Fuss Alexandra, Jagielski Christina H, Taft Tiffany
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
University of Michigan/Michigan Medicine, Ann Arbor, MI, USA.
Transl Gastroenterol Hepatol. 2024 Aug 26;9:73. doi: 10.21037/tgh-24-26. eCollection 2024.
Gaslighting is defined as behaviors inflicted on an individual which invalidate or call into question their ability to judge their own lived experience. Research into gaslighting in other contexts, such as domestic violence, underscore its potentially damaging effects. Medical gaslighting is an increasingly used, but poorly defined issue in a progressively more complex healthcare system in the United States. Limited studies constructively evaluate this breakdown in the provider-patient relationship and no studies exist evaluating gaslighting in the care of patients with digestive diseases. This narrative review aims to add clarity to the definition of medical gaslighting, evaluate the mechanisms that perpetuate gaslighting in gastroenterology practice and offer pragmatic solutions to begin to reduce its prevalence.
Narrative overview of the literature retrieved from searches of computerized databases.
The potential root causes of gaslighting in gastroenterology practices are multifaceted and complex, and encompass patient, provider, and systemic factors.
An important distinction for medical gaslighting from other forms of gaslighting is the role of intent. As such, we propose the term "medical invalidation" be added to this construct and conceptualize medical gaslighting as occurring on a continuum. Within each facet of the relationship between system, provider and patient there are opportunities to prevent and recover from the occurrence of medical invalidation/medical gaslighting.
煤气灯效应被定义为施加于个人的行为，这些行为会使他们对自身生活经历的判断无效或受到质疑。对家庭暴力等其他情境下煤气灯效应的研究强调了其潜在的破坏性影响。在美国日益复杂的医疗体系中，医疗煤气灯效应是一个使用越来越频繁但定义模糊的问题。仅有有限的研究对医患关系中的这种破裂进行了建设性评估，尚无研究评估消化系统疾病患者护理中的煤气灯效应。本叙述性综述旨在明确医疗煤气灯效应的定义，评估胃肠病学实践中使煤气灯效应持续存在的机制，并提供切实可行的解决方案以开始降低其发生率。
对通过计算机数据库检索获得的文献进行叙述性概述。
胃肠病学实践中煤气灯效应的潜在根本原因是多方面且复杂的，包括患者、医护人员和系统因素。
医疗煤气灯效应与其他形式煤气灯效应的一个重要区别在于意图的作用。因此，我们建议在这个概念中加入“医疗否定”一词，并将医疗煤气灯效应概念化为一个连续体。在系统、医护人员和患者之间关系的每个方面，都有机会预防医疗否定/医疗煤气灯效应的发生并从中恢复。
