Question #1 Propose a method for improved compliance for a patient at risk for heart disease. Identify potential lifestyle changes needed by such a patient and the reasons why such lifestyle changes may be hard to comply with, along with a proposed intervention to improve compliance.
Compliance serves as an approach to maintaining or improving health as well as managingsymptoms and signs of the disease allowing complex behavior process to fit in as strongly influenced by actual environmentsin which patients live, healthcare providers practice, the healthcare systems delivering care.The purpose for the compliance is based on the premisethat the patient will get well or stay well if the physician and healthcare organization will make appropriate recommendations, providing that the patienthas the necessary knowledge and resourcesto follow it (Burke, Dunbar-Jacob and Hill, 1997). For patient care especially for patients at risk of heart disease, improved compliance is needed such as for the treatment or heart disease prevention as there serves as a crucial factor for achieving positive lifestyle changes and amiably avoid further complications of the disease. The improved method of compliance will be dealing with long-term compliance to health centered promoting behaviors for instance, some patients having coronary heartdisease. The need to have health related compliancedealing to cardiac rehabilitation is essential for the situation of the at risk patient aside, using of certain weight and exercise conditioning programs. Thus, the need to execute as well as apply long term exercisetraining compliance in cardiac rehabilitation program, even though there might be presence of several life threatening disease process which can matter a lot. The lifestyle change is important to avoid the disease for example, the patient should stop and quit cigarette smoking and alcohol drinking that are done too much in a daily basis and the patient should undergo self assessment and rehabilitation, sort of meditation to completely terminate his bad vices and one indication of that change is ample following of the compliance, engaging oneself into physical activities to keep the mind and body well coordinated and through engaging also in a rigorous exercise and not to spoil the reality and pain there is when becoming a victim of a heart disease. Furthermore, the realizing of useful strategies to improve better health compliance, of such rationale for combining certain strategies from within modification of heart disease risk factors (Ades, 2001 pp. 895-897).
Thus, some of the lifestyle change may be hard to comply because of behavior and attitude where there is social effects in the society, and that stress strikes an option for the patient not to comply with change because for them smoking as well as alcohol drinking for example, does serve an outlet for them not to get hit by the pressures of work and pressing obligations of family life and personal life as well. The presence of problematic situation is also a factor why an individual can’t change his lifestyle in order for him to spare from some dreadful disease, heart disease in particular. There is the need to acquire some points of efficacy of cardiac rehabilitation programs needed to be put in actual shape but, there can be extent to which compliance towards heart disease intervention is effectively dependent on its underlying adherence. Non-compliance might occur along with such health care regimens and does vary across the process of disease prevention and treatment domains. There can be several existing compliance problems as it can be clinically significant, ideal mediator of clinical outcome of the cardiac rehabilitation compliance points. The patient should also be engaging into self related behavior therapy, physical exercise, nutrition modification and smoking and drinking cessation and the reporting of effective measuring of the compliance behavior (Ades, 2001 pp. 895-897).
Indeed, compliance intervention will employ various combinations of educational and behavioral strategies to improve heart disease prevention, such improved compliance in the array of medical, health care set up. The lifestyle change if being manifested will be demonstrating successful cardiac rehabilitation compliance (Ades, 2001 pp. 895-897) as there includes behavior training, self-monitoring as well as value based enhancement, the compliance measure and further application of health related approach deemed towards positive and effective promotion of heart disease risk and its reduction means. Aside, the need to integrate some of the observational methods for evaluating cardiac rehabilitation, the compliance effectiveness, and improvement in patients may enhance the quality of observation research and the assessing of effectiveness of the intervention into compliance of several health outcomes as well as subjective report as cardiac rehabilitation compliance were evident for improved patient health and healthy lifestyle reality as there assumes desirable benefits from the intervention.
Question # 2
(a) Describe the subjective experiences of hospitalized patients placing emphasis on perceived and actual loss control.
