Improving the Doctor-Patient Relationship in China: The Role of Balint Groups

2013 ◽  
Vol 46 (4) ◽  
pp. 417-427 ◽  
Author(s):  
Wei Jing ◽  
Heide Otten ◽  
Leonie Sullivan ◽  
Laurie Lovell-Simons ◽  
Martine Granek-Catarivas ◽  
...  
1972 ◽  
Vol 3 (4) ◽  
pp. 287-301 ◽  
Author(s):  
E. D. Wittkower ◽  
W. J. Stauble

The psychiatric role of the general practitioner covers a wide field and depends crucially upon his efforts to understand himself, his patient, and the doctor-patient relationship. The patient must be approached in terms of how he is affected emotionally by physical illness, and how his state of physical health is affected by his emotions. His behavior during initial stages of physical illness, his reaction to the diagnosis, and his feelings and interactions during the full-blown stages of illness are important areas for the doctor to explore in order to deal more effectively with a patient's withdrawal, depression, narcissism, frustration, or anxiety. The doctor must also explore his own motivations for choosing the medical profession in order to implement his role in caring for patients. Each of the models of the doctor-patient relationship–activity-passivity, guidance-cooperation, mutual participation-requires different degrees of emotional involvement on the part of the doctor. An understanding of the psychodynamics of this relationship, involving the attitudes and conflicts of both members, can help the general practitioner to handle effectively and successfully his patients in everyday practice. Practical suggestions are made for teaching psychological concepts to general physicians: improved courses in psychiatry in medical schools, emphasizing the “whole person” approach; ongoing seminars for doctors in practice–“Balint Groups”–in which the aim is to understand the nature of the patient's emotional conflicts, the doctor-patient relationship, and the part the doctor plays in it; refresher courses; and consultations with psychiatrists.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S342-S342
Author(s):  
Anu Priya ◽  
Hardev Bhogal

AimsTo evaluate feedback from Balint style case based discussion groups and to reflect on learning points.We have three medical students from Sheffield University on six week psychiatry placements at Bassetlaw Hospital and we get eighteen students in a year. In order to further develop their approach towards reflection and their understanding towards the doctor patient relationship we developed the Balint style case based discussion group, and each group of students attend three sessions during their placement.MethodThe groups are held on a weekly basis and consist of the three medical students and 1-2 facilitators. As the group is small one of the facilitators may participate with the students for the Balint process and to help encourage the students. Following completion of the third session of the discussion group we gain written feedback from the students. A total of 17 feedbacks have been reviewed over the period of November 2018 -November 2019.Result16 students stated that this was their first experience at Balint Group and all except one student felt that they were given a good introduction about Balint groups before starting. When asked about the most significant thing that they have learnt in the group, the majority of students marked reflecting feelings to improve relationships with patients, exploring why they feel a certain way with patients and that the doctor patient relationship can affect the consultation.One student stated that they would not recommend it to colleagues as they felt it was relevant more to doctors rather than medical students. Another student recommended having more people in a group.ConclusionOverall, it has been a positive experience with the medical students during the groups and with feedbacks. We have reflected on difficult topics like bereavement, fantasized about the purpose of a patient's delusion and shared the joy of a patient who was discharged after a long stay. While we think we have been able to teach the students some tips on reflection, we ourselves have been able to reflect on certain topics we would not have if not raised by the students. Some medical students have contacted the larger Balint Group in Sheffield for further sessions. Considering our experience, we will continue with the sessions at Bassetlaw Hospital.


2018 ◽  
Vol 6 (10) ◽  
pp. 1895-1901 ◽  
Author(s):  
Ahmad Kalateh Sadati ◽  
Seyed Ziauddin Tabei ◽  
Kamran Bagheri Lankarani

BACKGROUND: Doctor-patient relationship [DPR] refers to verbal and non-verbal communication between doctor and patient, which is of great importance in consultation sessions. AIM: Therefore, the present study attempts to explore the importance and value of DPR in Iran. MATERIAL AND METHODS: The method used in the study was conventional content analysis. The data were collected from 21 faculty members (FMs) of Shiraz University of Medical Sciences (SUMS), Shiraz, Iran, who participated in three focus group discussions (FGDs). Transcribed data were analysed using Conventional Content Analysis (CCA) which identified condensed meaning units, subthemes, and themes. RESULTS: Four themes were extracted from 198 meaning units, 87 condensed meaning units, and 17 subthemes. These included gateway [the role of DPR]; nonlinearity [the nature of DPR]; distortion (quality of DPR in the context); and dysfunctional system (weakness in health system). Generally, results showed DPR to be the gateway to consultations based on non-verbal communication and doctor empathy. The study showed distorted DPR which was due to the dysfunctionality of the health care system. CONCLUSION: As indicated DPR plays an important role in medical contexts, but if distorted it leads to an unsuccessful outcome. Therefore, to promote DPR, it is necessary to reinforce its structure. Thus, the infrastructure has to be modified and developed at all levels.


