Veronica Jackson
Associate Professor, Department of Physical Therapy, Alabama State University, 1155 North University, United States.
Corresponding Author Details: Veronica Jackson, Associate Professor, Department of Physical Therapy, Alabama State University, 1155 North University, United States.
Received date: 20th January, 2023
Accepted date: 01st March, 2023
Published date: 03rd March, 2023
Citation: Jackson, V., (2023). Interpersonal Patient Interactions with Allied Health Professionals: Respecting Patients to Enhance Positive Outcomes and Wellness in the Virtural World of Healthcare. J Rehab Pract Res, 4(1):140.
Copyright: ©2023, This is an open-access article distributed under the terms of the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Keeping the common theme of “respect” in the healthcare industry is vital to the clinician and patient success. In a song by Aretha Franklin, she sings, "R‐E‐S‐P‐E‐C‐T, find out what it means to me." The artist is speaking about someone respecting her as a person, as her "whole person". Allied health professionals either work independently in their own practices or within a healthcare system. In both scenarios, one must recognize and respect important concepts of culture, diversity, and "the whole person", with "in person" and virtual business/treatment practices. The next line she includes a synonym TCB," shorthand for "taking care of business." In healthcare this entails taking care of patient needs, from the examination to the discharge experience, even in the virtual world of healthcare. Healthcare professionals who understand, embrace, and market this concept of "respect" as a pillar of their practice will be economically stable and well-respected in the community of practice.
Key Words: Culture, Diversity, Respect, Allied Health, Well Being
In a song by Aretha Franklin, she sings, “R‐E‐S‐P‐E‐C‐T, find out what it means to me."The artist is speaking about someone respecting her as a person, as her “whole person", knowing who she is. The next line she includes a synonym TCB," with "TCB" her shorthand for "taking care of business." Allied health professionals either work independently in their own practices or within a healthcare system. In both scenarios, one must recognize and respect important concepts of culture, diversity, and "the whole person", in business and treatment practices. Patients can feel various "vibes" with healthcare providers and in order to maximize patient/clinician relationships in person or via virtual encounter, respect should be at the core of this experience. Clinicians can benefit from awareness of cultural differences and health disparities. According to Purtle [1], the COVID-19 pandemic is likely to have profound mental health impacts that pervade racial, ethnic, and class lines in the United States. Past disasters and public health emergencies, however, suggest that socially disadvantaged groups (e.g., racial/ethnic minorities, people with low income) will experience more psychiatric morbidity related to the pandemic than socially advantaged groups.
Plummer [2] developed the diversity petal that encompasses the many different aspects of a person that include: race/ethnicity, gender, age, mental/physical ability, sexual orientation, socioeconomic class, education, and religion. The "whole person" is influenced and guided by all of these areas of life. The “whole person" is defined as more than just what a person looks like or their occupation. According to Jonas et al. [3], A person is more than just their physical components or parts. They consist of the body and the external environment for sure but are also made up of at least three other dimensions including: (1) their behavior and lifestyle that interacts with the environment; (2) their social and emotional dimensions; and (3) their mental and spiritual dimensions, which bring meaning and purpose to life.
These dimension that make up a human being have been defined by classic writers such as Abraham Maslow in the Hierarchy of Human Needs. From birth, human beings have basic needs such as food, clothing, and shelter. Among other aspects are love, touch, and a feeling of value. Humans have a foundational need for a sense of belonging and of well‐being. Maslow’s Hierarchy helps the clinician to understand basic human needs. Maslow’s Hierarchy is a popular theory that has gained much attention from researchers and theorists. Maslow’s Hierarchy of Needs is a theory in psychology that became a part of the human relations school of thought. It claims that there are 5 stages of human needs that motivate behavior, proposed by Abraham Maslow theory in 1943. Hopper (2020) explains Maslow advocated that human needs can be organized into a hierarchy. This hierarchy ranges from physical needs such as food and water to abstract concepts such as self‐fulfillment. The Theory of Maslow Hierarchy of Needs can be used to help clinicians understand how clients have a need to be able to function with or without disability, pain, mental or emotional instability. In addition, in order to have good outcomes, one may need financial assistance, or spiritual guidance to optimize medical treatment. From a spiritual perspective, as a business owner or an allied health professional, one would benefit from understanding the foundational concept that each human is made in the image of God and should be treated with basic respect and dignity in every personal interaction with clients/patients.
