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Department of nervous diseases, psychiatry and medical psychology




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Ministry of Health of Ukraine

Bukovynian State Medical University

Department of nervous diseases, psychiatry and medical psychology



Approved on the methodology meeting

of the Department of nervous diseases, psychiatry

and medical psychology

on “____” ___________ 2009 (Report No __).

Chief of the Department

_______________________

Professor V.M.Pashkovskyy


MethodOLOGical INSTRUCTION

for the lesson

Theme 4: The basic requirements to the personality of medical workers. Psychological types of doctors. Profesiogram of general practitioner. A concept about professional deformation. Peculiarities of professions at which develops professional deformation. Signs of professional deformation, «syndrome of burning out». Ways of his warning. Communication in a medical environment. Observance of ethical requirements. Types of communication in medical environment: interpersonal, individually-group, collectively-individual, group. Peculiarities of communication between doctors, doctor – nurse.


For 4-th year students of medical faculty No 2


Module 1. Medical psychology

Topical module 2. Practical aspects of medical psychology


Сhernivtsi, 2009


^

1. Actuality Aim

Psychological side of relationships “patient-doctor” is important on all stages of diagnostic and therapeutic processes, but especially great value it acquires at the first meeting, establishment of psychological contact that proceeds diagnostics and therapy. The optimum psychological contact on 40% provides success, efficiency of interpersonality co-operation.

2. Hours: 2


3. Teaching goal

The students must know:

  • the basic requirements to the personality of medical workers;

  • psychological types of doctors;

  • a concept about professional deformation;

  • communication in a medical environment;

  • types of communication in medical environment;

  • peculiarities of communication between doctors, doctor – nurse.


and be able to:

  • objectively and scientifically determine the place and role of personality of medical workers;

  • interpret conditions to create healthy psychological climate in the medical environment;

  • analyze psychological peculiarities of patients with various pathologies;

  • to determine the way of communication between doctors, doctor – nurse;

  • know methods of research of personality;

  • evaluate the results of experimental-psychological research of patient’s personality and attitude toward a disease.

Assimilate practical skills

  • analyze psychological peculiarities of personality of medical workers;

  • communication with patients;

  • methods of research of «syndrome of burning out»;

  • experimental-psychological research of personality.


^ 4. List of disciplines necessary

for learning theme 1


Title of the discipline

Content of the discipline necessary for learning medical psychology

Anatomy

Brain construction

General psychology

Psychic functions of a normal person. Consciousness and self-consciousness. Psychology of personality.

Neuropsychology

Functions of different brain structures.

Normal physiology

Brain functions. Physiology of high nervous activity.


^ 5. Content of the theme

In the mutual relations «patient - doctor» a patient is predispositioned to add to the doctor|physician| those lines which|what| must help to overcome illness. Examining|considering| personality|individual| of doctor|physician| as meaningful|meaning| figure which|what| has certain|definite| magic capabilities, a patient can idealize him, expecting|waiting| the rapid|quick,fast| and effective healing of all enemies, has a hope sometimes not only on deprivation|privation| from somatic illness but also often unconsciously|irresponsibly|, on the decision of the psychological problems. This expectation of help not only in deprivation|privation| from illness but also in satisfaction of necessities and hopes dissatisfied before|earlier| (necessities in tenderness, sympathy, acceptance), results in|to| forming of transfer (transfer). A patient carries|transfers| on a doctor|physician| past experience of relationships with meaningful|meaning| people, expectations and hopes which|what| existed in these relations. If a patient carries|transfers| on a doctor|physician| the positive|staid| senses|feeling,sentiments| related|tied| to positive|staid| experience of mutual relations in the pas, we talk about the positive|staid| transfer. If a patient carries|transfers| the negative senses|feeling,sentiments| on a doctor|physician|, related|tied| to past|passing,last| negative experience of construction of relations is sense|feeling,sentiment| of crabbiness|irritability|, mistrust, hostility, talk about the negative transfer. In the mutual relations with a doctor|physician| a patient can project on him ambivalent| emotional experience, with experiencing in relation to|toward| him of sense|feeling,sentiment| of watchfulness and tenderness, trust|confidence| and hostility.

Reactions of transfer of patient (positive|staid|, negative, ambivalent)| – complicate communication with him, influence on efficiency of co-operation.

The phenomenon which|what| in the interpersonalities|individuals| mutual relations concernes by a term «psychological incompatibility|inconsistency|» has in the basis|foundation| more frequent mutual negative transfers and| contra-transfers .

Understanding and removal of portable reactions allows to build the relationships with the real man, not with own (traumatic) experience of the pas. The receipt of information about a patient foresees ability of doctor|physician| to formulate a question|o. In the process of questioning and review|examination,survey| of patient, doctor|physician| mentally sorting out all possible hypotheses which|what| the orientations formulated in a phase were. Casts aside vicious, deciding on 2-3 most reliable|trustworthy| in the world of new obtained information . Thus|on this grow| there is a previous|preliminary| diagnosis. In order that the previous|preliminary| diagnosis got|received| at the question and review|examination,survey| of patient in the phase of argumentation became final, it is necessary leadthrough of additional laboratory researches. Task of doctor|physician| – not only to write|orders| the proper directions but also to explain a patient to|by| passing of all necessary diagnostic procedures.

