3unit ib - the patient[1].ppt (part 2)

8/3/2019 3UNIT Ib - The Patient[1].Ppt (Part 2)

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PHARMACEUTICAL CARE 1PHARMACEUTICAL CARE 1(GENERAL PRINCIPLES OF HEALTH CARE)(GENERAL PRINCIPLES OF HEALTH CARE)

AssoAsso. Prof. Ma. Cristina. Prof. Ma. Cristina CatanguiCatangui -- DoriaDoria

UST Faculty of PharmacyUST Faculty of Pharmacy


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Good

Morning

!!!


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UNIT I:UNIT I:

OVERVIEW OF HEALTH CAREOVERVIEW OF HEALTH CARE


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Values and Benefits

The Health Beliefs Model

To fully serve person as a patient

- understand his/hervalues and beliefs in relationship to

the persons concept of health.

Common theme in health profession literature:

- to highlight the difference between the

professionals understanding of the patients

disease and the patients interpretation of feeling

unwell.


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Values and BenefitsThe Health Beliefs Model

In this distinction we see the:

- patients need formore than a scientific

formulation and treatment of problems.

Patients generally want:

- to feel understood and valued

- to be involved in:making sense of their health problems.

decisions about care management

.


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Values and Benefits



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Values and Benefits


Individual factors include:

perceived susceptibility to illness;perceived seriousness of illness,

perceived barriers to action;

perceived benefits of action, motivation, and self-

efficacy.


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Values and Benefits


Modifying factors include:

past personal and family experiences,

information and advice from family and friends,

age, knowledge, fitness level,

external influence of the media.


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Values and Benefits


Person:

decides if he or she is ready to take the health actionperceived as necessary by weighing its costs and

benefits. will finally act when a cue of some type occurs---usually

a profound negative event (e.g. stroke after uncontrolledhypertension, hospitalization after uncontrolledhyperglycemia secondary to uncontrolled diabetes).

practical representation of belief and holds up to bothcultural variation and differing definitions of health.


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Patient Relationships

The other decision makers who are in relationship to yourpatient.

A spouse may actually be decision maker in care or mayhave great influence.

A patient may make decisions through the family

members as a unit. Both of these relationships are observed as routine in

some cultures.

patient may have a caregiver, either voluntarily fromrelatives, friends, and neighbors, or formally through the

health system. other people important to the patient may play a role in

influence him or her.


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Medication Use

What does this person believe about the

use of medication as a form of treatment?

Many studies indicate that perceptions ofthe role of medication use are highly

varied---as varied as the characteristics

that affect concepts of health.


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Medication Use

Multiple studies have shown that:

- patients from different ethnic and cultural

backgrounds use alternative medicines or home

remedies, while also participating in a formalhealth care system approach.

Your knowledge of the patients beliefs and his

or her evaluations of treatment options- considered when developing therapeutic plans

and monitoring patient outcomes.


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Health Behavior

Healthrelevant behavior and attitudes

- products ofculture and are viewed in theoverall cultural contextin which they occur.

Fundamental to this new paradigm of practice- understanding behavior, its relationship tohealth, and methods by which it can be altered.

Current concepts of health behavior heavily

influenced by- social learning theory, self- efficacy theory,and a biopsychosocial view of health anddisease.


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Health Behavior

The way that patients behave in relationship totreatment depends on a complex interplay of:

- many psychological, social, and environmental

variables.

To assists them in reaching their goals- understand how behavioral techniques may beused.

Patients with less positive health practices

- more likely to be health illiterate. The stronger a persons perceived capability

to carry out behavior, the more successful heor she is in doing so.


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Health Behavior

Self-care

- a prominent aspect of patient behavior.

- an individual taking responsibility for both

identifying ones problem and determining

the preferred treatment.


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Health Behavior

Over-the-counter product market

- a person can, without ever consulting a

health professional, self-diagnose and

treat. Range of self-care products broad and

varied, including such things as

- herbal remedies, nutraceuticals,vitamins, minerals, and other dietary

supplements.


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Health Behavior

The concept of self-care- extends to patients in hospitals.

A recent study showed that 90% of hospitalpharmacy departments

- allowed own use medications to be brought inby patients.

Prior literature has shown that

- between 35 and 64% of patients bring their own

medications to the hospitals, averaging threemedications per patient.

- Patients often do so to reduce anxiety and lossof self-control while being hospitalized.


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Health Behavior

Individual also self-help by identifying

with self-help groups (e.g., Alcoholics

Anonymous).

- offer emotional support and practical

advice about a common problem they

share.

- almost always member run, voluntary,

and fairly inexpensive.


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Health Behavior

An estimated 15 million Americans are members

of self-help groups, which often lead patients to

seek health information.

- With 70,000+ web sites disseminating healthinformation, more than 50 million people are

seeking health information online.

