Introduction
I volunteered at Washington MedStar hospital, which is one of the largest hospitals in Washington. Washington MedStar is a 912-bed capacity hospital, and it provides quality health care services to hundreds of people on a daily basis. It offers both in-patient and out-patient health care services to patients in Washington and beyond. I specifically volunteered at OB/GYN Sonography Departments. Therefore, the main patients I observed were pregnant women. I observed patients who were 18 years and above. Although I did not spend a lot of time in the hospitals, I was able to observe a lot of things and learn a lot of lessons that will be useful in my profession.
What I Observed
The main issue that I observed was the high prevalence of high-risk pregnancies. A significant number of women whom I observed were suffering from high-risk pregnancy, which is mainly caused by medical conditions such as diabetes, hypertension, and preeclampsia. The main risk factors that were linked in high-risk pregnancy among the women I observed included diabetes, overweight and obesity, and hypertension. Interestingly, I observed that high-risk pregnancy was more common among African American women than their white counterparts. This could be explained by the fact that many African American women are more likely to suffer from obesity and diabetes than white women. More than half of patients who had high-risk pregnancies were African American women. Thus, I concluded that high-risk pregnancies are higher among Africa Americans than women from other racial groups.
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Secondly, I observed that there was little interaction with patients who visited the department, especially due to quick appointments. Health professionals did not spend sufficient time with patients who visited the department. The appointment could averagely last for about five minutes, which I believe was not enough for quality physician-patient interaction. However, I realized that the high number of patients in the hospital was the primary reasons why the appointments too little time. Many patients were waiting in the queue at any given time and doctors were forced to reduce physician-patient interaction time to serve as many patients as possible.
Thirdly, I observed a poor parent-child relationship. I realized that many patients who in the hospitals did not enjoy a strong bond with their children, which was a concern to many health care providers. However, noticed that the poor parent-child relationship was caused by many factors, as one of the patients told me. I learned that families play an important role in enhancing parent-child relationships. Constant conflict in the family can hamper the parent-child relationship, which ends up affecting the cognitive and social development of children. Besides, the health professional has a role to play in enhancing the parent-child relationship, especially through education. A significant number of health professionals in the department disclosed to me that they are rarely involved in family-related issues such as parental conflict.
Fourthly, women did not enjoy coming to appointments. They were mainly motivated to honor the appointments when their health conditions were worsening. However, the fear of being told bad news about their health status is one of the major reasons why many women skipped appointments, even though they are necessary. At the same time, the perception of being respected made women to skip appointments, and this was more common among black women than white women. Some black women, for instance, argued that being subjected to wait for long hours is a sign of disrespect, particularly because of their race. A lot of No-Shows characterized the hospital. Therefore, the decision by patients to skip appointments is in line with the Theory of Planned Behavior (TPB), which explains that patient-related behaviors are influenced by factors such as the vulnerability of the health condition, relationship with a health provider, and the perceived benefits and costs (Duncan, Forbes ‐ McKay & Henderson, 2012). Many pregnant women who did not have medical vulnerability skipped the medical appointments.
Finally, I observed that some of the women I observed smelled alcohol and marijuana. I was worried about this observation, particularly due to the many negative effects of harmful drugs on pregnant mothers and their fetus or children. I noticed that the use of drugs among pregnant women is common mainly because health professionals of its dangers do not warm them. Nonetheless, some the pregnant women were not worried, even when they knew the habit is wrong and dangerous. According to the proponents of TPB, women who drink alcohol or take drugs during pregnancies have a positive attitude towards drinking and are likely to stop, even after being informed of the dangers (Duncan, Forbes ‐ McKay & Henderson, 2012). Thus, health professionals can hardly change the behavior of pregnant women with a positive attitude towards drinking.
Discussion on What I Learned
A high-risk pregnancy is a common occurrence among many women, especially African American women because of lack of knowledge. Women with high-risk pregnancies have little information on what they should have done to prevent the problem. Specifically, an interaction with one of the women made me realize that she did not understand the intimacy of her body and the danger she was exposed to while pregnant (Oliveira & Mandú, 2015). Also, a significant number of women were not able to access detailed information about their health and that of their children. The problem was worse among African American women because of their low health literacy. At the same time, stress, anxiety, and depression are causing high-risk pregnancies among many mothers. The stress is mainly linked to the lack of financial and social support, interpersonal conflicts in families, and racism.
I learned that interpersonal conflict at family level was the main cause of poor parent-child relationship. Mothers opined that marital conflicts, including divorce or separation, disrupt their parenting skills, particularly when they are not able to cope with the challenges. The parental ability to cope with challenges affect the parent-child relationship, as a child may also find it difficult to cope (Oliveira & Mandú, 2015). Besides, postpartum depressions adversely affect the parent-child relationship, and it may result in the development and emotional problems, primarily to mothers. Also, lack of father involvement in parenting affects mother-child relationship. Fathers play a critical role in the cognitive development of their children.
Besides, I learned that the high rate of No-Shows among mothers was primarily linked to emotional barriers. Many patients are motivated to honor the appointment when they perceive it to be urgent and necessary. At the same time, I learned that many patients avoid appointments because of the fear of going through uncomfortable medical procedures. The fear of disrespect is making mothers to avoid appointments (Lacy et al ., 2004). The perception that a health care provider would not respect a patient’s culture or religious beliefs encourages them to avoid appointments. Therefore, No-Shows, which was common in the department, is influenced by many factors.
Conclusion
Patient's behavior is influenced by many factors, which may be internal or external. For instance, a cultural factor may determine the type of diet and how a patient responds to medical treatments or services. Socio-economic factors also influence health perception and decisions of patients. For instance, racism may make a patient feel that he or she may not get adequate treatment from a given physician. Also, emotional stability influences health behaviors and decisions significantly. As a result, patient education is one of the main strategies that can be used to address some of the challenges that are faced by patients.
References
Duncan, E. M., Forbes ‐ McKay, K. E., & Henderson, S. E. (2012). Alcohol use during pregnancy: An application of the Theory of Planned Behavior 1. Journal of Applied Social Psychology , 42 (8), 1887-1903.
Lacy, N. L., Paulman, A., Reuter, M. D., & Lovejoy, B. (2004). Why we don't come: patient perceptions of no-shows. The Annals of Family Medicine , 2 (6), 541-545.
Oliveira, D. D. C., & Mandú, E. N. T. (2015). Women with high-risk pregnancy: experiences and perceptions of needs and care. Escola Anna Nery , 19 (1), 93-101.
