Robiner William N, Petrik Megan L
Health Psychology, Division of General Internal Medicine, University of Minnesota Medical School, Mayo Mail Code 741, 420 Delaware Street, S.E., Minneapolis, MN, 55455, USA.
J Clin Psychol Med Settings. 2017 Mar;24(1):27-36. doi: 10.1007/s10880-017-9490-2.
Various problems can occur during encounters between health providers and patients. In some instances, clinicians attribute these problems to patients being "difficult." However, clinicians' perception of difficulties in the clinical encounter are also influenced by: clinicians' own attitudes, thoughts, and behavior; the specific setting in which patient and clinician interact; and properties of the healthcare organization in which they are embedded. This article explores how psychologists in medical settings can serve as a resource that: improves patient care for difficult patients; supports provider wellness; provides relevant education to clinical providers; and reduces the stress that difficult patients place on the healthcare system. The definition, scope, and impact of difficult patients in healthcare settings are reviewed, including an examination of patient, clinician, and systems factors that contribute to the etiology of difficult clinical encounters. Strategies are discussed that may prevent or limit the adverse impact of difficult patients in healthcare, with special emphasis on the roles of psychologists in interprofessional healthcare teams.
在医疗服务提供者与患者接触的过程中可能会出现各种问题。在某些情况下,临床医生将这些问题归因于患者“难相处”。然而,临床医生对临床接触中困难情况的认知也受到以下因素的影响:临床医生自身的态度、想法和行为;患者与临床医生互动的具体环境;以及他们所在的医疗保健机构的特性。本文探讨了医疗机构中的心理学家如何作为一种资源,发挥以下作用:改善对难相处患者的护理;支持医疗服务提供者的健康;为临床医疗服务提供者提供相关教育;减轻难相处患者给医疗系统带来的压力。本文回顾了医疗机构中难相处患者的定义、范围和影响,包括对导致困难临床接触病因的患者、临床医生和系统因素的考察。文中讨论了可能预防或限制难相处患者对医疗造成不利影响的策略,特别强调了心理学家在跨专业医疗团队中的作用。