IHC chapter 15 4th edition

The Patient as an Individual

1. Unit 6
Communication in the Health Care
Setting

2. Chapter 15
The Patient as an Individual

3. Patients as Individuals
•Patient well-being affected by attitude,
expressed concern, and technical skills
•Individuals are complex
–Cultural influences, personal experiences, and
basic human needs all play role

4. Philosophy of Individual Worth
•Every human being has worth
•Give same level of care regardless of
patients’ circumstances
–Some patients present unique challenges
•More difficult than others
•Experiencing pain and anxiety

5. Dealing with Prejudice
•Prejudice
–Negative feelings about people due to race,
cultural background, appearance, etc.
–Prevents seeing people as unique individuals
–Must identify own prejudices to deal with them
–However, encourage positive health changes
when necessary

6. Question
•True or False:
–Almost everyone has prejudices of some type.

7. Answer
•True
•Although possibly unaware of them, almost
all people have prejudices

8. Meaning of Culture
•Culture includes the following:
–Values and beliefs
–Social organization
–Family structure
–Language
–Religion
–Everyday activities

9. Purpose of Culture
•Provides guidelines for behavior
•Gives life predictability
•Provides means for people to live together
in relative harmony

10. Cultural Differences
•Customs vary among cultures
–Differences can cause misunderstandings
•Approaches:
–Appreciate different approaches to life
–Learn about other cultures
•Especially those of likely future patients

11. Cultural Differences
•Approaches:
–Avoid assuming patients will always
understand you
–Remember that members of cultural groups
may or may not practice certain customs

12. Cultural Differences
•Approaches:
–Be sensitive to possible cultural differences
and patient needs
–Ask appropriate questions to learn about
patients
–Recognize there are many cultural sub-groups

13. Dominant Culture
•Generally accepted foundational beliefs of
society or country
•Examples of U.S. culture:
–Importance of efficiency and punctuality
–Shaking hands when meeting new people

14. Subcultures
•Many subcultures exist in U.S.
–Individuals may have customs different from
dominant culture
•But never make assumptions about people based
on appearance
–Personal space
•Comfortable distance for conversation
•Varies among cultural groups

15. Question
•Comfortable personal space in the
dominant culture of the U.S. is about ____ .
A.6 inches
B.12 inches
C.18 inches

16. Answer
•C. 18 inches
•Comfortable personal space considered
appropriate by dominant culture of U.S.:
–Approximately 18 inches

17. Question
•True or False:
–A new female patient arrives at Dr. Hendrick’s
office wearing a long dress and a head
covering. It is safe for the medical assistant to
assume the patient is Muslim.

18. Answer
•False
•Never safe to assume anything about
patient’s culture based on appearance

19. Major U.S. Cultural Groups
•African Americans
•Asian Americans
•European Americans
•Hispanic Americans
•Native Americans

20. Question
•Which of the following immigrant groups
tends to retain their native language and
customs?
A.Young people looking for better economic
opportunities
B.Older adults escaping persecution
C.Professionals who have skills in the U.S.

21. Answer
•B. Older adults escaping persecution
•Older adults who feel forced to leave native
countries tend to retain customs more than
younger people

22. Question
•True or False:
–Direct eye contact is a sign of sincerity for most
cultural groups.

23. Answer
•False
•Eye contact
–Sign of sincerity in dominant U.S. culture
•However, many groups view as rude or aggressive

24. Health Care Beliefs
•Vary widely among cultural groups
•Differences include the following:
–Definitions of good health
–Causes of disease
–Methods of treatment

25. Health Care Beliefs
•Traditional Western medicine
–Practiced by most U.S. physicians
–Focused on physical aspects of body
–Employs scientific methods

26. Religion and Health Care
•Religious and spiritual beliefs influence
many health care practices
–Shamans
–Faith healing
–Illness as will of God or punishment for sins
–Prayer
–Evil eye

27. Harmony and Health
•Balance of body, mind, and spirit
•Growing interest in U.S.
•Basic belief of many cultures
–Chinese concept of yin and yang

28. Harmony and Health
•Body humor theory
–Traditional Hispanic belief
–Four fluids control body
–Hot and cold disorders and treatments

29. Question
•True or False:
–T’ai chi is a form of acupuncture that originated
in China and is becoming accepted in the U.S.

