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Artykuły w czasopismach na temat "Problematic doctor behaviour"
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Turabian, Jose Luis. "Doctor-Patient Relationship: The Difficult Balance between Patient Psychology and Community Sociology". Community Medicine and Health Education Research 1, nr 1 (20.12.2019): 40–50. http://dx.doi.org/10.33702/cmher.2019.1.1.6.
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Psychology and sociology share a common object of study, human behaviour, but from different perspectives. Sociologists have focused on macro variables, such as social structure, education, gender, age, race, etc., while psychology has focused on micro variables such as individual personality and behaviours, beliefs, empathy, listening, etc. Despite the importance of interpersonal relationship skills, they depend on the community or social context in which communication takes place, and by themselves may have little relevance in the consultation. The purely psychological analysis of the doctor-patient relationship often leads to an idyllic vision, with the patient-centred consultation as the greatest exponent, which rarely occurs in real life. The purely sociological or community / social analysis of the doctor-patient relationship leads to a negative view of the consultation, which is always shown as problematic. But, the psychological system in the doctor-patient relationship cannot be neglected, and its study is of importance, at least as an intermediate mechanism that is created through socio-community relations. Although the same social causes are behind the doctor-patient relationship, when acting on psychological factors in the consultation, they act as an optical prism scattering socio-community relations that affect the doctor and the patient, giving rise to a beam of different colors of doctor-patient relationship. In doctor-patient relationship there is a modality of psychotherapy, where attitudes, thoughts and behaviour of the patient, can be change, as well as it can be extended on the way of understanding and therefore changing, his social context. Because of the distance between socio-community relations and the form of doctor-patient relations is growing in complex societies, under these conditions, the sociological factor gives the important place to the psychological factor. Given these difficulties of the doctor-patient relationship one may ask how general medical practice can persist with the usual model of doctor-patient relationship. Pain and the desire to relieve them are the basic reasons for the patient and the doctor, and they do not disappear due to the contradictions of the doctor-patient relationship. In this way, the confrontation between sociological and psychological vision is replaced by an alliance of both currents, and each of them takes on meaning only in the general vision.
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Roque Pereira, M., A. Fornelos i A. R. Figueiredo. "Challenging Patient-doctor Interactions in Psychiatry – Difficult Patient Syndrome". European Psychiatry 41, S1 (kwiecień 2017): S719. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1297.
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IntroductionThe factors contributing to a challenging interaction between the roles of patient and physician may come from several sources. Each interrelation has its own modus operandis in which one of the individuals may not condone the persona the other individual is portraying. A mental illness or diagnosis is often stigmatised by the burden of stereotypical bizarre associations. That means the patient is generally not guilty and this is not another label they should carry. Though the mental health professional should be impervious to this, some degree of discomfort may throw some shadow on the clinical mediation of the interview and management of the pathology.ObjectiveTo provide an overview of what is beyond the label “difficult patient” in mental health care.AimsEvaluation of conflicts inside the patient-illness-physician triad.MethodsSearch for articles in Pubmed, Athens, Google Scholar databases, along with the hospital library.ResultsCharacteristics of problematic interactions in psychiatric care were described consistently across our references. Causality for these difficulties is vast and surpasses the patient's behaviour. Plus they are not unique in psychiatry. They can be explained by individual, interpersonal, and social factors.ConclusionSituational issues, along with patient and physician characteristics, modulate and frame what should potentially be a productive encounter. To become aware of what contributes to difficult clinical encounters and to be prepared to address them while cultivating good interpersonal communication skills is fundamental.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Choy, Melinda Ada, Elizabeth Sturgiss, Felicity Goodyear-Smith i Gavin JD Smith. "Digital Health Tools and Patients With Drug Use Disorders: Qualitative Patient Experience Study of the Electronic Case-Finding and Help Assessment Tool (eCHAT)". Journal of Medical Internet Research 22, nr 9 (14.09.2020): e19256. http://dx.doi.org/10.2196/19256.
