Health Sciences Exam 2

It is our ethical obligation as health professionals, public health experts, researchers, and administrators to ensure ___ for patients and families.

patient centered care

___ can disrupt patient centered care

cognitive errors

errors in health care can be based on ___ false ideas about people

overlearning

How to improve patient centered care?

critical thinking, research, using the other part of the brain

What is cognitive error?

a mental shortcut our brain takes to deal with a lot of information quickly

Cognitive biases are ___ and often committed ___

commonplace, unintentionally

How do we get better at catching cognitive biases?

use the prefrontal cortex to catch the biases, learn and remember by storing new memories in the temporal lobe, continue practicing to be better when under pressure and stressed

What is availability bias?

very recent or memorable experiences have extra influence on our decision making

What is confirmation bias?

tendency to give greater weight to data that support a preliminary diagnosis while failing to seek for or dismissing contradictory evidence

Which groups are more likely to be misunderstood in health care?

rural, disabilities, LGBTQ, people of color, heavier weights, lower socioeconomic status, older adults, teens, young adults, recent immigrants, limited english proficiency, religious minorities, substance misuse, diabetes, eating disorders, women, men

Research shows lower quality care occurs ___ for certain social groups

systematically

on average, the research shows ___ of certain social groups receiving worse health care

a pattern

cognitive errors we make about some social groups are sometimes ___ and sometimes ___ because of overlearned false ideas

unconscious, intentional

regardless of the intent, the ___ of those false ideas lead to ___ health outcomes

impact, negative

How many hospital closures have there been in missouri since 2014?

21

___ is a major cause of obesity

genetics

What are some false assumptions about people with disabilities?

incompetency, lack of sexuality or attractiveness, too expensive

How does lack of patient centered care affect patients?

risk of wrong diagnosis increases; people are disrespected, not believed, misunderstood, and hurt

white patients are more likely to receive better quality care than

black, native american, alaskan native, hispanic, native hawaiian/pacific island patient

literature published in 2016 found that physicians were significantly more likely to ___ because they believed ___

recommend white patients for bypass surgery than black patients; black patients were not as well educated and they would not take part in the necessary physical activity after surgery

what happened with the eGFR race corrections?

a race correction based on the belief that black people have higher muscle mass than white people prevented african americans from being referred for interventions because they were incorrectly assumed to be okay

race is a ___ construct

social; race is not biological

What is the % of genetic diversity that exists across humans?

0.01%

When was the human genome project?

early 1990s

__ and __ to the individual needs of your patient and their family

see and listen

__ health professionals to watch for biases

cue

more __ is needed to understand the experiences and unique health care needs of patients

research

how to strive as an undergraduate?

get involved, listen for understanding, don't try to explain someone else's experience to them, immerse yourself in learning opportunities

In a study of 395 primary care patients in 3 states asked "how would you take this medicine?" what percent did not understand the instructions on more than one label

46%

In a study of 395 primary care patients in 3 states asked "how would you take this medicine?" what percent with adequate literacy missed at least one label

38%

in a study of adults with literacy below the 6th grade level, what percent correctly read the instructions "take 2 tablets by mouth daily"

71%

in a study of adults with literacy below the 6th grade level, what percent could demonstrate the number of pills to actually take

35%

What is confusing about dosing instructions?

lots of ways to get it wrong, abbreviations, uncommon measurements, unfamiliar terms, inconsistent markings

What percent of physicians believed patients knew their diagnosis?

77%

What percent of patients actual knew their diagnosis?

57%

What percent of physicians states that they at least sometimes discussed their patients' fears and anxieties?

98%

What percent of patients said their physicians never discussed their fears and anxieties?

54%

What is the definition of health literacy?

the ability to obtain, read, understand, and use health information and services

What skills are needed to help people understand and use information to lead a health life?

understand appointment notices, following instructions on medication labels, get information about illness, participate in discussion of informed consent, making appropriate medical decisions

how is health literacy important in the public?

voting on smoking ordinances, vaccinations, emergency preparedness, wearing a helmet, causes of diabetes, OSHA workplace regulations

What does it mean to have proficient health literacy?

define medical terms, calculate share of employee's health insurance costs

What does it mean to have intermediate health literacy?

determine healthy weight from BMI chart, interpret prescription and OTC drug labels

What does it mean to have basic health literacy?

understand simple patient education handouts

What does it mean to have below basic health literacy?

circle date on appointment slip, understand simple pamphlet about pre-test instructions

How many Americans have difficulty understanding and using health information?

90 million

How many Missourians have basic or below basic health literacy?

1.6 million

What are the impacts of poor health literacy?

less likely to comply with treatment and medication plans, less use of preventative services, risks of hospitalizations and longer stays, not managing chronic conditions properly, increased costs and poor health outcomes, increased mortality

What percent of information do patients/parents forget as soon as they leave the office?

40-50%

What percent of information is recalled incorrectly by patients/parents?

50%

The __ information a patient is given, the __ they can recall.

more, less

What are the costs of low health literacy?

over four times higher annual health care costs

what are the economic costs of poor health literacy in missouri?

3.3 to 7 million dollars a year

what are the economic costs of poor health literacy in the US?

238 billion dollars a year

what are the human costs of poor health literacy?

increased pain and suffering, mental health, lost work and leisure time

Who pays the cost of low health literacy?

medicaid, medicare, employers, patients

Health literacy affects health ___

outcomes

Why is health literacy important?

most patients instructions are complex, delivered rapidly, easy to forget under stress; healthcare is increasingly complex

What aspects affect health literacy?

culture, religion, health disparities, compliance rates, education level

What universal precautions can be taken for health literacy?

strive to make visits consumer-centered, explain things clearly in plain language, focus on the key message and repeat, use the teach back method for understanding, use consumer-friendly educational material to enhance interactions, use medical interpretation services

What techniques should you use while talking with families?

always use plain language, slow down, break it down to shorter statements, focus on 2-3 important concepts, check for understanding