Chapter 13. Taking Charge of Your Health Care

Intro

Taking Charge of Your Health Care
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People have different preferences for the type of health service they want. Some want to know every detail of their condition and treatment, while others prefer to know little or nothing. Some want to be actively involved in choosing specific treatment regimens and caring for themselves, while others want professionals to be totally responsible for their care.

Check Your Health

PREFERRED TYPE OF HEALTH CARE

The following questionnaire based on the Krantz Health Opinion Survey asks about your desire for involvement in your health care. For each of the following statements, decide whether you agree or disagree with the statement and select the item in the column that best fits your opinion. Because each person is different, there are no “right” or “wrong” answers.

Question 13.1

1. I usually ask the doctor or nurse many questions about what he or she is doing during a medical exam.

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2. Except for serious illness, it’s usually better to take care of your own health than to seek professional help.

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3. I’d rather have doctors and nurses make the decisions about what’s best for me than for them to give me a whole lot of choices.

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4. Instead of waiting for him or her to tell me, I usually ask the doctor or nurse immediately after an exam about my health.

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5. It is better to rely on the judgments of doctors (who are experts) than to rely on “common sense” in taking care of your own body.

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6. Clinics and hospitals are good places to go for help since it’s best for medical experts to take responsibility for health care.

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7. Learning how to cure some aspects of your illness without contacting a physician is a good idea.

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8. It’s almost always better to seek professional help than to try to treat yourself.

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9. It is better to trust the doctor or nurse in charge of a medical procedure than to question what he or she is doing.

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10. Learning how to cure some aspects of your illness without contacting a physician may create more harm than good.

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11. Recovery is usually quicker under the care of a doctor or nurse than when patients take care of themselves.

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12. If it costs the same, I’d rather have a doctor or nurse give me treatments than do the same treatments myself.

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13. It is better to rely less on physicians and more on your own common sense when it comes to caring for your body.

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14. I’d rather be given many choices about what’s best for my health than to have the doctor make decisions for me.

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15. I usually wait for the doctor or the nurse to tell me the results of a medical examination rather than asking them immediately.

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16. I’d rather be given many choices about what’s best for my health than to have the doctor make the decisions for me. KHOS-B

t5Ga0Iog+TXVtQK5wfIlI2bvq9z8fRna
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{true} setModel("informationDisagreeScore", qqMC1 + qqMC3 + qqMC4 + qqMC8 + qqMC10 + qqMC15 + qqMC16)
{true} setModel("behavioralDisagreeScore", qqMC2 + qqMC5 + qqMC6 + qqMC7 + qqMC9 + qqMC11 + qqMC12 + qqMC13 + qqMC14)
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Your Score

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Information Score:

{model.informationScore}

Agree

{model.informationDisagreeScore}

Disagree

Behavioral Involvement Score:

{model.behavioralScore}

Agree

{model.behavioralDisagreeScore}

Disagree

The Information subscale measures a preference to ask questions and to be informed about medical decisions. The more you agree with these statements the more you prefer to ask questions and be informed about medical decisions.

The Behavioral Involvement scale measures preferences for degree of involvement and self-initiated action in health-care situations. The more you agree with these statements, the more you prefer to be involved and to take control in health-care situations.

You can compare you scores across both subscales to get an idea of what your strongest preference is for your involvement in health care. For example, a ratio of 4:7 (i.e., 4 agrees on Information subscale and 7 agrees on Behavioral Involvement subscale) would indicate a strong preference for behavioral involvement in your health care.

IMPROVE YOUR HEALTH

When patients who desire an active role in their health care feel a sense of control over their treatment and know what to do, they generally experience a better outcome (Clayman, Bylund, Chewning, and Makoul, 2015). Altshuler and colleagues (2016) developed a program to empower patients to actively communicate in their treatment plans. Their program focuses on how patients must understand their respective roles and responsibilities, view their health care providers, and vice versa, as partners, and use communication skills that promote shared decision-making. Although the program is geared toward patients with type 2 diabetes mellitus, it includes important lessons for anyone who needs empowerment to communicate with their health-care providers. In another study by Bennett and Diusbrow (1996), the authors gave suggestions to patients about to undergo an unpleasant or in other ways anxiety-provoking examination or procedure. Here are some of their suggestions.

