ABSTRACT
UNLABELLED: Giving bad news is inherent to the practice of medicine. Development of guidelines for this task has great value, although the orientations are only general and should be adapted to each case, allowing for the cultural idiosyncrasy of the people involved. OBJECTIVES: the present study aims to explore common practices of giving bad news in different hospital services in Santiago-Chile. MATERIALS AND METHODS: a qualitative methodology was applied through three focus groups with a sample of 33 physicians from two hospitals in Santiago-Chile. RESULTS: giving bad news is a frequent practice for which no training is given. It generates preoccupation and interest among professionals. There is no agreed procedure to communicate bad news. Each professional has had to develop his/her own way from his/her experience and observing others. Informing the patient is seen as an ethical duty, but in many cases it is not easy because of family pressure. Comments are made on different types of bad news, strategies for this communicational process and facilitators and barriers for it. CONCLUSION: Doctors' own professional past experience is a central factor in the way bad news is given, and so self-development mechanisms constitute an important challenge.
Subject(s)
Physicians/psychology , Truth Disclosure , Attitude of Health Personnel , Chile , Communication Barriers , Female , Focus Groups , Hospital Departments , Hospitals, Public , Humans , Male , Physician-Patient Relations , Professional-Family RelationsABSTRACT
The attention deficit hyperactivity disorder (ADHD) is the most common diagnosis in child psychiatry, and persists very often in adulthood. These patients have poor lifestyles, especially in affective, work and social areas. Although patients with ADHD have a high rate of comorbidity (e.g. drug and alcohol abuse, depressive and anxiety disorders), this diagnosis is missed by the general physician, deferring its identification and opportune treatment. This article is a review about this disorder and gives tools for its recognition and derivation.
Subject(s)
Humans , Male , Adult , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/drug therapy , Attention Deficit Disorder with Hyperactivity/physiopathologyABSTRACT
Establishing the frequency of mental disorders among patients cared for at the mental health unit of a primary care outpatient clinic of Santiago, Chile, is intended. In this connection, 618 medical records have been screened retrospectively (i.e. a whole universe excepting patients under age 15). A great majority of patients--with an absolute ratio of female patients (88.8%) were referrals from physicians' offices. The most frequent disorders were anxiety disorders and adjustment disorders. Comments are made on (a): the scarcity of referrals from larger general hospitals, and (b) the need for mechanisms apt at an early detection of the most frequent disorders to be set up.
Subject(s)
Mental Disorders/epidemiology , Adjustment Disorders/epidemiology , Adolescent , Adult , Age Distribution , Anxiety Disorders/epidemiology , Chile/epidemiology , Female , Humans , Male , Mental Health Services , Middle Aged , Morbidity , Primary Health Care , Retrospective Studies , Sex DistributionABSTRACT
Establishing the frequency of mental disorders among patients cared for at the mental health unit of a primary care outpatient clinic of Santiago, Chile, is intended. In this connection, 618 medical records have been screened retrospectively (i.e. a whole universe excepting patients under age 15). A great majority of patients--with an absolute ratio of female patients (88.8
) were referrals from physicians offices. The most frequent disorders were anxiety disorders and adjustment disorders. Comments are made on (a): the scarcity of referrals from larger general hospitals, and (b) the need for mechanisms apt at an early detection of the most frequent disorders to be set up.
ABSTRACT
The different stages of the divorce process effect varied influences upon the separating couple and its offspring. This extends also to the relation of family members with their social group. Even if a separation is attained, some union of the couple as parents must remain in order to decrease negative effects on children.
