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Lilliana Yzaguirre

on 27 May 2015

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Transcript of Medicine

Patient Care
One way for a doctor to increase patient satisfaction is to give the patient reassurance and hope
The Unsettled Patient
I Know the Feeling...
A doctor's office invites a sense of anxiety and nervousness
Mentor: Dr. Bishara
The act of removing someone's doubts and/or fears
We do this many times with children, when they are almost positive that there is something bad around, when there is not.
Reassurance offers confidence in a person and a mindset that everything is OK. It relieves worry and anxiety.
They insist that something is wrong with them
The doctor has to firmly reassure the patient to quell their worries and convince them that they are as healthy as a person can be
We sit there anticipating the worst. But it's just a regular checkup.
The doctor reassures us that there is absolutely nothing to worry about and we are normal and healthy
A feeling of trust
having grounds for believing that something good may happen
Hope is very important. It offers light after knowing only dark. It offers a chance for things to be good.
A Diabetes Patient
A Cancer Patient
Key To Giving Good Reassurance & Hope
Spiritual Touch
You are scared for your health and life.
You don't need to be afraid. There is still hope.

Medication is advanced

Many kinds to treatment

Take your medication and have a healthy lifestyle, you can surely live a long and healthy life.
Requires more gentleness, for they are more fragile.
Cancer patients have harsher days during the illness, and have lower chances of survival.
The Delivery
Doctor must have the right persona, attitude, and tone
If delivery of news is poor, then the reassurance and hope will be poor, and the patient will not feel better or stronger, but weak and frightened.
The doctor must show understanding of the patient's issue. This is important so that the patient doesn't feel alone
The doctor must then also be compassionate and show the patient that they care about their current state and will do all they can to make sure the patient can live their life
For the patients in more serious situations, a spiritual touch can help in giving reassurance and hope.
Many people find strength in spirituality. It gives them hope when situations seem too dark, and reassures them that things will be OK in the end
Stephanie Staples
"Ease my fear. I am sick and petrified. I do not know what lies ahead. My job, my finances, my family, everything is hanging. My fright may show up as anger to you, but please don't take it personally. I have so much going on, so many fears, questions and burdens. You are seeing me at my worst, and this is not the me that I am used to, but still, your calm voice and composed presence can help ease my fears."
Patient point of view:
Aasim Padela MD
The Robert Wood Johnson Foundation
"Treating patients with understanding and respect is fundamental to health care. As the field has become increasingly focused on metrics and outcomes, we have learned that how comfortable and respected patients feel directly impacts their health outcomes."

Dina Hardaway
Ada County Paramedics
"The top 3 ways to create an environment of comfort for a patient, are:
1. Showing Empathy
2. Creating a positive atmosphere by way of the attitude you exhibit
3. Providing the level of sensitivity established by the patient, family, and fellow responders."
Humans have always learned to change to their environment and find safety and comfort, to survive
Today, humans make sure wherever they are, that they are comfortable and safe
Human Nature
One way for a doctor to increase patient satisfaction is to care for the patient in a comfortable environment
Breaking the Mindset
Patient's Head Screams at:
White Washed Walls
Blinding Lights
Threatening Tools
Uncomfortable Temperature
Comfortable Environment
Environment affects patient mood

Surrounding Objects

Comfortable Environment = Satisfied Patient
A Wave of Color
Every color has a different wavelength, which allows for different colors
The longer the wavelength, the bolder the color, the more energy to perceive it
A Color Connected Brain
Eye makes contact
wavelengths are perceived
color is detected by hypothalamus
body responds with hormone secretion
Responses: positive or negative energy
Color Range
Bolder colors create stronger responses
longer wavelength,more energy to perceive

Surrounding colors influence the affect of the dominant color
Shade of color influences affect of color
The Big 4
Red: energy, exciting, higher heart beat,
aggression, activity stimulating

Blue: gentle, in nature, low heart beat,

Yellow: Joy, Playfulness, cheerfullness

Green: calm, in nature, tranquility,
Creating A Satisfactory Environment
Calm colors
Not too bold or energetic
Pale yellows, blues, greens
Lower heart rate and peaceful patient
Role of Light
Bright lights stun patient, creating anxiety and feeling of threat
Dim lighting creates depressing environment
Patients with ADRD need bright light during the day, to help them sleep at night
Lighting needs to be tailored to the case of each patient
Role of Temperature
Cold Temperature:
patient closes physically and mentally
Not willing to open up
Unsatisfied patient
Hot Temperature:
patient feels gross
unfocused on appointment
unsatisfied patient
Temperature must be just right for satisfied patient
Patient Audience
Environment requirements change due to age of patient
Children's Needs:
Fun, happy setting
Nothing threatening
Stuffed Animals, toys and games, lollipops, no med. tools displayed
Teenagers' Needs
Want to know what's going on, what's happening around them, questioning everything

Monitors are good, they give information to curious patient
Adult's Needs
Adults only mean business
want to go in, get the scoop, and get out
Environment is not on their minds a lot. They don't mind much about their surroundings, but on the treatment itself instead
One way for a doctor to increase patient satisfaction is to know and connect with the patient's culture
Activity Time!
In many cultures, the family — not the individual — is traditionally the primary focus of decision-making.

Family members’ role is to protect and take care of each other, particularly of those seen as the most vulnerable.

Family expects to be involved in key decisions affecting the patient, often talking with the doctor to decide if, when and how to share information with the patient.

Family roles and relationship differences between cultures.

Religious beliefs and their influence of healing

Language differences must be dealt with for effective and sensitive communication

What is Culture
Cultural awareness and sensitivity, is defined as, "the knowledge and interpersonal skills that allow providers to understand, appreciate, and work with individuals from cultures other than their own. It involves an awareness and acceptance of cultural differences, self awareness, knowledge of a patient's culture, and adaptation of skills."

