Health Professional and Patient Interaction

by Purtilo & Haddad

• ISBN13: 9780721692975
• ISBN10: 0721692974
• Edition: 6th
• Format: Paperback
• Copyright: 2002-02-19
• Publisher: Saunders

Summary

Revised and updated, the sixth edition of this comprehensive resource focuses on respectful interactions in a health care setting. Emphasizing effective communication with clients and patients, examples and scenarios are specifically relevant to health professionals. Content includes information and strategies for patients of all ages -- as well as abusive, depressed, and impaired patients. Clinically relevant format is easy to understand. Examples are included from a variety of allied heath professions and are easily transferred to real-life experiences. Scenarios facilitate thought-provoking classroom discussion. Content emphasizes a respect for diversity to guide readers through potential difficulties. Content has been thoroughly updated to include current health care settings, trends, and approaches. Two new chapters have been added - The Patient's Story and Some New Challenges. New boxes and illustrations have been included to make the text more reader-friendly. New Verbal Interactions quotes are included at the beginning of each chapter. Discussion questions are now located within chapter content to aid in comprehension. Respect is the text's on-going theme. Examples and case scenarios throughout the text emphasize this critical aspect of patient communication.

Table of Contents

PART ONE Creating a Context of Respect	1	(60)
Respect: The Difference It Makes	3	(16)
What is Respect?	4	(1)
Respect and Your Values	5	(8)
Personal Values	7	(2)
Professional Values	9	(2)
Societal Values	11	(2)
The ``Good Life'' and You	13	(2)
Respect for Values: Yours and Others'	15	(2)
Honoring that Values Change	16	(1)
Reclaiming and Replacing Values	16	(1)
Summary	17	(2)
Respect in the Institutional Settings of Health Care	19	(16)
The Functional Organization of Health Care	21	(1)
Characteristics of Institutional Relationships	22	(3)
Public- and Private-Sector Relationships	23	(1)
Total and Partial Institutions	23	(2)
The Interface of Institutions and Society	25	(4)
Laws and Policies Maintaining High Standards of Competence	25	(2)
Laws and Policies Related to Discrimination	27	(1)
Other Laws and Policies	27	(1)
Laws, Policies, and Change	28	(1)
Rights, Responsibilities, and the Work Environment	29	(1)
Patients' Rights Documents	29	(1)
Grievance Mechanisms	30	(1)
Informed Consent: The Basic Contract Guiding Interaction	30	(3)
Disclosure of Relevant Information	30	(1)
Giving or Refusing Consent	31	(2)
Summary	33	(2)
Respect in a Diverse Society	35	(26)
Bias, Prejudice, and Discrimination	36	(2)
Respecting Differences	38	(12)
Race	40	(1)
Gender	41	(2)
Age	43	(1)
Ethnicity	43	(2)
Socioeconomic Status	45	(2)
Occupation and Place of Residence	47	(1)
Health Status	48	(1)
Religion	49	(1)
Sexual Orientation	49	(1)
Cultural Sensitivity and Competence	50	(2)
Summary	52	(3)
Appendix 3-1 Introduction to the Berg Cultural/Spiritual Assessment Tool	55	(5)
Part One Questions for Thought and Discussion	60	(1)
PART TWO Respect for Yourself	61	(46)
Respect for Yourself as a Student	63	(14)
How the Desire to Help Will Help You	64	(1)
How Do I Become an Expert?	64	(5)
Knowledge (Theoretical Concepts)	65	(1)
Skills	66	(2)
Attitudes and Character	68	(1)
On-Site Education: New Challenges	69	(2)
Critical Thinking: An Essential Tool	71	(1)
The Art of Critical Thinking	71	(1)
Psychological Factors in Critical Thinking	72	(1)
Finding Meaning in the Student Role	72	(3)
Why Do I Feel Anxious?	73	(1)
How Can I Respond Constructively to Anxiety?	74	(1)
Reaping the Rewards of Preseverance	75	(1)
Summary	75	(2)
Respect for Yourself in Your Professional Capacity	77	(12)
Developing Your Capacity to Help	78	(5)
Intimate versus Personal Help	78	(1)
Social Helping Relationships	79	(1)
Therapeutic Helping Relationships	80	(3)
Being an Expert Helper	83	(1)
Shared Responsibility for Optimal Care	84	(2)
What about Working with Assistants?	84	(1)
