Chapter 13. Taking Charge of Your Health Care

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.

Blend Images / Alamy

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.

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.