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Resumo: Introdução: Como um componente substancial na relação médico-paciente, a comunicação pode ser determinante na construção da hipótese diagnóstica e na adesão ao tratamento por parte do paciente, e, por isso, há a necessidade de compreender os fatores que influenciam no processo comunicativo e descrever a efetividade dele. Objetivo: Este estudo teve como objetivo avaliar os impactos da comunicação inadequada na relação médico-paciente. Método: Vinte e três pacientes voluntários com a maioridade atingida preencheram questionários de informações socioeconômicas, uso da linguagem e impressões da consulta médica. O médico preencheu um questionário sobre a experiência da consulta. Resultado: Os resultados indicaram que os pacientes apresentaram alguma dificuldade em comunicar ao médico o que sentiam, e, de modo complementar, os médicos, em 20% dos casos, tiveram algum grau de dificuldade de chegar à hipótese diagnóstica a partir do relato do paciente, o que se relaciona com a linguagem pouco descritiva utilizada pela maior parte dos pacientes. Conclusão: Dada a necessidade da qualidade da comunicação entre o médico e o paciente, conhecer os fatores que impactam o processo comunicativo é o primeiro passo para a garantia de um atendimento eficaz com autonomia do paciente e maior adesão ao plano terapêutico.
Abstract: Introduction: As a substantial component of the doctor-patient relationship, communication can be crucial in the construction of a diagnostic hypothesis and patient adherence to treatment. It is therefore necessary to understand the factors that influence the communicative process and describe the effectiveness of the communication. Objective: The aim of this study is to evaluate the impacts of inadequate communication in the doctor-patient relationship. Method: Twenty-three voluntary patients of legal age completed questionnaires on socioeconomic information, language use, and impressions of the medical consultation. The doctor filled out a questionnaire regarding their experience of the consultation. Result: The results indicated that patients experienced some difficulty in communicating their feelings to the doctor, and furthermore, in 20% of cases, doctors encountered some degree of difficulty in reaching a diagnostic hypothesis based on the patient's report, which is related to the predominantly non-descriptive language used by most patients. Conclusion: Given the need for high quality communication between the doctor and the patient, understanding the factors that impact the communicative process is the first step towards ensuring effective care with patient autonomy and improved adherence to the treatment plan.
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Introducción: La comunicación por parte del logofonoaudiólogo con el paciente afásico y su familia garantiza el bienestar biopsicosocial de estos y favorece una adecuada relación médico-paciente. Objetivo: Evaluar una propuesta de estrategia para el fomento del principio de beneficencia entre el logofonoaudiólogo, el paciente afásico y su familia en el Policlínico Universitario Dr. René Vallejo Ortiz, ciudad de Manzanillo, Granma, Cuba. Método: Fue aplicada la técnica de Iadov o criterio de usuario que permitió evaluar la propuesta. Para ello se encuestaron 15 logofonoaudiólogos de la provincia de Granma, Cuba, se escogieron de manera intencional 10, cuyas cualidades cumplían los requisitos exigidos para ser considerados usuarios. Se utilizaron diferentes métodos, técnicas y procedimientos para procesar y analizar los datos recogidos. La escala valorativa Likert facilitó la interpretación cualitativa de los datos recogidos. Resultados: Desde el criterio individual el 60 % de los usuarios consideró la propuesta bastante adecuada; la valoración más baja fue de adecuada (20 %). El cálculo de la valoración grupal, el índice obtenido (0,5 %) le confirió confiabilidad a la propuesta para ser implementada. Conclusiones: Los usuarios consideran que la propuesta de estrategia cumple con los requisitos para la aplicación. No obstante, existen algunos elementos que pudieran dificultar la ejecución de la misma: la incorrecta preparación científico-metodológica de los facilitadores, el uso inadecuado de los métodos y técnicas educativas, así como la negativa de aquellos logofonoaudiólogos que no concienticen la necesidad de alcanzar modos de actuación acorde a los principios y valores profesionales.
