Professional Documents
Culture Documents
R. Sjamsuhidajat
Tjakra Wibawa Manuaba
Sutrisno Alibasyah
PERIOPERATIVE COURSE
INDONESIAN COLLEGE OF SURGEONS
INDONESIAN COLLEGE OF ANESTHESIOLOGY
DOCTOR PATIENT
RELATIONSHIP
No
more paternalistic
Should be on partnership basis
Equal position
Communication is not:
as some would say, simply good
manners, empathy, being nice or
pandering to the patients.
BUT
it offers a much more effective
consultation, and improved outcomes for
both
patients and doctors.
HOPEFULLY.NOT
The blind leading the blind?
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Underlying Premises
- Communication skills teaching and learning
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Underlying Premises..
- Coordinated approach to communication
skills teaching throughout medical education
is necessary.
- A skill, based on approach to communication
skills teaching is essential.
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Changes.
Negative
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Emotional changes
Usually
temporary
Depending on Emotional Stability, past
experiences, psychological maturity, internal
representation, cognitive processing, traumatic
stressor and probably education?
Awareness
of Emotional reaction.
Return toward normal balance (in
majority cases)
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Emotional Reaction
Emotional Processing
Awareness of Emotional Reaction
Returns
DEPRESSED!
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STRESS / DEPRESSION
Suppressed into
Subconsciousness
-
Becoming chronic
Change of value system
Reappraisal
Disturbance of emotional processing
Failure to complete the emotional processing
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-Clearer
-More effective & efficient communication
-Honesty & openness.
-Trust
-Mutual respect
-Politeness
-Adherence
-Collaboration.
-More accurate information
-Prevention of violent situation
-Informed consent
-Legal aspects
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Preparation
Summarizing
Negotiating the Agenda
Listening
Picking up Cues
The use of Silence
Discovering the patients concern and ideas
Encouraging the expression feeling
Picking up the non verbal cues
Building rapport
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Conditioning
Empathy
Acceptance
Discovering the patient starting point
Discovering the patients feeling
Gauging what and how much information to give
Discovering whether a patient is a seeker or and
avoider of information
Giving support
Giving clear jargon- free explanation
Chunking and checking information giving
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PREPARATION :
- Set Up appointment as soon as possible
- Un interrupted time
- comfortable & familiar atmosphere
- Invite spouse, family, friends as appropriate
- adequately prepared for patient background, education
situation, records.
- Doctor should put aside personal feeling.
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A HAUNTED SITUATION?
A PROVOCATIVE ATMOSPHERE FOR CONSULTATION?
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SPECIAL ISSUES
SPECIAL ISSUES
CULTURAL ISSUES.
- Cross Cultural Perspective
- Ethnic Complexities
- Do not stereotype patients
- Culture is a textured pattern of beliefs &
practices.
- Patients culture provide him/her ideas about
health and illness, notions about causality, etc
- Modern doctors very often encounter problems
relating to cultures, traditions etc.
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SPECIAL ISSUES
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THANK YOU
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