Making the Connection
Medicine is a cultural system with its own specific values, language, and practices that inform the way clinicians practice, and it must be translated, interpreted and negotiated with patients and their families.

Physician should gain knowledge from the patient's medical and family history

What is the best way for a doctor to increase patient satisfaction?
A World of Nervous Patients
And all cared for with patient centered care...
Knowledge through open ended questions and story accounts by the patient and family.
What do they think is happening, how did it start.
Listen to patient and family, make them feel as though they are being heard.
Doctor should have basic knowledge of common cultures
Communication is fundamental and language gap must be bridged so patient can feel that a provider understands them
Language Barrier
Community Cultural Leaders

Understand cultural practices
Have access to services to help the patients.
Language services for non-English speakers Appropriately trained interpreters and written translations of forms and patient education materials.
Doctors can be correctly educated
Doctor must be patient in gaining knowledge
Religious beliefs play powerful role in patient recovery.
Doctor must know beliefs so they do not offer services that the patient believes against.

Doctor does not want to offend patient
Religious Examples
Real Life Scenario
A doctor's reassurance and hope can only mean so much.

A patient could be deep in despair that the words do not help

Doctor couldn't simply not be good with words
In one area, there are usually one or two common cultures.

Doctor would be well acquainted, patient will expect the doctor to know

Patient will view it as just and not anything special.
Environment affects a person whether they like it or not, even with the person not realizing it. The body takes everything in and immediately reacts to it.
Now you know...
Ask your doctor...

Make a change...
"Our environment, the world in which we live and work, is a mirror of our attitudes and expectations. You are a product of your environment. So choose the environment that will best develop you toward your objective.
-Earl Nightingale
Essential Question
Doctor must give them hope. Trust in the treatment
Culture can be defined as an organized group of learned responses, shared meanings, values, rituals and modes of interacting that influence how people understand and make sense of the world. Culture plays a significant role in defining how patients and families make meaning out of illness and suffering, expressions of pain, expectations about care, hopes for the future and views regarding death.
Women's Health Care Physicians
American College of Obstetricians and Gynecologists
Women's Health Care Physicians
American College of Obstetricians and Gynecologists
Mentor: Sara C.
Differences in Culture
Doctor must know so the patient can feel respected
Culturally Connected
Medical facility can be alien and scary
Culture offers familiarity and comfort
Culturally connected doctor can offer a friend, not a stranger, and understanding of the patient and situation
Gaining the Knowledge
The Medical Culture
The unacknowledged,culture: the medical culture.
Doctor's Should Reach Out
Patient interview allows trust, connection to begin
Role of Family
Ex: Euro-Americans, Korean- Americans, Mexican-Americans, Chinese-Americans

Disclosure of Medical Information

Full or unfiltered disclosure seen as disrespectful, impolite or even cruel, and they may regard it as harmful to the patient.

Concerned that information about serious illness can provoke depression, anxiety or even eliminate hope.

Ex: The Navajo traditionally believe the spoken word can shape reality and to talk about death can actually cause it.

Disclosure of information to go through cultural filter
Information can reach patient in safest way: by doctor alone, doctor with family, indirectly
Consultation strengthens cultural connection
Doctor-Family Consultation
Understanding the patient and family perspective is also critical in showing respect
Interpreters are necessary for any patient who speaks a language different from the clinician’s.

Misunderstandings can affect a patient’s sense of hope.
Religious Beliefs
Cases: Man became more ill from deprivation
Family offended about window
Muslims and Jews have beliefs affecting the eating of meat
Hindus, like Buddhists, are usually vegetarian.
Jehovah's Witnesses believe that that the spirit is in the blood so is unacceptable to perform blood transfusions and organ transplantation.

Many religions are opposed to termination of pregnancy.

Original Scenario—Insurance
An Amish woman undergoes a cesarean delivery. After surgery, the woman and her husband are interviewed by a social worker who was called by a nurse to see the couple because they had no health insurance. The social worker immediately begins to tell them how to enroll in Medicaid. They are visibly upset and will no longer talk to the social worker. They refuse to complete any paperwork for Medicaid. They ask to leave the hospital as soon as possible

Culturally Sensitive Approach

The social worker is called by a nurse because the couple does not have health insurance. The social worker is aware that this is an Amish couple and knows that generally Amish people do not believe in or accept what they consider to be welfare. When the social worker meets with the couple, she confirms that they are not seeking assistance in acquiring health insurance; she helps them plan transportation home, and she assists them in reaching other members of their Amish community who, by tradition, provide financial and other assistance to their own people.
1. Design a hospital room for your target audience (child, teen, or adult)

2. Include in your design:
- colors of walls
- objects found in the room (5 minimum)
- specifics of temperature & lighting

3. Have an explanation for all parts of design
Group representative will share out in the end
Kurt Sevinc
Cypress Int. Univ.
Each patient requires the comfort of familiarity
Wall hangings
Calm colors are still needed and familiarity of nature and paradise
Joseph Anjali
Center for Health Design
-Malcolm Gladwell, Blink: The Power of Thinking Without Thinking
"When you meet someone for the first time, or walk into a house you are thinking of buying, or read the first few sentences of a book, your mind takes about two seconds to jump to a series of conclusions. "
"The first two seconds is perfectly rational. It’s thinking–its just thinking that moves a little faster and operates a little more mysteriously than the kind of deliberate, conscious decision-making that we usually associate with “thinking.”
The Best Way for a Doctor to Increase Patient Satisfaction is to treat their patient in a comfortable environment
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