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Communicating About Health Current Issues And Perspectives 5th Edition Athena Du Pré - Solutions
3. Suppose your test results show a genetic propensity for a disease that, so far, we don’t know how to prevent. Would you want to know?Why or why not?
2. Are you worried that genetic test results may be used to discriminate unfairly against individuals or groups of people? Why or why not?
1. If it were affordable, would you undergo genetic testing? Why or why not?
7. Doctors say one reason they overtreat patients is because they may be sued for malpractice if they don’t do everything possible. How would you resolve this dilemma?
6. If research is able to develop improved treatment options but the cost of the research significantly raises health care costs, should the system continue to fund research? What if higher costs mean some people will lose their insurance?
5. Who should decide which care will be funded?Doctors? Funding agencies? Community members?Patients? Legislators?
4. If you could fund only two of the following procedures, which would you choose? On what criteria would you base your choices?a. Surgery to help an infertile couple conceive a childb. Plastic surgery to improve the appearance of a person born with a facial deformityc. Chemotherapy for a very sick
3. If two patients suffer from the same condition, should they be treated differently? What if one is a child and one is very old? What if one is famous and the other is unknown? What if one is homeless and the other is a community leader?
2. If there is a slight chance that an expensive experimental drug will prolong a dying person’s life, should the insurance company or health organization pay for use of the drug?
1. If one person can afford expensive treatment but another cannot, is it okay to refuse care to the less affluent person?
• What factors might affect your ability to understand complex medical information in the future?
• Can you think of a time when you didn’t understand health-related information? If so, what did you do?
9. Imagine that your grandfather is the hypothetical patient described in the chapter as Mr. S. What types of professionals would you choose to be on his care team? What factors would you like them to focus on mostly? Why?
8. What do you say to health professionals who are devastated by a mistake and want to apologize, yet are afraid that doing so will invalidate their malpractice coverage and possibly destroy their careers?
7. In the case of Willie King, whom do you believe should be held responsible for amputating the wrong leg? Why? Whom, if anyone, should be sued? Who should pay the extra medical bills?
6. Name some strategies for avoiding burnout as a caregiver. Which of these do you, or might you, incorporate into your own life whether you are a caregiver or not?
5. What do you think of the “Blowing the Whistle”case study? Why do you think substance abuse is higher than normal among health care providers?
4. Describe the provisions of the Health Insurance Portability and Accountability Act (HIPAA).What would you change about the act, if you could, to make it more effective in terms of communicating about health?
3. Describe how time constraints may affect patient–caregiver communication and influence caregiver satisfaction. How do you respond to some health professionals’ argument that they must limit patient’s input so they can keep exams within a particular time limit? How might organizational
2. Considering the transformation at Virginia Mason Cancer Center, what might medical staff members do to improve the environment and reduce wait times? Be creative.
1. Create a hypothetical scenario that illustrates role theory in the context of a health care interaction.
2. Would you want the doctor to undergo counseling and have a second chance to practice medicine?Why or why not?
1. If you discovered that your doctor was abusing narcotics, would it change your opinion of him or her?
• Who has the highest average salary—registered nurses, pharmacists, or physical therapists?
• What percentage work in health care now?
• What percentage of Americans worked in health care prior to 1960?
• What are some of your emotional hot buttons, and how might they influence you as a patient or a caregiver?
• If so, what caused you to feel that way?
• Even if you did not show it outwardly, have you ever been surprised by your emotional reaction in a health care experience?
5. How far do you think the federal government should go to enforce privacy regulations? Do you agree with adding staff members, more paperwork, and oversight committees? Would you suggest other or additional measures?
4. Some people believe the private-environment regulations are too strict. For example, an orthodontist who previously encouraged patients and families to move throughout the clinic and get to know staff members issued an HIPAA Alert saying, “We must now regretfully restrict all patients and
3. Have you ever felt that you had to discuss confidential medical information within earshot of others (e.g., at a pharmacy counter or during a medical visit)? Do you feel this is a serious problem?If so, what would you do to fix it?
2. Under what circumstances, if any, would you like to receive health-related information through the mail? Do you feel it is important that people have an opportunity to opt out of such mailing lists?
1. Have you been asked to sign a HIPAA Alert? Did you understand the information provided? Did you feel that you had to sign?
• In your opinion, how can patients collaborate with care providers to manage time effectively?
• How do you respond to some health professionals’ argument that they must limit patients’ input so that they can keep visits within a particular time limit?
• Why do you think it happened?
• If so, what have you observed?
• Have you seen evidence of caregivers who come to resent the demands of their patients or to depersonalize them?
• Can you imagine feeling a similar way under the same sort of pressure?
• What is your reaction to residents’admission that they sometimes yearn for a declining patient to go ahead and die so that they can finally get some rest?
5. Have you ever stopped taking prescription medicine before you were supposed to or missed a dosage? Have you engaged in unhealthy habits you would rather not admit to your doctor? If so, what factors affected your decision? Do any of the factors covered in this chapter apply to your situation?If
4. Think of the most dissatisfying health experience you have ever experienced. Create two columns on a sheet of paper. On the left side, write down what happened. On the right side, rewrite the experience to be more satisfying. What would you change? Why?
3. Imagine a scenario in which someone you love has been having agonizing headaches and doctors cannot figure out what is wrong. Write down several communication options that incorporate Jerome Groopman’s (2007) advice to patients.
2. If you were a health professional and a patient felt the treatment advice you gave her was unlikely to work, would you want to know about her reservations?Why or why not? What is the best way the patient might express her disagreement?
