METHODOLOGICAL INSTRUCTION
for the lesson
Theme : Psychology of health professionals and diagnostic and treatment process.
For 3-th year students of stomatological faculty
1.Actuality Aim
Psychological side of relationships “patient-doctor” is important on all stages of diagnostic and therapeutic processes, but especially great value it acquires at the first meeting, establishment of psychological contact that proceeds diagnostics and therapy. The optimum psychological contact on 40% provides success, efficiency of interpersonality co-operation.
2.Hours: 2
3.Teaching goal
The students must know:
-the basic requirements to the personality of medical workers;
-psychological types of doctors;
-a concept about professional deformation;
-communication in a medical environment;
-types of communication in medical environment;
-peculiarities of communication between doctors, doctor - nurse.
and be able to:
-objectively and scientifically determine the place and role of personality of medical workers;
-interpret conditions to create healthy psychological climate in the medical environment;
-analyze psychological peculiarities of patients with various pathologies;
-to determine the way of communication between doctors, doctor - nurse;
-know methods of research of personality;
-evaluate the results of experimental-psychological research of patient’s personality and attitude toward a disease.
Assimilate practical skills
-analyze psychological peculiarities of personality of medical workers;
-communication with patients;
-methods of research of «syndrome of burning out»;
-experimental-psychological research of personality.
4.List of disciplines necessary for learning theme 1
Title of the discipline / Content of the discipline necessary for learning medicalpsychology
Anatomy / Brain construction
General psychology / Psychic functions of a normal person. Consciousness and self-consciousness. Psychology of personality.
Neuropsychology / Functions of different brain structures.
Normal physiology / Brain functions. Physiology of high nervous activity.
5.Content of the theme
In the mutual relations «patient - doctor» a patient is predispositioned to add to the doctor those lines which must help to overcome illness. Examining personality of doctor as meaningful figure which has certain magic capabilities, a patient can idealize him, expecting the rapid and effective healing of all enemies, has a hope sometimes not only on deprivation from somatic illness but also often unconsciously, on the decision of the psychological problems. This expectation of help not only in deprivation from illness but also in satisfaction of necessities and hopes dissatisfied before (necessities in tenderness, sympathy, acceptance), results in forming of transfer (transfer). A patient carries on a doctor past experience of relationships with meaningful people, expectations and hopes which existed in these relations. If a patient carries on a doctor the positive senses related to positive experience of mutual relations in the pas, we talk about the positive transfer. If a patient carries the negative senses on a doctor, related to past negative experience of construction of relations is sense of crabbiness, mistrust, hostility, talk about the negative transfer. In the mutual relations with a doctor a patient can project on him ambivalent emotional experience, with experiencing in relation to him of sense of watchfulness and tenderness, trust and hostility.
Reactions of transfer of patient (positive, negative, ambivalent) - complicate communication with him, influence on efficiency of co-operation.
The phenomenon which in the interpersonalities mutual relations concemes by a term «psychological incompatibility» has in the basis more frequent mutual negative transfers and contra-transfers .
Understanding and removal of portable reactions allows to build the relationships with the real man, not with own (traumatic) experience of the pas. The receipt of information about a patient foresees ability of doctor to formulate a question. In the process of questioning and review of patient, doctor mentally sorting out all possible hypotheses which the orientations formulated in a phase were. Casts aside vicious, deciding on 2-3 most reliable in the world of new obtained information . Thus there is a previous diagnosis. In order that the previous diagnosis got at the question and review of patient in the phase of argumentation became final, it is necessary leadthrough of additional laboratory researches. Task of doctor - not only to write the proper directions but also to explain a patient to passing of all necessary diagnostic procedures.
The last phase of intercourse is the phase of correction. Meeting with a patient must have completion not only in a professional plan but also in psychological. Task of this phase - to give an emotional support for the patient. Unverbal conduct of doctor in this phase matter very much. Maintenance of final phrase is important, for example, “now there are three: you, I and Your illness, If you will be on my side, we will overcome it». This is expressed by quiet, sure voice, is accompanied by the friendly look, gesture, accompanying and simultaneously such, that invites a patient on the next meeting.
During a therapeutic process it is necessary to remember the following psychological aspects:
-illness especially heavy is related to the threat of invalid, becomes independent by a psychical trauma.