Resect is the foundation of any relationship especially in a virtual relationship. This initial interaction between the client and clinician should be one of respect and appropriate communication. As with any good relationship there is a sharing of ideas and getting to know one another. This relationship should be no different. It is through this relationship that the clinician assesses patient needs, assist in determining the care to be given, and evaluates this care. For the patient, this relationship can be positive, ineffective, or may hinder progress towards recovery. The success of the client-clinician relationship depends on how well the clinician knows people and how the patient/client feels about their relationship with their provider. In a qualitative study related to diverse patient perspectives on respect in healthcare, by Beach at el, [4], respect was defined in two ways by clients: 1) being treated like a person (“like you’re a person not just a statistic, or another patient”), and 2) being treated as an equal (“treat me as an equal, like I matter”).
An understanding of how personality develops and the ability to recognize behavior and motives as they actually exist are essential to developing a helping and healthy relationship. In a study by Beach at el. [5] related to moral obligation of health professionals, the respect that health professionals promote has both a cognitive dimension (believing that patients have value) and a behavioral dimension (acting in accordance with this belief). In other words, as a clinician, what does your verbal and non-verbal language say to a patient or client that stands in need of medical services from you?
Humans come from all types of different backgrounds and have different lifestyles. The way in which a provider approaches the patient can have a positive or negative impact on patient behavior that can bring about the optimal changes desired. Patients are more apt to listen to a provider that respects them, and feels like they have a healthy relationship with them. According to Harris [6], the role of the primary health provider in prevention of chronic diseases is essential for good health outcomes. Lifestyle risk factors like tobacco use, alcohol, and obesity are things that require education that starts with openness in a healthy patient/client relationship where respect, dignity, and trust can be identified by the client. For example, there are other major players in today’s society that healthcare professionals have to deal with like opioid addiction within their patient roster.
According to Harris [6] risk assessment is designed to provide a framework for patient education and decision making about lifestyle changes and pharmacy-therapy. In order to have viable and meaningful conversations about these types of health concerns, a good patient clinician needs to be in place.
Chronic vascular diseases including heart disease, diabetes, kidney disease and stroke represents a substantial and increasing portion of health care expenditure and practitioner workloads. Behavioral risk factors for these include smoking, poor nutrition, hazardous alcohol consumption and physical inactivity (known by the acronym SNAP). These issues are not always easy topics of discussion and having a meaningful relationship with patients would help to enhance these discussions and possibly compliance with health care plan.
The virtual world of healthcare has opened the door to reach patients/clients in a holistic way. During virtual visits with patients, clinicians are able to see right into the environment of the client. Some clients may feel more comfortable and safe to open up about other issues that may be going on in their life that affect their health. This climate could help foster a better client/clinician relationship developing trust, compassion, and caring. A communication of alternative ideas to a problem could be a turning point in someone’s life decisions in their personal environment. A person is a product of their environment. Humans function within their family, workplace, and community. Environment, hereditary, and nurturing play an important role in personality development and it is important to understand what stage of life someone is in during their treatment. The virtual innovation of healthcare contact with patients during an acute or chronic illness can bring the comfort and confidence one needs to get through a difficult situation whether a surgical, non-surgical, or mental health issue. “Diffusion of Innovation” is defined as a process by which an innovation spreads amongst and gets absorbed/ accepted or assimilated by the market [7]. It is truly amazing to see a new product or service hit the market, and witness the success of it. Sometimes it happens by “word of mouth”, hearing someone else talk about the product or service, or actually experiencing it firsthand. In today’s digital society, the product can even become a trending item on social media. A positive healthcare encounter experience can be shared for anyone to view on social media, and try, so respect of persons and developing a good client-clinician relationship is essential for meeting the needs of the client.
