Patient Practitioner Communication

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MSc Health Psychology
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Psychological Aspects of Healthcare
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7PS005
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2011/12
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030077519
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Word Count - 2,196
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Critically evaluate the extent to which patient-practitioner communication influences patient responses to the adoption of one health behaviour. Patients diagnosed with chronic conditions such as hypertension need to adhere to health behaviours and lifestyle changes such as stopping smoking, eating healthily, taking more exercise, reducing sodium intake and most importantly adhering regularly to prescribed medication programmes. These health behaviours will reduce the risk of the condition in terms of severity and also decrease the likelihood of further problems developing related to hypertension such as advanced cardiovascular disease. Non-adherence to medication routines however is a large problem and can result in disease worsening, further complications, increased hospitalisation, early disability and even death, furthermore non adherence is thought to occur in at least 50% of those being treated for chronic disease (Stimson, 1975). Non-adherence is thought to be heavily influenced by the interaction between the patient and practitioner (Francis et al, 1969) therefore the patient centred approach is central to the uptake of health behaviours for patients. This approach involves the acknowledgment of the biological, social and psychological elements involved in the treatment of the chronic illness, and does not use the biomedical model alone. Intentional non-adherence may occur in patients due to values such as body image, habits, money, convenience, cultural beliefs, and fears with regards to side effects. It has been stated that doctors must listen to what their patients are telling them as they are the most knowledgeable and informative about their own lifestyles, beliefs, attitudes (Vanderford et al, 1997) and outcome expectancies (Horne et al, 2005). The patient empowerment model (Anderson, 1995) states that the patient is in control of his or her own illness, however visits the doctor in order to be counselled, to gain professional guidance, and to be given psychosocial support. Empowerment training programmes are used to heighten the patient’s knowledge with regards to their condition and the medication prescribed. In addition Stewart et al (1995a) developed a model of patient centred communication which includes six constructs that are crucial for successful patient practitioner communication 1) Exploring both the disease and the illness experience 2) understanding the whole person 3) finding common ground regarding management 4) incorporating prevention and health promotion 5) enhancing the doctor patient...
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