PHARMACEUTICAL CARE 1

(GENERAL PRINCIPLES OF HEALTH CARE)

May T. Magtoto
UST Faculty of Pharmacy
UNIT I:

OVERVIEW OF HEALTH CARE

1. GENERAL INTRODUCTION

Kindness is a language which the deaf can hear
and the blind can see.

Anon
THE PATIENT

We must understand the patient as
someone who possesses certain
Strengths
Vulnerabilities
Preferences
Worries and fears
Hopes and joys
THE PATIENT AS A PERSON
Who is this person who comes to you as a
patient?

What does this person want?

What does this person need?
PATIENT
any recipient of medical attention,
care or treatment
originally meant one who
suffers
PATIENT
Alternative terms:

health consumer, health care
consumer or client
Outpatients and Inpatients
Outpatients
An outpatient (or out-
patient) is a patient who
is not hospitalized for 24
hours or more but who
visits a hospital, clinic, or
associated facility for
diagnosis or treatment.
Inpatients
An inpatient (or in-
patient), on the other
hand, is "admitted" to the
hospital and stays
overnight or for an
indeterminate time,
usually several days or
weeks (though some
cases, like coma patients,
have been in hospitals for
years).

The patient is the central reason
for your work and the only
reason for a health profession.
The Patient: A Health Context
Disease is any abnormal condition,
affecting either the whole body or any of
its parts, which impairs normal functioning.
Disease is described in terms of negative
symptoms combined with the directly
related physical pathology that causes
those symptoms.
In this model, the concept of health is
represented by the absence of disease.
In this view, health is a body-mind- spirit
concept perceived as a harmonious
equilibrium between the interplay of yin and
yang

Yin and yang- describes how seemingly opposite or contrary forces are
interconnected and interdependent in the natural world; how they give rise to
each other as they interelate to each other. Eg. Hot and cold
- Complementary forces interacting to form dynamic system


Several traditions are practiced within our
communities, such as Chinese herbal
medicine, indigenous North American
medicine, and chiropractic, acupuncture,
homeopathy, and naturopathic medicine.
The same patients who use these
alternative approaches also participate in
the mainstream Western philosophies.
Measures of health are changing today.
Increasingly, we see writings about
recognition of
1. diversity
2. the value of the whole person and the richness
of life,
3. broad concern about the person, and
4. the need of inclusion of spirituality

MODELS OF HEALTH

Medical model The absence of disease or disability
WHO State of complete physical, mental and social
well-being and not merely the absence of
disease or infirmity
Wellness Model Health promotion and health progress toward
higher functioning, energy comfort, and
integration of mind, body and spirit
Environmental
Model
Adaption to physical surroundings; a balance
free from undue pain discomfort and
disability.

If we know the model that best fits our patient, we
can offer professional care that meets those needs and
acknowledge the influences that modify ones
expectations of care.
How do you know what concept the
patient has of health?

Each of us has our own concept, but it is
formed by many factors like, cultural
influences, values and beliefs
Cultural Influences
Culture is described as a property of
society.
No such thing as a pure culture, because
there is diversity, often recognizable as
subcultures.
Variation may exist in education,
socioeconomic status, and practiced
religions.
Access to care will continue to be segregated into
3 identifiable groups of patient:
1. Empowered consumers who have resources,
use technology, and want to share in health
decision making
2. Worried consumers who have health insurance
but no choice in plan
3. People who are excluded because they have
no form of health insurance or method of
payment other than out of pocket
Pharmacists should view health and
illness from the patients perspective.

How can we understand a persons culture
in a way that helps to meet his or her
health care goals and needs?


Learn the values and attitudes that were
passed down from one generation to the
next.
Understanding a patients cultural view of
illness

This approach requires a reasonable
understanding of the culture as a whole
before you can confidently apply this
knowledge.

Health professionals should become
culturally competent through the on-going
process of integrating cultural awareness,
knowledge, skill, encounters, and desire.
Campinha-Bacote described this model of
cultural competence in HC delivery as a
framework for developing and
implementing culturally responsive care.
The model assumes that culture
competence is a process, not an event.
It recognizes that there is more variation
within ethnic groups than across groups.
It assumes that the provision of culturally
responsive care is directly related to the
health professionals level of competence
in the context of each patient.
The model defines the concept as follows:
1. Cultural awareness is the self-understanding of
ones own cultural and professional
background.
2. Cultural knowledge is the process of seeking
and obtaining an educational foundation about
different cultural and ethnic groups.
3. Cultural skill is described as the ability to
collect relevant cultural data about the patients
problem as well as performing a culturally
based physical assessment.
The model defines the concept as follows:
4. Cultural encounter involves the health
professional engaging in cross-cultural
interactions with individuals from diverse
backgrounds.
5. Cultural desire is the motivation of the health
care provider to engage in the process of
culturally responsive care.
How does one become culturally
competent?
1. Live with the group
2. Learning can be accomplished through
reading
convening focus groups
participating in community activities.
Cultural competence is discovery of the way
in which a health care provider can move a
relationship with a patient from parallel to
mutual through increasing the providers
knowledge, skills and understanding.