Introduction: Communication by the speech-language pathologist with the aphasic patient and his family guarantees their biopsychosocial well-being and promotes an adequate doctor-patient relationship. Objective: To evaluate a proposed strategy to promote the principle of beneficence between the speech-language pathologist, the aphasic patient and their family at the Policlínico Universitario Dr. René Vallejo Ortiz, Manzanillo city, Granma province, Cuba. Method: The Iadov technique or user criteria was applied that allowed the proposal to be evaluated. For this, 15 speech-language pathologists from the province of Granma, were surveyed; 10 were intentionally chosen, whose qualities met the requirements to be considered users. Different methods, techniques and procedures were used to process and analyze the data collected. The Likert rating scale facilitated the qualitative interpretation of the data collected. Results: From individual criteria, 60% of users considered the proposal quite appropriate; the lowest rating was adequate (20%). The calculation of the group assessment, the index obtained (0.5%) conferred reliability to the proposal to be implemented. Conclusions: Users consider that the strategy proposal meets the requirements for the application. However, there are some elements that could make its execution difficult: the incorrect scientific-methodological preparation of the facilitators, the inappropriate use of educational methods and techniques, as well as the refusal of those speech-language pathologists who do not raise awareness of the need to achieve methods. of action in accordance with professional principles and values.
Introdução: A comunicação do fonoaudiólogo com o paciente afásico e sua família garante o seu bem-estar biopsicossocial e promove uma adequada relação médico-paciente. Objetivo: Avaliar uma proposta de estratégia para promover o princípio da beneficência entre o fonoaudiólogo, o paciente afásico e sua familia na Policlínico Universitario Dr. René Vallejo Ortiz, cidade de Manzanillo, Granma, Cuba. Método: Foi aplicada a técnica de Iadov ou critérios de usuário que permitiram avaliar a proposta. Para isso, foram entrevistados 15 fonoaudiólogos da província de Granma, foram escolhidos 10 intencionalmente, cujas qualidades atendiam aos requisitos para serem considerados usuários. Diferentes métodos, técnicas e procedimentos foram utilizados para processar e analisar os dados coletados. A escala de classificação Likert facilitou a interpretação qualitativa dos dados coletados. Resultados: A partir de critérios individuais, 60% dos usuários consideraram a proposta bastante adequada; a classificação mais baixa foi adequada (20%). No cálculo da avaliação do grupo, o índice obtido (0,5%) conferiu confiabilidade à proposta a ser implementada. Conclusões: Os usuários consideram que a proposta de estratégia atende aos requisitos para aplicação. Porém, existem alguns elementos que podem dificultar sua execução: o incorreto preparo científico-metodológico dos facilitadores, o uso inadequado de métodos e técnicas educativas, bem como a recusa dos fonoaudiólogos que não conscientizam sobre o necessidade de alcançar métodos de ação de acordo com princípios e valores profissionais.
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From an ethical point of view, the ethical characteristics of the consciousness of the Chinese national community contain an ethical starting point based on "love"; ethical path with "people first" as the core; ethical vision for the purpose of "prosperity". The consciousness of the Chinese national community greatly conforms to the teaching objectives and teaching content of medical ethics. Therefore, medical ethics teaching from the perspective of the Chinese national community should implement the fundamental task of helping students develop good morals and enhance the moral quality of "love"; take the "community of doctor-patient destiny" as the starting point of education and build the concept of "people first"; strengthen the country’s sense of responsibility of "prosperity and strength" and establish the mission of "rooting and maintaining health at the grassroots level", build a strong consciousness of the Chinese national community.
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In Qing Dynasty, doctor-patient relationship in the imperial court had distinct characteristics because of the particularity of the objects of diagnosis and treatment. Diaries of famous doctors has become an important research material from a unique perspective. Ji En Lu and Bei Xing Ri Ji contain many research materials on doctor-patient relationship in Qing Palace. By systematically sorting out the contents of the royal doctor-patient relationship in the two diaries, and analyzing them in detail from the three dimensions of doctors, patients and diagnosis and treatment situations, it can be known that patients’ strong performance will interfere with the diagnosis and treatment process to a great extent, and doctors’ low status makes it difficult for them to cope with the complicated diagnosis and treatment environment and affects the curative effect. Learn from the past and the present, further provide reference for the current patient strong special doctor-patient relationship.
