Important Medical Decisions
| Autor: | Jerald Kay, Stephen F. Bauer, William H. Sledge, Susan G. Lazar, Stephanie Giannandrea, Beth Brodsky, Eric M. Plakun, William C. Offenkrantz, Lawrence H. Rockland, John M. Oldham, Michael V. Pantalon, Lisa A. Mellman |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Value (ethics)
Psychotherapist media_common.quotation_subject Decision Making Motivational interviewing Directive Counseling Resistance (psychoanalysis) Motivational Interviewing Ambivalence Best interests medicine Humans Ethics Medical media_common Motivation Physician-Patient Relations Communication Barriers Beneficence Fear Patient Simulation Patient Compliance Anxiety Patient Participation medicine.symptom Psychology Autonomy |
| Zdroj: | Journal of Psychiatric Practice. 19:98-108 |
| ISSN: | 1538-1145 |
| DOI: | 10.1097/01.pra.0000428556.48588.22 |
| Popis: | GOALS The use of motivational interviewing (MI) when the goals of patient and physician are not aligned is examined. A clinical example is presented of a patient who, partly due to anxiety and fear, wants to opt out of further evaluation of his hematuria while the physician believes that the patient must follow up on the finding of hematuria. BACKGROUND As patients struggle in making decisions about their medical care, physician interactions can become strained and medical care may become compromised. Physicians sometimes rely on their authority within the doctor-patient relationship to assist patients in making decisions. These methods may be ineffective when there is a conflict in motivations or goals, such as with patient ambivalence and resistance. Furthermore, the values of patient autonomy may conflict with the values of beneficence. METHOD A patient simulation exercise is used to demonstrate the value of MI in addressing the motivations of a medical patient when autonomy is difficult to realize because of a high level of resistance to change due to fear. DISCUSSION The salience of MI in supporting the value of patient autonomy without giving up the value of beneficence is discussed by providing a method of evaluating the patient's best interests by psychotherapeutically addressing his anxious, fear-based ambivalence. |
| Databáze: | OpenAIRE |
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