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Special Issue "Psychosocial Interaction between Physicians and Patients"

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Pathergasiology & Psychology".

Deadline for manuscript submissions: closed (30 November 2016)

Special Issue Editors

Guest Editor
Prof. Dr. Ian Olver

Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
Website | E-Mail
Interests: public health and health services; oncology and carcinogenesis; psychology; medical and health sciences; health care sciences and services
Guest Editor
Dr. Megan Best

Psycho-Oncology Co-operative Research Group (PoCoG); Faculty of Medicine; University of Sydney, Sydney, Australia
Website | E-Mail
Interests: spiritual care; suffering; bioethics; doctor-patient communication; genomics

Special Issue Information

Dear Colleagues,

The quality of life of patients is determined by their physical, psychosocial and spiritual wellbeing. Each must be assessed and managed. Throughout an illness, psychosocial support may be required at each stage of the illness, from diagnosis and treatment and then in facing the issues of survivorship. The issue of whether patients should be routinely screened for psychosocial distress, how that could be achieved, and which patients require intervention is an ongoing area of debate. As evidence for successful management strategies emerge, guidelines for psychosocial support are desirable. Communication between physicians and patients is a key pillar of support. This includes dealing with the shock of a serious diagnosis, clear communication about management options, including symptom control, breaking bad news, communicating with patients who are suffering and communicating about end-of-life issues. These discussions will embrace sensitive areas around physical issues with body image, lifestyle issues, such as those around relationships and sexuality, emotional and spiritual wellbeing and existential distress. The acquisition of these skills by physicians requires ongoing education and increasingly these are addressed within a multidisciplinary team. Furthermore, these interactions must accommodate a full spectrum of ages, socioeconomic circumstances and cultural diversity. We encourage researchers to contribute papers to ensure a rich Special Issue on these topics.

Prof. Dr. Ian Olver
Dr. Megan Best
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • physicians
  • patients
  • psychosocial
  • physician–patient relations
  • communication
  • spiritual wellbeing
  • suffering
  • end-of-life

Published Papers (5 papers)

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Research

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Open AccessArticle
Implementing a Psychotherapy Service for Medically Unexplained Symptoms in a Primary Care Setting
J. Clin. Med. 2017, 6(12), 109; https://doi.org/10.3390/jcm6120109
Received: 10 October 2017 / Revised: 13 November 2017 / Accepted: 16 November 2017 / Published: 29 November 2017
Cited by 2 | PDF Full-text (3646 KB) | HTML Full-text | XML Full-text | Correction
Abstract
Medically unexplained symptoms (MUS) are known to be costly, complex to manage and inadequately addressed in primary care settings. In many cases, there are unresolved psychological and emotional processes underlying these symptoms, leaving traditional medical approaches insufficient. This paper details the implementation of [...] Read more.
Medically unexplained symptoms (MUS) are known to be costly, complex to manage and inadequately addressed in primary care settings. In many cases, there are unresolved psychological and emotional processes underlying these symptoms, leaving traditional medical approaches insufficient. This paper details the implementation of an evidence-based, emotion-focused psychotherapy service for MUS across two family medicine clinics. The theory and evidence-base for using Intensive Short-Term Dynamic Psychotherapy (ISTDP) with MUS is presented along with the key service components of assessment, treatment, education and research. Preliminary outcome indicators showed diverse benefits. Patients reported significantly decreased somatic symptoms in the Patient Health Questionnaire-15 (d = 0.4). A statistically significant (23%) decrease in family physicians’ visits was found in the 6 months after attending the MUS service compared to the 6 months prior. Both patients and primary care clinicians reported a high degree of satisfaction with the service. Whilst further research is needed, these findings suggest that a direct psychology service maintained within the family practice clinic may assist patient and clinician function while reducing healthcare utilization. Challenges and further service developments are discussed, including the potential benefits of re-branding the service to become a ‘Primary Care Psychological Consultation and Treatment Service’. Full article
(This article belongs to the Special Issue Psychosocial Interaction between Physicians and Patients)
Figures