Respect is the beginning of having a vibrant relationship with patients in order to have conversations about mental health and spiritual needs. Health care providers can be the gatekeepers to making appropriate referrals to mental health and spiritual counseling when needed. Healthcare providers may not have religious convictions but can identify when their clients may be in need of one of these services. Human beings may present with mental health issues besides their primary reason for seeing an allied health professional and if a healthy patient/clinician relationship exist, this opens the door to health coaching. Jonas and Rosenbaum [3] assert that health coaching is an evidence-based process that assists patients in engaging and empowering them for their own health improvement through behavior change. Mental health disorders are health issues of patients that sometime need special attention by clinicians. According to Brådvik [8], suicide is a major health problem, and the global suicide mortality rate amounts to 1.4% of all deaths worldwide. Most suicides are related to psychiatric disease, with depression, substance use disorders and psychosis being the most relevant risk factors. However, anxiety, personality-, eating-, and trauma-related disorders, as well as organic mental disorders, also contribute. If a good healthy client/clinician relationship exist, the client maybe inclined to disclose at risk behaviors in order for interventions to be identified. According to the CDC and NIMH, nearly 46,000 lives were lost to suicide in 2020 alone. Comments or thoughts about suicide, also known as suicidal ideation, can begin small, for example, “I wish I wasn’t here” or “Nothing matters.” But over time, they can become more explicit and dangerous. This is why a good client/clinician relationship that represents dignity and respect is so important to establishing trust within this relationship. Furnes et al. [9], asserts that effective communication is a fundamental element in all nursing and forms an integral part of quality patient care. Telehealth has become an option for health care concerns especially post COVID. Shanbehzadeh et al. [10] notes that anxiety and depression were the most common mental health problems post COVID-19, so it is in the best interest of providers to prepare clinicians with continuing education experiences to know how to effectively communicate with patients that they encounter with mental health issues.
The National Wellness Institute promotes Six Dimensions of Wellness: emotional, occupational, physical, social, intellectual, and spiritual. Addressing all six dimensions of wellness in our lives builds a holistic sense of wellness and fulfillment. Health care providers that come in contact with patients/clients need to be aware of these 6 dimensions of wellness to assess patients in these areas are tell how they impact overall health. It is also wise to know in order to create interventions to address any issues within a dimension. According to the National Wellness Institute [11], wellness is a conscious, selfdirected and evolving process of achieving full potential. Wellness is multidimensional and holistic, encompassing lifestyle, mental and spiritual well-being, and the environment. Wellness is positive and affirming
There are well-defined demographics that have been affected post COVID related to mental illness. Purtle [1] notes, that data from the U.S. Bureau of Labor Statistics show that, between April 2019 and April 2020, the unemployment rate increased from 3.6 to 14.7 for the U.S. as a whole but from 11.5 to 31.2 among Blacks and from 3.7 to 16.7 among Latinos. Purtle also notes that, the mental health sequel of the COVID-19 economic fallout is likely to be substantial, with one model suggesting that unemployment caused by the pandemic could result in 9570 additional suicides per year worldwide. Clinicians are in a unique position to promote spiritual and emotional well-being and should understand how these elements impact counseling and relationships. According to Wickramaratn [12], spiritual wellness should include encouragement of patients to open up one’s mind to the beliefs of the world rather than being held up by one’s own beliefs. Health care professionals should also encourage patients to lead one’s life according to one’s values rather than feeling untrue to oneself by doing otherwise. Clinicians should also encourage patients to be in tune with their emotions and feelings and to seek the necessary counseling needed to help with overall wellness.
