scholarly journals Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Eduardo Lazcano-Ponce ◽  
Angelica Angeles-Llerenas ◽  
Rocío Rodríguez-Valentín ◽  
Luis Salvador-Carulla ◽  
Rosalinda Domínguez-Esponda ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Healthcare Professionals ◽  
Communication Patterns ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Open Communication ◽  
Explicit Communication

Abstract Background Paternalism/overprotection limits communication between healthcare professionals and patients and does not promote shared therapeutic decision-making. In the global north, communication patterns have been regulated to promote autonomy, whereas in the global south, they reflect the physician’s personal choices. The goal of this study was to contribute to knowledge on the communication patterns used in clinical practice in Mexico and to identify the determinants that favour a doctor–patient relationship characterized by low paternalism/autonomy. Methods A self-report study on communication patterns in a sample of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were used to analyse paternalism and associated factors. Results A high prevalence (68.7% [95% CI 60.0–70.5]) of paternalism was observed among mental health professionals in Mexico. The main determinants of low paternalism/autonomy were medical specialty (OR 1.67 [95% CI 1.16–2.40]) and gender, with female physicians being more likely to explicitly share diagnoses and therapeutic strategies with patients and their families (OR 1.57 [95% CI 1.11–2.22]). A pattern of highly explicit communication was strongly associated with low paternalism/autonomy (OR 12.13 [95% CI 7.71–19.05]). Finally, a modifying effect of age strata on the association between communication pattern or specialty and low paternalism/autonomy was observed. Conclusions Among mental health professionals in Mexico, high paternalism prevailed. Gender, specialty, and a pattern of open communication were closely associated with low paternalism/autonomy. Strengthening health professionals’ competencies and promoting explicit communication could contribute to the transition towards more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future.

scholarly journals Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico.

2020 ◽  
Author(s):  
Eduardo Lazcano-Ponce ◽  
Angelica Angeles-Llerenas ◽  
Rocío Rodríguez-Valentín ◽  
Luis Salvador-Carulla ◽  
Rosalinda Domínguez-Esponda ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Healthcare Professionals ◽  
Mental Healthcare ◽  
Communication Patterns ◽  
Self Report ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Open Communication ◽  
Ethical Implications ◽  
Explicit Communication

Abstract Background: Paternalism/overprotection limits communication between healthcare professionals and patients and does not promote shared therapeutic decision-making. In the global north, communication patterns have been regulated to promote autonomy, whereas in the global south, they reflect the physician’s personal choices. The goal of this work was contribute to knowledge of the communication patterns used in clinical practice in Mexico and to identify the determinants that favour a doctor-patient relationship characterized by low paternalism/autonomism. Methods: A self-report study of communication patterns within a sample of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were performed to analyse paternalism and associated factors. Results: A high prevalence (68.7% [95% CI 60.0-70.5]) of paternalism was observed among mental healthcare professionals in Mexico. The main determinants of low paternalism/autonomism were medical specialty (OR 1.67 [95% CI 1.16-2.40]) and gender, with female physicians more likely to explicitly share diagnoses and therapeutic strategies with patients and their families (OR 1.57 [95% CI 1.11-2.22]). A pattern of highly explicit communication was strongly associated with low paternalism/autonomism (OR 12.13 [95% CI 7.71-19.05]). Finally, a modifying effect of age strata on the association between communication pattern or specialty and low paternalism/autonomism was observed. Conclusions: Among mental healthcare professionals in Mexico, an elevated paternalism prevailed. Gender, specialty, and a pattern of open communication were closely associated with low paternalism/autonomism. Strengthening the competencies of health professionals and promoting explicit communication could contribute to the transition towards more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future.

scholarly journals Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico.

2020 ◽  
Author(s):  
Eduardo Lazcano-Ponce ◽  
Angelica Angeles-Llerenas ◽  
Rocío Rodríguez-Valentín ◽  
Luis Salvador-Carulla ◽  
Rosalinda Domínguez-Esponda ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Healthcare Professionals ◽  
Mental Healthcare ◽  
Communication Patterns ◽  
Self Report ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Open Communication ◽  
Ethical Implications ◽  
Explicit Communication

