Exam 1 Review

What does this refer to

• The degree to which a patient can obtain, communicate, process, and understand health information and services to make informed health decisions.

Health literacy

What does this refer to

• Differences in the incidence, prevalence, mortality, and burden of diseases and other health conditions that exist among specific populations.

  • Infant mortality among non-Hispanic black patients when compared to non-Hispanic white patients.

  • Cancer rates among Asian and Pacific Islanders higher when compared to other populations

Health disparity

What does this refer to

• A group of people (that make up our society) that can be thought of as individuals who possess special needs.

  • Make up every society

Special Populations

What does this refer to

• Race

• Gender

• Education

• Religion

• Culture

• Diet

• Income

• Others?

What defines a special population?

What does this refer to

• : caused by an automatic association between two or more traits —a sterotype

• Unfortunate influence on diagnoses and management

• Stereotypes are based on unsubstantiated association of unrelated traits.

• They are normal but can lead to bias

Ascertainment bias

What does this refer to

• : a consistent shift (positive or negative) in thoughts and behavior that is not substantiated by facts.

Bias

What does this refer to

• A framework for eliciting the patient’s understanding and cultural context

• Series of questions a provider must use to obtain an understanding of the patient’s view of health and disease.

  • What do you think caused your problem?

  • What do you think your sickness does to you?

  • What are the most important results you hope to receive from this treatment?

  • What do you fear most about your sickness?

Kleinman explanatory model

What does this refer to

• Another model for cross-cultural communication

LEARN model

What does this refer to

• Listen to the patient’s perspective

L from Learn model

What does this refer to

• Explain and share one’s own perspective

E from LEARN model

What does this refer to

• Acknowledge differences between the two perspectives

A from LEARN model

What does this refer to

• Recommend a treatment plan

R from LEARN model

What does this refer to

• Negotiate a mutually agreed upon treatment plan

N from LEARN model

What does this refer to

• Major factor in overcoming health

  • Family prayer group necessary at hospital

• Strong desire for nature

  • Room with a view of trees, flowers etc…

• Health is a result of chance

  • God’s will

  • Healing is a sign of forgiveness

• Predestined life events

  • Feeling of having a little control or no control over events and life

• Patient may have the choice not adhere to medications for conditions

  • Diabetes

  • Hypertension

Religious Beliefs

What does this refer to

• Respect “Personal Bubble”

  • Eye contact included

Social beliefs

What does this refer to

• Men tend to make decisions for the household

• Elders are valued, honored, and respected

• Strong sense of family

  • Care for the elderly rather than put in a home

  • Delay treatment until all members of the family present

  • Family often accompanies to visits

  • Large number of visitors

• Allow family presence as much as possible

• Involve family in the patient’s care as much as possible.

• Go slow and allow for the patient to feel comfortable with you

• Continuity of care important

• Listen well and try not to interrupt

Social beliefs, Gender relationships

What does this refer to

• When obtaining clinical history from a pediatric patient who can you collect them from?

The patient or a guardian

What does this refer to

• Normal function of human development

Human sexuality

What does this refer to

• Delayed sexual activity

• Protected sex

• Promiscuity

Concept of responsible sexuality is important for public health

What does this refer to

• _________ : targets at-risk healthy population to prevent a health condition

  • Promotion of regular exercise to prevent development of chronic disease, such as hypertension or cardiovascular disease

Primary preventative medicine

What does this refer to

• _________ : identification and treatment of an individual who has a risk factor for a disease or are with a disease and unaware

  • Routine screenings in women for breast cancer

Secondary preventative medicine

What does this refer to

• ______: Prevention of additional complications for a person with a disease

  • Podiatric and ophthalmologic exams for diabetics to prevent further complications

Tertiary preventative medicine

What does this refer to

• Integrates a patient’s readiness to change by understanding the cycle/continuum of behavioral modification.

Prochaska’s Transtheoretical Model

What does this refer to

Prochaska’s Transtheoretical Model

What does this refer to

• Standard Precautions

• Personal Protective Equipment PPE

• Do a chart check prior to room entry

Ways to prevent Blood Bourne pathogens BBP

What does this refer to

• Uncontrolled chronic stress leads to ______

  • Consists of emotional exhaustion, a decreased perception of personal accomplishments, and the loss of empathetic connections, (depersonalization and detachment).

  • Negative outcomes-decreased productivity, decreased job satisfaction, depression, relationship problems, substance abuse, and suicide.

  • Contributors-excessive workload*, financial and economic factors, administrative responsibilities, low autonomy, work-life balance, lack of boundaries.