Insist on Being Heard. Describe your symptoms, complaints, and concerns as fully and clearly as possible. Your health is at stake here, so don’t hold back or cover up because of embarrassment or anxiety. By the same token, don’t exaggerate your symptoms. If you feel that your provider is not giving you his or her full attention, or is cutting you off too quickly, say something like, “Doctor, if I may just finish. I want to make sure you have the full picture.” Always remember to state your opinion and to ask questions.

Be Assertive. Don’t Accept a Treatment You Don’t Want. Once you know the kind of support that you are most comfortable with, don’t wait passively for someone to give it to you. Ask for it. If you are not satisfied with a particular recommendation, seek another opinion. Don’t feel pressured to blindly accept a medical regimen that doesn’t feel right.

Take the Procedure Seriously. If you were about to compete in the Ironman Triathlon, you would certainly be nervous, but you would prepare ahead of time in order to ensure your chances of success. Being an active participant in treatment begins by channeling your anxiety into the design of your training plan. Gathering information about the procedures that will be used, what you can expect to feel, and any options that you might have will help you approach the procedure with greater confidence.

Instruct Your Body Beforehand. Give yourself mental instructions during the days before the procedure, just as an athlete does when “psyching” or visually preparing for a big event. The most direct mind-body approach is a specific instruction that helps you exert some control over physical responses that might affect recovery, such as muscle tension or blood flow. Some patients find it helpful to record their program for later playback.

Respect Your Coping Style. Research has shown that patients cope best when their health care provider takes their coping style into consideration. However, coping styles can vary by the context of the stressor. Taking things a step further, you will cope best if you are aware of your own preferred ways of coping with stressful situations. Are you a blunter, who prefers not to be overwhelmed with information or asked to make too many decisions? If so, don’t worry about asking too many questions because you think it is expected of you. Conversely, if you are a monitor, acknowledge your need to feel a sense of control over the situation by asking your physician, nurses, and other staff members for as much information as you feel you need. Good hospitals and clinics are flexible and experienced enough to be able to meet the needs of both types of patients.

SOURCES

Altshuler, L., Plaksin, J., Zabar, S., Wallach, A., Sawicki, C., Kundrod, S., & Kalet, A. (2016). Transforming the patient role to achieve better outcomes through a patient empowerment program: A randomized wait-list control trial protocol. JMIR Research Protocols, 5(2), e68.

Bennett, H. L., & Diusbrow, E. A. (1996). Preparing for surgery and medical procedures. In D. Goleman & J. Gurin (Eds.), Mind-body medicine: How to use your mind for better health (pp. 401–427). Yonkers, NY: Consumer Reports Books.

Clayman, M. L., Bylund, C. L., Chewning, B., & Makoul, G. (2016). The impact of patient participation in health decisions within medical encounters: A systematic review. Medical Decision Making, 36(4), 427–452.

Adapted from Ferguson, T. (1996). Working with your doctor. In D. Goleman & J. Gurin (Eds.), Mind-body medicine: How to use your mind for better health (pp. 429–450). New York, NY: Consumer Reports Books.

Krantz, D. S., Baum, A., & Wideman, M. V. (1980). Assessment of preferences for self-treatment and information in health care. Journal of Personality and Social Psychology, 39(5), 977–990.

Nevid, J. S., Rathus, S. A., & Rubenstein, H. R. (1998). Health in the new millennium (pp. 659–660). New York, NY: Worth.

Sweeny, K., Melnyk, D., Miller, W., & Shepperd, J. A. (2010). Information avoidance: Who, what, when, and why. Review of General Psychology, 14(4), 340–353.