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Introducción: La interacción enfermera-paciente durante el período preoperatorio permite el afronte intraoperatorio y posoperatorio, pero no se hace por desidia o por sobrecarga laboral. Objetivo: Describir las reflexiones en torno a la interacción enfermera-paciente durante el período preoperatorio en un hospital público. Métodos: Investigación cualitativa descriptiva, realizada en el Hospital Belén en Lambayeque, Perú, durante abril y mayo del 2020. La población fueron 20 enfermeras experimentadas en atención preoperatoria. Se realizó muestreo no probabilístico, por técnica de bola de nieve que saturó con ocho enfermeras. Los datos se recolectaron con entrevista semiestructurada por llamada telefónica, y fueron procesadas mediante análisis de contenido. Resultados: Tres categorías: a) Elementos indispensables en la interacción: empatía y comunicación terapéutica, b) Interacción para valorar y cuidar de la dimensión emocional, espiritual y física del paciente en el preoperatorio, c) Beneficios de la interacción para la recuperación en el posoperatorio basados en la educación al paciente y su familia. Conclusiones: La interacción enfermera-paciente se inicia a través de la empatía que siente la enfermera y la confianza que genera en el paciente, lo que favorece la comunicación terapéutica, esencial para valorar y cuidar de las necesidades emocionales, espirituales y físicas previa a la intervención quirúrgica. Asimismo, la educación sanitaria al paciente y al familiar es fundamental para el cumplimiento de las indicaciones en el posoperatorio, de manera que haya una recuperación exitosa. Sin embargo, se necesita adecuada dotación del personal de enfermería y comunicación asertiva entre el equipo de salud y la familia(AU)
Introduction: Nurse-patient interaction during the preoperative period allows intraoperative and postoperative coping, but is not done out of idleness or work overload. Objective: To describe the reflections about nurse-patient interaction during the preoperative period in a public hospital. Methods: Descriptive and qualitative research carried out at Belén Hospital in Lambayeque, Peru, during April and May 2020. The study population consisted of twenty nurses experienced in preoperative care. Nonprobabilistic sampling was done, using the "snowball" technique, permitting to identify eight nurses and thus reach saturation. The data were collected with a semistructured interview by telephone call and processed by content analysis. Results: Three categories emerged: a) indispensable elements for interaction: empathy and therapeutic communication; b) interaction to value and care for the emotional, spiritual and physical dimensions of the patient in the preoperative period; and c) benefits of interaction for recovery in the postoperative period based on patient and family education. Conclusions: Nurse-patient interaction starts through the empathy felt by the nurse and the trust that thus produced in the patient, which favors therapeutic communication, essential to value and care for the emotional, spiritual and physical needs prior to surgery. Likewise, health education to the patient and family is essential to comply with postoperative indications, in view of a successful recovery. However, an adequate nursing staff and assertive communication between the health care team and the family are needed(AU)
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Humans , Surgical Procedures, Operative , Preoperative Care , Preoperative Period , Nurse-Patient Relations , Patient Care Team , Qualitative ResearchABSTRACT
A key feature of medical curricula across the world is the interaction of medical students with patients at teaching hospitals. However, patients may not be comfortable engaging with medical students in certain situations, and there are a number of possible reasons for this. Teaching hospitals often overlook the need to take consent for such interactions. Certain measures can be taken to increase the confidence of patients in the medical students treating them. Studies on the subject make it clear that this ethical question is common throughout the world.
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Introducción: Este trabajo presenta el proceso de construcción de un protocolo de ingreso del paciente y su familia a la Unidad de Cuidado Intensivo UCI. Objetivo: Diseñar un protocolo de ingreso del paciente y su familia a la UCI del Hospital Universitario Nacional de Colombia como una estrategia para fortalecer la interacción enfermero-paciente/familia, con base en aspectos de humanización en la atención y la Política de seguridad del paciente. Metodología: El protocolo se realiza teniendo en cuenta los lineamientos de la propuesta de Saura y Saturno en 1996 para la elaboración de protocolos clínicos. También se utiliza la estructura de la Guía para la elaboración de protocolos de la Fundación Índex, con los hallazgos obtenidos de una revisión documental. Además, el protocolo se somete a un juicio de expertos. Resultado: Producto de este trabajo, se elabora un protocolo de ingreso del paciente y su familia a la UCI para el HUN estandarizando el proceso del ingreso a la UCI con aspectos de humanización y con la incorporación de la política de seguridad del paciente. Conclusión principal: Se realizó un protocolo de ingreso del paciente y su familia a la UCI para el HUN para cualificar este proceso en la práctica profesional, estandarizándolo con sustento en la evidencia disponible, con consideraciones especiales como la humanización en la atención y con la incorporación de la política de seguridad del paciente.
