sociology and cultural awareness

PHAR2003

• person-centred care

• communication skills

• evidence based medicines

• inter-professional collaboration

contemporary model of good pharmacy practise

• understands the illness experience of the patient'

• understands each patient’s experience is unique

• fosters an egalitarian relationship (seeing the patients decisions as equally important in decision making) with the patient

• develop self awareness of their personal effect on patient

• builds a therapeutic alliance with aptients to meet mutually understood goals

patient centered care

• better outcomes in chronic health problems

• increased patient satisfaction

• reduced patient anxiety

• improved professional satisfaction

• improved business outcomes

outcomes of person-centred care

1. bio-psycho-social perspective - broadening focus of pharmacist-patient interaction to include psychological and social factors and physical symptoms

2. patient as a person - exploring the meaning of illness and health to each individual patient

3. sharing power and responsibility - the patient as the decision maker and considering them as an expert in their health

4. therupeutic alliance - relationship as a means of promoting health

5. pharmacist as a person - particular qualities, attitudes and values of a pharmacist are important

principles of person centered care

• Health and illness are social phenomena

• affects everyone

• individual reactions are socially patterned

• health affects our relationships and identity and how we present ourselves

• used to understand individuals and society and why they behave in a certain way in relation to health and illness

sociology

• community

• income and social status

• education

• policy

• health care

• lifestyle

factors that influence health

• malfunction of a physical process or structure

• socio-behavioural - a bio-physical state influenced by individual and psychosocial issues such as beliefs, thoughts and behaviour

illness

• state of complete physical, mental and social well being and not merely the absence of diseases and infirmity

health

• professionally defined but health experts argue about definition

disease

• defined by the individual and can be influenced

• defined by society

illness

• shown to be associated within illness and poor health

• high levels of anxiety, depression, anger/hostility - disease prone and slower recovery

effects of personality in illness

• undertaken by an individual who believes himself to be healthy for the purpose of preventing or detecting illness in an asymptomatic state

• taking vita c to prevent cold

preventative health behaviour

• any behaviour undertaken by an individual who feels ill to relieve that experience or to better define the meaning of the illness experience

illness behaviour

• adopted when an individual perceives themselves to be sick, takes on a socially determined role

• patient is not blamed for being sick

• patient is exempt from work and other responsibilities

• illness is seen as legitimate as long as the patient accepts that being ill is undesirable

• The patient is expected to seek competent help to get well again

sick-role behaviour

• once given a medication and it starts to benefit a patient

• they patient stops using it as they are getting better and dont feel the need to use it anymore as it is not much of a concern to them anymore

• this is common with hypertension and cholesterol medications

sick role and non-adherence

• professional as a dominant and autonomous person, one way communication, expert

• patient - passive and dependent of professional, expected to cooperate, level of control is low, privileges of sick role

• not a good relationship

paternalistic health care relationship

• agreement between the patient and professional

• it is a process

• acting as partners to reach an agreement on when and why medicines to use medicines

concordance

• extent to which a person’s behaviour in terms of taking medications, following diets or executing lifestyle changes, coincides with medical advice.

• following exactly what professional states

• paternalistic

compliance

• extent to which a person’s behaviour in terms of taking medications, following diets or executing lifestyle changes coincides with agreed recommendations from a health care provider

• professional negotiating with a patient

• shared agreement

adherence

• reinforce prescriber’s instruction and provide other important info

• explore patient ideas, concerns and expectations

• develop a rapport with the patient

• provide additional info

• decide with patient

concordance process

• person’s ability to find, understand and use health info

• low health literacy is an issue with diverse cultural and background

• simple, clear and repeat key points

Health literacy

• expanding cultural knowledge and adaptation of services to meet culturally unique needs

• culture - patterns of human behaviour including thoughts, actions, customs, values and beliefs that can bind a recial ethnic relgious group

• age, sex, sexual orientation, occupation and socioeconomic status, ethnic origin, religious, disability

cultural competence

• different beliefs about medical conditions and meds

• different in how they seek care

• differences influenced by time of arrival in Aus, length of settlement, level of education

• religious background and different life experiences

cultural awareness

• to provide care in a manner that is respectful of a person’s culture and belief and that is free from discrimination

cultural safety

• patient more likely to discuss health beliefs

• patients feel comfortable and more likely to return

• stronger patient and community relationships

benefits of increasing cultural safety

• be aware of own cultural beliefs

• be aware of judging other people’s behaviour and beliefs about healthcare

• be aware of making assumptions about cultural influences and applying generalisations

• Understand that the behaviour and beliefs of people within each culture can vary considerably.

• Understand that not all people identify with their cultural or religious background.

• Increase your knowledge about different cultural health practices and issues through cultural background information sessions and/or resources and cultural awareness training.

• Understand the importance of appropriate communication

consideration to make on cultural awareness

• Health information posters and leaflets portraying different ethnic groups and languages

• Private counselling space

• Use of interpreter services

• Staff training

• Advice is jargon free, plain language, with the assistance of diagrams, written resources and visual aids

• Local Aboriginal Health Workers

• Discuss at staff meetings

• Employing staff from other cultures

• Staff from different cultural backgrounds can teach other staff members about their culture

• Cultural training courses (accredited or approved by PSA, RACGP, the Pharmacy Guild or NACCHO)

Incorporating cultural awareness in pharmacy