Deck 3: Patientcaregiver Communication

Question 1

What is the significance of considering communication to be a transaction?

A) People are either senders or receivers during communication episodes.
B) Meaning is defined as an intention located in the mind of the sender.
C) Communicators exert mutual influence on each other such that the way one behaves suggests how the other "should" behave.
D) All of these are part of the definition.

Answer 1

C
Explanation: The transactional model recognizes that communication is a collaborative accomplishment.

Question 2

Which of the following best describes the "A Mother's Experience at the Dentist" case study?

A) The writer was thrilled when her daughter's dental appointment revealed no cavities.
B) The writer was upset when the dental staff was insensitive to her daughter's needs.
C) The writer was grateful that the dental staff did not make her feel guilty for not bringing her daughter in sooner.
D) The writer remembers her feeling of helplessness when her daughter was required to undergo a very painful procedure.

Answer 2

C
Explanation: The experience is a good example of empathic communication.

Question 3

"I am, well, I'm worried, it's probably nothing, but, um . . ." Distress markers, stutters and stammers such as these indicate that the patient is probably:

A) Not very smart
B) Building up to an important disclosure
C) Just trying to kill time
D) Delaying the end of a medical visit because he or she is lonely

Answer 3

B
Explanation: Patients often stutter and stammer when they are working up to important disclosures.

Question 4

The experts recommend that health professionals ask " " at least three times before launching into a physical exam.

A) Are you okay?
B) What is your name?
C) What else?
D) Are you sure?

Question 5

Mr. Johnson is angry that he was not discharged from the hospital sooner, and he takes it out on the health educator who comes to prepare him for home care. When a patient or care provider steps over the line, as in delivering insults and making inappropriate expressions of anger, this is best described as:

A) Antidecorous
B) A transgression
C) Boundary spanning
D) Disenfranchisement

Question 6

Dr. Brown feels that the patient might be unable to cope with the news that she is dying. Traditionally, doctors were allowed to withhold information if they felt that disclosing it would make the situation worse. What is this called?

A) Physician reticence
B) Medical modicum
C) The Safe Secret Rule
D) Therapeutic privilege

Question 7

Lucinda was relieved when the nurse practitioner came in with a smile, introduced herself, and seemed eager to hear more about Lucinda's life and concerns. She thought to herself, "This is a person I can trust to care about me, to avoid judging me, and to offer the expertise I need to get better." As a result, Lucinda told the nurse practitioner about a frightening health concern she hadn't shared with anyone else. This episode is a good example of the:

A) Adaptive Structuration Theory
B) Disclosure Decision-Making Model
C) Elaboration Likelihood Model
D) Coordinated Disclosure Approach

Question 8

The model of collaborative interpretation relies on all of the following factors EXCEPT:

A) Patients must be willing to take an active role in health care transactions.
B) Care providers must treat patients like partners involved in a cooperative process.
C) Patients and caregivers must agree that physicians are more capable of making medical decisions than patients are.
D) Environments and procedures should encourage both patients' and professionals' input.

Question 9

When a patient introduces a medical concern in the last few moments of a medical encounter, it is called:

A) A doorknob disclosure
B) A transgression
C) Blocking
D) Patronization

Question 10

All of the following are tips for avoiding or minimizing transgressions EXCEPT:

A) Take stock of personal needs and social expectations.
B) Establish clear boundaries for talk and touch.
C) Send ambiguous messages.
D) Seek the counsel of friends and coworkers.

Question 11

You thought Ms. Patterson would not be upset to hear that her niece was in the hospital. But as you began to tell her, you could tell she was distraught, so you moved closer and gave her some time to react to the news. The principle of communication that says that communicators exert mutual influence on each other such that the way one behaves suggests how the other should behave is called:

A) Codependence
B) Relativity
C) The Principle of Reactivity
D) Transactional

Question 12

Which of the following is most true based on research described in your textbook?

A) Most doctors allow patients to talk for about 5 minutes and then the doctors take over.
B) Physicians could use more training on how to limit patient's lengthy disclosures.
C) Physicians have traditionally done most of the talking in medical encounters.
D) Patients usually talk more than doctors do.

Question 13

As the term is described in your book, which of the following best describes collaborative medical communication?