Introduction: This work shows the construction process of a protocol for the admission of the patient and his family to the Intensive Care Unit ICU. Aim: To design a protocol for the admission of the patient and his family to the ICU of the National University Hospital of Colombia as a strategy to strengthen the nursepatient/family interaction, based on aspects of humanization in care and the Patient Safety Politic. Methodology: The protocol is carried out considering the guidelines of the proposal of Saura and Saturn in 1996 for the elaboration of clinical protocols. The structure of the Guide for the preparation of protocols of the Index Foundation is also used, with the findings obtained from a documentary review. In addition, the protocol is submitted to an expert judgment. Result: As result of this work, a protocol for the admission of the patient and his family to the ICU was elaborated for the HUN, standardizing the process of admission to the ICU with aspects of humanization and with the incorporation of the patient safety politic. Main conclusion: A protocol for the admission of the patient and his family to the ICU for the HUN was made to qualify this process in the professional practice, standardizing it with a support of the available evidence, with special considerations such as humanization in the care and with the incorporation of the patient safety politic.
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Humans , Male , Female , Clinical Protocols , Intensive Care Units , Patient Safety , Nurse-Patient RelationsABSTRACT
Based on the doctor-patient interaction forum of Haodaifu Online,Xunyiwenyao and Youwenbida,taking advantage of the text mining technologies and methods such as Chinese word segmentation,data cleaning and filtering,word frequency statistics,semantic network map and visualization,extract and summarize the symptoms,causes,common drugs,complications,non-drug therapy and nursing method of Deep Vein Thrombosis (DVT),the paper verifies the availability of text mining method in exploring the prevention law and method of diseases and the feasibility of application of doctor-patient interaction Q&A network data source in medical research.
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Objective:The online health community is a new business model which combines of the internet in-formation technology and the medical service. Through analyzing the development of the online health community in China, the author puts forward the policy recommendations to promote the rapid integration of internet technology and the traditional medical services. Methods:The crawler program of collecting data from haodf. com website is built up, and information was gathered from 166 hospitals in Beijing and 12,497 physicians' personal online platform informa-tion was analyzed. Data regarding the development of online health community were analyzed from the aspects of phy-sicians' activity, patients' visits and satisfaction, etc. Results:The information of hospitals and physicians provided by Haodf. com website was mainly gathered from public tertiary level hospitals. The professional titles of the physicians are mainly intermediate and deputy-senior ones. Only one-third of the physicians who opened the personal online pa-ges keep high activity and the patient satisfaction score was very high. Conclusion: The online health community in China has a certain scale and began to gradually change the traditional medical service system thereby altering the mode of medical treatment. However, its development prospects of important factors are based on the data usability and effectiveness of the online perform and deep using in health reform.
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The aim of the “Dismantling Psychotherapy Research Study” was to evaluate whether the psychotherapist is more or less active in connection to his or her countertransference, the therapist-patient-interaction and the patient’s level of object relationship quality. We worked with 234 tape- recorded therapy sessions with depressed patients from the Munich Psychotherapy Study (Huber, 2012), a comparative quasi-experimental study of psychoanalysis (PA), psychodynamic therapy (PD) and Cognitive behavioral therapy (CBT). The study aimed to maximize external validity by examining non-manualized and representative psychotherapies under the conditions of day-to-day practice. The tape recordings were rated and analyzed using the Psychotherapy Process Q-Set (PQS), the Countertransference Questionnaire/Therapist response questionnaire (CTQ/TRQ), the Shedler-Westen-Assessment Procedure-200 (SWAP) and the Quality of Object Relations Scale (QORS). 90 patients with a definite diagnosis of depressive disorder and 12 clinical psychologists/psychotherapists with at least 5 years of professional experience took part in the study. Findings show a clear correlation between the therapist’s activity and the ongoing countertransference. Further, the therapist’s activity is linked to the patient’s emotional and psychological state. This implies a more active therapeutic work as well as a better therapy outcome treating healthier patients. However, therapy outcome is not necessarily related to the patient’s object relation quality. Nevertheless, it has become clear that a therapist responding with negative countertransference and acting it out impairs not only the patient-therapist-interaction but also the therapeutic process itself. The findings illustrate that there are specific countertransference feelings related to the patients’ respective unconscious transference. We conclude to encourage therapists to use their own countertransference reactions as a diagnostic and therapeutic asset.
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Objective To analyze the negative experience from medical practice of medical students by Balint group case study,and to explore new approach for training doctor-patient communication skills.Methods 10 times of Balint group activities were held in Zhongshan Hospital of Fudan University,with one case each time.Grounded theory approach were applied for analyzing discussion record.Results The cases were occurred in doctor-patient interaction,teamwork,conflict between one's personal life and vocational development planning.Trigger events involved doctor-patient conflict,conflict of values,decision making problem while conffronted with incurable patients,role ambiguity,unfair treatment.Topics of discussion included emotional experience with patients,career development orientation,medical teamwork,clinical education of medical student.Conclusion Through practice of Balint group,medical students in teaching hospital can improve their awareness of complicating psycho-social problem of patients and themselves,as well as handling it.And it can improve the professional identity,professional growth and professional self-identity.