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Background One of the promises of digital health is to better engage patients and improve care for vulnerable populations. Patients with drug use disorders are a vulnerable population who often do not receive the care they need, both for their drug use disorders as well as their other health care needs. Appropriate primary care for patients with drug use disorders needs to be patient-centered, holistic, highly accessible, and engaging. The electronic Case-finding and Help Assessment Tool (eCHAT) was designed as a patient-centered tool for the identification and measurement of problematic health behaviors and mood states. Objective The aim of this study was to explore the patient experience of eCHAT at an Australian family medicine clinic for patients with drug use disorders. Methods A total of 12 semistructured interviews were conducted with patients, two interviews were conducted with doctors, and one focus group was conducted with patient advocates who were former patients of the clinic where the study took place. The transcripts were analyzed using inductive thematic analysis. Results The key themes identified from the interviews and the focus group were as follows: (1) eCHAT helped reduce stigma related to drug use in the doctor-patient consultation, (2) restricted answer options impacted the ability of patients to tell their stories, (3) patient-related response factors, (4) increased efficiency in the consultation process, and (5) divergence in level of concern around security and privacy. Conclusions eCHAT has the potential to help vulnerable patients in primary care to engage more with their doctors and reduce experiences of stigma. eCHAT may be a useful digital health intervention in a family medicine clinic for patients with drug use disorders. It has the potential to improve patient engagement and access to health care, which are crucial areas of need in this vulnerable population. However, it is important to clearly communicate the privacy risk of digital health tools and to implement eCHAT such that it will add value to, rather than displace, in-person consultations with the family doctor.
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Jose Luis, Turabian. "Psychotropic drugs prescription block the positive effects of the doctor-patient communication and relationship". Archives of Psychiatry and Mental Health 5, nr 1 (18.02.2021): 014–17. http://dx.doi.org/10.29328/journal.apmh.1001029.
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The fact that general practitioner (GP) or psychiatrist understands the psychosocial effects of prescribing on the doctor-patient relationship is as important, if not more so, than knowing pharmacology. Any prescription of drugs modifies the doctor-patient relationship. Drugs, especially psychotropic drugs, act on symptoms and change thoughts, feelings, and behaviors; they can create both physical and psychological dependency; they can discourage a deep search for real solutions, both on the part of the doctor and the patient; they can affect the doctor’s access to the patient and the problem will be out of their reach. Psychotropic drugs can make the effect of the doctor in himself as a drug more difficult, favor an insignificant or problematic or little human relational context, where the GP/psychiatrist does not delve into the true meaning of the symptoms, and the patient tends not to get involved, to make an emotional withdrawal, to be passive before the prescribed drug, and can result in the chronification and structuring of functional symptoms that become organic, with lack of cooperation of the doctor and the patient, and paradoxically with over-compliance or therapeutic discontinuity and the lack of pharmacological adherence, absences to appointments or delays or cancellations of visits, and the denial of responsibility of both the doctor and the patient.
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Doh, Young Yim, Bugeun Kim, Seul Lee i Gahgene Gweon. "The Cyclic Value-Context Reinforcement Model of Problematic Internet Use: Empirical Validation Using a Thematic Analysis of Children’s Counseling Data". Journal of Medical Internet Research 22, nr 7 (14.07.2020): e17996. http://dx.doi.org/10.2196/17996.
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Background Research on problematic internet use has focused on devising diagnostic criteria or describing the factors that influence internet overuse. However, a paradigm shift is necessary in studying the phenomenon of increased internet use not just from a pathological point of view but also from a developmental point of view that considers children’s behavior of adapting to a technology-oriented society. Objective In this paper, we propose the Cyclic Value-Context Reinforcement Model (CVCRM) to understand problematic internet use behavior. The purpose of our study was to construct a developmental process model that provides a holistic understanding of problematic internet use behavior of children and to empirically validate the proposed model by conducting a thematic analysis on actual counseling data. Methods To validate the CVCRM, we conducted thematic analysis using the counseling data from 312 Korean children aged 7-18 years. For the coding process, 7 master’s and doctoral student researchers participated as coders, and 2 professors supervised the coding process and results. Results This project was funded from October 2015 to September 2019 to analyze counseling data from 312 children who participated in counseling sessions during January 2012 to May 2014. Based on the data analysis, we present the CVCRM, which integrates existing theoretical approaches and encompasses the 3 interacting aspects that induce and reinforce problematic internet use in children: psychosocial value, environmental context, and internet utility. Specifically, using counseling data, we empirically ascertained that problematic internet use behavior feeds into children’s psychosocial values and environmental contexts, which in turn facilitates problematic internet use in a cyclical manner. Conclusions Through this empirical validation, the CVCRM can provide a theoretical framework and an integrated perspective on the developmental mechanism of problematic internet use behavior of children.
