“Balance is Be with the patient without being the patient“, emphasized the Spanish philosopher and writer Miguel de Unamuno. In an increasingly technological world, a study in United kingdom He warned that Patients' lived experiences They are being It is underestimated by health professionals.
that it investigation Conducted with more than 1,000 patients and doctors and revealed examples of underestimation in patient reports. He was responsible for a team of Cambridge University And King's College London. It was published in the specialized journal Rheumatic diseases.
They found that doctors considered patients' self-evaluations to be the least important in making decisions about diagnosis. also It found that professionals reported that patients exaggerated or underestimated their symptoms more frequently than patients reported.
However, it is known that listening to patients' words can also help in accurately diagnosing the problem they are experiencing.
One patient who participated in the study shared frequent feelings of not being believed and being considered “degrading and dehumanized.”
He stated: “If I had continued to take into account the doctors’ experience over my experience, I would have died… when I enter the doctor’s office and my body is treated as if I have no control over it and what I do.” The feeling is not right, it is a very unsafe environment… I tell them my symptoms and they tell me this symptom is wrong, or that I can't feel pain there, or in this way“.
The researchers focused on patients with a type of… LupusIt is an autoimmune disease that is particularly difficult to diagnose. They examined the value doctors placed on 13 different types of tests used in diagnosis. It included evidence such as brain scans, patient opinions and observations of family and friends.
Experts in family medicine, pain medicine and bioethics are consulted information Which Patients with other diseases may face similar situations due to a lack of empathy and listening. By health professionals.
At work in United kingdomLess than 4% of doctors consider patient self-assessment to be one of the three most important tests.
Instead, doctors included their own assessments up front, although they acknowledged that they often mistrusted diagnoses that often involved invisible symptoms, such as headaches, hallucinations, and depression.
These symptoms can reduce quality of life and are often misdiagnosed, the research authors explained. Therefore, these symptoms are not treated as properly as other visible symptoms, such as a rash.
Nearly half (46%) of the 676 patients reported that they had never been asked or had never been asked about their self-assessment of the disease, although others reported very positive experiences. It has also been shown that women are more likely to be told that their symptoms are “psychosomatic”. Male doctors were statistically more likely to say that patients exaggerate symptoms.
“It's time to move on My fatherand often dangerous,The doctor knows best To one A more equal relationship Patients with lived experiences and doctors with acquired experiences work more collaboratively. Sue Farringtonco-chairman of Alliance Against Rare Autoimmune Rheumatic Diseases. The research was funded by The Lupus Trust and LUPUS UK.
The lead author is a Ph.D. Melanie Sloan“It is very important that we listen to and value patients' opinions and their own interpretations of symptoms, especially in the case of chronic diseases,” stressed, from the Department of Public Health and Primary Care at the University of Cambridge. “But we also need to make sure that doctors have enough time to explore each patient's symptoms carefully.” Completely, which is difficult under the limitations of current health care systems.
In conversation with information since United State, Marie Catherine BeachProfessor and researcher at the Center for Health Equity Berman Institute of Bioethics Follower Johns Hopkins UniversityHe pointed out that “the study highlights a very important problem that has not received sufficient attention.” “It is a widespread phenomenon and is not limited to rheumatic diseases.” Patients with other disorders express their symptoms, but they are not always heard.
It is known, says Professor Beach, that “it is not always possible for a person to remember everything perfectly or to be able to accurately attribute the reasons why something happened, so sometimes patients may not be right.” A classic example is an upper respiratory infection: patients may think they have a bacterial infection that needs antibiotics, but that doesn't mean that's true.
He admitted that patients sometimes make mistakes. “Doctors can overgeneralize this point and ignore comments that should not be ignored,” he said. “I think there is a general bias against insured patients, which is nothing more than a cognitive bias.”
Beach also opined that “as a society we have a bias toward forms of data that are objective rather than subjective. We have racial, pathological (e.g., mental disorders) and perhaps gender biases that cause us to believe some people more than others.”
In the face of the lack of two-way dialogue and the search for more certain answers, there is much to work on on the part of health professionals and patients.
According to Maria Julia Apariciophysician and coordinator of the University's Interdisciplinary Center for Chronic Pain and Palliative Care Jose de San Martin Clinical Hospital Follower University of Buenos Airesin Argentina, “It is a frequent complaint from patients that doctors do not listen to them. “This is due to the lack of a prior relationship between them, and the lack of time available for consultation.”
Many times – said Aparicio information– The patient does not feel satisfied and consults with another specialist and requests new studies. “Consequently, the consultation is diverted to seeing studies, and what prompted you to see a health professional initially is left in the background,” he said.
The key is “education of health professionals because we do not receive enough training in empathy and active listening in undergraduate or postgraduate studies. All professional and professional teams should be trained to listen to patients and their families. In this way, the task becomes much easier, it brings us closer and allows our work to stand out and make us feel patient.
while, Karen KopitowskiHead of the Family and Community Medicine Service at the Italian Hospital of Buenos Aires and President Argentine Federation of Family and General MedicineHe pointed out that listening to the words expressed by patients also helps in diagnosing diseases.
“Having a patient who speaks only once in a consultation is not the same as having a trusted and reliable specialist. There are patients who talk more. Others express concerns about certain diagnoses because of certain symptoms. It is important for professionals to ask patients about their beliefs and fears and that they can Hear them.”
The specialist also does not support challenging the patient for not following the recommendations given. “Patients should not be afraid or defiant. “They have the right to be heard and get clarifications about diseases and symptoms,” he commented.
According to American expert Beach, “As patients, we can often tell when a doctor takes our concerns, reports, or ideas seriously. You should always look for a doctor who takes you seriously. If they're really stuck working with this doctor, the best thing anyone can do is keep coming up with their thoughts and explaining their reasons. If they still refuse, you can change professionals.
Non-profit organization AARPwhich helps people over the age of 50 with United StateShare this Recommendations so that doctors can hear patients:
1. Make a personal connection. Before discussing concerns, you should break the ice with a greeting or even a joke.
2. There is no need to be distracted. After saying hello, get straight to the reason for the consultation.
3. You must tell the whole truth. If you do not speak frankly, the doctor cannot be expected to listen to the ailments or solve them appropriately.
4. You can practice in advance how you will speak, especially with uncomfortable topics, such as talking about incontinence or diarrhea.
5. “It's just aging” should not be accepted as a response from professionals when talking about a symptom
6. Questions should not be saved until the end, because when the consultation is about to end, the specialist is already thinking about the next patient. You should bring a list of concerns and share them within the first minutes.
7. You can go accompanied to a medical consultation. A loved one or family member can write down information and remember the issues they wanted to discuss. It can also be used to remember your doctor's instructions after a consultation.
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