied to other life-changing losses

Loss and Grieving

• can be triggered by bad news

• stages may repeat, or become difficult to move through

Denial

(1)

• “This can't be happening to me”

• the person may feel confused, afraid, numb, or on autopilot and may struggle with simple routine tasks

Anger

(2)

• “If only I had taken care of myself”

• involves second-guessing, hatred, self-doubt, embarrassment, irritation, shame, hurt, frustration, and anxiety

• The person begins to understand the situation more clearly, may blame others, and may feel helpless

Bargaining

(3)

• “I take insulin every day… I will stop smoking if only…”

• the person struggles to find meaning, reaches out to others, wants to tell their story, and may remain angry while becoming more open to alternatives

Depression/Detachment

(4)

• “What's the point?”; feelings of helplessness, hopelessness, and being overwhelmed, along with low energy and withdrawal from activities

Acceptance

(5)

• The person has processed initial grief emotions

• recognizes the loss cannot be undone

• can begin planning for the future and re-engaging in daily life

Communicating with Difficult Patients

• remember effective communication principles

  • emotional patients may have difficulty formulating clear messages, so allocate extra time

• 4 Es

Using the 4 E's During Patient Interactions

• stay on track

• prepare for the exchange

• create an environment that encourages genuine communication and connection

• communicate reasons for delays, that you care about their time and appreciate their patience

• apologize

Communicating Delays to Patients

• explain the reason for delays

• show concern for the patient's time

• appreciate their patience

• apologize

H.E.A.R.T. Method

Approach to handling patient complaints

• Hear their story

• Empathize with them

• Apologize

• Respond to the problem

• Thank them

H.E.A.R.T. — Hear

Listen to the patient's story and concern.

H.E.A.R.T. — Empathize

Acknowledge and show understanding of the patient's feelings and experience.

H.E.A.R.T. — Apologize

Offer an apology for the patient's negative experience or inconvenience.

H.E.A.R.T. — Respond

Address the problem and take appropriate steps to resolve it.

H.E.A.R.T. — Thank

Thank the patient for raising the concern and giving you the opportunity to address it.

Phrases to Avoid When Handling Patient Concerns

• “No” or “I can't”

• “I don't know”

• “That's not my job”

• “That's not my fault”

• “We're short staffed”

• “Calm down”

• “I'm busy right now”

• “I can't release any information to you.”

Why Patients Are Vulnerable

• social expectations

• psychological factors such as loss of dignity

• obstacles within healthcare environments can increase vulnerability

Supporting Vulnerable Patients

• remove obstacles in the healthcare environment

• empower patients by explaining their choices

• inform them they can stop a procedure or do it another time when appropriate

• advocate on their behalf