“Difficult” patients tend to worsen attention, studies found ;
(HealthDay) what happens to medical care when the patient is an idiot?
Dutch researchers asked the question in two new studies, and the answer should do grumps think the best of their bad behavior :. “Disruptive” patients may worsen care physicians
The results are not definitive because the researchers tested how doctors responded fictional vignettes, rather than the real-life encounters. Still, the results suggest that patients taking a scene distracts doctors do their job.
“Patients who behave disruptively, showing disrespect or aggression can induce their medical to errors of diagnosis,” said Dr. Silvia Mamede, who worked on both studies. She is an associate professor with the Institute of Medical Research in Education Rotterdam Erasmus Medical Center in the Netherlands.
It is estimated that 15 percent of patients treated in doctors’ offices are aggressive, disrespectful, too demanding or distrustful, Mamede said.
“As expected, these behaviors cause emotional reactions in doctors,” she said.
But these patients actually worsen attention? Doctors have talked a lot about this issue, but researchers have not investigated this matter, according to Mamede.
The study authors could have supervised the actual medical visits’ to find an answer, but said Mamede approach would have been “impossible” because each case is very different.
Instead, the researchers created vignettes “neutral” disturbing patients and patients who do such things as make frequent demands, ignoring the doctor’s advice and act helpless. doctors are then asked to diagnose patients.
This approach is “feasible, ethical and reasonable,” said Dr. Donald Redelmeier, senior principal scientist of the Institute for Clinical Evaluative Sciences in Toronto. Redelmeier co-he wrote a commentary accompanying the study.
In a study of medicine physicians 63 relatives of Rotterdam, “doctors perform 42 percent more errors in disturbing than in patients who do not interrupt when cases were complex, and 6 percent more errors when cases were simple, “said Mamede. (The doctors did a better job when they had more time to think about their diagnoses ;. Experts determined the correct diagnoses)
The other study, which included 74 residents in internal medicine, produced similar results: In cases that are considered moderately complex “, doctors perform 20 percent more errors compared with neutrals difficult patients,” he added
studies do not provide information on the frequency with which physicians received a completely correct or not answered completely diagnosis. Instead, the researchers noted diagnoses depending on whether they were correct, partially correct or incorrect.
what’s going on? Mamede said Disruptive distract patients medical to “capture” their attention, preventing focuses more on the actual conditions of doctors.
It is not clear, he said, if worse care will make even more frustrating to deal with over time, creating a vicious cycle of increased diagnoses of disorders and vaguer disruptive patients.
But Redelmeier said a “negative feedback loop” as possible.
What can you do?
“Physicians should be trained to deal with these explicit and effective disruptive behavior,” said Mamede. “An aggressive patient can it calm. A patient who shows a lack of confidence in your doctor may refer you to another doctor,” he suggested.
As for patients, Redelmeier referred to the points that he and a co-author make the comment. Patients, they said, you can try to channel your emotion in polite comments; for example, “Thanks for having me. I’m scared of what I am experiencing and that is why I am here looking for something that might help.”
Still, the editorialists added, “real people … can not always control his temper when suffering or pain.” More research is needed to determine the best approaches, Redelmeier suggested.
The study was published online on March 14 in the journal BMJ Quality and Safety .
This article was originally published on medicalxpress, Read the original article
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