-vibrations of feel, especially at the beginning of therapy, often result in doubting of patient, uncertainty of curing, in the competence of treatting doctor. Patient became in situation with the deficit of information and vagueness. An alarm is the most frequent emotional reaction. In such periods especially important hard position doctor, simple, logically clear explanations, his confidence and optimism.
-influencing of hospitalization, when patient goes in a new social situation for him with the sharp changing of way of life.
-attitude of patient toward medications.
-psychological influencing of extract.
On forming of mutual relations «patient - doctor» influence a sex, age, level of education, social status. There are three models of their mutual relations: guidance, partnership and contract model.
A partner model is more democratic.
A contract model was folded in the conditions of requiring payment medicine. It allows to structure and control a medical process both of its participants. Legal responsibility for the results of treatment is carried by a doctor, but psychological responsibility in a certain measure lies on a patient. Executing payment of medical services, a patient takes title to choose a doctor.
THE PROFESSIONAL BURN-OUT SYNDROME CONCERNES AS THE STATE OF EMOTIONAL, PSYCHICAL AND PHYSICAL EXHAUSTION THAT DEVELOPS AS A RESULT OF CHRONIC UNSOLVED STRESS ON A WORKPLACE
Burning-out is accompanied by physical, emotional and psychical exhaustion:
1.Chronic fatigue - exhaustion, tiredness, a sense of being physically run down
2.Anger at those making demands
3.Self-criticism for putting up with the demands
4.Cynicism, negativity, and irritability
5.A sense of being besieged
6.Exploding easily at seemingly inconsequential things
7.Frequent headaches and gastrointestinal disturbances
8.Weight loss or gain
9.Sleeplessness and depression
10.Shortness of breath
11.Suspiciousness
12.Feelingsof helplessness
13.Increased degree of risk taking
Every professional which works in medicine can clash with BOS. That is why medical personal must not only to know about it but also haw to prevent it.
The prophylaxis of development of burn-out syndrome consists in acceptance on itself of responsibility for the work, the professional result and in delegation of part of responsibility to the clients and patients. In ability to take it easy and dates to itself time for achievements in life and at work. Because the professional falling and even deadlocks is the natural stages of professional development of the every specialist. For a doctor, forming of own world view which provides success in-process is important, to proceed in capabilities own heartfelt and spiritual forces.
5.2.Theoretical questions:
1.The basic requirements to the personality of medical workers;
2.Psychological types of doctors;
3.A concept about professional deformation;
4.Communication in a medical environment;
5.Types of communication in medical environment;
6.«Syndrome of burning out».
7.Peculiarities of communication between doctors, doctor - nurse.
5.3.Practical training during the tutorial
1.Clinical observation of the behavior of the medical personal.
2.Research of «Syndrome of burning out».
5.4.Materials for self-control
A.Questions for self-control:
1)The basic requirements to the personality of medical workers;
2)Psychological types of doctors;
3)A concept about professional deformation;
4)Communication in a medical environment;
5)Types of communication in medical environment;
6)«Syndrome of burning out».
7)Peculiarities of communication between doctors, doctor - nurse.
B.Tasks for self-control
1.Typical, ordinary - II level.
2.Untypical, no ordinary - III level.
C.Tests for self-control.
Literature
1.R.J.Gatchel An introduction to health psychology. - New York: Random house. - 386 p.
2.Lectures.
3.Internet resource.
4.Вітенко I.C., Вітенко T.I. Основи психології: Підручник для студентів вищих медичних навчальних закладів III - IV рівнів акредитації. - Вінниця, 2001.
5.Вітенко І.С., Чабан О.С., Бусло О.О. Сімейна медицина: психологічні аспекта діагностики, профілактики і лікування хворих. - Тернопіль, ’’Укрмедкнига”, 2002.
6.Гавенко В.Л., Вітенко І.С., Самардакова Г.О. Практикум з медичної психології. - Харків: Регіон-інформ, 2002.
7.Квасенко А.В., Зубарев Ю.Т. Психология больного. М., 1980.
8.Лакосина Н.Д., Ушаков Г.К. Медицинская психология. М., 1984.
9.Менделевич В.Д. Клиническая и медицинская психология. - М.: Мед.прес., 1998.
10.Ю.Мягков И.Ф., Боков С.Н. Медицинская психология: основы патопсихологии и психопатологии: Учебник для вузов.- М.: Издательская корпорация „Логос”, 1999.
Prepared by assistant A.O. Kaminska
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