Subject(s)
Humans , Child , Pediatrics/ethics , Pediatrics , Pediatrics/organization & administration , Mental Health , Mental Disorders/psychology , Child Behavior/psychology , Pediatrics/standards , Pediatrics/trends , Mental Health Services/ethics , Mental Health Services/organization & administration , Psychosocial ImpactABSTRACT
En la época de formación, durante la carrera de Medicina, los aspectos relativos a la comunicación humana han caído sistemáticamente en el olvido: se asume que un profesional de la salud sabe entrevistar. Esta visión, sin duda idealizada, conlleva otra fantasía: pensar que sea cual sea el tipo de pregunta o la forma de dialogar con el niño y las familias se obtienen resultados similares. La entrevista clínica (EC) es considerada por algunos como un medio para obtener datos significativos, negando las emociones y los sentimientos que encierra toda relación humana. Sin negar el papel instrumental de la EC, entrevistamos, en efecto, para conseguir algo, aunque este algo sea a veces simplemente una comunicación. La entrevista en sí misma debe ser objeto de investigación científica y solo entonces seremos capaces de aplicar estrategias de aprendizaje capaces de mejorar nuestro perfil (AU)
Human communication skills have been systematically forgotten during medical training at University. It is assumed that a professional involved in health knows how to conduct an interview. This view, undoubtedly idealized, takes along another fantasy: to think that whatever the question is or the way to dialogue with a kid or his/her family, the results are similar. Clinical interview (CI) is considered by some as a way to obtain significant data, without taking into account any emotions and feelings that any human relation has. In fact, we interview, unregarding the instrumental role of CI, to obtain something, even though this something is sometimes merely a communication. The interview itself must be the object of scientific research, only then we will be able to apply learning strategies useful to improve our skills (AU)
Subject(s)
Humans , Primary Health Care/methods , Medical History Taking/methods , Communication , Data Collection/methods , AptitudeABSTRACT
Las técnicas de comunicación ayudan a los profesionales sanitarios a establecer relaciones clínicas gratificantes con los pacientes y sus familias. La relación asistencial tiene, en sí misma, valor educativo; una relación de calidad mejora la adherencia a nuestras recomendaciones. La capacidad para averiguar y entender el porqué un paciente y una familia concretos acuden en busca de ayuda y consejo y acordar con ellos qué hacer, exige de nosotros habilidades de comunicación. Nuestra forma y estilo de relacionarnos con los niños, los adolescentes y sus familias es fundamental para el proceso de establecimiento o cambio de hábitos. Escuchar reflexivamente, expresar nuestra aceptación, obteniendo y reforzando selectivamente las propias declaraciones de automotivación son las características y el origen de la eficacia de la entrevista motivacional (EM). ¿Cómo podemos los pediatras, que trabajamos emitiendo consejos o recomendaciones, potenciar la motivación de los niños y sus padres para el cambio? Las personas cambian de muy diversas maneras y por una multitud de razones diferentes. La EM es una aproximación destinada a ayudar a los pacientes a que adquieran un compromiso y alcancen el deseo de cambiar. Una relación interpersonal centrada en el paciente, en la que el pediatra tiene una empatía adecuada, una calidez no posesiva y autenticidad proporciona la atmósfera ideal
Communication techniques help health professionals to establish gratifying clinical relations with the patients and their families. Health care relation has, in itself, an educative value; a quality relation makes a better adherence to our recommendations. The capacity to find and understand why a specific patient and family come to us looking for help and advice and to agree with them what can be done, demands communication abilities. The way and stile we communicate with the children and adolescents and their families is fundamental to the process of establishing and changing habits. Listening reflexively, showing our approval, obtaining and strengthening selectively their own statements of automotivation are the features and the origin of the efficacy of motivational interview (MI). How can we paediatricians, who work giving advice and recommendations, promote motivation in children and parents for change? People change in very different ways and for very different reasons. The MI is an approximation bound to help patients to acquire a compromise and to reach the will of change. An interpersonal relation centred in the patient, with the paediatrician showing an appropriate empathy, not possessive warmth and authenticity provides the ideal atmosphere
Subject(s)
Humans , Directive Counseling , Motivation , Persuasive Communication , Child Health Services/organization & administration , Negotiating , Attitude of Health PersonnelABSTRACT
In the last years it has been suggested that idiopathic obstructive cholangiopathy is a pathologic process with evolutive studies: extrahepatic biliary atresia and neonatal hepatitis. The possibility of a viral agent as the inciting factor has been investigated. This report shows four male and one female with confirmed idiopathic obstructive cholangiopathy with different clinical picture. There was evidence of cytomegalovirus infection in two patients, rubella infection in one patient, hepatitis B virus infection in one patient and Epstein-Barr virus infection in one patient. While other causes of neonatal cholestasis were excluded, we suggest that those viruses has an etiologic role in the initial injury and the progression of the disease.
