PHA 320 Pharmacy Communications Midterm Exam | Questions and Answers What is patient-centered care? providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring
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PHA 320 Pharmacy Communications Midterm Exam | Questions and Answers What is patient-centered care? providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions What are the five dimensions of patient centered care? 1. Understand all aspects of the patient's illness 2. Perceive all patients as a person 3. Foster an egalitarian relationship. 4. Build a therapeutic alliance 5. Develop self-awareness What are the steps in the medication use process? 1. Patient perceives healthcare need 2. Patients interprets problem 3. Patient will either take action or not 4. If they take action, they will self-help, consult a nonmedical person, or contact healthcare professional 5. Healthcare professional recommendation 6. Patient accepts or refuses 7. Patient monitors response 8. Follow up visit or no follow up Describe medication centered care? Simply telling the patient about the drug: side effects, dose, route, not giving any other information. What is task centered care? Making sure you fill a prescription in a timely manner, disregarding the patient experience. What is practitioner centered care? Patient is acted on by the practitioner based on what he or she thinks is the best course of action. No patient interaction. What are the patient-centered care pharmacist responsibilities? Develop trusting relationships Engage in open exchange of information Involve patients in decision-making Help patients reach therapeutic goals THIS ALL EQUALS EFFECTIVE COMMUNICATION What is the pharmacist's goal of patient-centered care communication process? make the understanding of the patient and you regarding the disease, illness experience, and treatment goals as congruent as possible Interpersonal skills are ___ oriented? relational and process oriented focus on the effect of communication of someone else The process by which messages are generated and transmitted by one person, and subsequently received and translated by another Interpersonal communication 5 elements of interpersonal communication? 1. sender 2. message 3. barriers 4. receiver 5. feedback What comprises a message? verbal and non-verbal components (non-verbal components are much more important) What comprises verbal components? Thoughts, ideas, emotions and information What comprises nonverbal components? Emotions, attitudes, information. Can include tone, speed, inflection of voice. Most important of the 5 elements of interpersonal communication? feedback *It ensures that the intended meaning of the message is understood What is the receiver's job in communication? Decodes the message based on past experiences and considers both the verbal and nonverbal components. Barriers to communication? 1. environmental - crowding, counter height, etc. 2. personal - stereotyping, language barriers 3. patient-related - perception of healthcare, pharmacist 4. administrative - time allowance, view of managers Main concern during patient-communication? patient safety Communication that occurs in addition to spoken word? nonverbal communication (NVC). Includes behaviors, psychological responses, and environmental interactions. Does verbal or nonverbal communication account for over half of the communication experience? nonverbal communication What can potentially go wrong with nonverbal communication? It is easily misunderstood by the receiver, since the message is received in a personal way based on past experiences. Be careful about making assumptions. Kinesics? body language *includes placement of arms, legs, facial expressions and posture Key components for successful patient interaction? 1. varied eye contact 2. relaxed posture 3. comfortable gesturing 4. squared shoulders 5. erect body position 6. soft facial expression Distance between individuals is called? Proxemics *includes intimate space (touch-18in), personal space (18in - 4 ft), social space (group of people interacting) and public space (presenter to audience). Components that affect the tone of the environment? 1. color scheme 2. lighting 3. use of space 4. employee dress 5. order 6. cleanliness Voice inflection, pitch, rythm, volume and tone is called? Paralinguistics Tips for successfully navigating NVC? 1. avoid focussing on a single cue 2. utilize both verbal and NV communication 3. observe people prior to interaction if possible 4. be aware of your own NVC/ mixed messages you may send What are the critical components of an effective patient interview? 1. medical history 2. medication history 3. social history 4. personal history 5. family history 6. review of symptoms 7. physical exam Why is a complete medication history important in interviewing? -Determine drug-related adverse effects -Determine drug-drug, drug-food, or drug-disease interactions -Monitor clinical signs that may be masked by drug -Evaluate lab findings (some drugs affect lab results) -Prevent prescribing errors -Document health problems What are the communication components of an effective interview? Active listening Probing skills Asking sensitive questions Use of silence Establishing rapport Use of empathy What is active listening? A dynamic process that includes hearing what is being said plus processing and interpreting the words that are spoken (or unspoken). What are some external and internal distractions from active listening? External - flickering lights, noise, other duties Internal - Personal matters, judgement of person Strategies for effective listening during a patient interview? 1. use active listening (hear, process, and interpret) 2. eliminate external and internal distractions 3. use good eye contact 4. react to ideas, not the person 5. read NVC 6. listen to HOW something is being said 7. provide feedback Probing Skills? asking questions that elicit the most accurate information Ask ___ or ____ instead of "why"? "How" or "What" *allows the patient to reflect on the answer without feeling judged Why is it inappropriate to use "why" when asking patients questions? patients may feel the need to justify their actions What to avoid when interviewing the patient? 1. interrupting the patient 2. interrogation (several questions in succession) 3. leading questions T or F: You should only use open-ended questions when interview the patient. False. Use a combination of question types to improve flow to conclusion. Usually start with open and transition to closed to pinpoint the problem. Techniques for asking sensitive questions? 1. universal statements 2. discuss the reason 3. lead into current time frame 4. use consistent approach 5. mix with less threatening topics T or F: Silence can be an effective component of the interview process True, allows patient to gather their thoughts. What are barriers to establishing rapport with patients? Lack of feeling respected Feeling as though their words are not heard Not knowing who you are and your role in their care Strategies for developing rapport with patients? 1. good eye contact 2. sincere and friendly greeting 3. avoid stereotyping and judging 4. greet all persons that accompanied the patient 5. introduce others that came with you Intellectual identification with feelings, thoughts, or attitudes of another Empathy Directed approach of interviewing? need specific pieces of information *more control over the process Non-directive approach of interviewing? outcome is unknown or ambiguous *interview is free-flowing *patient raises discussion points Starting the interview? 1. great and introduce self 2. confirm patients identity 3. state subjects to be covered 4. amount of time needed 5. purpose/expected outcome What are some tips for conducting the interview? -avoid making recommendations too early -be flexible -maintain objectivity -note non-verbal messages -minimize note taking What are some ways to obtain medication information? -Brown bag (review meds prior to interview) -Written list (from patient or chart) -Direct patient recall (may miss some) -Outside source (like a pharmacy, with permission) SOAP note? A technique for documentation Subjective: reported by patient or caregiver Objective: provided by lab test or physical exam Assessment: description of problem Plan: steps to resolve the problem Assertive behavior direct expression of ideas, opinions and desires conflicts are faced and solutions are collectively found communicate in an atmosphere of trust Passive behavior avoid conflicts at all cost anxiety in relationships "victims" being manipulated Problem: put the needs of others above themselves, lack of communication, secretly angry with others. Aggressive behavior seek to "win" at all times promote own interests at all cost
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