The last phase of intercourse is the |physician phase of correction|. Meeting with a patient must have completion not only in a professional plan but also in psychological. Task of this phase – to give an emotional support for the patient. Unverbal conduct of doctor|physician| in this phase matter very much. Maintenance of final phrase is|appears| important, |accomplish| for example, “now there are three: you, I and Your|yours| illness, If you will be on my| side|flank|, we will overcome it|it|». This|it| is expressed|offered| by quiet, sure voice, is accompanied by the friendly look, gesture, accompanying and simultaneously such, that invites a patient on the next meeting.

During a therapeutic process it is necessary to remember the following psychological aspects:

- illness especially|in particular case| heavy|difficult| is related|tied| to the threat of invalid, becomes|stands| independent by a psychical trauma.

- vibrations of feel, especially|in particular case| at the beginning of|in the beginning of| therapy, often result in|to| doubting of patient, uncertainty of curing, in the competence of treatting|treot| doctor|physician|. Patient became in situation with the deficit of information and vagueness. An alarm is|appears| the most frequent emotional reaction. In such periods especially|in particular case| important hard position doctor|physician|, simple, logically clear explanations, his|its| confidence and optimism.

- influencing of hospitalization, when patient goes in a new social situation for him with the sharp changing of way of life.

- attitude of patient toward|to| medications.

- psychological influencing of extract.

On forming of mutual relations «patient - doctor» influence a sex, age, level of education, social status. There are three models of their mutual relations: guidance, partnership and contract model.

A partner model is more democratic.

A contract model was folded in the conditions of requiring payment medicine. It allows to structure and control a medical process both of its participants. Legal responsibility for|after| the results of treatment is carried by a doctor|physician|, but psychological responsibility in a certain|definite| measure lies on a patient. Executing|implementing| payment of medical services, a patient takes title to choose a doctor|physician|.


THE PROFESSIONAL BURN-OUT SYNDROME CONCERNES AS THE STATE OF EMOTIONAL, PSYCHICAL AND PHYSICAL EXHAUSTION THAT DEVELOPS AS A RESULT OF CHRONIC UNSOLVED STRESS ON A WORKPLACE

Burning-out is accompanied by physical, emotional and psychical exhaustion:

  1. Chronic fatigue - exhaustion, tiredness, a sense of being physically run down

  2. Anger at those making demands

  3. Self-criticism for putting up with the demands

  4. Cynicism, negativity, and irritability

  5. A sense of being besieged

  6. Exploding easily at seemingly inconsequential things

  7. Frequent headaches and gastrointestinal disturbances

  8. Weight loss or gain

  9. Sleeplessness and depression

  10. Shortness of breath

  11. Suspiciousness

  12. Feelings of helplessness

  13. Increased degree of risk taking

Every professional which|what| works in medicine can clash with BOS. That is why|that is why| medical personal must not only to know about it but also haw to prevent it.

The prophylaxis of development of burn-out syndrome consists in acceptance on itself of responsibility for the work, the professional result and in delegation of part of responsibility to the clients and patients. In ability to take it easy and dates to itself time for achievements in life and at work. Because the professional falling and even deadlocks|blind-alleys| is the natural stages of professional development of the every specialist. For a doctor|physician|, forming of own world view which|what| provides|secures| success in-process is|appears| important, to proceed|restores| in capabilities own heartfelt|sincere| and spiritual forces.


^ 5.2. Theoretical questions:

  1. The basic requirements to the personality of medical workers;

  2. Psychological types of doctors;

  3. A concept about professional deformation;

  4. Communication in a medical environment;

  5. Types of communication in medical environment;

  6. «Syndrome of burning out».

  7. Peculiarities of communication between doctors, doctor – nurse.


^ 5.3. Practical training during the tutorial

1. Clinical observation of the behavior of the medical personal.

2. Research of «Syndrome of burning out».


5.4. Materials for self-control

A. Questions for self-control:

  1. The basic requirements to the personality of medical workers;

  2. Psychological types of doctors;

  3. A concept about professional deformation;

  4. Communication in a medical environment;

  5. Types of communication in medical environment;

  6. «Syndrome of burning out».

  7. Peculiarities of communication between doctors, doctor – nurse.


B. Tasks for self-control

1. Typical, ordinary – II level.

2. Untypical, no ordinary – III level.

C. Tests for self-control.

Literature

  1. R.J.Gatchel An introduction to health psychology. – New York: Random house. – 386 p.

  2. Lectures.

  3. Internet resource.

  4. Вітенко І.С., Вітенко Т.І. Основи психології: Підручник для студентів вищих медичних навчальних закладів ІІІ – ІV рівнів акредитації. – Вінниця, 2001.

  5. Вітенко І.С., Чабан О.С., Бусло О.О. Сімейна медицина: психологічні аспекти діагностики, профілактики і лікування хворих. – Тернопіль, ”Укрмедкнига”, 2002.

  6. Гавенко В.Л., Вітенко І.С., Самардакова Г.О. Практикум з медичної психології. – Харків: Регіон-інформ, 2002.

  7. Квасенко А.В., Зубарев Ю.Т. Психология больного. М., 1980.

  8. Лакосина Н.Д., Ушаков Г.К. Медицинская психология. М., 1984.

  9. Менделевич В.Д. Клиническая и медицинская психология. – М.: Мед.прес., 1998.

  10. Мягков И.Ф., Боков С.Н. Медицинская психология: основы патопсихологии и психопатологии: Учебник для вузов.- М.: Издательская корпорация „Логос”, 1999.


Prepared by assistant N.V.Bagriy


Positive review

Prof. assistant N.S. Karvatska


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