Abstract Background: Paternalism/overprotection limits communication between healthcare professionals and patients and does not promote shared therapeutic decision-making. In the global north, communication patterns have been regulated to promote autonomy, whereas in the global south, they reflect the physician’s personal choices. The goal of this work was contribute to knowledge of the communication patterns used in clinical practice in Mexico and to identify the determinants that favour a doctor-patient relationship characterized by low paternalism/autonomy.Methods: A self-report study of communication patterns within a sample of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were performed to analyse paternalism and associated factors. Results: A high prevalence (68.7% [95% CI 60.0-70.5]) of paternalism was observed among mental healthcare professionals in Mexico. The main determinants of low paternalism/autonomy were medical specialty (OR 1.67 [95% CI 1.16-2.40]) and gender, with female physicians more likely to explicitly share diagnoses and therapeutic strategies with patients and their families (OR 1.57 [95% CI 1.11-2.22]). A pattern of highly explicit communication was strongly associated with low paternalism/autonomy (OR 12.13 [95% CI 7.71-19.05]). Finally, a modifying effect of age strata on the association between communication pattern or specialty and low paternalism/autonomy was observed.Conclusions: Among mental healthcare professionals in Mexico, an elevated paternalism prevailed. Gender, specialty, and a pattern of open communication were closely associated with low paternalism/autonomy. Strengthening the competencies of health professionals and promoting explicit communication could contribute to the transition towards more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future.

scholarly journals Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico

2020 ◽  
Author(s):  
Eduardo Lazcano-Ponce ◽  
Angelica Angeles-Llerenas ◽  
Rocío Rodríguez-Valentín ◽  
Luis Salvador-Carulla ◽  
Rosalinda Domínguez-Esponda ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Healthcare Professionals ◽  
Mental Healthcare ◽  
Medical Specialty ◽  
Communication Patterns ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Open Communication ◽  
Therapeutic Decisions ◽  
Explicit Communication

Abstract Background Paternalism/overprotection limits communication between the healthcare professionals and patients and does not promote shared therapeutic decisions. In developed countries, communication patterns have been regulated to promote autonomy, whereas in developing countries, they reflect the physician’s personal choice. The goal of this work was contribute to knowledge of communication patterns used in the clinical practice in Mexico, and identify the determinants that favor a low paternalist/autonomist doctor-patient relationship. Methods A self-report study of communication patterns within a sample of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were performed to analyze paternalism and associated factors. Results A high prevalence (68.7% [95% CI 60.0-70.5) of paternalism was observed among mental healthcare professionals in Mexico. The main determinants of low paternalism/autonomism were the medical specialty (OR 1.67 [95% CI 1.16-2.40]) and the sex, whereby female physicians were more likely to explicitly share diagnoses and therapeutic strategies with patients and their families (OR 1.57 [95% CI 1.11-2.22]). A pattern of highly explicit communication was strongly associated with low paternalism/autonomism (OR 12.13 [95% CI 7.71-19.05]). Finally, a modification effect of age strata on association between communication pattern or speciality and low paternalism/autonomism was observed. Conclusions Among mental healthcare professionals in Mexico, an elevated paternalism prevailed. Sex, medical specialty, and a pattern of open communication were closely associated with low paternalism/autonomism. Strengthening the competencies of health professionals and promoting explicit communication could contribute to achieving a transition towards a more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future.

scholarly journals Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico.

2020 ◽  
Author(s):  
Eduardo Lazcano-Ponce ◽  
Angelica Angeles-Llerenas ◽  
Rocío Rodríguez-Valentín ◽  
Luis Salvador-Carulla ◽  
Rosalinda Domínguez-Esponda ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Healthcare Professionals ◽  
Mental Healthcare ◽  
Communication Patterns ◽  
Self Report ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Open Communication ◽  
Ethical Implications ◽  
Explicit Communication

Abstract Background: Paternalism/overprotection limits communication between healthcare professionals and patients and does not promote shared therapeutic decision-making. In the global north, communication patterns have been regulated to promote autonomy, whereas in the global south, they reflect the physician’s personal choices. The goal of this work was contribute to knowledge of the communication patterns used in clinical practice in Mexico and to identify the determinants that favour a doctor-patient relationship characterized by low paternalism/autonomy.Methods: A self-report study of communication patterns within a sample of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were performed to analyse paternalism and associated factors. Results: A high prevalence (68.7% [95% CI 60.0-70.5]) of paternalism was observed among mental healthcare professionals in Mexico. The main determinants of low paternalism/autonomy were medical specialty (OR 1.67 [95% CI 1.16-2.40]) and gender, with female physicians more likely to explicitly share diagnoses and therapeutic strategies with patients and their families (OR 1.57 [95% CI 1.11-2.22]). A pattern of highly explicit communication was strongly associated with low paternalism/autonomy (OR 12.13 [95% CI 7.71-19.05]). Finally, a modifying effect of age strata on the association between communication pattern or specialty and low paternalism/autonomy was observed.Conclusions: Among mental healthcare professionals in Mexico, an elevated paternalism prevailed. Gender, specialty, and a pattern of open communication were closely associated with low paternalism/autonomy. Strengthening the competencies of health professionals and promoting explicit communication could contribute to the transition towards more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future.

