概括
医生经常遇到"困难"的病人,这个概念自1978年以来一直在探索. 本系列通过具有挑战性的患者互动来检查提供者转型,提供超越旧分类的新见解.
科学领域:
- 生物伦理学生物伦理学
- 医学人文学科 医学人文学科
- 医疗保健提供者教育教育
背景情况:
- 詹姆斯·格罗夫斯1978年的一篇文章"照顾讨厌的病人"指出了医生对某些患者的厌恶.
- 格罗夫斯对"讨厌"患者的分类 (依附者,有权要求者,操纵性的帮助拒绝者,自我毁灭性的否认者) 被重新审视.
- 这种分类学在捕捉"困难"患者互动的复杂性方面的局限性是公认的.
研究的目的:
- 探索当代医疗保健中"困难"患者互动的多方面的性质.
- 呈现各种各样的提供者关于他们与具有挑战性的患者的经验的报道.
- 突出通过这些遭遇发生的变革性学习.
主要方法:
- 从各种医疗保健环境中对提供者叙述的定性分析.
- 探索与患者互动的个人账户,这些患者被认为是"困难的".
- 专注于医疗保健提供者的主观经验和反思.
主要成果:
- 提供者叙述揭示了个人变革和对患者护理的不断变化的理解.
- 与"困难"患者的互动为提供者提供了深刻的学习机会.
- 医疗服务提供者反思他们的行动,确定改善患者体验的领域.
结论:
- "困难"患者的概念需要一个细微的理解,超越最初的分类.
- 提供者自我反思和转变是具有挑战性的患者互动的关键结果.
- 这些经验为提高未来的患者护理和提供者教育提供了宝贵的教训.
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