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Introduction: In Southeast Asia there is a big gap between the partnership style now desired by patients and the reality of actual practice, which reflects a more paternalistic style. Asian culture, with its hierarchical social system, less autonomy for members of society and less verbally explicit communication style contributes to this difference. This paper describes the development and validation of a guideline to help doctors in the context of the study to become more patient-centered. Method: To develop a guideline, we triangulated results from previous studies on doctor-patient communication with in-depth interviews with communication skills teachers at an Indonesian School of Medicine. To validate the guideline, we interviewed international experts who had conducted research on this subject in an Asian context. Results: Southeast Asian patients expect more partnership in their consultations. In this respect they do not differ from Western patients. Three other distinct issues emerged from the data. Firstly, the social and cultural context of their communities is very important for Southeast Asian patients compared with patients from the West who, on the whole have more autonomy. Secondly, much of the communication expressed by patients and their families with doctors is non-verbal compared with Western patients. Thirdly, traditional medicine still holds an important place. Conclusion: There is a shifting paradigm towards partnership communication during doctor-patient consultations in Southeast Asian context. Our guideline alienates the skills needed to consult effectively also tabulates what needs to be taught to young doctors in order to enhance their responsiveness to Southeast Asian patients. It builds on Western models of the consultation enriched with contextual examples.
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@#Objective To investigate the effect of Doctor-patient Interaction Model on hemiplegia after acute stroke.Methods 200 cases with mderate to severe hemiplegia were divided into treatment group and the control group with each 100 cases according to whether their family supporting rehabilitation.Cases in treatment group received interaction model rehabilitation.They were assessed with National Institutes of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment(FMA),Barthel Index(BI)10 d,1 month,3 months,6 months,12 months after rehabilitation,and the Geriatric Depression Scale(GDS)1 year after rehabilitation.Results The scores in all the assessment of the cases in the treatment group improve mostly 3 month after rehabilitation(P<0.01),while the BI improved 6-12 month after rehabilitation(P<0.01).The incidence of depression reduced 18% compared with that of the control group(P<0.01).Conclusion Doctor-patient interaction can improve the outcome of patients with moderate to severe hemiplegia.
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The purpose of this study was to identify metacommunicative behaviors between nurses and patients in a pediatric unit. The research method included observation using videotaping. Data were collected from December, 2001 to February, 2002. Total six nurses, and eight patients and their mothers in a pediatric unit participated in this study. The interactions were videotaped under the participants' consent. The participants were observed for total 8 hours over 2-day period. Special episodes which were identified as metacommunicative behaviors in the taped interactions were transcribed. Transcription included verbal and nonverbal interactions. Selected episodes were classified using Mitchell's definition. Each classified definitions were named, and categorized by its purpose. The results were as follows: Nineteen metacommunicative behaviors which used frequently by nurses-approaching, mediating eye level, eye contact, touching, encouraging, turnabout, mimic voice, giving choices, friendly demand, expansion, tagging, repeating and confirming, identification, reflection, baby talk, symbolization, description of acts, relaxed posture, turning away- were identified and organized into four categories. They were call for attention, facilitating response, empathy, and tension release. In conclusion, nurses in this study used metacommunicative behaviors frequently and these behaviors were effective in interacting with children. It is suggested that any educational programs to teach communication skills to nurses need to include techniques on metacommunicative behaviors. This will help nurses to be more sensitive to different characteristics of their patients.
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Child , Humans , Empathy , Mothers , Negotiating , Observational Study , Posture , Voice , Child HealthABSTRACT
The factors that affect the nurse-patient interaction were identified, Sixty-six nurses participated in the cross-sectional survey. Based upon the literature, the factors were classified into 4 categories : the patient, the nurse, the family caregiver, and the situational factors. The data were collected with the open-and closed-ended questionnaire developed by researchers. In the closed-ended questionnaire, the significant factors differentiating the best-liked from the least-liked caring situation were found in all factors expect the nurse factors. None of the nurse factors was found to be significant. In patient factors, the physically attractive stereotype was found to affect patient-nurse interaction . As expected, family caregiver factors were found to affect the nurse-patient interaction. The content analysis was done to identify the specific factors affecting nurse-patient interaction. In both of the best-liked and the least-liked caring situation, the patient factors were the most contributing causes as likely as 68.51% and 66.45%, respectively. Some factors that nurses perceived as causes for the best-liked and the least-liked to care were presented. In conclusion, these results show that nurses are influenced by stereotypes in caring patients. So, some programs to increase awareness of the biases of nurses are included in in-service education. Also the incentives to encourage nurses are needed.