Conflicts in healthcare: a communication issue

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Fulvio Fiorini

Fulvio Fiorini1, Antonio Granata2

1 UOC Nefrologia e Dialisi, AULSS 5 Polesana, Ospedale SM della Misericordia, Rovigo
2 UOC Nefrologia e Dialisi, Ospedale S. Giovanni di Dio, ASP1, Agrigento

Corrispondenza a:
Fulvio Fiorini
U.O.C. Nefrologia e Dialisi
AULSS5 Polesana
Ospedale SM della Misericordia
Viale Tre Martiri,140
45100 Rovigo
Tel: 0425.393443
Email: fulvio.fiorini@aulss5.veneto.it

 

Abstract

Conflicts are situations in which two or more people come into disagreement: they are an integral part of social life caused by the inability to find a solution to a dispute. Conflicts are constantly present within families and in all social organizations; in the health sector, they are part of the daily routine. The most common causes of conflict are the lack of resources and the divergence in objectives. All conflicts can quickly escalate, so it is essential to recognize them in order to defuse them as soon as possible. Doctors, as managers, must recognize the early signs of latent conflict in order to better manage them and possibly use them in order to stimulate change in the organization.

Keywords: conflict, resources, communication, change

Sorry, this entry is only available in Italian.

Introduzione

I conflitti sono situazioni nelle quali due o più persone entrano in opposizione o disaccordo perché i reciproci interessi, posizioni, bisogni, desideri, valori sono incompatibili, o sono percepiti come incompatibili: in tutto ciò giocano un ruolo importante le emozioni e i sentimenti. La relazione tra le parti in conflitto può uscirne rafforzata o deteriorata in funzione di come si sviluppa il processo di risoluzione del conflitto [1]. 

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Psychology of the communication between doctors/nurses and patients in nephrology and dialysis

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Valentina Paris

Valentina Paris1, Fulvio Fiorini2

1 Psicologa, già Infermiera di Nefrologia e Dialisi, Bergamo, già Presidente ANED
2 UOC Nefrologia e Dialisi, AULSS 5 Polesana, Ospedale SM della Misericordia, Rovigo

Corrispondenza a:
Fulvio Fiorini
UOC Nefrologia e Dialisi
AULSS 5 Polesana, Rovigo
Viale Tre Martiri 140
Tel: 0425/393443
Email: fulvio.fiorini@aulss5.veneto.it

 

Abstract

People with a chronic kidney condition can live with their disease for several years, during which the illness becomes “an integral aspect of life” and requires “an arduous and continuous process of adaptation at multiple levels: cognitive, emotional and physical”. Often, communicating with doctors is not helpful to these patients in understanding what is happening and reorganizing their lives, as ineffective communication strategies are employed. It is in fact necessary to overcome obstacles such as the use of incomprehensible technical language, ambiguity, the lack of communication training and the abundance of stressful situations.

Chronically ill patients have the right to be informed in a simple, clear and impartial way about their condition and its possible treatments; this information will help them manage their kidney disease, “accept” it and find the motivation to adhere to medical prescriptions over time.

 

Keywords: Communication, doctor, nurse, chronic patient

Sorry, this entry is only available in Italian.

Introduzione

Quando una persona perde la funzionalità dei propri reni, la sua vita e quella dei suoi familiari cambia redicalmente perché la malattia renale è cronica, la dialisi e il trapianto sono terapie impegnative e continuate nel tempo [1]. 

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Doctor-Patient communication

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Fulvio Fiorini

Fulvio Fiorini1, Antonio Granata2

1 UOC Nefrologia e Dialisi, Ospedale Santa Maria della Misericordia, AULSS5 Polesana, Rovigo
2 UOC Nefrologia e Dialisi, Ospedale San Giovanni di Dio, Azienda Sanitaria, Agrigento

Corrispondenza a:
Fulvio Fiorini
UOC Nefrologia e Dialisi
Azienda ULSS5 Polesana – Rovigo
Viale Tre Martiri, 140
45100 Rovigo
Tel +390425393443
Mail fulvio.fiorini@aulss5.veneto.it

 

Abstract

The Doctor-Patient relationship is of fundamental importance in the field of care and continues to undergo profound transformations. In ancient times the doctor was “authoritarian”: the patient was considered a passive element, incapable of understanding, knowing and acting for his own health. The doctor then became a “paternalistic” figure and it is only recently that the patient has become a responsible subject who interacts with the doctor in the definition and evaluation of every health intervention. The patient needs to be actively involved and informed, participating in the therapeutic process and in monitoring the positive and negative effects of the treatment. The doctor needs to communicate in a way that is simple and appropriate in order to avoid misunderstandings, which are very common as patients and doctors can often attribute different meanings to certain words. Doctors need to be aware that such a possibility exists and verify that the patient has understood the real meaning of his words. As good communication between doctors and patients is a strategic factor in care, communication courses should be included in any Medical Degree course.

 

Keywords: communication, doctor, humanisation, patient

Sorry, this entry is only available in Italian.

