Department of Anaesthesiology and Intensive Care Medicine, Friedrich Schiller University, Jena, Germany.
Patient Educ Couns. 2009 Nov;77(2):172-8. doi: 10.1016/j.pec.2009.03.021. Epub 2009 Apr 15.
Patients are increasingly attracted to homeopathy despite the unproven effectiveness of homeopathic remedies. Clinical benefit of homeopathy may be due to communication. This review aims to identify and assess effective communication patterns in homeopathy.
Narrative review and synthesis of published communication patterns, patient narratives and the author's professional experience as a homeopathic practitioner.
In the biomedical model, where the focus is on disease, communication is physician-centered with early redirection of patients' concerns, and associated with reduced compliance, increasing risk of malpractice claims and low professional fulfillment. The biopsychosocial and the developing integrative medicine models are based on biomedicine but aim to include the whole person. Patient-centeredness is a behavior that elicits, respects and incorporates patients' wishes, allows active patient participation and is related to improved outcomes. The homeopathic model is based on holism and comprehension of the totality of the patient and uses patient-centered communication with a high degree of physician co-operation, empathy, hopefulness, enablement and narrative competence, all of which can improve outcomes.
Both biopsychosocial and homeopathic models rely on patient-centered communication. Regardless of conceptual differences, they overlap in their common respect for the totality and individuality of the patient. The study of the homeopathic model shows that respect for the whole person is a basic requirement to entrench patient-centeredness more firmly in medicine.
Medical education should include values such as individual coping strategies, the benefits of a sound and healthy life-style and the necessity of hope and enablement. Health care should be redesigned to honor physicians who practice these values.
尽管顺势疗法的疗效未经证实,患者仍越来越多地被顺势疗法所吸引。顺势疗法的临床疗效可能归因于沟通。本综述旨在确定和评估顺势疗法中的有效沟通模式。
对已发表的沟通模式、患者叙述以及作者作为顺势疗法从业者的专业经验进行叙述性回顾和综合。
在以疾病为重点的生物医学模式下,沟通以医生为中心,早期转移患者的关注点,与降低依从性、增加医疗事故索赔风险和降低专业满意度相关。生物心理社会和不断发展的整合医学模式基于生物医学,但旨在纳入整个人。以患者为中心是一种引出、尊重和整合患者意愿的行为,允许患者积极参与,与改善结果相关。顺势疗法模式基于整体论和对患者整体的理解,采用以患者为中心的沟通方式,医生高度合作、富有同理心、充满希望、赋予能力和具备叙事能力,所有这些都可以改善结果。
生物心理社会和顺势疗法模式都依赖于以患者为中心的沟通。无论概念上有何差异,它们都共同尊重患者的整体和个体性。对顺势疗法模式的研究表明,尊重整个人是将以患者为中心更牢固地扎根于医学中的基本要求。
医学教育应包括个体应对策略、健康生活方式的益处以及希望和赋予能力的必要性等价值观。应该重新设计医疗保健系统,以尊重实践这些价值观的医生。