Deck 9: Factors Surrounding Illness: Illness Cognitions, Adherence, and Patient-Practitioner Interactions

Question 1

Ray is someone who thinks he is always right.Because he has a confirmation bias, and only looks for evidence supporting his beliefs, he thinks he has been correct more times than he actually has.This is referred to as ______.

A)self-fulfilling prophecy
B)simple attribution error
C)illusory correlation
D)impression management

Answer 1

illusory correlation

Question 2

There are many cultural reasons that explain why people do not recognize that they have symptoms of an illness.Often, a long time passes from a symptom occurrence to its being recognized as a problem.This can be harmful and is referred to as ______.

A)appraisal delay
B)utilization delay
C)illness delay
D)cultural delay

Answer 2

appraisal delay

Question 3

Tony monitors his symptoms to an extreme level and makes repeated trips to the doctor for the smallest symptom.At his last appointment his doctor told him that his health was fine, but he found a new doctor because he didn't believe that he was all right.He is likely to ______.

A)be a hypochondriac
B)score high on conscientiousness
C)be an extrovert
D)be demonstrating self-efficacy

Answer 3

be a hypochondriac

Question 4

Research by Chowdhury, Islam, Gulshan, and Chakraborty (2007) has shown that ______.

A)older mothers were less likely to use midwives than younger mothers
B)women who experienced menopause reduce their frequency of seeking professional healthcare
C)younger mothers are less likely to seek professional healthcare at the time of birth than older mothers
D)urban women were less likely to seek professional health care than rural women

Question 5

A patient's attitude toward self-care and the extent to which they want to be a part of their treatment is referred to as the level of ______.

A)adherence
B)patient-practitioner coherence
C)self-efficacy
D)behavioral involvement

Question 6

In many ______ communities, children with vision problems are not given glasses so that the child and his or her siblings will attract spouses with good vision or from highly valued families.

A)Latino
B)Middle Eastern
C)Hindu
D)Orthodox Jewish

Question 7

Monae didn't think she was sick, and are she ignored all the symptoms of her breast cancer.She only looked for evidence that she was healthy.This is called ______.

A)self-fulfilling prophecy
B)confirmation bias
C)selective attention
D)impression management

Question 8

The varying ways that individuals respond to physiological symptoms, monitor internal states, recognize symptoms, and utilize health care are all considered ______.

A)illusory correlations
B)proactive coping
C)illness behaviors
D)reactivity measures

Question 9

In many cultures, spiritual healers are typically consulted first for all illnesses, but especially for ______.

A)appendicitis
B)stage 4 breast cancer
C)heart attacks not characterized by the classic symptom of chest pain
D)physical suffering from emotional trauma due to witnessing the suffering of others

Question 10

Some people are more sensitive to their health states than others.They often feel greater discomfort because of their increased vigilance.They score high in ______.

A)private body consciousness
B)behavioral involvement
C)self-fulfilling prophecies
D)self-regulation

Question 11

A major cultural difference in the reporting and perception of physical symptoms is that ______.

A)European Americans are higher than African Americans
B)women are higher than men
C)older adults are higher younger adults
D)people in the Northeastern U.S.are higher than those in other parts of the U.S.

Question 12

When Wayne found received his colon cancer diagnosis, he was in denial.He went through chemotherapy and took medications as prescribed.He never asked any questions when seeing his oncologist; his wife often accompanied him to his appointments and did more of the talking.Wayne is considered to be low in ______.

A)cultural competency
B)adherence
C)patient-practitioner coherence
D)informational involvement

Question 13

Perhaps the most common individual factor that influences the recognition of symptoms and the seeking of treatment is ______.

A)age
B)religion/denomination
C)personality
D)geographic location

Question 14

Very often we do not realize or recognize the true causes of our symptoms.If you have been very stressed, and start putting on weight because of it, you may first instead blame a new diet.The underlying psychological process is known as ______.

