Repairing “Difficult” Patient-Clinician Relationships

Dudzinski, Denise M.; Alvarez, Carrol A.

doi:10.1001/journalofethics.2017.19.4.medu3-1704

Cited by 5 publications

(2 citation statements)

References 7 publications

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“…Moreover, our findings indicate that patients may face difficulties raising relational discontinuity with their providers. Accordingly, the role of providers may be to actively seek patient feedback, put the subject of relational continuity explicitly on the agenda with patients and develop more positive and sustainable relationships with their patients [ 46 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

Dealing with Discontinuity in Cancer Care Trajectories: Patients’ Solutions

Vermond

Habhoubi

Groot

et al. 2021

Patient

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Introduction Patients with cancer require specialized care from different care providers, challenging continuity of care in terms of information, relationships, and/or management. The recognition of discontinuity of care has led to different initiatives by the healthcare system over the years. Yet, making use of the theory on boundary objects and brokers, this research explores the active role of patients themselves in resolving discontinuity along their care trajectories. Methods Semi-structured interviews were conducted with 33 patients to unravel the discontinuities that they experience and their attempts to resolve these. Interview data were analyzed using directed-content analysis informed by concepts from boundary crossing literature (i.e., data were searched for potential boundary objects and brokers). Results To re-establish continuity of care, patients actively use the objects and people provided by the healthcare system when these meet their needs. Patients also introduce own objects and people into the care trajectory. As such, information and management discontinuity can typically be resolved. Relational continuity appears to be more difficult to resolve, in some cases leaving patients to take drastic measures, such as changing care providers. Discussion The use of boundary crossing theory in improving care from a patient perspective is relatively novel. When patients and providers together address the objects and people that support establishing continuity of care, a continuous care process may be encouraged. We advocate an integrated approach, rather than provider or healthcare system initiatives exclusively, to patient care and continuity.Debbie Vermond and Souad el Habhoubi were shared first authorship.

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Section: Discussionmentioning

confidence: 99%

Dealing with Discontinuity in Cancer Care Trajectories: Patients’ Solutions

Vermond

Habhoubi

Groot

et al. 2021

Patient

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“…Antagonistic behaviour, such as 'acting out' and becoming what is often described as a 'difficult' or 'noncompliant' patient, is not well tolerated (Dudzisnki & Alvarez, 2017). This may be seen in patients refusing to stay in bed, demanding different food, yelling, refusing to stay in their room, refusing to take certain medications, refusal to participate in therapies-a whole host of behaviours frequently assessed as 'noncompliance' with treatment (Scarlett & Young, 2016).…”

Section: A Formally Administered Way Of Lifementioning

confidence: 99%

Hospitals as total institutions

2021

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The image of the hospital is presented to the public as a place of healing. Though the oft-criticized total institutions of the past have been notably dismantled, the totalizing practices therein are now operationalized in the health care system. Through the lens of Erving Goffman, this article offers ways in which health care institutions operationalize totalizing practices, contributing to the mortification of patients and nurses alike in service to the bureaucratic machine. This article examines the ways in which totalizing practices may disrupt the agency of both patients and nurses alike.

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Distressed Parents and Family Issues

Judd-Glossy

Twohy

2020

Clinical Handbook of Psychological Consultation in Pediatric Medical Settings

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Repairing “Difficult” Patient-Clinician Relationships

Cited by 5 publications

References 7 publications

Dealing with Discontinuity in Cancer Care Trajectories: Patients’ Solutions

Dealing with Discontinuity in Cancer Care Trajectories: Patients’ Solutions

Hospitals as total institutions

Distressed Parents and Family Issues

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