30. Answer
•False
•T’ai chi
–Form of Chinese martial arts
–Involves focusing mind and performing slow
body movements

31. Herbs and Plant Medicines
•Used for thousands of years
•Many used today
•Growing interest in U.S. in “natural”
remedies
–Not controlled by Food and Drug
Administration (FDA)
–Can be harmful

32. Maslow’s Hierarchy of Human Needs
•Developed by American psychologist
Abraham Maslow
•Human behavior motivated by efforts to
meet needs
•Five categories of needs ranked in order of
importance for human fulfillment

33. Maslow’s Hierarchy of Human Needs
•Level 1: physiological
–Food, shelter, and water
•Level 2: safety and security
–Free from physical and psychological harm
•Level 3: love and affection
–Friendships and intimacy

34. Maslow’s Hierarchy of Human Needs
•Level 4: self-esteem
–Opinion individual has of self
•Level 5: self-actualization
–Achievement of full personal potential

35. Question
•True or False:
–It is necessary to fully meet each need on
Maslow’s hierarchy before moving up to the
next level.

36. Answer
•False
•Life is dynamic process
–Not necessary to fully meet need category
before moving to next level

37. Maslow’s Hierarchy of Human Needs
•Illness and injury alter human needs
•Full recovery may involve moving up
hierarchy
•Role of health care professionals:
–Recognize patients’ needs
–Help patients meet needs at each level

38. Defense Mechanisms
•Responses to perceived threats to self-
esteem
–Provide relief from mental discomfort and
anxiety
–Commonly used at times of stress
•E.g., illness, injury

39. Defense Mechanisms
•Compensation
–Meet need through substitution
•Control
–Use inappropriate control to make up for loss
of control elsewhere
•Denial
–Pretend something is not true

40. Defense Mechanisms
•Displacement
–Transfer feelings about one person to another
•Acting out
–Express difficult feelings by performing extreme
behavior
•Malingering
–Pretend to be ill

41. Defense Mechanisms
•Projection
–See own weaknesses in others
•Rationalization
–Explain behavior with socially acceptable
reason
•Regression
–Use inappropriate behavior for age

42. Defense Mechanisms
•Repression
–Keep unpleasant memories out of awareness
•Withdrawal
–Refuse to communicate with others or
participate in social activities

43. Question
•If the health care professional suspects a
patient is displaying a defense mechanism
to deal with fear, it is best to _____ .
A.Show interest in patient’s well-being
B.Tell the patient not to worry
C.Ignore the patient’s behavior

44. Answer
•A. Show interest in the patient’s well-being
–Demonstrate acceptance of patient’s feelings,
listen, provide information as needed

45. Dealing with Loss
•Losses include:
–Death of loved one
–Independence
–Physical ability
–Good health
•Loss can significantly influence patient
behavior

46. Dealing with Loss
•Health care professionals can help patients
deal with loss
–Recognize significance to individuals
–Give patients opportunity to share feelings
–Help patients explore ways to deal with loss

47. Ways Individuals Deal with Loss
•Seek support from family and friends
•Find comfort in religion
•Draw on self-esteem
•Employ problem-solving techniques
•Use defense mechanisms
•Become angry or depressed

48. Individual Needs
•Effectiveness of health care worker
dependent on
–Understanding and respecting individual
differences
•Patients have different perceptions of health
care setting

49. Determining Individual Needs
•Observe patient’s behavior and ways of
interacting with others
•Determine whether language barriers
present
•Ask questions to learn individual
preferences

50. Determining Individual Needs
•Listen carefully to patient’s responses
•Some patients need more information than
others
–Explain what is being done and why

51. Question
•True or False:
–It is appropriate to ask patients directly about
their health care beliefs.

52. Answer
•True
•Appropriate to ask patients questions about
health care beliefs
–Should be done in inquiring manner
•Rather than judgmental