A)confirmation bias
B)misattribution
C)the fundamental attribution error
D)an acculturation error

Question 15

Snell (1962) found that African Americans who believed they have been "hexed" could be treated effectively by a psychiatrist using hypnosis, even when the psychiatrist did not believe in hexing.This is an example of ______.

A)a self-fulfilling prophecy
B)shamanism
C)misattribute
D)an illusory correlation

Question 16

Leanne has recently been getting stomachaches in the evening and explains the pain as being caused by the gluten in her diet.This is an example of ______.

A)making an attribution
B)the self-fulfilling prophecy
C)social sanctioning
D)the confirmation bias

Question 17

Hmong Americans consider epilepsy to be ______.

A)a biological disorder
B)the mark of a shaman
C)the first visible symptom of schizophrenia
D)a neurological disorder that is exacerbated by psychological distress

Question 18

The Commonsense Model is based on the parallel processes of how we use ______ to guide our behavior.

A)thinking and feeling
B)selective attention and filtering
C)short-term and long-term memory
D)past experiences

Question 19

People who spend a lot of time in the sun or in tanning booths may know about the dangers of UV rays, but ignore them.Even if they start developing brown spots, a possible symptom of the early stages of skin cancer, they might tell themselves that they are more likely to freckle and will point to how good they feel as further evidence to support that they are not getting skin cancer.They would be using ______.

A)selective bias
B)self-fulfilling prophecy
C)confirmation bias
D)actor-observer bias

Question 20

Evidence suggests that the underutilization of medical resources by Asian Americans is caused by ______.

A)under-referral by their health practitioners
B)the lack of translators in Asian languages
C)a basic misunderstanding and mistrust of Western health care
D)the misunderstanding of providers about the needs of Asian patients

Question 21

Which of the following is most likely to use health services at the highest level?

A)Mexican-American men
B)parents who are physicians themselves
C)European-American men
D)women

Question 22

Which of the following is TRUE?

A)When the physician pays closer attention to the patient after diagnosis by following up more often adherence increases.
B)Adherence rates are higher for chronic rather than acute conditions.
C)The majority of research has shown that about 10% of patients do not fully adhere to their medical regimens.
D)All patients begin their medical regimen with the full intention of adhering.

Question 23

Cultural diversity can affect some of the interpersonal relationships between staff.Give one example noted in the textbook.

A)East Indian male physicians treat European American patients with more respect than they treat patients from their own cultural background.
B)Nurses are the only employees who do not have interpersonal relationship issues due to their relatively low status and their culture of caregiving.
C)Nurses of Asian or Latina backgrounds are sometimes reluctant to stand up to questionable behavior by European American doctors.
D)There is no evidence of religion affecting decisions about health care, but it has been found to cause tensions between employees.

Question 24

Which of the following triggers is an example of social sanctioning?

A)Majaira has developed more symptoms over the past week and many are getting worse.
B)Majaira has pain that interferes with the ability to go to work.
C)Majaira has such low energy that she can't take care of her three young children.
D)As an employee at her company, Majaira has been given an incentive to stop smoking.

Question 25

Many times people will know they have a problem (they noticed they have symptoms) but will not go to a doctor.This can make the problem difficult to treat and is called a(n) ______.

A)appraisal delay
B)a self-fulfilling prophecy
C)illness delay
D)the guidance-cooperation model

Question 26

Treatments that are associated with low levels of adherence include treatments that ______.

A)are long term
B)do not change the patient's daily routine, because they are more likely to forget to incorporate the change
C)are short term, because they are less likely to become a habit
D)are relatively simple; it is assumed that they probably will not be effective

Question 27

Which of the following is FALSE?

A)Treatment seeking varies by ethnicity.
B)The nature and quality of symptoms serve as triggers to seek treatment.
C)European-Americans have been found to use lay-referral systems more than non-European Americans.
D)Women use health services at a significantly higher rate than do men.

Question 28

______ refer to close relationships with friends and family members of one's own ethnic group that many non-European Americans consult before they use the medical system.

A)Lay-referral systems
B)Socially sanctioned groups
C)Cultural buffer systems
D)Sustos

Question 29

Which of the following is FALSE?