When Should I Refer Patients to Other Professionals?	85	(1)
Teams and Teamwork	86	(1)
Self-Respect and Lifelong Learning Habits	87	(1)
Summary	87	(2)
Enhancing Self-Respect through Good Personal Habits	89	(18)
Self-Respect through Nurturing Yourself	90	(8)
Overcoming Illusions of Invulnerability	91	(1)
Adopting Generative Approaches to Professional Tasks	92	(4)
Respect for Your Need for Solitude	96	(2)
Showing Respect for Each Other	98	(4)
The Ties That Bind	99	(1)
Finding Mechanisms That Support Support	100	(1)
Play:Enjoying Each Other's Company	101	(1)
Summary	102	(2)
Part Two Questions for Thought and Discussion	104	(3)
PART THREE Respect for the Patient's Situation	107	(34)
Challenges to Patients	109	(18)
Maintaining Wellness	110	(1)
Reckoning with Change	110	(3)
Loss of Former Self-Image	111	(2)
Special Challenges of Inpatients	113	(5)
Losses Associated with Institutional Life	114	(3)
Loss of Independence	117	(1)
Special Challenges of Ambulatory Settings	118	(1)
Special Challenges of the Home Care Patient	119	(1)
Weighing Losses and Privileges	120	(2)
Some Advantages of Remaining in the Patient Role	122	(2)
Escape	122	(1)
Financial Gain	122	(1)
Social Gain	123	(1)
Respectful Responses to Malingering	124	(1)
Summary	125	(2)
Respect for the Patient's Personal Relationships	127	(14)
Facing the Fragility of Relationships	127	(4)
``Will Others Lose Interest?''	128	(2)
``Will We Weather the Winds of Change?''	130	(1)
Abiding Uncertainty	131	(2)
Fighting Stigma	133	(2)
Discovering Values: Old and New	135	(3)
Religious Values and Practices	135	(2)
Paying for Care	137	(1)
Summary	138	(1)
Part Three Questions for Thought and Discussion	139	(2)
PART FOUR Respect through Communication	141	(46)
The Patient's Story	143	(14)
Who's Telling the Story?	144	(3)
The Patient's Story	145	(1)
The Medical Record	145	(2)
Awareness of Literary Form in Your Communication	147	(2)
Narrative Language is Not Transparent	147	(1)
Language Creates Reality	148	(1)
Contributions of Narrative to Respectful Interaction	149	(5)
Literary Tools	149	(1)
Poetry	150	(1)
Short Stories	151	(2)
Illness Stories/Pathographies	153	(1)
Where the Stories Intersect	154	(1)
Summary	154	(3)
Respectful Communication in an Information Age	157	(30)
Talking Together	158	(1)
Models of Communication	159	(1)
The Context of Communication	160	(4)
Face to Face or Distant	161	(1)
One-to-One or Group	161	(2)
Institution or Home	163	(1)
Choosing the Right Words	164	(5)
Vocabulary and Jargon	164	(2)
Problems from Miscommunication	166	(1)
Clarity	167	(1)
Tone and Volume	168	(1)
Choosing the Way to Say It	169	(3)
Attitudes	170	(2)
Communicating Beyond Words	172	(6)
Facial Expression	172	(1)
Gestures and Body Language	173	(1)
Physical Appearance	174	(1)
Touch	174	(1)
Proxemics	175	(2)
Differing Concepts of Time	177	(1)
Communicating Across Distances	178	(3)
Written Tools	179	(1)
Voice and Electronic Tools	180	(1)
Effective Listening	181	(3)
Summary	184	(1)
Part Four Questions for Thought and Discussion	185	(2)
PART FIVE Components of Respectful Interaction	187	(50)
Professional Relatedness Built on Respect	189	(18)
Build Trust by Being Trustworthy	190	(5)
Building Trust within Different Models of Relationship	191	(1)
Reassurance and Trust	192	(3)
Tease Out Transference and Countertransference	195	(1)
Recognize the Difference: From Casualness to Professional Caring	196	(4)
Caring as Attitude and Behavior	198	(1)
Caring---from the Patient's Perspective	199	(1)
It (Almost) All Depends on Dependence	200	(3)
Types of Dependence	200	(3)
Respect as Empowerment	203	(1)
Summary	204	(3)
Professional Boundaries Guided by Respect	207	(16)
What is a Professional Boundary?	208	(2)
Recognizing What a Meaningful Distance Is	210	(1)
Physical Boundaries	211	(3)
Unconsented Touching	211	(2)
What About Dual Relationships?	213	(1)
Psychological-Emotional Boundaries	214	(5)
Pity	214	(2)
Overidentification	216	(1)
Caring Too Much	217	(2)
Maintaining Boundaries for Good	219	(2)
Summary	221	(2)
Professional Closeness: Respect at Its Best	223	(14)