Burnout

What does this refer to

• Emergency Medicine

• Primary Care

• Oncology

• Palliative Care/Hospice

High Level Burnout Specialties

What does this refer to

• Learning/Practice Environment

• Society and Culture

• Rules and Regulations

• Health Care Responsibilities

• Organizational Factors

External Factors Affecting Clinician Well-being

What does this refer to

• Personal Characteristics

  • One’s own self-care plan and resilience, individual skills

• Practice Characteristics

  • Workload, hours, patient contact v. administrative, teamwork, autonomy

• Cultural Characteristics

  • Organizational factors, certification requirements, support, practice acts

Wellness model

What does this refer to

• Book longer visits for new provider or new patient

• Make an impression

• Don’t look into your computer only

• Know when and when not to interrupt a patient.

Overcoming time constraints

What does this refer to

• Approach to medicine that addresses the socioeconomic and neighborhood/environmental factors that pose obstacles to making healthy decisions and attaining optimal health

Population-health approach

What does this refer to

• Counseling and education

• Clinical interventions

• Long-lasting protective interventions

• Changing the context to make individuals’ default decisions healthy

• Socioeconomic factors

Population health impact pyramid

What does this refer to

• Assessment

  • Monitor health

  • Diagnose & investigate

• Policy development

  • Inform, educate empower

  • Mobilize community partnership

  • Develop policies

• Assurance

  • Enforce laws

  • Link to/provide care

  • Assure competent workforce

  • Evaluate

Core functions of public health

What does this refer to

• Physical environment

  • air & water quality

  • housing & transit

• Social & economic factors

  • education

  • empolyment

  • income

  • family & social support

  • community safety

• Clinical care

  • access to care

  • quality of care

• Health behaviors

  • tobacco use

  • diet & exercise

  • alcohol & drug use

  • sexual activity

Factors that Affect Population Health

What does this refer to

• Good __________ lets us have good decisions, ______ based medicine and tests

  • Do not use aromatherapy

Research

What does this refer to

• An independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services

  • Talks to people about their weight, glucose levels, etc.

U.S Preventative Task Force

What does this refer to

• Preventative screenings

• Vaccination schedules

• Travel health

• Surveillance

• Slows the onset and progression of chronic disease

Ways to increase the improved health care of the population

What is the number 1 reason for the high cost of insulin

The need for a lifesaving product

What does this refer to

• Denial

• Anger

• Bargaining

• Depression

• Acceptance

Elisabeth Kubler-Ross’s stages of grief

What does this refer to

• In the case of an emergency, a provider does not need _________

Consent

Can a specialist provide a referral to a PCP (True or False)

True

Asthma may be acquired from a work related injury (True or False)

True

What are methods to improve joints

ergonomics

Can social networking (ex: email) from a patient to a provider reduce healthcare cost?

Yes

What does this refer to

• Age

• Gender

• Population

• Household composition (like presence of children)

Demographic factors that affect disease transmission

Occupational injury may require worker compensation, reporting to OSHA, and contacting poison control (True or False)

True

The vast majority of state laws mandate physician supervision or collaboration. (True or False)

True

What type of supervision and collaboration is the following

• Agreements made at the time of employment that delineate the duties and responsibilities of both parties, based on the anticipated scope of PA practice. Formal agreements are required in many states.

Prospective

What type of supervision and collaboration is the following

• The oversight and availability of the physician that occurs on a daily basis forms the bulk of the element of concurrent collaboration General supervision means the physician must be available to the PA at all times. Direct supervision means the physician must be physically present at all times. Personal supervision (the most restrictive) means the physician must of present in the room when the PA provides care.

Concurrent

What type of supervision and collaboration is the following

• Process of evaluating the performance, clinical activities and quality of care provided by the PA.

Retrospective

If you see a question with primary prevention, think

what the patient can do (you are trying to encourage the patient to do something)

What does this refer to

• Careful, systematic, patient study and investigation of some field of knowledge, undertaken to discover or establish facts or principles” Webster’s

• “A systematic, organized process that goes through a number of sequential (or near sequential steps). (Forister & Blessing text p 7)

• Basic science, pure, experimental, applied, descriptive, survey, clinical, policy, epidemiological, anthropological, educational, sociological, psychological, workforce

Research

What does this refer to

1. Patient demographic information

2. Reason for referral/goals of therapy

3. Consultation only vs. consultation and management

4. What concerns do you as a referring provider have? What concerns does the patient have that need addressed?

• What elements of care are needed

• Emotional/Patient violence

• mental health/substance use

• Physical health- assigned gender at birth and present gender health concerns

Elements for providing a referral