A)One of the major causes of dissatisfaction with the treatment seeking process is that physicians do not spend enough time with each patient.
B)Most doctors have a quota of patients they need to see in one day and that limits how much time they can spend with each patient.
C)Design features such as lighting and noise are correlated with quality of care for patients.
D)Because medicine is a hierarchical profession, culture influences inter-doctor and inter-nurse relationships, but not doctor-nurse relationships.

Question 30

Steve did not finish his antibiotic prescription because he was feeling better, and he saved the remaining pills in case he would feel ill later in the season.This is an example of ______.

A)creative nonadherence
B)directive treatment
C)unintentional nonadherence
D)passive aggressive noncompliance

Question 31

Jerica is a college student with limited income.She has an infection in her piercing near her navel, and knows that she needs to get a prescription for an antibiotic, but she still has not made the appointment due to her lack of money to pay for the appointment.Jerica is demonstrating ______.

A)creative nonadherence
B)utilization delay
C)illness delay
D)cultural delay

Question 32

Recent work suggests that treatment adherence can be increased by ______.

A)increasing the complexity of the medical regimen so that patients pay closer attention to the practitioner's recommendations
B)having the physician pay closer attention to the patient after the diagnosis with more monitoring and follow-ups
C)not charging the patient until the follow up appointments are completed
D)rapidly changing the patient's daily routine of a preferred behavior rather than having the change be slower and therefore, perceived as more difficult

Question 33

Which of the following is NOT one of the five triggers (Zola, 1964) that increase the likelihood of a person seeking treatment?

A)degree to which the symptoms frighten you
B)whether you have experienced the symptom before
C)the nature and quality of symptoms
D)if the symptoms interfere with work or personal relationships

Question 34

Ulrich, Simons and Miles (2003) found that patient stress was lowest during blood draws when ______.

A)television was played in the waiting rooms
B)videotapes of nature scenes were playing
C)classical or quiet music is played
D)furniture in the waiting room is plush and comfortable

Question 35

The extent to which a patient's behavior matches with his or her practitioner's advice is referred to as ______.

A)social sanctioning
B)utilization
C)adherence
D)conformity

Question 36

Women from this ethnicity background believe that a week or a month resting period (lying-in) is needed after the birth of their babies.This is the period of time the mother spends in bed to recover.

A)German
B)European American
C)African American
D)Asian American

Question 37

It is becoming more common for employers to require that their employees visit a doctor to lose weight or to quit smoking.Employers also make employees get symptoms checked out.This form of trigger to seeking health care is called ______.

A)social cooperation
B)social interference
C)social sanctioning
D)socialized medicine

Question 38

Calista's doctors play a pivotal role in making decisions in the hospital for her because she was unable to do so (because of her medical condition).This type of patient-practitioner interaction is referred to as the ______ model.

A)autonomous
B)default
C)active-passive
D)prescriptive

Question 39

Not having enough money is often a major reason for someone to not actually obtain medical health care even after they have made the decision to seek care.This would be considered ______.

A)appraisal delay
B)utilization delay
C)illness delay
D)the active-passive model

Question 40

Modi et al.(2008) found that preadolescents and adolescents who had better adherence ______.

A)were more mature than their peers
B)saw their providers several times during their treatment time
C)were more likely to be from collectivist cultures than from individualistic cultures
D)spent more of their treatment time supervised by their mothers

Question 41

Although there are patients of various backgrounds who have had negative encounters with people in the health care system, there is no research evidence that people from certain cultural groups are given less information or treated worse than other groups.

Question 42

Research has shown that Americans of Middle Eastern or Indian descent are often believed to be demanding and to express their pain freely.

Question 43

Research has shown that playing daytime television in healthcare waiting rooms helps to decrease patient stress.

Question 44

Women both perceive and report more physical symptoms than men do.

Question 45

Which of the following by medical professionals is most likely to encourage good communication with their patients who come from many different cultural backgrounds?

