Razzaghi Mohammad Reza, Afshar Leila
Professor, Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Assistant Professor, Department of Medical Ethics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Med Ethics Hist Med. 2016 Nov 8;9:14. eCollection 2016.
In any clinical encounter, an effective physician-patient relationship is necessary for achieving the desired outcome. This outcome is successful treatment, and therefore, the relationship should be a healing one. In addition, in the Islamic view, the physician is a manifestation of God's healing attribute, which is usually undermined in everyday therapeutic communications. Yet there are few empirical data about this experience and how it occurs in the clinical context. This study was conducted to develop a model of physician-patient relationship, with the healing process at its core. Our goal was to explain the nature and characteristics of this encounter. In Islamic teachings, healing is defined as "cure" when possible and if not, reducing pain and suffering and ultimately finding a meaning in the illness experience. This study was a qualitative inquiry. Data were collected through 17 open-ended, semi-structured interviews with physicians who had an effective relationship with their patients. The participants' experiences and their perception regarding the relationship were subjected to grounded theory content analysis. For establishing the trustworthiness of the data collection and analysis we used triangulation, peer review, and member checking. The findings showed that the components of the patient-physician healing relationship could be categorized in the four key processes of valuing the patient as a person, effective management of power imbalance, commitment, and the physician's competence and character. This leads to forming the three necessary relational elements of trust, peace and hope, and being acknowledged. Their importance has been better demonstrated in a relationship which incorporates the spiritual aspects of patient care and also physician's satisfaction. The physician-patient relationship has a central role in patient outcome. This relationship has an understandable structure and its components may have an effective impact on promoting the patient's experience of the health system.
在任何临床接触中，有效的医患关系对于实现预期结果都是必要的。这个结果就是成功的治疗，因此，这种关系应该是一种治愈性的关系。此外，在伊斯兰教观点中，医生是上帝治愈属性的体现，而这一属性在日常治疗交流中通常被忽视。然而，关于这种体验及其在临床环境中如何发生的实证数据很少。本研究旨在构建一个以治愈过程为核心的医患关系模型。我们的目标是解释这种接触的本质和特征。在伊斯兰教教义中，治愈在可能的情况下被定义为“治愈”，如果不可能，则减轻痛苦并最终在疾病体验中找到意义。本研究是一项定性调查。通过对与患者建立了有效关系的医生进行17次开放式、半结构化访谈收集数据。对参与者关于这种关系的经历和看法进行了扎根理论内容分析。为了确保数据收集和分析的可信度，我们采用了三角验证、同行评审和成员核对。研究结果表明，医患治愈关系的组成部分可分为四个关键过程，即把患者当作一个人来重视、有效管理权力不平衡、承诺以及医生的能力和品格。这导致形成信任、和平与希望以及被认可这三个必要的关系要素。它们的重要性在包含患者护理精神层面以及医生满意度的关系中得到了更好的体现。医患关系在患者治疗结果中起着核心作用。这种关系具有可理解的结构，其组成部分可能对提升患者对医疗系统的体验产生有效影响。
