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[The doctor-patient relationship in chronic pelvic and perineal pain]
J-J Labat1, M Bensignor, M Boutet
1Centre fédératif de pelvipérinéologie et clinique urologique, CHU de Nantes, 44093 Nantes, France. jjlabat@chu-nantes.fr
Objective:
To analyse the doctor-patient relationship from the patient's point of view and from the doctor's point of view.
Material And Methods:
Experience of a chairman of a chronic pelvic and perineal pain patient association (AFAP-NP) and experience of doctors specialized in chronic pelvic and perineal pain.
Results:
Management of a patient with chronic pelvic and perineal pain requires knowledge and understanding of the patient's trajectory disease, the history of the disease and the patient's hopes and disappointments, and evaluation of the patient's personality and family, social and work environment.
Conclusion:
As pain is an emotional experience, the type of doctor-patient relationship determines the quality of subsequent management. A number of basic principles should be applied: believe the patient, avoid making the patient feel responsible for failure, avoid overestimating the secondary benefits, avoid making the patient passive and dependent, learn to reinterpret the patient's symptoms, ask "how" does the pain persist rather than "why", clearly define the patient's demand and adapt management to realistic and accessible objectives.
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