Psychiatric Ethics

2021 ◽  
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Child And Adolescent Psychiatry ◽  
Social Contexts ◽  
Psychiatric Research ◽  
Liaison Psychiatry

Ethical issues inherent in psychiatric research and clinical practice are invariably complex and multifaceted. Well-reasoned ethical decision-making is essential to deal effectively with patients and enhance their care. Drawing on the positive reception of Psychiatric Ethics since its first publication in 1981, this highly anticipated fifth edition offers psychiatrists and other mental health professionals a coherent guide to dealing with the diverse ethical issues that challenge them. This edition has been substantially updated to reflect the many changes that have occurred in the field during the past decade. Its 25 chapters are grouped in three sections, as follows: 1) clinical practice in child and adolescent psychiatry, consultation-liaison psychiatry, psychogeriatrics, community psychiatry, and forensic psychiatry; 2) relevant basic sciences such as neuroethics and genetics; and 3) philosophical and social contexts including the history of ethics in psychiatry and the nature of professionalism. Principal aspects of clinical practice in general, such as confidentiality, boundary violations, and involuntary treatment, are covered comprehensively, as is a new chapter on diagnosis. Given the contributors’ expertise in their respective fields, Psychiatric Ethics will undoubtedly continue to serve as a significant resource for all mental health professionals, whatever the role they play in psychiatry. It will also benefit students of moral philosophy in their professional pursuits.

Fundamentals of Neurobiology

2018 ◽  
pp. 17-28
Author(s):  
S. Nassir Ghaemi
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Hepatic Metabolism ◽  
Basic Knowledge ◽  
Manic Depressive ◽  
Psychiatric Conditions ◽  
Clinical Pictures ◽  
The Brain

This chapter examines the basic pharmacology of psychotropic drugs. Besides knowing what drugs do to certain chemicals or proteins in the brain, it is important to know where drugs affect those chemicals or proteins. There is some basic knowledge about neuroanatomy that is relevant to the clinical practice of psychopharmacology. It is accepted that neurobiology is an important factor in the etiology and pathophysiology of major psychiatric conditions—like schizophrenia and manic-depressive disease, as well as in other psychiatric clinical pictures. The general summary usually provided is that neurobiology represents a diathesis to psychiatric conditions, which is supplemented by environmental stress to produce observed clinical pictures. This mixture of genetics and environment is oversimplified in the minds of most mental health professionals. In fact, the mix depends on the illness. The biochemical neuroanatomy of the monoamines, glutamate, and GABA in the brain are discussed. Pharmacokinetic aspects of psychopharmacology are reviewed, including hepatic metabolism, drug half-lives, dosing, and tolerance and sensitization.

Smart Phone Applications in Clinical Practice

2013 ◽  
Vol 35 (4) ◽  
pp. 283-295 ◽  
Author(s):  
Joel Epstein ◽  
Amanda Bequette
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Mobile Devices ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Smart Phone ◽  
Computing Power ◽  
Advantages And Disadvantages ◽  
The Future

Smart phone usage has greatly increased in recent years. Not only has the computing power of these mobile devices dramatically improved but so has the variety of functions they can accomplish—an amazing array of tasks that once would have been considered remarkable. Historically, mental health professionals have been quick to embrace smart phone technology and there are now literally hundreds of applications for practitioners and clients alike. This article discusses the advantages and disadvantages of using smart phone technology in clinical practice and considers the implications for the future of clinical practice.

Issues in Planned and Unplanned Disruptions in Clinical Practice

2017 ◽  
pp. 537-547
Author(s):  
A. Steven Frankel
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Negative Impact ◽  
Family Members ◽  
Best Interests ◽  
Significant Negative Impact ◽  
Insurance Model

Disruptions in clinical practice that are not adequately planned for can have a significant negative impact on clients, family members, and colleagues. This chapter addresses the problem of unanticipated disruptions in clinical practice due to death, disability, and illness. Challenges associated with each of these situations are illustrated. Proactive and thoughtful ways of preparing for them are presented. Topics include the professional will (with descriptions of needed elements), approaches involving groups of cooperative colleagues, and a “quasi-insurance model” that was developed because many mental health professionals have not embraced the first two approaches. Recommendations for addressing these situations with our clients’ best interests in mind are presented.

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