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Medical Artificial Intelligence (AI) makes the traditional doctor-patient relationship present a new pattern, but also highlights many ethical problems: inability to protect the rights and interests of patients, weakening the main responsibility of medical personnel, weakening the practical ability of medical personnel, and challenging the main status of medical personnel, etc.. It is necessary to improve relevant laws, regulations and regulatory system, adhere to the main status of medical personnel, improve the public awareness and acceptance of medical AI, and strengthen the construction of ethical system of AI, so as to deal with the ethical anomie caused by intelligent medical treatment and promote the harmonious development of doctor-patient relationship. It is expected that through the combination of AI and professional ethics principles, AI will be brought into daily clinical practice responsibly, to provide patients with better medical services.
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In the Nicomachean Ethics, Aristotle expounded his thoughts on health by analogy. Through summarizing Aristotle’s main thoughts on health, which including clarifying that the purpose of medicine is health, thinking that only moderation can create, promote and maintain health, emphasizing active-passive doctor-patient relationship, and generally respecting medical discipline and healthy life, this paper founded that his thoughts on health have obvious limitations. The limitations included: ignored the purpose of medicine also included group health; the "moderation" theory lacked accuracy and scientificity; weakened the patient’s right to speak in the doctor-patient relationship and did not give a clear guide to "how to live a healthy life". And then explored the enlightenment of Aristotle’s health thoughts to the development of contemporary society.
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The communication between professional health caregivers, which mainly composed of medical staff, and patients and their families plays an important role in hospice care. The effective doctor-patient communication can guide terminal patients and their families to establish a correct medical view, reduce excessive medical treatment, and improve the quality of life for terminal patients. This paper briefly described the communication context of hospice care, the communication subject and the current situation of hospice care, analyzed the problems and challenges encountered by professional health caregivers, which mainly including medical staff, in the communication context of hospice care diagnosis and hospice care, and made the prospects of the development of effective communication measures.
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Ethical sensitivity is a behavioral concept emerging in recent years, which has attracted high attention from all sectors of society. Ethical sensitivity not only affects the clinical decision-making, doctor-patient relationship and medical quality of medical staff, but also provides the possibility to identify, predict and solve ethical problems in clinical. Combined with previous studies, this paper analyzed the current situation of ethical sensitivity of medical personnel in China, and took pediatric medical staff as an example to analyze the factors affecting the ethical sensitivity of medical staff from clinical practice and related theories, including age, working years, occupational categories, education level, work environment, empathy ability, etc. At the same time, this paper analyzed the causes of the ethical sensitivity of medical staff from the perspective of clinical practice and related systems, and put forward corresponding countermeasures, so as to improve the ethical sensitivity of medical staff and help to build a harmonious doctor-patient relationship.
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By introducing the connotation of deductive teaching and analyzing the significance of early contact clinical course of "doctor-patient communication", the author reinterpreted the educational concept of deductive teaching combined with the characteristics of medical humanities, and reformed the early contact clinical course of "doctor-patient communication" by introducing deductive teaching method. Taking the early contact clinical course of "doctor-patient communication" of a medical university as an example, the teaching framework was designed to share experience from three aspects: teaching content, teaching process and teaching effect evaluation. At the same time, combined with the characteristics of the course and the needs of students, found out the problems encountered in the teaching process, and put forward constructive opinions and strategies, in order to provide theoretical and practical reference for the teaching of medical humanities course.
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To construct a simple and two-way interactive doctor-patient communication mode, in order to provide guidance tools for doctor-patient communication, improve the effectiveness of doctor-patient communication for cancer patients, optimize medical experience, reduce doctor-patient disputes, and provide new perspectives and ideas for the study of doctor-patient communication. Literature review and qualitative research were used to construct the index framework of ESER doctor-patient communication model, and Delphi method was used to revise and improve the index content, and evaluate its reliability and validity. The results showed that after two rounds of expert letter consultation, the final ESER doctor-patient communication mode was established, including 4 primary-level indicators, 8 second-level indicators and 40 third-level indicators. The positive coefficient of experts was 100% in both rounds. The authority coefficient of experts was 0.85 in the first round and 0.91 in the second round, indicated a high degree of overall authority. Coefficient of variation (CV) were less than 0.25, and the Kendall’s W coefficient for significant χ2 test, P values were less than 0.05, which was statistically significant. It can be considered that the coordination degree of experts was high; Cronbach’s α coefficients in the first and second rounds of importance evaluation were 0.952 and 0.971, respectively, which indicated that the index framework had good reliability and validity. Based on the needs of cancer patients for doctor-patient communication, build a two-way interactive ESER doctor-patient communication mode, integrate medicine and humanities, which can be used as a guiding tool for medical staff to communicate with cancer patients, so as to enable doctors and patients to achieve mutual trust, cooperation and win-win results.
