دورية أكاديمية
Third-Year Medical Students' Reactions to Surgical Patients in Pain: Doubt, Distress, and Depersonalization.
العنوان: | Third-Year Medical Students' Reactions to Surgical Patients in Pain: Doubt, Distress, and Depersonalization. |
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المؤلفون: | Kopecky KE; Department of Surgery, Stanford University, Stanford, California, USA., Zens TJ; Department of Surgery, University of Wisconsin, Madison, Wisconsin, USA., Suwanabol PA; Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA., Schwarze ML; Department of Surgery, University of Wisconsin, Madison, Wisconsin, USA; Department of Medical History and Bioethics, University of Wisconsin, Madison, Wisconsin, USA. Electronic address: schwarze@surgery.wisc.edu. |
المصدر: | Journal of pain and symptom management [J Pain Symptom Manage] 2018 Nov; Vol. 56 (5), pp. 719-726.e1. Date of Electronic Publication: 2018 Aug 23. |
نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 8605836 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-6513 (Electronic) Linking ISSN: 08853924 NLM ISO Abbreviation: J Pain Symptom Manage Subsets: MEDLINE |
أسماء مطبوعة: | Publication: New York, NY : Elsevier Original Publication: [Madison, WI : Dept. of Anesthesiology, University of Wisconsin--Madison, 1986- |
مواضيع طبية MeSH: | Pain* , Physician-Patient Relations*/ethics , Surgical Procedures, Operative*/ethics , Surgical Procedures, Operative*/psychology, Students, Medical/*psychology, Adult ; Curriculum ; Depersonalization ; Education, Medical, Graduate ; Emotions ; Female ; Humans ; Interpersonal Relations ; Male ; Middle Aged ; Pain Perception ; Qualitative Research ; Stress, Psychological |
مستخلص: | Context: Medical students have limited instruction about how to manage the interpersonal relationships required to care for patients in pain. Objectives: The objective of this study was to characterize the experiences of medical students as they encounter pain, suffering, and the emotional experiences of doctoring. Methods: We used qualitative analysis to explore the content of 341 essays written by third-year medical students who described their experiences with surgical patients in pain. We used an inductive process to develop a coding taxonomy and then characterized the content of these essays related to empathy, patient-clinician interaction, and descriptions of clinical norms. Results: Students found it difficult to reconcile patient suffering with the therapeutic objective of treatment. They feared an empathic response to pain might compromise the fortitude and efficiency required to be a doctor and they pursued strategies to distance themselves from these feelings. Students described tension around prescription of pain medications and worried about the side effects of medications used to treat pain. Students felt disillusioned when operations caused suffering without therapeutic benefit or were associated with unexpected complications. Although patients had expressed a desire for intervention, students worried that the burdens of treatment and long-term consequences were beyond patient imagination. Conclusion: These observations about patient-doctor relationships suggest that there is a larger problem among clinicians relating to patient distress and personal processing of the emotional nature of patient care. Efforts to address this problem will require explicit instruction in skills to develop a personal strategy for managing the emotionally challenging aspects of clinical work. (Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.) |
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معلومات مُعتمدة: | UL1 TR002373 United States TR NCATS NIH HHS |
فهرسة مساهمة: | Keywords: Pain; curriculum; ethics; patient-doctor relationship; surgery |
تواريخ الأحداث: | Date Created: 20180826 Date Completed: 20191016 Latest Revision: 20200108 |
رمز التحديث: | 20221213 |
مُعرف محوري في PubMed: | PMC6944465 |
DOI: | 10.1016/j.jpainsymman.2018.08.008 |
PMID: | 30144537 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1873-6513 |
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DOI: | 10.1016/j.jpainsymman.2018.08.008 |