A) Participants act as peers who openly discuss health options and make decisions together.
B) Patients are encouraged to choose health care providers who are highly similar to themselves.
C) Managed care executives, caregivers, patients, and family members work together to assure the best care possible.
D) Patients with similar concerns assist each other by answering questions, serving as social support networks, and sharing their own experiences.

Question 14

Daniel sought a medical team who would listen to his ideas and treat him as an active participant in his own care. His ideas are consistent with:

A) The model of collaborative interpretation
B) The health belief model
C) The cognitive two-step flow process
D) The elaboration likelihood model

Question 15

After a physical therapy session, Chuy can barely sleep because he is in so much pain. But rather than say something to his therapist, Chuy continues to go along with whatever instructions he is given. This is a good example of the:

A) Tyranny of the urgent
B) Elasticity model of patient compliance
C) Rhetoric of passivity
D) Communication anxiety theory

Question 16

A patient says, "I believe this all began when I lost my job. I was so depressed and bored, I started eating too much. Then my liver started acting up. At that point, I got really scared and decided I had better do something fast." Which of the following best describes the process of patients telling their stories?

A) Narrative medicine
B) Supernormal identity management
C) Social exchange theory
D) The Principle of Compounded Interest

Question 17

A person who upholds the model of collaborative interpretation is most likely to make which of the following statements?

A) "Patients should follow their doctors' orders without question."
B) "Caregivers must treat patients like partners involved in a cooperative process."
C) "Patients are like children and doctors are like parents."
D) "Patients are consumers, and health professionals should cater to their wishes."

Question 18

You engage a client in a motivational interviewing session to talk about his desire to be more physically active. So far, he hasn't been successful at incorporating regular workouts into his schedule. Following the tenets of motivational interviewing, you might say all of the following EXCEPT:

A) "What are the advantages of not working out more often?"
B) "Why don't you team up with a workout partner? That always works for me."
C) "On a scale of 1 to 10, how important is working out to you?"
D) "What do you think it would take to move a little closer to your goal?"

Question 19

You decided to start a new, healthier diet this week. But you ate cake at your sister's birthday party Tuesday and were so hungry Wednesday that you grabbed a hamburger on the way to a meeting. In the language of sense making, you have experienced:

A) Gaps
B) Contrasensical confounders
C) Goal ambivalence
D) Health belief conflicts

Question 20

Since she became a medical assistant, Sonia is surprised how differently patients react to the same illnesses and treatment plans. Some seem to be upset, whereas others are relatively calm. Which of the following perspectives emphasizes that health outcomes are neither static nor definitive; instead, one factor may influence others in unforeseen ways?

A) Integrative health model
B) Dynamic model of health care interaction
C) Transitory health quotient
D) Medical standpoint theory

Question 21

The idea that we influence each other's communication styles is known as transactional communication.

Question 22

Collaborative communication establishes patients and care providers as peers who openly discuss health options and make mutually satisfying decisions.

Question 23

A diatribe is a conversation in which both people participate fully and equitably, each influencing the encounter in ways that make it a unique creation.

Question 24

If someone who is going through a difficult health experience says, "I'm trying to keep a positive attitude and hope for the best," they are presenting a sustaining narrative.

Question 25

"The thing that impressed me about Dr. Hanna was that he didn't come down on me real hard. I didn't feel like I had been sent to the vice principal's office and he was wagging a finger in my face saying, 'You'd better do this' or 'You'd better do that.'" This patient is describing a physician-centered transaction.

Question 26

Motivational interviewing is designed to explore and resolve the ambivalence people naturally feel about a lifestyle change.

Question 27

A statement such as "I am just trying to hold it together, aware that I will probably fall apart if things get worse" is illustrative of a preserving narrative.

Question 28

In motivational interviewing the "elicit-provide-elicit" pattern refers to instances in which a professional asks a person to identify a problem, then the professional offers a solution to the problem and asks the decision maker how they feel about the solution.

Question 29

An enduring narrative involves a sense of stoically living through one's suffering.

Question 30

When patients take an active role in medical encounters they are enacting a "rhetoric of agency."

Question 31

Name and describe at least three guiding principles of motivational interviewing. Would you enjoy being part of such an interview? Why or why not?

Question 32

Name and describe the four types of narratives identified by Janice Brown and Julia Addington-Hall.

Question 33

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.