2017 ◽  
Vol 41 (S1) ◽  
pp. S683-S683 ◽  
Author(s):  
I. Ferraz ◽  
A. Guedes

The doctor-patient relationship (DPR) is very ill; it is in need of emergency assistance. Although there have been change in this relationship, no current model is satisfying. In 1972, Robert Veatch defined some models of DPR. Likewise, Pierloot, in 1983, and Balint, in 1975 and ultimately, Mead and Bower, 2000 with the model of Person-center-care (PCC) medicine.ObjectiveEvaluate the different kinds of DPR described in the literature and propose an abduction-based model of the Servant DPR, in which patients are protagonists in their treatment.MethodsPubmed literature review of the last forty years with the keyword ‘physician-patient relations’.DiscussionWhile nursing care advanced in its professional efficacy through Watson's human care and through the leader servant model, the DPR models demonstrated that the doctors are lost in their posture, even feeling as abused heroes. Models that include the patient in decision-making and that value the patient as a person (PCC) promise a revolution in the medical realm. Nevertheless, the PCC model is not enough to heal the DPR itself, because the role of the doctor must be changed to adapt to the relationship, otherwise, the PCC by itself can increase the burden upon the doctor. Doctors with a role of remunerated servant (not slave), like any other professional who delivers a service with excellence, focusing in the main actor, the patient, can heal the DPR.ConclusionThe Servant DPR gives a positive counter transference, increasing the doctor's motivation and giving him back the sense of purpose in medicine, increasing the health system's effectiveness.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2012 ◽  
Vol 98 (6) ◽  
pp. e152-e154
Author(s):  
Enrico Aitini ◽  
Paola Bordi ◽  
Chiara Dell'Agnola ◽  
Elisa Fontana ◽  
Wanda Liguigli ◽  
...  

The role of classical literature on the subject of pain and suffering in cancer and other serious illnesses, not only from the point of view of patients but also of hospital personnel, family, friends and family doctors, has not been deeply exploited to favor the human and professional experience of young and not so young oncologists. This manuscript is the result of an effort made by postgraduate students and faculty members at the School of Oncology at Parma University to review the literature on this subject. The aim of our work is to convey the message that before teaching relationship techniques it is important to instill a culture focused on the doctor-patient relationship. Classical literature can make an important contribution to awareness in this area.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S259-S259
Author(s):  
Sudha Jain ◽  
Emma Adams ◽  
Alyson Lee

Aims1. To compare the experience of psychiatric trainees in Ireland of online Balint Groups (BG) in contrast to face to face groups.2. To assess the general attitudes of trainees to BG using the Psychological Medical Inventory (PMI) (Ireton and Sherman, 1988) scale.MethodAn online survey comprising two sections: 1. A questionnaire exploring participants experience, effectiveness and obstacles to attending the two formats of BG with a free text box response. 2. General attitude of trainees towards BG using PMI scale.An online cross-sectional survey using Survey Monkey. An invitation to participate in the survey was emailed to all trainees by the College of Psychiatrists in Ireland. All data were anonymised, and all data processing was conducted in line with GDPR. Statistical analysis was undertaken using Microsoft Excel. Thematic analysis was applied to the free-text box responses.Result16.49% (64/388) responded to the survey. Responses were uniform across all stages of training. 97% of respondents attended BG; 72% attended both formats, 25% attended only face-to-face and 3% online only. 65% of respondents preferred face to face compared to 18% online, whilst 11% stated no preference.On thematic analysis, trainees asserted a preference for face-to-face, describing better group cohesion, feeling safer to share, increased ease of interpreting non-verbal communication, and that conversation was more fluid. They described greater ease of engagement with the group/facilitator and preferred direct social interaction with peers.Conversely, most trainees acknowledged that online groups were convenient to attend, less time consuming & mitigated COVID risk associated with face-to-face meetings. Common themes against the use of online groups were: less psychotherapeutic in nature, technical issues, silences, unable to see participants faces and as though speaking “into the void”.Regarding trainees' attitudes to attending BG, most of the trainees found BG had been beneficial in developing more interest and confidence in dealing with the psychological aspects of patient care. Trainees agreed that skills improved in developing an excellent doctor-patient relationship, recognising patients under stress/ in distress, systemically obtaining psychological information and making treatment decisions based upon psychological needs and psychotherapeutic engagement. They agreed that they could better understand the influence of doctors' emotions on the doctor-patient relationship.ConclusionThis survey showed that most trainees find BG beneficial in developing better doctor-patient relationships, preferring face-to-face rather than online BG. However, they found online more convenient. A blended learning approach could provide trainees with the benefits of both formats of BG.


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