[The look into the look: how patients' suffering is perceived by health workers]

The literature about the surgical treatment of the urologic patient shows an increased attention to the outcome measures related to the quality of life and satisfaction of the treated subject. In this context, a crucial position must be attributed to the quality of the relationships among all the subjects involved in the therapeutic process, and especially among caregivers and patients. Cognitive and emotional dimensions play an important role at this regard, to which a spread sensitivity as for the "local culture" of care must correspond. The aim of this study is to identify the health workers' perception and representation of the cognitive and emotional needs of the patients and their relationship with the organizational complexity of the department. The study was implemented in the Urology Department of the Ospedali Riuniti in Bergamo. It involved eleven health workers (two medical doctors and nine nurses). Each of them underwent a semi-structured interview. The anonymous interview transcripts were analyzed using the T-Lab thematic content analysis program. The study highlighted sensitive areas such as: informative dialogue with the patient, reactivity facing the intervention according to gender, the subject's self-adapting process to the clinical environment and the organizational functioning of the department. The health workers' need of new approaches to meet the needs of the subjects under treatment and their family is underlined. Furthermore, the requirement of consistent functional organizational changes to improve the quality of relationships in the process of care is pointed out. The health workers reported both critical situations, efforts, perceived difficulties and important relational resources to face them.