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Nguyen, Thi Thu Huong, Katherine M. White, Marguerite C. Sendall i Ross McD Young. "Patterns of drinking alcohol and intentions to binge drink among medical students in Vietnam". Health Education Research 34, nr 4 (5.06.2019): 447–59. http://dx.doi.org/10.1093/her/cyz019.
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Abstract Alcohol use is common among Vietnamese students. Previous qualitative findings showed Vietnamese medical students believed they were not binge drinkers while reporting many binge drinking occasions they participated in or witnessed. This dichotomy warrants examination. This study aims to establish drinking patterns and examine the factors underlying Vietnamese medical students’ binge drinking intention and behaviour. This study used a prospective-correlational design, with two waves of data collection, drawing from established health behaviour models. At Time 1, 206 students completed the Alcohol Use Disorder Identification Test, the standard Theory of Planned Behaviour measures (attitude, subjective norm and perceived behavioural control) and their underlying beliefs, as well as group norm, role identity, drinking culture and past binge drinking behaviour. At Time 2, 156 medical students reported their binge drinking behaviour 2 weeks later. Only 6.8% of participants were classified as problematic drinkers and few participants reported binge drinking occasions at the 2-week follow-up. Perceived behavioural control, friends’ group norms, role identity as future doctors, and past behaviour significantly predicted binge drinking intentions and key beliefs were identified. This study indicated Vietnamese medical students’ limited engagement with binge drinking and identified key factors to address for those with risky drinking behaviour intentions.
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Arekeeva, Svetlana Timofeevna. "DRAMATURGIC CREATIVITY OF THE UDMURT WRITER-EDUCATOR I. S. MIKHEEV: PROBLEMATICS OF PLAYS, NATURE OF CONFLICTS". Yearbook of Finno-Ugric Studies 13, nr 3 (25.09.2019): 446–54. http://dx.doi.org/10.35634/2224-9443-2019-13-3-446-454.
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The content of the study is an analysis of the plays by the Udmurt writer-educator I. S. Mikheev in the aspect of identifying their problems, the nature and types of conflicts depicted. Since the conflict is a key category of the dramatic work, the nature of its forming speaks both of the playwright’s skill and the pressing problems that worried him. According to the author of the article, in the works of I. S. Mikheev social, moral, national and socio-political problems are brought up to date, which are revealed through a variety of conflicts. In the plays “En Lushka” (“Do not steal”) and “Viz’tem Onton” (“Stupid Onton”), the playwright depicts the dramatic fate of heroes whose behavior, from the point of view of those around them, contradicts generally accepted morality: in the first case, attention is focused on the role of the “institute” of community, regulating the normative behavior of people in a way of lynching; in another case, on the immutability of God's punishment in relation to a person who has transgressed the permitted line. The playwright devoted his other plays to a rational, culturally enlightened person, free from obsolete habits and prejudices: “Pellyashch’kishch’” (“Fortune-teller”), “Udmurt Doktor” (“Udmurt doctor”); to people who identify themselves with the Udmurt culture and their native language with a wide scope of application: “Udmurt Dyshetyshch” (“Udmurt teacher”); to the independent and possessing equal rights Udmurt people, free from national and social oppression: “Udmurtyoslen revolyutsi poton azh’yn ulemzy” (“Life of the Udmurts before the revolution”). The study of plot conflicts made it possible to establish that the playwright develops a confrontation between the individual and the community, between the individual and the collective; depicts the battle between the old, the obsolete and the advanced, progressive; actualizes the generational gap; reveals social and interethnic contradictions and demarcations.