The healthcare professional should always be aware of his or her patient’s emotional status. Patients should accept one’s feelings than denying them. One should have a positive impression towards life than a negative one. According to Wickramaratne [12] assert that relationships are maintained well by a well person. The emotional wellness dimension includes the awareness and acceptance of the emotions of an individual. This dimension consists of positivity one feels with oneself and his life. This also includes capability of an individual to deal with his emotions and feelings such as development of autonomy, realistic assessment of limitations and ability to deal with stress. Many times clinicians have to have realistic conversations that involve dealing with loss of a body part, loss of function, or even a loss of loved one.
There is strength in having a plan of action when dealing with the public in the realm of healthcare within the virtual platform. The healthcare industry can benefit from always having a good knowledge and background of knowing the value of patient safety, valuing diversity, and cultural humility. These principles compliment the overall well-being of the client. Patient safety may mean teaching someone how to eat and pushing themselves away from the table. It could mean taking the to show someone how the anatomical size of their stomach. Valuing diversity could be accepting someone’s educational and communication level, and teaching them how to be more effective in their communication to benefit them. Cultural humility could mean respecting a person who has decided to use medicinal marijuana for chronic pain relief in order to provide for themselves.
Patient safety in the virtual world may look a little different than in person. For example, the clinician needs to be sure that not only are verbal instructions correct but providing the patient with written instructions can be useful in your absence. Ensuring that a family member is aware of medical information that would benefit the patient like removing rugs and cords from the floor to prevent falls. Valuing diversity is the key to a good patient/clinician relationship. Healthcare providers have a responsibility to understand that with every patient encounter there is a new individual culture, none like any before. Each patient has a unique personality, background, experiences, and way of life, and providers must accept this challenge each time a new patient enters into their presence. This action of accepting those who may not look like you, act like you, speak like you, or view the world as you do require cultural humility. Cultural humility leads to respecting those that we may not understand, but still allows us to share common things with each other as human beings made in the image of God.
There are core professional behaviors that all healthcare providers are capable of personifying that include accountability, integrity, professionalism, and communication. Healthcare professionals should demonstrate accountability in having a desire to assume responsibility for learning and change and seek and respond to feedback from multiple sources. Integrity should be at the heart of every healthcare provider demonstrating adherence to high ethical standards and showing proof and rational for actions. It also means being trustworthy and recognizing one’s limitations. Professionalism in the virtual world is an important piece of the puzzle which is behaving in a manner that is expected and accepted in the environment in which one works. This entails keeping scheduled appointments, being prepared to listen and treat patients, and appearing in appropriate attire even on camera. Demeris [13] asserts that, in the context of virtual communities it is important to address the actual process and frequency of communication between members. Communication is the foundation of the virtual management models and is the process by which information is exchanged between individuals through a common system with consistent body language with sensitivity. It is also important to respond appropriately to the body language of others. Fronda et al. [14] asserts that communication is not only verbal and written, it includes body language, attitude, and tone. Patients and family members are able to pick up on inconsistent and bad behavior of healthcare providers with “bad” bedside manners, now bad “virtual” manners.
The virtual environmental model should provide a comfortable, respectful, and dignified place of service. Most people opt for a virtual setting due to the convenience and staying in the confront of their own home, as the patient is looking for a safe space to discuss their health concerns. This is another reason why respect of others is needed for this type of setting. In this virtual environment, clinicians should demonstrate a realization that illness brings about physical pain, doubt, depression, and sometimes fear of recovering and returning to the previous prior level of functioning.
The awareness of the concept of respect is an acceptance of the numerous feelings in oneself and of others in the realm of wellness. The virtual platform has the capacity for patients and health care providers to express and handle feelings in an effective manner. A clinician can encourage and assist patients to gain the ability to be independent while also realizing the importance of asking and appreciating others’ help which enables in forming interdependent relationships where mutual commitment, trust, and respect act as a foundation for making professional referrals and other medical referrals as needed. Patients will be able to bounce back, return to work, take challenges, and face risks. A healthcare team approach to the virtual management model can help patients manage life in a personally benefitting manner, where one accepts one’s actions which makes life an exciting and hopeful journey towards wellness.
The authors declare no conflict of interest.
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