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The COVID -19 epidemic not only brings heavy burden to the society, but also makes the originally tense doctor-patient relationship closely connected from another aspect, which objectively becomes a new opportunity to improve the doctor-patient relationship. By comparing and analyzing the current situation of the doctor-patient relationship before and after the COVID -19 epidemic, this paper discussed the causes of tension between doctors and patients, and proposed corresponding solutions, so as to promote the continuation and development of highly harmonious doctor-patient relationship during the COVID -19 epidemic prevention and control period in the future.
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In order to understand the experience and to sort out hot spots and frontier problems of doctor-patient communication research in China. CiteSpace(5.8.R2) software was used for visualized analysis of 2 130 doctor-patient communication related Chinese literatures collected from CNKI database. The research framework and study quality and efficiency were evaluated by subject clustering analysis. The results reflected the characteristics of obvious practice forerunner, prominent academic consciousness, rich exploration achievements, more learning and reference. There were also shortcomings such as theoretical sublimation, innovative thinking, regional crossover, local experience and other aspects. Therefore, the research field should be expanded to media-based information and emotional connection, the research method should be expanded to the combination of big data mining and individual analysis-evaluation, the subject should be expanded to the depth cooperation of experts from multiple disciplines, and the research scope should be expanded to the whole process of multiple disciplines and fields.
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The aim is to evaluate the effect of therapeutic communication on cervical cancer patients’ preoperative anxiety and hope level. The convenience sampling method was used to select the inpatients who will receive radical surgery for cervical cancer in the department of obstetrics and gynecology of the Second Affiliated Hospital of Xi’an Jiaotong University from November 2016 to November 2019 as the research object. 50 patients were grouped by the random number table method: 25 patients were in the intervention group, and 25 patients were in the control group. Patients in the intervention group were given therapeutic communication on the basis of routine nursing, and patients in the control group were given routine nursing. Both groups were investigated with the Self-Rating Anxiety Scale (SAS) and Herth Hope Index (HHI) on the first day of admission and the day before surgery. Before the intervention, there was no statistically significant difference between the two groups (P>0.05) . After the intervention, the anxiety level of the intervention group was lower than that of the control group (P<0.05), and the hope level was higher than that of the control group (P<0.05). It can be seen that therapeutic communication can alleviate preoperative anxiety of cervical cancer patients, improve their hope level, promote patient recovery, and ease tense medical relationship.
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Objective sampling method was used to conduct a questionnaire survey on outpatients in two hospitals in Guangdong province in order to evaluate patients’ satisfaction with the quality of medical service. This paper explored the factors that affect patients’ evaluation of medical service quality, and found that patients’ age was negatively correlated with the evaluation of medical service quality. It is suggested that the establishment of friendly medical institutions should be carried out according to the national policy. At the same time, the management mechanism of hospital should be improved, the number of medical service centers for "efficient" should be increased, and the medical service personnel should be regularly trained; carry out medical knowledge education in community, improve the popularization of personal medical knowledge and close the cognitive gap between doctors and patients.
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By reviewing the research context of narrative medicine in China in the past five years and sorting out the development status of narrative medicine in clinical practice in China, this paper pointed out the reasons why narrative medicine is difficult to implement in clinical practice in China at present. It mainly includes three points: the awareness of narrative medicine within the clinical medical community is not high; the humanities community focuses on the development of narrative medicine in medical education, resulting in rather scarce research on narrative medicine based on clinical practice; the research objects of narrative medicine are too narrow, ignoring the importance of the public and the front-line clinical personnel in the clinical practice of narrative medicine. Accordingly, this paper proposed corresponding countermeasures: it is advocated to investigate the awareness of narrative medicine in clinical medicine and the public, and it is suggested to list them as important objects of narrative medicine education. At the same time, it is recommended that the relationship between narrative medicine and doctor-patient communication should be clarified theoretically to guide the construction of a harmonious doctor-patient relationship in clinical practice.
