Social science & medicine
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Social science & medicine · Jan 1984
Doctor-patient interaction, patients' health behavior and effects of treatment.
Studies of doctor-patient communication and its consequences are usually limited to factors that may determine patients' compliance with doctors' instructions. But many patients besides or instead of following doctors' advice undertake additional activity in order to get well. The purpose of this study was to explore the whole range of patients' health behavior, its connection with the process of doctor-patient interaction (as an independent variable) and with the treatment results (as a dependent variable). ⋯ It was found that some characteristics of the doctor-patient interaction; doctors' directiveness, doctors' emotional attitude towards the patient, patients' activity, patients' partnership status had an effect on patients' health behavior (compliance with doctors' orders and patients' spontaneous health activity). Even stronger was the connection between these with the degree of patients' compliance with doctors' instructions but were positively connected with the amount of patients' spontaneous health activity. Authors analyzed these findings in the light of psychosomatic medicine.
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Social science & medicine · Jan 1984
Courage: a neglected virtue in the patient-physician relationship.
The contribution that the virtues can make to the moral life in general and to the moral community constituted in the patient-physician relationship more specifically is gaining increased scholarly attention. This paper explores the meaning and relevance of the virtue of courage for patients and physicians. Courage is presented as a virtue for physicians in addition to the excellences of competence and compassion and a virtue for patients in addition to the excellences of compliance and gratitude. ⋯ Patients are held to have a duty to learn about the nature of human existence and to develop the character necessary to its negotiation. Patients and physicians can be agents of courage who come together in a context of care and concern where certain goods are preserved even, at times, in the midst of loss. Thus, courage is presented as a relevant and important moral virtue for the patient-physician relationship in which those qualities that define who we are as a moral community are expressed and sustained.
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Social science & medicine · Jan 1984
Managing medical mistakes: ideology, insularity and accountability among internists-in-training.
By the end of graduate medical training, novice internists (collectively known as the housestaff) were initiated into the experience of either having done something to a patient which had a deleterious consequence or else having witnessed colleagues do the same. When these events occurred, the housestaff engaged in social-psychological processes, utilizing a variety of coping mechanisms and in-group practices to manage these mishaps. Three major mechanisms were utilized by the housestaff for defining and defending the various mishaps which frequently occurred: denial, discounting and distancing. ⋯ Housestaffers come to feel that nobody can judge them or their decisions, least of all their patients. As they progress through training even internal accountability cohorts--the Department of Medicine, teaching faculty and peers--are discounted to varying degrees. They have developed a strong ideology justifying their jealously guarded autonomy.(ABSTRACT TRUNCATED AT 400 WORDS)