The Effect Of Direct Eye Contact On Preoperative Surgical Patients And Counseling Intervention On Postoperative Anxiety, Depression And Posttraumatic Stress Disorder

To the study the effect of direct eye contact counseling method on pre-operative surgical patients and counseling intervention along with the medical follow-up of post-operative surgical patients. Methodology : 60 pre-operative surgical patients who had been identify with major or minor need of surgical assistance were consulted by two different method such as ( 30 patients with direct eye contact consultation) and (30 patients with non-direct eye contact consultation) and assessed by Peer assessment of outpatient consultation Rating Scale (2007) by Keely et al 1. Followed by the consulting session we compared the willingness and acceptance of surgical procedure by the number of participants and found that the direct eye contact method is more effective than non-direct eye contact. During the surgical treatment follow-up, we have categorized 30 patients in to two groups such as Group A - Control group: 15 patients who have undergone medical treatment alone and Group B - Experimental group: 15 patients who have undergone medical treatment and counseling intervention. Both groups were assessed by using Hamilton Anxiety Rating Scale (1959) 2, Beck’s Depression Inventory (1996) 3 and PTSD Check List Civilian Version (PCL-C) (1994) 4. Result: The findings indicate that the direct eye contact consultation method is more effective than non-direct eye contact consultation. The post-operative surgical patients treated with counseling intervention along with the medical treatment found to be less subjected to anxiety, depression and Posttraumatic stress disorder. Implications: The results obtained from this study can be helpful in designing better counseling technique for the post-operative surgical patients to reduce their anxiety and depression level.

Unindo-se à família humana / Joining the human family / Uniéndose a la familia humana

Discutem-se os fenômenos de imitação neonatal e de imitação recíproca mãe e bebê para a promoção de sintonia em relação ao senso de self em desenvolvimento e à vivência de pertencimento do bebê. Formulam-se vínculos com o conceito psicanalítico de identificação primária, bem como com as teorias psicanalíticas de espelhamento, imitação e identificação introjetiva. Propõe-se que essa imitação evolutiva [developmental imitation] pressupõe o equilíbrio entre a posição do bebê real e a de suposto ocupante interno da mãe. Considera-se que esse equilíbrio forneça o alicerce para a identificação projetiva e a assimilação da experiência, conduzindo ao enriquecimento do senso de identidade. Em contraposição, pode ocorrer a identificação adesiva ou a identificação projetiva na imitação que envolve mimetização. Ilustram-se essas hipóteses com material proveniente de observações de bebê e do tratamento de duas crianças do espectro autístico.

The phenomena of neonatal imitation and of mutual imitation by mother and baby in the service of attunement are discussed in relation to the infant's developing sense of self and experience of belonging. Links are proposed to the psychoanalytic concept of primary identification, as well as to psychoanalytic theories of mirroring, imitation and introjective identification. It is suggested that developmental imitation presupposes a balance between the position of the actual baby and that of the mother's supposed internal occupant. This balance is seen as underlying introjective identification and the assimilation of experience, leading to an enriched sense of identity. In contrast, in the kind of imitation involving mimicry, adhesive or projective identification may be operative. These hypotheses are illustrated with material from infant observation and from the treatment of two children on the autistic spectrum.

Se discuten los fenómenos de imitación neonatal y de imitación recíproca madre y bebé para promover la sintonía en relación al sentido del self en el desarrollo y la vivencia de pertenencia del bebé. Se formulan vínculos con el concepto psicoanalítico de identificación primaria, así como con las teorías psicoanalíticas de reflejo, imitación e identificación introyectiva. Se propone que esta imitación evolutiva [developmental imitation] presupone el equilibrio entre la posición del bebé real y la de supuesto ocupante interno de la madre. Se considera que este equilibrio ofrece la base para la identificación proyectiva y la asimilación de la experiencia, llevando al enriquecimiento del sentido de identidad. En contrapartida, puede ocurrir la identificación adhesiva o la identificación proyectiva en la imitación que involucra la mimetización. Se ilustran estas hipótesis con material proveniente de observaciones de bebé y del tratamiento de dos niños del espectro autístico.

Medical Interview Skills and Patient Satisfaction Levels in a Setting Utilizing Electronic Medical Records / General Medicine

<b>BACKGROUND</b> : Electronic medical records (EMRs) were first introduced in the 1960s, and in Japan they are starting to become popular. Recognizing the need to adapt to a new clinical setting with EMRs, we aimed to explore which interviewing skills were associated with patient satisfaction in this era of EMR use.<br><b>METHODS</b> : A prospective observational study was conducted to evaluate interviewing skills among medical residents and to collate data on patients' satisfaction levels at an outpatient general medicine walk-in clinic at a teaching hospital in Japan. Five trained raters reviewed the video recordings of these interviews and assessed them based on a predetermined set of criteria for medical interview skills developed specifically for an outpatient EMR setting. The relationships between these assessment scores and patient satisfaction levels were analyzed.<br><b>RESULTS</b> : Significant skills that were associated with higher scores of patient satisfaction included : employed appropriate eye contact (P=0.021) ; and, invited patients directly without using a microphone (P=0.008). In addition, the degree of keyboard typing during interviews was not associated with patient satisfaction.<br><b>CONCLUSIONS</b> : In an outpatient setting with EMR, using good non-verbal communication skills to build trustful relationships with patients is more likely to influence patient satisfaction levels. Even when physicians are typing on a keyboard, if they keep appropriate eye contact during medical interviews, patient satisfaction can be improved.