Introduzione

Il rapporto medico-paziente è un libro aperto, un “work in progress”, che nel corso dei secoli ha subito e continua a subire profonde trasformazioni in relazione e parallelamente a quelle della vita sociale.

Sulla problematicità del rapporto comunicativo tra medico e paziente tanto è già stato scritto: molta attenzione è stata dedicata all’argomento sia dai clinici, sia dagli psicologi, sia dai sociologi, ma solo negli ultimi anni il problema è stato affrontato con il metodo della ricerca scientifica.

In questa sede si vuole brevemente porre in evidenza le molteplici caratteristiche di questo rapporto, che è alla base della vita di quasi tutti i cittadini. 

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Relationships between Medicine and Spirituality

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Simonetta Pulciani, Emanuele Nutile

Simonetta Pulciani1, Emanuele Nutile2

1 Centro Nazionale Malattie Rare, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Roma, Italia. simonetta.pulciani@iss.it
2 Via Illiria 18, 00183, Roma, Italia. Già dirigente psicologo/psicoterapeuta DSM ASL Roma B.

Autore corrispondente:
Simonetta Pulciani, Istituto Superiore di Sanità
Viale Regina Elena 299, 00161, Roma, Italia
email: simonetta.pulciani@iss.it
+390649904420

 

Abstract

This review aims at analysing the links between medicine and spirituality, two seemingly distant concepts. Medicine at its beginnings was imbued with rituals that invoked the intervention of supernatural powers, as man were unable to treat diseases and struggled to bear the suffering caused by them and the fragility of their own bodies. Today, in the post-genomic era, medicine has gained great benefits from new and extraordinary scientific and technological achievements, permitting sophisticated therapeutic and diagnostic approaches, which assure cures not previously possible. Even considering these great accomplishments in medicine and technology, it should be borne in mind that diseases not only induce bodily changes in sufferers, but also affect their emotional state and social interactions. Illness, especially when serious and in presence of a poor prognosis, raises profound questions around the meaning of life, affections, suffering and death. In the last few decades scientists, doctors, theologians, psychologists and others, in considering these questions, have emphasized the importance of spirituality as a relevant factor in the care of the sick and their illnesses.

Drawing from some thoughts expressed in the book, “When the Breath Becomes Air,” authored by the physician Paul Kalanithi, we claim that spirituality should be perceived as an important contributing factor in the therapeutic path. Our aim is to deepen the meaning of spirituality, differentiating it from religion, faith and mysticism, and to understand how it should be integrated with post-genomic medicine to enhance its positive aspects and effects.

Keywords: Spirituality, Medicine, communication, patients, physicians

Sorry, this entry is only available in Italian.

Introduzione

Nel libro “Quando il respiro si fa aria” il medico Paul Kalanithi, un neurochirurgo morto all’età di 37 anni per un tumore incurabile ai polmoni, narrando la sua esperienza di medico e paziente, tratta del rapporto che l’essere umano ha con la malattia e la sofferenza (1). Come medico era stato sempre sensibile al dolore dei pazienti e dei loro cari ed esplicitamente dichiarava che “l’eccellenza tecnica non è abbastanza”. 

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Talking about medicine through mass media

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Fulvio Fiorini

Fulvio Fiorini, Antonio Granata1, Yuri Battaglia2, Michele A.A. Karaboue3

UOC Nefrologia e Dialisi, Aulss5 Polesana, Ospedale SM della Misericordia, Rovigo
1 UOC Nefrologia e Dialisi, Ospedale S. Giovanni di Dio, Agrigento
2 UOC Nefrologia e Dialisi, A.O.U. S.Anna, Ferrara
3 Sezione Medicina Legale, Dipartimento Medicina Sperimentale “L. Vanvitelli”, Università della Campania, Napoli

Indirizzo per la corrispondenza:
Fulvio Fiorini
U.O.C. Nefrologia e Dialisi
AULSS5 Polesana
Ospedale SM della Misericordia
Viale Tre Martiri,140
45100 Rovigo
Tel 0425.393443
Mail  fulvio.fiorini@aulss5.veneto.it

 

Abstract

The ability to communicate is central to all professional activities and therefore being able to communicate effectively with mass media is essential. The medical doctor often needs to communicate not with a single patient or with a group of family members, but with “an important number of patients” through a microphone, a newspaper, a radio or a television. In this case it is not necessary to provide specific information on a single clinical case, but to provide simple, general information on a single pathology or a group of diseases to an interviewer or journalist, who will probably elaborate it at his own discretion making it usable to a diverse and unspecified audience. It is therefore important to be relevant to the question, clear in the presentation, but also synthetic to respect the time limits of interview.

KEY WORDS: communication, medicine, mass media, patients

Sorry, this entry is only available in Italian.

INTRODUZIONE

Comunicare in modo efficace rappresenta il primo obiettivo di qualsiasi individuo, Azienda o Società, pena l’esclusione da tutte le relazioni ed i processi del mondo circostante (1). 

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