Integrity in Words and Conduct	224	(1)
Paying Close Attention to this Person	225	(2)
Little Things Mean a Lot	227	(2)
Personal-Hygiene Detail	228	(1)
Personal-Comfort Detail	228	(1)
Personal-Interest Detail	229	(1)
Expanding-Awareness Detail	229	(1)
Reality Testing as a Form of Respect	229	(2)
Finding a Comfortable Level of Intimacy	231	(2)
Summary	233	(1)
Part Five Questions for Thought and Discussion	234	(3)
PART SIX Respectful Interaction: Working with Patients Effectively	237	(72)
Respectful Interaction: Working with Newborns, Infants, and Toddlers	239	(18)
Human Development and Family	240	(9)
Family: An Evolving Concept	241	(5)
Useful Principles of Human Growth and Development	246	(1)
Theories of Human Development to Guide You	247	(2)
From Newborn to Infant	249	(1)
The Normal Newborn	249	(1)
Life-Threatening Circumstances	249	(1)
Moving into Infancy	250	(1)
Infant Needs: Respect and Consistency	250	(2)
Everday Needs of Infants	251	(1)
The Toddler: Becoming a ``Self''	252	(1)
Toddler Needs: Respect and Security	253	(1)
Summary	254	(3)
Respectful Interaction: Working with the Child and Adolescent	257	(12)
The Childhood Self	258	(1)
Needs: Respect and Relating	258	(5)
Play and Toys	259	(1)
School Issues	259	(1)
Family---A Bridge to Respectful Interaction	260	(3)
The Adolescent Self	263	(1)
Early and Late Adolescence	263	(1)
Needs: Respect, Autonomy, and Relating	264	(2)
Family and Peers---Bridges to Respectful Interaction	265	(1)
Summary	266	(3)
Respectful Interaction: Working with the Adult	269	(20)
Who is the Adult?	269	(1)
Needs: Respect, Identity, and Intimacy	270	(14)
Psychosocial Development and Needs	272	(2)
Social Roles in the Middle Years	274	(2)
Work as Meaningful Activity	276	(3)
Biological Development during the Adult Years	279	(1)
Stresses and Challenges of Midlife	280	(3)
Doubt at the Crossroads and Midlife Crisis	283	(1)
Working with the Patient of Middle Years	284	(1)
Summary	285	(4)
Respectful Interaction: Working with the Older Adult	289	(20)
Views of Aging	291	(1)
Antithesis of Health and Vigor	291	(1)
Unwelcome Reminder of Mortality	291	(1)
Underprivileged Citizens	291	(1)
Aging as a Clinical Entity	292	(1)
Older People as a Cultural Treasure	292	(1)
Needs: Respect and Integrity	292	(6)
The Psychology of Aging	293	(1)
Friendship and Family Ties	294	(4)
Where ``Home'' Is	298	(1)
The Challenge of Changes of Aging	298	(5)
Challenge to Former Self-Image	298	(3)
Physical Changes Characteristic of Aging	301	(1)
Mental Changes Characteristic of Aging	302	(1)
Interacting with Cognitively Imparied Older People	303	(2)
Assessing a Patient's Value System	305	(1)
Summary	305	(2)
Part Six Questions for Thought and Discussion	307	(2)
PART SEVEN Some Special Challenges	309	(46)
Respectful Interaction When the Patient is Dying	311	(26)
Dying and Death in Modern Society	312	(5)
Dying: Denial and Beyond Denial	314	(3)
Responses Associated with Dying and Death	317	(6)
Fears of Dying	317	(2)
Fear of Death Itself	319	(2)
Other Responses	321	(1)
Responses of the Patient's Family	322	(1)
Setting Treatment Priorities	323	(6)
Information Sharing	323	(2)
The What and How of Telling	325	(1)
Treating Losses and Fears	326	(2)
Helping Patients Maintain Hope	328	(1)
Providing the Right Treatment at the Right Time in the Right Place	329	(3)
Hospice and Home Care Alternatives	329	(1)
The Appropriate Treatment: Cure or Comfort?	330	(2)
When Death is Imminent	332	(2)
Maximizing Comfort	332	(1)
Saying Good-Bye	333	(1)
Accepting Rejection	334	(1)
Summary	334	(3)
Respectful Interaction in Other Difficult Situations	337	(18)
Sources of Difficulties in the Health Professional and Patient Interaction	338	(8)
Sources within the Health Professional	338	(4)
Sources within Patients	342	(1)
Sources in the Environment	342	(4)
Difficult Health Professional and Patient Relationships	346	(3)
The Aggressive Patient	346	(1)
The Self-Destructive Patient	347	(2)
Showing Respect in Difficult Situations	349	(2)
Summary	351	(1)
Part Seven Questions For Thought and Discussion	352	(3)
Index	355