Patient-Practitioner Relationship

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  • Created by: germimuh
  • Created on: 08-05-22 14:21
Who investigated non-verbal communications & when?
McKinstry and Wang 1991
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What was the sample used by McKinstry and Wang?
475 patients from 5 clinics across Lothian, Scotland
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What was the method used by McKinstry and Wang? 1/2
Participants shown 8 photographs and asked which dr they'd be happiest seeing for the first time (scored 0-5), whether they'd have more confidence in the ability of any of the drs based on appearance, if they'd be unhappy consulting with any of them and..
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What was the method used by McKinstry and Wang? 2/2
..which doctor looked the most like their own doctor. They were then asked a series of closed questions about doctors' dress.
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What were the results of McKinstry and Wang's study?
Patients significantly preferred male doctors wearing a formal suit and tie, and female doctors in white lab coats or a skirt and blouse. Older patients preferred traditionally dressed doctors. 64% said the way their doctor dressed was important.
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What are the strengths and weaknesses of McKinstry and Wang's study?
Strength: Large diverse sample means results can be generalised
Weakness: Judgement based on appearances alone, so seen as reductionist as in real life, many aspect affect how a patient views their doctor
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Who investigated the comprehension of medical terminology and when?
McKinlay 1975
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What was the sample used by McKinlay?
87 families using maternity services in Aberdeen, Scotland. Interviewed 4 times across 18months
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What was the method used by McKinlay? 1/2
13 medical words were read out in the context of a sentence and the participants were asked what the words meant. Responses were transcribed and then put into 4 categories: (A: did not understand B: incorrect understanding C: vague understanding..
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What was the method used by McKinlay? 2/2
..D: well understood). The transcripts were scored by two doctors that were working blind (unaware of the other's score). The participants were split into 'utilisers' who regularly used the maternity services and 'nonutilisers' who didn't.
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What were the results of the study by McKinlay?
For nearly all 13 words, the utilisers had a higher percentage of score D than the underutilisers.
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What was the conclusion of the study by McKinlay?
Those who regularly use medical services have a better understanding of medical terminology than those who use it less often.
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What are the strengths and weaknesses of the study by McKinlay?
Strength: Transcripts scored with the doctors blind to each group the participant was in, so the study is more valid due to objective scoring.
Weakness: Sample limited in terms of geography and type of participant, so hard to generalise
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What is a patient-centred consultation style?
Doctor asks open questions to allow the patient to expand on answers
Doctor limits the use of medical jargon to ensure understanding
Patients active in conversation
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Who investigated the effects of 'directing' and 'sharing' styles of consultation on patient's satisfaction and when?
Savage and Armstrong 1990
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What was the sample used by Savage and Armstrong?
359 patients from an London GP, participants randomly assigned to either sharing or direct consultation styles.
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What was the method used by Savage and Armstrong?
GP unaware of which style to use until the patient entered the room. An independent observer confirmed the style was followed. Patient's questioned immediately after their consultation.
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What percentage of each group felt they had received an excellent explanation from their GP?
45% of the directing style group felt they received an excellent explanation, 24% of the sharing style group felt the same. After a week, this decreased to 33% and 17% respectively.
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What percentage of each group felt their GP had a full understanding of their issue?
62% of the directing style group felt the GP had a full understanding of the issue, 37% of the sharing style group felt the same. After a week, this decreased to 39% and 18% respectively.
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What was the conclusion of the study by Savage and Armstrong?
A more directing style of consultation brings about more satisfaction in patients
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What are the strengths and weaknesses of the study by Savage and Armstrong?
Strength: Standardised procedure = replicable and reliable
Weakness: Sample geographically limited, so difficult to generalise
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What is a type I error?
Doctor diagnoses somebody to be healthy when the patient is actually physically/psychologically ill.
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What is a type II error?
Doctor diagnoses somebody as ill when they are healthy.
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What did Sarafino (2006) note that patient's do that could hinder communication with their doctor? (know atleast 3)
- Patient criticises doctor or becomes angry
- Patient clearly ignores what the doctor is saying
- Patient insists of more testing when the doctor says there is no need
- Patient wants diagnosis of a condition the doctor does not think they have
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Who investigated the amount of information given at a genito-urinary clinic via computerised interview versus a paper questionnaire and when?