Figure 1

Open AccessFeature PaperArticle
Barriers to Seeking Help for Skin Cancer Detection in Rural Australia
J. Clin. Med. 2017, 6(2), 19; https://doi.org/10.3390/jcm6020019
Received: 22 December 2016 / Revised: 31 January 2017 / Accepted: 8 February 2017 / Published: 13 February 2017
Cited by 1 | PDF Full-text (215 KB) | HTML Full-text | XML Full-text
Abstract
This study explores rural South Australians’ barriers to help-seeking for skin cancer detection. A total of 201 randomly selected rural adults (18–94 years, 66% female) were presented with a skin-cancer-related scenario via telephone and were asked the extent to which various barriers would [...] Read more.
This study explores rural South Australians’ barriers to help-seeking for skin cancer detection. A total of 201 randomly selected rural adults (18–94 years, 66% female) were presented with a skin-cancer-related scenario via telephone and were asked the extent to which various barriers would impede their help-seeking, based on an amended version of the Barriers to Help-Seeking Scale. Older (≥63 years) and less educated participants endorsed barriers more strongly than their younger, more educated counterparts in the following domains; “Concrete barriers and distrust of caregivers”, “Emotional control”, “Minimising problem and Normalisation”, “Need for control and self-reliance” (every domain other than “Privacy”). Socioeconomic disadvantage, gender, and farmer status did not predict stronger overall barriers, but some gender and occupation-related differences were detected at the item level. Farmers were also more likely to endorse the “Minimising problem and normalization” domain than their non-farmer working rural counterparts. Widely endorsed barriers included the tendency to minimise the problem, a desire to remain in control/not be influenced by others, reluctance to show emotion or complain, and having concerns about privacy or waiting times. Full article
(This article belongs to the Special Issue Psychosocial Interaction between Physicians and Patients)
Open AccessArticle
Help-Seeking in Suicidal Situations: Paramount and yet Challenging. Interactions between Significant Others of Suicidal Persons and Health Care Providers
J. Clin. Med. 2017, 6(2), 17; https://doi.org/10.3390/jcm6020017
Received: 30 November 2016 / Revised: 20 January 2017 / Accepted: 6 February 2017 / Published: 13 February 2017
Cited by 3 | PDF Full-text (215 KB) | HTML Full-text | XML Full-text
Abstract
Significant others are often crucial for suicidal persons or suicide attempters’ access to care, yet little is known about their efforts to seek help. This article presents the findings of a qualitative pilot study carried out in Switzerland on the help-seeking process of [...] Read more.
Significant others are often crucial for suicidal persons or suicide attempters’ access to care, yet little is known about their efforts to seek help. This article presents the findings of a qualitative pilot study carried out in Switzerland on the help-seeking process of 18 significant others, their perception of the care received by their loved one, and the interactions and collaboration they experienced with professionals. Most significant others repeatedly sought out support for their loved one and themselves. The help-seeking process seemed mostly difficult, was seldom successful on the first attempt, and was filled with multiple difficulties, such as availability and continuity of care and cooperation issues with professionals. Two-thirds of participants were not satisfied with the care provided to their loved ones and half of them faced challenges in their cooperation with professionals, i.e., poor sharing of information or not being acknowledged as partners or supported by professionals. Based on their experience, providing education about suicidal crises and care programs to significant others might lighten their burden and improve their cooperation with professionals, who in turn may benefit from training in communication issues and specific methods of cooperation with significant others in suicidal situations. Full article
(This article belongs to the Special Issue Psychosocial Interaction between Physicians and Patients)
Open AccessFeature PaperArticle
Why do We Find It so Hard to Discuss Spirituality? A Qualitative Exploration of Attitudinal Barriers
J. Clin. Med. 2016, 5(9), 77; https://doi.org/10.3390/jcm5090077
Received: 22 July 2016 / Revised: 26 August 2016 / Accepted: 29 August 2016 / Published: 1 September 2016
Cited by 4 | PDF Full-text (204 KB) | HTML Full-text | XML Full-text
Abstract
Background: Despite known health benefits of spiritual care and high patient interest in discussing spirituality with their physicians, the frequency of spiritual discussions in the medical consultation is low. We investigated spiritual conversations for doctors caring for patients with advanced cancer; why these [...] Read more.
Background: Despite known health benefits of spiritual care and high patient interest in discussing spirituality with their physicians, the frequency of spiritual discussions in the medical consultation is low. We investigated spiritual conversations for doctors caring for patients with advanced cancer; why these conversations so difficult; and what the underlying challenges are for discussing spirituality with patients; Methods: Participants were contacted through the Australian and New Zealand Society of Palliative Medicine and the Medical Oncology Group of Australia, including physicians from two secular countries. Semi-structured interviews were taped and transcribed verbatim. The text was analyzed using thematic analysis; Results: Thematic saturation was reached after 23 participants had been interviewed. The following themes were identified: (1) confusing spirituality with religion; (2) peer pressure; (3) personal spirituality; (4) institutional factors; (5) historical factors; Conclusion: This study explored the underlying attitudes contributing to the reluctance doctors have to discuss spirituality in the medical consultation. Underlying confusion regarding the differences between religion and spirituality, and the current suspicion with which religion is regarded in medicine needs to be addressed if discussion of spirituality in the medical consultation is to become routine. Historical opposition to a biopsychosocial-spiritual model of the human being is problematic. Full article
(This article belongs to the Special Issue Psychosocial Interaction between Physicians and Patients)

Review

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Open AccessFeature PaperReview
Improving Communication between Physicians and Their Patients through Mindfulness and Compassion-Based Strategies: A Narrative Review
J. Clin. Med. 2017, 6(3), 33; https://doi.org/10.3390/jcm6030033
Received: 17 January 2017 / Revised: 6 March 2017 / Accepted: 8 March 2017 / Published: 17 March 2017
Cited by 11 | PDF Full-text (275 KB) | HTML Full-text | XML Full-text
Abstract
Communication between physicians and patients is a key pillar of psychosocial support for enhancing the healing process of patients and for increasing their well-being and quality of life. Physicians and other health professionals might benefit from interventions that increase their self-care, awareness, compassion, [...] Read more.
Communication between physicians and patients is a key pillar of psychosocial support for enhancing the healing process of patients and for increasing their well-being and quality of life. Physicians and other health professionals might benefit from interventions that increase their self-care, awareness, compassion, and other-focused concern, and reduce the chances of distress and burnout. There is substantial evidence for the contribution of different management strategies to achieve these aims. The goal of this article is to review the potential effect of mindfulness and compassion-based strategies for the improvement of physician-patient interactions. The acquisition of the necessary skills by physicians requires continuous education. Future research will be useful for identifying more evidence on the cost-effectiveness of this type of intervention. Full article
(This article belongs to the Special Issue Psychosocial Interaction between Physicians and Patients)
J. Clin. Med. EISSN 2077-0383 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
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