1. Write a paragraph about a health concern you or someone you know has experienced. Does your description mostly reflect the Voice of Lifeworld or the Voice of Medicine? How?
6. On what grounds, if any, should health professionals judge whether a patient is emotionally capable of making a life-or-death judgment about emergency treatment?
5. Sometimes it is in the best interest of society or health care workers to know if a person has a contagious disease (such as AIDS). If the person doesn’t consent to a test for that disease, do you think it should be permissible to perform the test without the person’s knowledge? (A vial of
4. In medical research, is it ever justified to deceive people (as in giving placebos) to make sure they are not just responding to the power of suggestion?If so, under what conditions?
3. Some people, such as those with terminal illnesses, are willing (even anxious) to try untested therapies. Researchers may not know what results to expect, and they may even anticipate negative outcomes. Who should decide whether the patient undergoes untested therapies? Should public money be
2. Sometimes medical information is difficult to understand fully. How should we establish if the consenting person is informed enough to give consent?
1. Do you agree with Jauhar’s decision? Why or why not? What would you have done in his place?
3. Do you think reward systems are a good idea?Why or why not?
2. If you said yes, would you be likely to cease those behaviors if the reward were no longer available?
1. Would you be more likely to engage in healthy behaviors if you might receive a cash award or prize for doing so?
• Brainstorm some other terms we might use.Which is your favorite?
• Do you feel the term patient is accurate when describing well people seeking to maintain their own health?
• What factors would make it easier for you to communicate openly?
• If so, what held you back?
• Have you ever found yourself reluctant or unable to tell a health professional what you wanted to say?
4. How can patients help ensure that they get the information they want?
3. Sometimes doctors feel they will alarm or confuse patients (especially young patients) by giving them medical details. Do you agree?
2. Do you think Sarah could have communicated more effectively? If so, how?
1. Do you think the first doctor could have communicated more effectively with Sarah? If so, how?
9. What are the assumptions and techniques of motivational interviewing? Would you enjoy being part of such an interview? Why or why not?10. Think of a health concern you have experienced personally. When asked about it, what does your narrative include? What elements of the narrative are most
8. Compare the assumptions of physician-centered and collaborative communication. How is the caregiver’s role different in each model? How is the patient’s role different? What are some of the reasons that many people are shifting from provider-centered to collaborative communication?
7. Compare a “rhetoric of passivity” with a “rhetoric of agency.” What are some communication strategies caregivers and patients can use to accomplish collaborative interpretation? Apply these to an example of your own.
6. According to the disclosure decision-making model, what three considerations affect whether people disclose nonvisible health concerns to someone else?
5. How could patients and caregivers lessen the likelihood of doorknob disclosures?
4. Why might patients and caregivers commit transgressions? What are some methods for handling transgression attempts? Provide a few examples.
3. What is therapeutic privilege? What guidelines would you suggest for using this privilege?
2. Traditionally, health professionals have had more control over medical conversations than patients have had. What factors contribute to the prevalence of provider-centered communication?Describe some of the communication patterns involved. How do patients’ behaviors contribute to these
1. What is the significance of regarding patient–caregiver communication as transactional?
2. Think of the last time you felt unhealthy. What resistance factors were involved? Was alignment restored? If so, how?
1. In what ways do your daily activities support your self-image? How would you feel if you lost the ability to perform these activities?
• In how many did it worsen?
• In how many states did patient-centered care stay the same?
• Between 2007 and 2012, how many states saw improvements in patient-centered hospital care?
• What happened as a result?
• Did you reveal your concern or not?
• If so, what factors did you consider?
• Have you ever had to make a difficult decision about whether to share a health concern with someone else?
• In your experience, in what ways do the rules and routines of medical settings encourage open communication? In what ways do they discourage it? What would you change if you could?
• What could professionals do?
• If so, what could patients do to help accomplish this?
• In your opinion, should health professionals and patients work toward greater equity in medical conversations?
7. If you were the patient, are there any circumstances in which you would wish information to be withheld from you?
6. Is it ever permissible to give a patient’s family information without telling the patient? If so, under what circumstances?
5. What if patients do not say “Don’t tell me” outright, but their actions seem to suggest that they don’t want to know if the news is bad? Would you tell them?
4. What if you were a physician and a patient told you, “If this condition is terminal, don’t tell me”?Would you withhold information even if it meant making treatment decisions on the patient’s behalf?
3. How do you respond to the argument that physicians can never be sure about patients’ odds of recovery, so it’s sometimes better to withhold information that might diminish their hope?
2. If physicians withhold information, should they go so far as to lie if patients ask outright about their prognosis?
1. If you were Anna’s physician, would you tell her that she does not have long to live? Why or why not?
• What would you do as a health professional if a patient refused medical tests that might lead to better care? Would the patient’s state of mind make a difference in your decision? If so, how?
• In your opinion, should health professionals engage in friendly email exchanges with patients, or should they maintain a greater interpersonal distance than that? Why?
7. Which provisions of the Affordable Care Act do you support? Which do you oppose? Why?
6. Do you support or oppose the idea of an individual mandate? Why? What role, if any, do you think employers should play in defining and paying for employees’ health insurance?
5. Are you more in favor of a single-payer or a multipayer system? Why?
4. Do you think managed care is mostly good or mostly detrimental? Why? What pros and cons are most important to you? If you were able to change managed care for the better, what might you do?
3. With what social groups do you identify in terms of age, education, race, ethnicity, or any other terms? Do you feel these groups are well served by health care? Why or why not? What health communication advantages do you have as a member of these groups? What disadvantages?
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