Robinson and West 1992
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What was the sample used by Robinson and West?
69 patients of a genito-urinary clinic
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What did Robinson and West's study find?
Significantly more symptoms were reported via the computerised interview than the paper questionnaire.
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Who investigated why patient's delay treatment and when?
Safer et al 1979
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According to Safer et al, what are the three stages of why patient's delay treatment? 1/2
1. Appraisal delay - time taken for someone to interpret a physical symptom as an indicator of illness
2. Illness delay - time taken between someone realising they are ill and deciding to seek medical attention
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According to Safer et al, what are the three stages of why patient's delay treatment? 2/2
3. Utilisation delay - Time taken between deciding to seek medical attention and actually doing so.
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What is hypochondriasis according to Sarafino?
'Tendency of individuals to worry excessively about their health, monitor their bodily sensations closely, make frequent unfounded medical complaints and believe they are ill despite reassurances from physicians that they are not'
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What did Barlow and Durand (1995) note about hypochondriasis? (know atleast 3) 1/2
- Characterised by a person's fear that they are ill
- Pre-occupation with bodily symptoms eg person believes sweating is a sign of illness
- Belief that a healthcare professional's judgement is incorrect
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What did Barlow and Durand (1995) note about hypochondriasis? (know atleast 3) 2/2
- Visits a range of healthcare professionals with the belief the last one missed something
- Mistakenly believes they have a disease/illness
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What did Barlow and Durand (1995) believe could cause hypochondriasis?
- A stressful lifestyle
- Exposed to family life where there was a disproportionate amount of illness
- Attention-seeking mechanism
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What were the three types of hypochondria noted by Fallon (2010)? 1/2
1. Obsessive-anxious type: worry they are ill despite reassurances from a doctor they are not. Believe the doctor has missed something.
2. Depressive type: Refusal to see a doctor, or cry to the doctor that they are going to die so there's no point..
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What were the three types of hypochondria noted by Fallon (2010)? 2/2
..testing them.
3. Somatoform type: Exhibiting symptoms of an illness, and assuming it is the worst possible illness.
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What is Munchausen syndrome?
A 'factitious disorder' that describes symptoms that are artificially produced by the patient.
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What did Turner and Reid (2002) note as the three main features of Munchausen syndrome?
Simulated illness
Pathological lying
Wandering from place to place
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What is Munchausen by Proxy?
Carer of a person deliberately exaggerates/fabricates illness of the person in their care.
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What are the three levels of Munchausen by Proxy noted by Criddle (2010)? 1/2
1. Mild (symptom fabrication): Caregiver claims the person they care for experiences mild symptoms of an illness they do not have.
2. Moderate (evidence tampering): Caregiver manipulates lab specimens and falsifies medical records.
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What are the three levels of Munchausen by Proxy noted by Criddle (2010)? 2/2
3. Severe (symptom induction): Caregiver induces symptoms, examples include poisoning
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Who did the case study into Munchausen Syndrome and when?
Aleem and Ajarim 1995
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Who did Aleem and Ajarim study?
22-year-old female university student referred to the hospital for potential immune deficiency
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What did Aleem and Ajarim find out? 1/2
Pt complaining of swellings in her groin. Tests showed scarring from previous procedures but were normal. Four days later, patient developed a breast lesion with no explanation, raising suspicions. She underwent psychiatric assessment but was unaware she
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What did Aleem and Ajarim find out? 2/2
was being assessed for Munchausen. When not in her bed, a nurse found a syringe of faecal material. On realisation, the patient immediately left the hospital.
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What are the strengths and weaknesses of Aleem and Ajarim's case study?
Strength: Case study allowed lots of detailed qualitative data, so finding should be valid.
Weakness: As it was a case study, it's hard to generalise because the woman may have been a unique case.
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Other cards in this set

Card 2

Front

475 patients from 5 clinics across Lothian, Scotland

Back

What was the sample used by McKinstry and Wang?

Card 3

Front

Participants shown 8 photographs and asked which dr they'd be happiest seeing for the first time (scored 0-5), whether they'd have more confidence in the ability of any of the drs based on appearance, if they'd be unhappy consulting with any of them and..

Back

Preview of the back of card 3

Card 4

Front

..which doctor looked the most like their own doctor. They were then asked a series of closed questions about doctors' dress.

Back

Preview of the back of card 4

Card 5

Front

Patients significantly preferred male doctors wearing a formal suit and tie, and female doctors in white lab coats or a skirt and blouse. Older patients preferred traditionally dressed doctors. 64% said the way their doctor dressed was important.

Back

Preview of the back of card 5
View more cards

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