ISSN:0022-4537    

DOI:10.1111/j.1540-4560.1979.tb00786.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

The interpersonal relationship between physician and patient involves a highly charged affective component. As a result, patients' satisfaction with medical care, their compliance with treatment regimens, and the outcome of treatment tend to be substantially related to their physicians' ability to satisfy their socio‐emotional needs in the health care encounter. This critical aspect of health care is termed “rapport.” While it is not yet clear exactly how rapport with patients can be achieved, evidence reviewed here suggests that a physician's ability to establish rapport with patients is at least partially dependent upon his or her communication skills, especially the ability to decode and encode nonverbal messages of affect. Implications for teaching physicians the elements of empathic communication are disc

ISSN:0022-4537    

DOI:10.1111/j.1540-4560.1979.tb00787.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

The failure of patients to follow recommendations made to them by health experts usually represents a hazard to the patient's health, a waste of health resources, and a source of frustration to the health expert. Many studies of such failure lead to the conclusion that every patient should be considered as potentially “non‐compliant.” The most promising site for intervention is in the expert‐patient interaction. Viewing compliance as a property of the transaction between expert and client, it is appropriate to see the responsibility for establishing compliance as shared between expert and client. From this viewpoint, several models of the expert‐client relationship are reviewed. Three areas of responsibility can be assigned to experts—exploring the individual patient's situation fully; anticipating the patient's difficulties in following recommendations; and communicating information in a way that will maximize its effectiveness. Recognition of these responsibilities will have numerous consequences for those who teach health professionals and for psychologists engaged in the study of communicatio

ISSN:0022-4537    

DOI:10.1111/j.1540-4560.1979.tb00788.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

This paper examines dominant sources of social power and influence that affect the degree to which patients adhere to recommended regimens for prevention or treatment and their rate of recovery. Referent power of health‐care practitioners, as contrasted with their expert, coercive, reward and legitimate power, is expected to be most effective when internalization of medical recommendations by the patients is essential. The paper explores specific ways that a health‐care professional can gain referent power, using weight control treatment as an example. It presents a conceptual framework that provides a rationale for a number of relationship‐building techniques and offers evidence that referent power is effective in promoting adherence to treatment and more healthful behavior, and in influencing critical outcome measures such as weight loss. Analysis of the relative efficacy of various methods of building and using referent power and the possible limiting conditions on its effectiveness are also disc

ISSN:0022-4537    

DOI:10.1111/j.1540-4560.1979.tb00789.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Proper health care necessitates face‐to‐face interaction between health providers and their patients. This direct contact is important for two sets of reasons: the provider must assess the special quality and intensity of the patient's symptoms, emotions and pain; and the provider must create positive expectations, provide emotional support, and enlist the patient's cooperation with treatment. Regarding medical diagnosis, patients are often unable or unwilling to describe precisely and completely what is wrong with them. Regarding medical treatment, a number of factors make kind words and verbal prognoses from practitioners insufficient to communicate the expectations essential to “placebo” effects and the sense of commitment known to be therapeutic to a distraught patient. Effectivenonverbalcommunication—through touch, facial expression, voice tone, etc.—is essential for successful patient‐practitioner interaction. Major aspects of nonverbal communication that are of direct relevance to health care have been studied scientifically but have not yet been systematically utilized. Promising areas of application are reviewed

ISSN:0022-4537    

DOI:10.1111/j.1540-4560.1979.tb00790.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

More than most medical procedures, abortion is embedded in a social context that has implications for psychological reactions of patients. Following a brief history of legislation and research on abortion, correlates of post‐abortion reponses are reviewed. A social‐psychological framework is suggested which views abortion as a stress experience. Responses to the experience will be a function of the nature and meaning of the pregnancy to the individual woman, her defensive and coping style, and the social environment surrounding the abortion experience. Psychological effects of the procedure on the partner and on health professionals who perform abortions are also conside

ISSN:0022-4537    

DOI:10.1111/j.1540-4560.1979.tb00791.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

This paper focuses on the effect of cancer on the patient's interpersonal relationships, and the ultimate impact of these relationships on the patient's emotional adjustment to the disease. In a detailed theoretical analysis, both the patient's reaction to the illness and others' responses toward the patient are explored. Concerning the patient, the following issues are discussed: (1) fears and uncertainties that develop as one attempts to cope with the diagnosis; (2) the consequent need for clarification and support; and (3) the barriers to receiving validation and support from others. Others' reactions to the patient are hypothesized to be a function of a conflict between (1) their feelings about the illness, which are predominantly negative; and (2) their beliefs about appropriate behaviors to display when interacting with cancer patients (optimism and cheerfulness). This conflict results in behavioral responses that are unintentionally damaging to the patient, including physical avoidance, avoidance of open discussion of the illness, and discrepancies among behaviors. The impact of others' behavior on the patient and the patient's subsequent attempts to solve their interpersonal problems are discussed. The paper concludes with implications for intervention and research.

ISSN:0022-4537    

DOI:10.1111/j.1540-4560.1979.tb00792.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Hospitals are commonly regarded as unpleasant places to be. The reason is that, as a total institution, the hospital creates a depersonalizing environment that forces the patient to relinquish control over his or her daily existence. It is suggested that patients cope with depersonalizing loss of control by assuming “good patient” behavior or “bad patient” behavior. Predictions are offered as to who will show which behavior pattern under which circumstances. However, a review of these patterns suggests that some “good patients” may actually be in a state of anxious or depressed helplessness, whereas “bad patients” are exhibiting anger and reactance against the perceived arbitrary removal of freedoms. An analysis of the behavioral, cognitive, affective and physiological correlates of these patterns, as well as the behaviors they elicit in staff, suggests that both the “good patient” and the “bad patient” sustain health risks. It is argued that a more informed and participative role for the hospital patient can eliminate or offset many of these risks and actually improve the level of physical and psychological health

ISSN:0022-4537    

DOI:10.1111/j.1540-4560.1979.tb00793.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Until recently the health care professions gave little systematic attention to psychosocial needs of the dying person and his or her family. There seemed to be no place for death in the prevention and cure‐oriented outlook of our health care systems. This situation is now undergoing rapid change. Analysis of our society'sdeath systemindicates that “comfort care” has started to take its place along with the more dominant death system functions of curing and killing. Particular attention is given to the emergence of thehospicemovement. Improved care of the terminally ill person may not be enough, however, to meet rising expectations for a higher quality of life, in general, and in the dying situation in particular. It is suggested that our society will not be content with a terminal phase of life in which physical distress is well controlled and individual dignity maintained. Rather, we seem to be questing for a form of dying that is “healthier” than ordinary life and that actualizes values whose attainment had previously been frustrated. Pleasurable dying and glorious death may be major “consumer demands”

ISSN:0022-4537    

DOI:10.1111/j.1540-4560.1979.tb00794.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

ISSN:0022-4537    

DOI:10.1111/j.1540-4560.1979.tb00795.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY