Psychological Impact of the Physician-Patient Relationship on Compliance: A Case Study and Clinical Strategies

2002 ◽  
Vol 12 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Charles V. Pumilia
2018 ◽  
Vol 2 (1) ◽  
pp. 19
Author(s):  
Luiz Alberto Queiroz ◽  
Nara Lima Alexandre

Background: Medicine has been gaining high technological power, essential for many diagnoses and current treatments. On the other hand, one observes the distancing of the physician from what should be his instrument of work: the person.  Bahiana School of Medicine has been implementing actions aimed at integrating the student into the subjective elements of medical practice through such subjects as the Psychodynamics of the Medical Clinic. Objectives: To portray the reality of the teaching of the discipline Psychodynamics in the Bahiana School of Medicine and Public Health; to evaluate the performance of the psychodynamic material taught in the 7th semester of the medical course, as well as the need to teach humanistic fundamentals to the student community of this school. Methods: Case study conducted through documentary analysis, interview with professor of the subject and application of questionnaire. After approval by the Ethics Committee, questionnaires containing sex, age, year of the course, questions related to the subjects developed in the subject were applied, such as doctor-patient relationship, death and dying, medical vocation and humanization etc. Results: The goal of psychodynamics is to provide an integral view of the patient. The questionnaires were answered by 124 students distributed between the 4th, 5th and 6th grades. 88.7% agreed that the subject provided grounds for establishing an effective physician-patient relationship. 91.2% agreed that the subject drew attention to the therapeutic aspect that can have the doctor-patient relationship. 99.2% agree that in order to meet humanity, it is first necessary to humanize. 86.3% of the students agree on the need to teach humanistic fundamentals throughout the course. Conclusions:A Psicodinâmica da Clínica médica vem atingindo os objetivos propostos. Há necessidade do ensino de fundamentos humanísticos durante todo curso de medicina.Background:Medicine has been gaining high technological power, essential for many diagnoses and current treatments. On the other hand, one observes the distancing of the physician from what should be his instrument of work: the person.  Bahiana School of Medicine has been implementing actions aimed at integrating the student into the subjective elements of medical practice through such subjects as the Psychodynamics of the Medical Clinic. Objectives:To portray the reality of the teaching of the discipline Psychodynamics in the Bahiana School of Medicine and Public Health; to evaluate the performance of the psychodynamic material taught in the 7th semester of the medical course, as well as the need to teach humanistic fundamentals to the student community of this school. Methods: Case study conducted through documentary analysis, interview with professor of the subject and application of questionnaire. After approval by the Ethics Committee, questionnaires containing sex, age, year of the course, questions related to the subjects developed in the subject were applied, such as doctor-patient relationship, death and dying, medical vocation and humanization etc. Results: The goal of psychodynamics is to provide an integral view of the patient. The questionnaires were answered by 124 students distributed between the 4th, 5th and 6th grades. 88.7% agreed that the subject provided grounds for establishing an effective physician-patient relationship. 91.2% agreed that the subject drew attention to the therapeutic aspect that can have the doctor-patient relationship. 99.2% agree that in order to meet humanity, it is first necessary to humanize. 86.3% of the students agree on the need to teach humanistic fundamentals throughout the course. Conclusions: A Psicodinâmica da Clínica médica vem atingindo os objetivos propostos. Há necessidade do ensino de fundamentos humanísticos durante todo curso de medicina.


2006 ◽  
Author(s):  
Luigi Anolli ◽  
Fabrizia Mantovani ◽  
Alessia Agliati ◽  
Olivia Realdon ◽  
Valentino Zurloni ◽  
...  

1987 ◽  
Vol 12 (1) ◽  
pp. 55-97 ◽  
Author(s):  
Fran Carnerie

AbstractMany individuals develop a temporary state of cognitive and emotional impairment after being diagnosed with catastrophic illness. Thus, when crucial decisions about medical treatment are required, they are unable to assimilate information; or worse, the legal need to be informed can rival a psychological desire to not be informed. The Canadian informed consent doctrine is unresponsive to crisis and clinically impracticable, and so paradoxically compromises the integrity and autonomy it was designed to protect. Many aspects of the physician-patient relationship and clinical setting also undermine the philosophical values enshrined in this doctrine. This further jeopardizes the individual's integrity. The Article explores proposals for change such as delaying the informing and consenting, improving the concept of consent, and improving the role of the physician.


2021 ◽  
pp. bmjspcare-2020-002764
Author(s):  
Catherine Owusuaa ◽  
Irene van Beelen ◽  
Agnes van der Heide ◽  
Carin C D van der Rijt

ObjectivesAccurate assessment that a patient is in the last phase of life is a prerequisite for timely initiation of palliative care in patients with a life-limiting disease, such as advanced cancer or advanced organ failure. Several palliative care quality standards recommend the surprise question (SQ) to identify those patients. Little is known about physicians’ views on identifying and disclosing the last phase of life of patients with different illness trajectories.MethodsData from two focus groups were analysed using thematic analysis with a phenomenological approach.ResultsFifteen medical specialists and general practitioners participated. Participants thought prediction of patients’ last phase of life, i.e. expected death within 1 year, is important. They seemed to find that prediction is more difficult in patients with advanced organ failure compared with cancer. The SQ was considered a useful prognostic tool; its use is facilitated by its simplicity but hampered by its subjective character. The medical specialist was considered mainly responsible for prognosticating and gradually disclosing the last phase. Participants’ reluctance to such disclosure was related to uncertainty around prognostication, concerns about depriving patients of hope, affecting the physician–patient relationship, or a lack of time or availability of palliative care services.ConclusionsPhysicians consider the assessment of patients’ last phase of life important and support use of the SQ in patients with different illness trajectories. However, barriers in disclosing expected death are prognostic uncertainty, possible deprivation of hope, physician–patient relationship, and lack of time or palliative care services. Future studies should examine patients’ preferences for those discussions.


Sign in / Sign up

Export Citation Format

Share Document