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Oruh, Emeka Smart, Chima Mordi, Akeem Ajonbadi, Bashir Mojeed-Sanni, Uzoechi Nwagbara i Mushfiqur Rahman. "Investigating the relationship between managerialist employment relations and employee turnover intention". Employee Relations: The International Journal 42, nr 1 (6.01.2020): 52–74. http://dx.doi.org/10.1108/er-08-2018-0226.
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Purpose The purpose of this paper is to investigate the relationship between managerialist employment relations and employee turnover intention in Nigeria. The study context is public hospitals in Nigeria, which have a history of problematic human resource management (HRM) practice, a non-participatory workplace culture, managerialist employment relations and a high employee turnover intention. Design/methodology/approach Based on a qualitative, interpretive approach, this paper investigates the process by which Nigerian employment relations practices trigger the employee turnover intention of doctors using 33 semi-structured interviews with key stakeholders in public hospitals. Findings This study found that Nigeria’s managerialist employment relations trigger the employee turnover intention of medical doctors. Additionally, it was found that although managerialist employment relations lead to turnover intention, Nigeria’s unique, non-participatory and authoritarian employment relations system exacerbates this situation, forcing doctors to consider leaving their employment. Research limitations/implications Studies on the interface between managerialism and employment relations are still under-researched and underdeveloped. This paper also throws more light on issues associated with managerialist employment relations and human resources practice including stress, burnout and dissatisfaction. Their relationship with doctors’ turnover intention has significant implications for employment policies, engagement processes and HRM in general. The possibility of generalising the findings of this study is constrained by the limited sample size and its qualitative orientation. Originality/value This paper contributes to the dearth of studies emphasising employer–employee relationship quality as a predictor of employee turnover intention and a mediator between managerialist organisational system and turnover intention. The study further contributes to the discourse of employment relations and its concomitant turnover intention from developing countries’ perspective within the medical sector.
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Waddington, Ivan, Andrea Scott-Bell i Dominic Malcolm. "The social management of medical ethics in sport: confidentiality in English professional football". International Review for the Sociology of Sport 54, nr 6 (9.10.2017): 649–65. http://dx.doi.org/10.1177/1012690217733678.
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This paper examines one of the major ethical challenges in the practice of sports medicine, confidentiality. Drawing on interview and questionnaire data with doctors and physiotherapists working in English professional football clubs, it explores the degree to which ethical compliance has improved since the publication of, and publicity surrounding, an earlier study of medical practice in professional football conducted by Waddington and Roderick. Thus, it provides an updated empirical examination of the management of medical ethics in sport. The data illustrate how the physical and social environmental constraints of sports medicine practice impinge upon the protection of athlete-patient confidentiality, how ethical codes and conflicting obligations converge to shape clinician behaviour in relation to lifestyle and injury issues, and the ethically problematic contractual constraints under which clinicians and athletes operate. It demonstrates that medical ethical practice continues to be very variable and draws on Freidson’s work on medical ‘work settings’ to argue that there is a need to augment existing confidentiality policies with more structurally oriented approaches to ensure both professional autonomy and medical ethical compliance in sport.
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Markovic, Lovro, Daragh T. McDermott, Sinisa Stefanac, Radhika Seiler-Ramadas, Darina Iabloncsik, Lee Smith, Lin Yang, Kathrin Kirchheiner, Richard Crevenna i Igor Grabovac. "Experiences and Interactions with the Healthcare System in Transgender and Non-Binary Patients in Austria: An Exploratory Cross-Sectional Study". International Journal of Environmental Research and Public Health 18, nr 13 (27.06.2021): 6895. http://dx.doi.org/10.3390/ijerph18136895.