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The intervention and prevention of perioperative hypothermia is not only reflected in the technical level, but also reveals the important role of humanistic care in the whole intervention work. If perioperative patients have hypothermia, it is likely to cause a series of complications such as postoperative shivering, which seriously threatens the life safety of patients. Prevention and intervention was based on a comprehensive understanding of the causes and hazards of hypothermia, especially the impact on the lives of the elderly. Effective supervision was implemented in the whole process of operation, such as dynamic monitoring of vital signs including body temperature, followed by room temperature regulation, body temperature protection and preoperative and postoperative psychological nursing. At this time, the sense of responsibility, good humanistic care of medical staff are of positive significance to effectively prevent and reduce the probability of perioperative hypothermia and accelerate the postoperative rehabilitation of patients.
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Medicine is the subject of studying human and its inherent humanistic attribute endows medicine with the temperature it deserves. However, with the continuous improvement of medical testing technology and treatment technology, medical workers pay more attention to diseases and ignore humanistic care, which has become an important factor in the aggravation of patients’ burden and the tension relationship between doctors and patients. There are many virtues in Chinese traditional culture. Sun Simiao’s medical ethics thought of "great doctor with professionalism and sincerity" embodies the core value of the humanistic spirit of Chinese traditional medicine. In his medical ethics thought, the moral and ethics of "great doctor with professionalism and sincerity", the medical practice attitude of "being cautious and diligent", the values of "benevolence for the world" and the professional conduct of "honesty and truth" still have strong practical significance at present. It is the good material to cultivate the humanistic spirit of medical students. This is of great value to integrate Sun Simiao’s medical ethics thought into cultivate medical students with both "professionalism" and "sincerity", practice the original intention of medical and health undertakings, and carry forward cultural self-confidence.
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In order to further understand the cognitive attitude of different groups towards the rank of rights and interests in medical decision-making and its influencing factors, and provide theoretical reference for the practice of medical decision-making, this study conducted convenience sampling through the questionnaire star enterprise edition. The collected data were descriptive statistical analysis with SPSS 21.0 software and joint hypothesis testing. The results showed that there were differences in the cognition of religious beliefs on the same individual’s rights and interests rank among the sample population (P<0.05). There were differences in the cognition of professional title, working years and institution level on the attitude of rights and interests rank in the group of medical institutions (P<0.05). In the ranking of the importance of individual rights usually involved in medical activities, the rights to life, health and equality were the most important. Most people can rationally view the rights and interests of doctors, patients and stakeholders. In medical decision-making, we should adhere to the principle of right rank, give priority to safeguarding the right to life and give consideration to fairness and justice. In the face of conflicts of interest, we should do a good job in value evaluation, safeguard the reasonable interests of patients and give consideration to the demands of family members.
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At present, the contradiction between the lack of pediatricians and the increasing demand for pediatric medical services has become more and more prominent. Taking pediatricians as the research object, this paper explored the needs and motivation of professional development of pediatricians in China by referring to a series of excellent foreign research results, so as to improve the professional development of pediatricians, reconstruct the ecology of pediatricians and patients, then improve medical experience, and alleviate the "shortage of pediatricians" and "difficulty in seeing a doctor" in pediatrics. Enhancing the work enthusiasm and professional motivation of pediatricians can not only improve the satisfaction of patients, but also enhance the quality of medical services, so as to promote the growth of the hospital’s own economic and social benefits.
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China’s foreign aid medical work is an important part of development of friendly relations with foreign countries and an important way to build a human health community. African countries generally have backward economic and social development, poor medical and health conditions and different languages and cultures, which makes the development of foreign aid medical work special and challenging. Foreign aid doctors and local patients share common feelings, mutual respect, equality, mutual trust and sincere cooperation, and building a community of destiny with the common goal of defeating diseases is an essential content to promote the health of the people of the recipient countries and realize the community of human health. Taking the work practice of the eighth batch of China (Shaanxi) medical team assisting Malawi as an example, this paper expounded the specific practice of building a community of doctor-patient in foreign aid medical work and discussed its significance, to provide theoretical and practical basis for the smooth development of foreign aid medical work in the future.