Man is whole. The body cannot be healed without taking into account the psyche. However, many doctors still ignore this fact. Agnieszka Gołaszewska talks about the patients, their expectations and needs as well as the patient-doctor relationship with the psychologist Agata Wytykowska.
A lot has been said recently about the role of the doctor-patient relationship in the treatment process. So why, instead of respect and empathy, we deal so often with outright disregard?
The situation is complex. On the one hand, we are dealing with ossified institutions and their work standards that do not keep up with the changes in the approach topatient . On the other hand, the poor financial situationhe alth care-doctors , fighting for the survival of their facilities, stop paying attention to the patient's quality of life (i.e. the degree of satisfaction of important needs), they feel a little relieved of good everyday standards. The final effect of such an approach is the loss of the patient in the system.
So what do we need to do to make doctors see the patient, not just his disease?
It is true that psychology has been in the medical studies program for many years, but it is necessary to change the curriculum and increase the number of hours. For example, doctors must be taught how the psyche influences the daily functioning of a person, how to talk to the sick, etc. In fact, we are all just learning to appreciate the influence of the psyche on the quality of life. What we feel can both increase our quality of life, improve everyday functioning, but it can also have a destructive effect.
We all know that the psyche is important in the healing process. So why does it only end with theory?
Doctors do not know how to talk to the patient. They are also not aware of the role of their attitude towards the patient in the treatment process. I have heard quite often from doctors that they are not therapists. And yet man is whole. The body cannot be healed without taking into account the psyche.
What does this result from?
The natural tendency of each of us is to run away from emotions that are difficult for us (fear, anxiety, anger). Another patient with his fear makes the doctor prefer to shut up, go into procedures, standard questions, so that the patient does not reveal his emotions, e.g. he cries. Because what to do with it then, how to react.
Isour expectations that the doctor will see us as a human being is something exorbitant?
It's time to dispel one of the myths. Most of us do not expect a doctor to support him emotionally. Therefore, the doctor does not have to play the role of a therapist. Often, only respect and compassion are enough, i.e. understanding that the sick person is afraid, accepting it and not running away. Minor elements - e.g. shaking a hand, saying good morning with a smile, asking how someone is feeling and listening to the answer by looking at the patient rather than writing out papers. Sometimes such a small change brings a very significant improvement in the doctor-patient relationship.
Patient in the he althcare system - who is he really? Subject or intruder?
Often our he alth service still treats patients on a mass scale, only as cases. It is favored by dressing the patient in pajamas, which further dehumanizes him. This creates additional negative conditions for the disease process, which is stressful in itself. And yet disease is like sterile soil. For something to grow, we need to support it. Taking care of your mental condition is therefore a kind of fertilizer. Of course, nothing will grow from the fertilization itself, you have to sow something (in this case, give the drug), but we can create conditions for the drug to work faster and better.
What can be the effects of a good relationship between the doctor and the patient?
The attitude of the doctor to the patient - which many do not know or do not remember - affects whether the patient will want to continue treatment, or will not give up therapy scared and discouraged. Having confidence in the doctor, the patient feels much less anxiety. This improves his psychophysical condition. It is easier to treat. It is also easier for a family to take care of a sick person who is in a better emotional state (fear, hope, faith less). After all, the role of the family in the therapeutic process is huge. So the chain of positive elements grows, and its first link is a good doctor-patient relationship.
Clinical psychologists have been appearing in treatment teams for several years. However, this is still not the norm. Why?
First, there are no jobs. But not only. Yet many doctors do not see the need for such cooperation and do not treat psychologists as full members of the team. In fact, both sides, i.e. both doctors and psychologists, are just learning to cooperate. Not only organizational but also mental changes are needed. Only a properly educated student as a doctor will feel the need to add a psychologist to the team and finally force him to hire him. It is a long road, but positive changes are slowly becoming visible. So let's hope thatUltimately, the demands placed on doctors will force them to develop certain habits and they will become more open to the patient.
Research project - please describe it in a few words. And why were patients with neuroendocrine tumors (NETs) selected?
Maybe backwards. People with NET tumors are specific patients, namely the survival time in this disease is quite long. This allows longer observation. Moreover, so far, not only in Poland, but also in the world, such patients have not been examined in terms of their quality of life. The aim of the program that is about to start is to investigate what their quality of life looks like, how it changes throughout the disease, and finally whether the quality of life depends on certain psychological characteristics: temperament and coping strategies. Mental vegetation is something fatal for these patients, it is impossible to live with a permanently lit red button, because it will burn out. We should get the first results next summer.