R ead the case study in box 4.3 (impact of physician attitudes on patient behavi
ID: 162319 • Letter: R
Question
Read the case study in box 4.3 (impact of physician attitudes on patient behavior: A true story) in the course textbook Schiavo, 2014, page 119.
Discuss how the provider-patient communication affects the outcome of treatment?
Recall from your experience a story that show the important of this kind of communication.
BOX 4.3. IMPACT OF PHYSICIAN ATTITUDES ON PATIENT BEHAVIOR: A TRUE STORY Carmen was a sixty-one-year-old Spanish woman visiting her relatives in the United States (The name of the patient and some other facts have been changed to protect the patient's and physicians' privacy) During her trip, she was hospitalized for emergency spine surgery. She had been suffering from excruciating back pain that her physicians in Spain had mis diagnosed. While in the United States, her pain had worsened, and it turned out that a major infection had almost destroyed two of her vertebrae and was threatening her ability to walk. The surgery was successful. However, Carmen felt isolated in a foreign hospital where she could not communicate with physicians and nurses. She spoke no English. Her relatives visited her as often as they could, but they also needed to deal with work and family obligations. They hired an interpreter for a few hours each day so Carmen could communicate with the hospital staff and perhaps feel a little less lonely Approximately fifteen days after the surgery, one of Carmen's physicians recommended that she try to stand up and sit on a chair. When he went to visit Carmen, he did not speak to her through the interpreter. He just instructed the nurse to help her and did not show much empathy for Carmen's pain. Carmen tried to get out of bed, but her pain was really bothering her. After the first attempt, she asked her interpreter to tell the physician that she was tired; she needed to rest and might try later. A few hours later, her internal medicine specialist came by. She had been alerted about the earlier events and had called Carmen's relatives to discuss how to approach this issue. She greeted Carmen warmly and started to speak with her through her interpreter. Carmen talked about her attempt to stand up. She was still in a lot of pain. Despite the words of reassurance by her relatives who had just telephoned her, she was not sure she wanted to try again. After all, in most countries, patients who have this kind of surgery, or even less invasive surgery, are confined to bed rest for much longer. Carmen found the request unreasonable. The internist explained to Carmen that this was a common procedure in the United States and helped improve and accelerate a patient's rehabilitation. She highlighted the benefits of early ambulation. She also showed empathy for Carmen's pain. She mentioned that she would consult pain specialists to see whether they could do something to reduce her pain while she tried to regain mobility. Through the interpreter, she made sure that Carmen understood all the information and also asked if she had additional questions.Explanation / Answer
carmen was found to be critically ill in a foreign country wit a different language. This has caused her an uncertain anxiety about herself and how she will go through all these pain and medication. she was found herself traped in the bad health, that too in a foreing country so that she unconciesly become suspecious and confused about every thing she was told to perform. Although she has a great support of her friends and family relatives she was indeed clueles.
At this critical time a physician empathy with the patients pain woks wonder for the speedy recovery of the patients. In this case when carmen refused to stand on her body from bed due to sever pain, the doctor did not took the help of her interpretator to firstly mentally prepare her for the procedure. when carmen experienced pain for the very first time during standing, she lost all her hopes to stand so early.
But when the internist sympathased with carmen and explained her with the help of her interpretator that it is general procedure and everyone goes sucessfully with it and also it will lead to early recovery, carmen made her mind to try again to stand on her feet. The assistance provided by internist and nurse gives her a cofidence which plays a vital role in her standing and early recovery. She recoverd in a less than months time and was able to walk on her own with the help of a stick. soon she will be all fine.
if carmen would have not been encouraged to stand it would have taken her long to be cured, also she might have developed some other ailments due to long medications which her weak body has to bear. The story trully imphasises the need to show empathy with patients dealing with pain. Showing concern and syphathy is a part of patients cure or we can say it is one of the pills that the physician must give to their patients.
when i was in my high school, i got a knee injury during riding bicyle. The wound was washed and dressing was done and the nurse told me to come again for dressing after 2 days. I went for dressing after 2 days, the nurse told me that it can hurt me little but i have to wear it coz only this way its going to be alright. she almost narrated me to keep quit during dressing, if i shout it will cause her work diverted and the wound may get deeper!!! omg !!
I patiently gone through the dressing and believe me if she had not made my mind before the dressing, i might have aborted the procedure in the middle of it. It was painful, but the hope that it will be ok after this gave me the courage to toletare all the pain.
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