- Online information is frequently inaccurate, and

people general have poor information-evaluation

skills.


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Health Behavior

However, the fact that 50 million people

use the Internet for this purpose

- potential of the source as part of a largerhealth communication system.

- An investigation and understanding of the

Internets influence on health beliefs and

behaviors is needed.


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Health Behavior

As a pharmacist,

- accessible to the public yet have a highdegree of expertise.

- Patient will seek you out to verify the

accuracy of health information and obtain

your advice.


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Types ofPatients

To optimally care for a patient,

- need to determine what type of patient

the patient is.- Your goal should be to:

recognize and respect the patients

autonomy and support him or her in thedetermination of needs.


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Types ofPatients

In this context, you might view the patient ascoming from three different possible points ofview:

1. The patient as a consumer. The patient viewsyou (the professional) as a competitorwhohas something he or she wants or needs, butviews you as willing to give as little as possiblefor the amount of money. In this case, theconsumer shops around for the commodity(i.e., health care services, pharmaceuticals).


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Types ofPatients

In this context, you might view the patient

as coming from three different possible

points of view:

2. The patient who is dominated by the

professional. The patient views him- or herself

as powerless in decision making and hands

over in a highly dependent way the decisionsto be made to you ( the health professional).


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Types ofPatients

In this context, you might view the patient as

coming from three different possible points of

view:

3. The patient as autonomous and interdependentwith the professional. The patient views him- or

herself as vulnerable and seeks care in an

interdependent fashion. The patient wants to

trust the professionals expertise. However, heor she wants to participate in, rather than hand

over, decisions to the professional.


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Types ofPatients

As a pharmacist,

- encounterall three types of patients.

- Understanding them can help you todetermine how to best meet their needs.

- professional responsibility remains the

same in all three cases. The way you meetyour responsibility will vary.


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THE PATIENT-PHARMACIST

RELATIONSHIP

Does the patient have a concept of the

pharmacist as a care provider?


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RELATIONSHIP

Expertise and Trust

Some research suggests that from apatient perspective,

- pharmacist expertise is the main factornecessary for establishing qualityrelationship between pharmacist andpatients.

Mutual disclosure

- critical for building trust in pharmacistpatient relationship.


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RELATIONSHIP

Expertise and Trust

In a study of 200 patient who came to the

pharmacist for prescription,

- 80% expressed the importance of

confidence(professional trust), while

- 58% thought the knowing and liking

(personal trust) the pharmacist was

important in their selection of a pharmacy.


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RELATIONSHIP

Expertise and Trust

For a nonprescription remedy,

- 72% stated they would accept the pharmacists

advice. For prescription medication,

- 57% were willing to accept advice.

A strong interrelationship exists between- personal and professional trust in both selecting

a pharmacy and accepting advice from a

pharmacist.


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RELATIONSHIPUnderstanding the Pharmacist as Healer

Some patient view as a healer.

Pharmacists

- occupy a specialized community role,holding the social status as a healer by theuse of medications as treatment.

- recognized as experts who hold the capacity

to cure as well as harm. In general, as with other healers, the

pharmacist is a trusted and respectedmember of the community.


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RELATIONSHIP

Understanding the Pharmacist as Healer This status is grated by patients who give the pharmacist

this power.

When a patient seeks a pharmacist for advice,

- he or she is placing trust in the intention and skill of thepharmacist.

Many patients understand the pharmacist

- has knowledge that is specialized for this purpose.

For the patient who invests in relationship, a hand holdor touch to the forearm has meaning from you as ahealer, every bit as much as the medications youdispense, monitor, and educate about.


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RELATIONSHIP

Understanding the Pharmacist as Merchandiser

Some patients may view you as

- a merchandiser, recommending drug product

from the point of view of sales. The 2001 National Pharmacy Consumer Survey

found that

- 30% of patients view pharmacists as their first

choice for information regarding medications,

- only 4% view pharmacists as their first choice

for information regarding disease.


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RELATIONSHIP

Understanding the Pharmacist asMerchandiser

Individuals may have pre-formed ideas aboutthe role and value of pharmacist without everhaving a direct experience with a pharmacist.

A patients perception of the pharmacist is

- formed by interacting with you.

To change perceptions, change the patientsexperiences by

- helping them realize all the health care valueyou can provide.


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RELATIONSHIP


Patients usually come to pharmacists

- to receive services, products, and /or care.

It is usually their choice.

However, as illness progresses or acute eventsrequire intervention,

- the patients choices become limited. When patients come to the hospital to get care,

they dont choose you.


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RELATIONSHIP


You are assigned or provided.

Similarly, when patients are referred to homecare services or long-term facilities, pharmacistservices are assigned.

As choice is eliminated, the patient becomes

more dependent on the- pharmacists attributes as a care provider who

advocates for patient needs.


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3unit ib - the patient[1].ppt (part 2)

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