Subjective experiences of hospitalized patients does gain a deeper understanding of how they experience and evaluate the care and treatment process as there placed emphasis on perceived and actual loss control as there implies subjective experience from the patient into such perceived outcome, for instance how their needs were being met in the medical care. The patients perceived their needs and the care based on their previous experience of the care area, their perceived trajectory of illness as well as the patient character, attitude which represented the patient’s definition of himself and the situation. The patient expectation of illness and character must be taken into consideration thus, having Iimprovement in the satisfaction level, the compliance within thinking and alertness. For example, some patients have experience loss control of urinary activity along with stress and gaining or losing weight. Subjectivity can be a usefulcomponent of outcome measures of heart disease compliance measures. The patient’s understanding of the experience will help them accept the importance of hospitalization, also such possible discrepancy between the patients’ and the hospital’s perspectives on treatment goals.
(b) What is the role of the clinical health psychologist in hospital settings? Provide examples
Pike (1996, p. 106), indicated that, “health psychologists form vital part of health-care teams in the general hospital. Basing their interventions on scientific theory, standardized assessment and clinical skills, they are able to help patients through emotional adjustment, information and the establishment of health-inducing behavior” (Pike, 1996, p. 106). Indeed, the role of the clinical health psychologist in hospital setting is deemed towards actual and ideal understanding of research assimilation to identify behaviors and experiences that promote health, give rise to illness, and influence the effectiveness of health care. Thus, recommending ways to improve health care as well as policy, also ways to reduce smoking and the improvement of nutrition so as to promote health and prevent illness. Furthermore, they aim to change health behaviors for the dual purpose of helping people stay healthy and helping patients adhere to disease treatment regimens. For example, some practitioners emphasize education and effective communication as a part of illness prevention because many people do not recognize, or minimize, the risk of illness present in their lives. Moreover, many individuals are often unable to apply their knowledge of health practices owing to everyday pressures and stresses. When there is little hope of recovery, health psychologist therapists can improve the quality of life of the patient by helping the patient recover, identifying the best ways for providing therapeutic services for the bereaved.
(c) Analyze the relationship between physician and patient in the hospital setting, and the outpatient setting. What potential problems can develop in the physician-patient relationship? How can physicians improve their relationship with patients?
There can be the preserving of physician-patient relationship from the time of managed care as there may be problems into effective development of physician-patient relationship for instance, some patients may feel that they are wasting physician’s valuable time and does not include details of history which deemed unimportant and are embarrassed to mention things they think will place them in an unfavorable light and the physician might not have the information needed to make good treatment decisions. Thus, the physicians should attend to patient comfort, show attention with nonverbal cues, such as nodding as well as acknowledge and legitimize feelings and ask for further health concerns. There may be occasions when no agreeable compromise can be reached between the physician and the patient. Indeed, the physician is obliged to provide the patient with resources to locate ongoing medical care, the effective teaching of physicians will improve physician behavior, medical outcomes as well as patient satisfaction. “Furthermore, with an increasing emphasis on value and efficiency in health care delivery, quality time between physician and patient is an increasingly valuable resource. Physicians spend time in face to face contact with patients gathering information, and developing relationship, doing administrative work related to visits and maintaining their knowledge base. Aside, physician time should be considered a resource just like other components of the health care system. For nonprocedural providers, it is the predominant source of income. Health systems should make efforts to understand how to allocate time according to patients’ needs rather than on a fixed visit schedule and to include patients’ input in these decisions”(Dugdale, Epstein and Pantilat, 1999 pp. 34-36)
Ades, P. (2001), Cardiac Rehabilitation and Secondary Prevention of Coronary Heart Disease. The New England Journal of Medicine Vol. 345, No. 12 September 20, 2001
Burke, L. Dunbar-Jacob, J. and Hill, M. (1997), Compliance with Cardiovascular Disease A Review of the Research. Annals of Behavioral Medicine
Dugdale, D. Epstein, R. and Pantilat, S. (1999), Time and the Patient–Physician Relationship. Society of General Internal Medicine. General Internal Medicine. 1999 January; 14(S1): S34–S40.
Pike, D. (1996), The role of the health psychologist in a general hospital setting. International Journal of Therapy and Rehabilitation, Vol. 3, Iss. 2, 01 Feb 1996, pp 106 – 109
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