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Medical care of transgender and non-binary (TNB) patients if often a complex interdisciplinary effort involving a variety of healthcare workers (HCWs) and services. Physicians not only act as gatekeepers to routine or transitioning therapies but are also HCWs with the most intimate and time-intensive patient interaction, which influences TNB patients’ experiences and health behaviors and healthcare utilization. The aim of this study was to investigate the physician–patient relationship in a sample of TNB individuals within the Austrian healthcare system, and explore its associations with sociodemographic, health-, and identity-related characteristics. A cross-sectional study utilizing an 56-item online questionnaire, including the Patient-Doctor Relationship Questionnaire 9 (PDRQ-9), was carried out between June and October 2020. The study involved TNB individuals 18 or older, residing in Austria, and previously or currently undergoing medical transition. In total, 91 participants took part, of whom 33.0% and 25.3% self-identified as trans men and trans women, respectively, and 41.8% as non-binary. Among participants, 82.7% reported being in the process of medical transitioning, 58.1% perceived physicians as the most problematic HCWs, and 60.5% stated having never or rarely been taken seriously in medical settings. Non-binary participants showed significantly lower PDRQ-9 scores, reflecting a worse patient–physician relationship compared to trans male participants. TNB patients in Austria often report negative experiences based on their gender identity. Physicians should be aware of these interactions and reflect potentially harmful behavioral patterns in order to establish unbiased and trustful relations.
Rozprawy doktorskie na temat "Problematic doctor behaviour"
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Kennedy, Judith Ronelle Graduate Program in Professional Ethics School of Philosophy UNSW. "The treatment engagement model as a tool for identifying problematic doctor behaviour. Three case studies". Awarded by:University of New South Wales. Graduate Program in Professional Ethics, School of Philosophy, 2006. http://handle.unsw.edu.au/1959.4/28220.
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This thesis is an exploration of professional behaviour in health care settings, using a Model of Treatment Engagement that is developed as a tool for ethics critique. The Model is tested and refined using data on: a psychiatric ???treatment??? carried out on over 1,127 occasions in a 15 - 40 bed non-acute hospital during the period 1961-1979; the problematic withdrawal of all life-support from a 37 year old man who had suffered acute brain trauma some five days previously, in a tertiary hospital in March 2000; and a clinical experiment recently proposed for the emergency setting and intended to encompass five hospitals and the NSW Ambulance Service. In each case, the Model proves useful in identifying the shift from the treatment paradigm and the ethical imperative of ensuring the patient (or his/her agent) appreciates the difference between what is proposed and what would normally be done. It reveals how doctors who dealt with the patient but did not decide on treatment contributed to ethically troublesome practice. It clarifies how having multiple doctor players in the treatment situation gave rise to the need to suppress dissenting views. Doctors who were close enough to the action to comprehend its nature, by not dissenting, reinforced the problematic choice for the actor and validated it in the eyes of observers. The lack of dissent at the level of doctors working under supervision, appeared to be a function of institutional arrangements. At the consultant level, there was evidence of pressure to concur from other consultants and indirect evidence of a fear of ostracism. The public responses in the two modern cases point to there being a strong idea in Sydney???s medical community that dissent should not be publicly displayed once a decision on how to treat has been made. I conclude there are two steps to reviewing ethically problematic treatment situations. The first consists of identifying the shift from the treatment paradigm. The second consists of establishing why the problematic choice is translated into action. The Treatment Engagement Model is put forward as a useful tool for both these analyses.
Książki na temat "Problematic doctor behaviour"
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Perugi, Giulio, Giulia Vannucchi i Lorenzo Mazzarini. The treatment of cyclothymia. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198748625.003.0010.
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The treatment of cyclothymia is problematic due to its rather complex clinical picture (early onset, lack of clear-cut episodes, high co-morbidity), a challenging patient–doctor relationship and a high sensitivity to medications. This chapter summarizes available evidence on pharmacological treatment, psychoeducation, and psychotherapy for cyclothymic patients. The management of cyclothymia should rely on integrated strategies. The psychopharmacological treatment has to follow the principle of ‘go slow and stay low’. Mood stabilizers should be the first option and antidepressants and antipsychotics should be used cautiously and for short periods of time to manage depressive, anxious, or hypomanic symptoms. Psychoeducation should be started from the beginning and is aimed to promote a better knowledge of the disorder and its effects on daily life as well as adherence to medications. The inclusion of individual psychotherapeutic treatments (eg, cognitive behavioural treatment) should also be considered.