A)using medical jargon to specify the nature of the medical condition
B)asking open-ended questions
C)conveying the medical information in very simple terms regardless of the educational background of the patient to be sure that they understand
D)making small talk by asking questions such as, "How are you doing?" to reduce tension

Question 46

European American children of Italian descent are frequently taken first to the eldest family female, then to a paterna, then to a curandera, then a pharmacia and then to a Western medical clinic for an asthma attack.

Question 47

Social scientists have argued that individuals use stereotypes ______.

A)as a shortcut to save cognitive energy
B)only when interacting with someone of a different ethnic background, but not when interacting with someone of a different sex
C)because they lack the ability to engage in critical thinking
D)because people are poor observers when in their own natural environments

Question 48

Cultural competence ______.

A)plays a role in the quality of communication between doctors and patients
B)impacts how patients feel about their health care providers, but does not affect quality of care
C)is a new construct that has not yet been measured with a quantitative scale in empirical studies
D)refers to degree of acculturation of the health care provider

Question 49

Among minority patients, traditional medicine continues to be important regardless of the significant increase in the use of Western medicine.

Question 50

Explain how acculturation and ethnic identity can play an important part in the use of Western mental health and medical health services.

Question 51

______ mistrust of the healthcare system is often cited as a cause of racial disparities in health.

A)Chinese Americans'
B)African Americans'
C)Mexican Americans'
D)Japanese Americans'

Question 52

Which of the following is FALSE regarding research to date?

A)Some cultural groups are given less information and treated worse than other groups.
B)Men over 50 are less likely to be admitted to the hospital intensive care unit and are more at risk of dying there and in the hospital compared to their female counterparts.
C)There is evidence for differential treatment in medical settings based on the patient's sex.
D)Medical professionals have stereotypes about how people of certain ethnic groups express their pain.

Question 53

Which of the following is TRUE when comparing men and women?

A)Women older than 50 receive fewer emergency medical treatments compared to men of the same age.
B)Evidence of gender bias favors women when it comes to knee surgery; physicians are more likely to recommend knee surgery for women because they are more likely to be overweight.
C)Most of the research shows that differential treatment by sex occurs primarily among women of low SES backgrounds.
D)Men are more at risk of dying in intensive care and in the hospital because they tend to delay treatment more than their female counterparts.

Question 54

Both verbal and nonverbal behaviors influence the quality of communication between doctors and patients.

Question 55

If a patient is communicating to a provider about all but the most important piece of information, and the physician is supposed to supply that piece of information to make the whole message comprehensible, this is an example of ______.

A)active-passive model
B)individualistic communication
C)mutual cooperation model
D)collectivistic communication

Question 56

The Commonsense Model of Illness Behavior takes culture into account when examining how people adapt to health threats.

Question 57

Research on how culture affects communication between patient and practitioner has found that compared to collectivist patients, individualist patients are ______.

A)more reserved
B)more likely to get right to the point
C)more attentive
D)less anxious and concentrate better

Question 58

Individuals with low self-esteem have been found to report more health problems.

Question 59

In a study examining help seeking for emotional problems, Spencer and Chen (2004) found that Chinese Americans who experienced language-based discrimination were more likely to ______.

A)seek out informal help from friends and relatives rather than from physicians
B)avoid all health care
C)seek higher educated providers
D)self-medicate

Question 60

A recent study found that when participants were made to think of the common cold they actually walked more slowly than their counterparts with a cold who did not focus on the common cold.

Question 61

Explain how cultural diversity among health care staff can affect the care of patients.Please give three examples of cultural issues that can affect a patient's care.

Question 62

Describe some of the cultural clashes concerning the Lee family and their traditional Hmong beliefs concerning the illness of their daughter, and the Western doctor's reaction to their daughter's illness.What might have been done by the health care system to improve the outcome of the daughter's care?

Question 63

Describe two reasons why a person might delay seeking medical treatment in a clinical setting.

Question 64

Explain two factors that can decrease adherence to medical treatment of a patient.

Question 65

Discuss some of the unique challenges of getting adolescents to adhere to their medical regimen.What could a health professional do to address this (use two specific examples)?