This well organised, easy to read book includes many detailed case histories of difficult patient interactions and suggestions for how to be most effective. Study/discussion questions can be found at the end of each chapter with one unresolved case for discussion. The author has interacted with thousands of patients. This book is an excellent teaching text.
Physicians enter their professions with the highest of hopes and ideals for compassionate and efficient patient care. Along the way, however, recurring problems arise in their interactions with some patients that lead physicians to label them as "difficult." Some studies indicate that physicians identify 15% or more of their patients as "difficult." The negative feelings that physicians have toward these patients may lead to frustration, cynicism. and burnout. Changing How We Think about Difficult Patients uses a multi-tiered approach to bring awareness to the difficult patient conundrum, then introduces simple, actionable tools that every physician, nurse, and caregiver can use to change their mindset about the patients who challenge them. Positive thoughts lead to more positive feelings and more effective treatments and results for patients. They also lead to more satisfaction and decreased feelings of burnout in healthcare professionals. How does this book give you an advantage? Caring for difficult patients poses a tremendous challenge for physicians, nurses, and clinical practitioners. It may contribute significantly to feelings of burnout, including feelings of exhaustion, cynicism, and lost sense of purpose. In response, Dr. Naidorf offers a pragmatic approach to accepting patients the way they are, then provides strategies for providers to find more happiness and satisfaction in their interactions with even the most challenging patients and families. Here are just some of the topics the author discusses in detail: What Makes a "Good" Patient? The Four Core Ethical Principals of the Clinician-Patient Relationship The Four Models of the Physician-Patient Relationship What Challenges Anybody with Illness or Injury? How "Good" Patients Handle the Challenges of Illness and Injury Six Common Reactions to Illness and Hospitalization On "Taking Care of the Hateful Patient" Standards for Education in Medical Ethics De-escalation Strategies Cultural, Structural, and Language Issues Types of Patients Who Tend to Challenge Us The Think, Feel, Act Cycle Recognizing Our Preconceived Thoughts Three Common Thought Distortions About Patients Asking Useful Questions Getting Out of the Victim Mentality Guiding our Thoughts Through a Common Scenario Show Compassion, Feel Compassion If you're a healthcare provider or caregiver, Changing How We Think about Difficult Patients will give you the benefit of understanding your most challenging patients, and a roadmap to positively changing your mindset and actions to better deliver care and compassion for all.
This volume offers guidelines for managing the therapist-patient relationship during crisis intervention and longer-term therapy with patients who exhibit borderline symptoms. Since to do no harm is the primary goal of any therapist who encounters such a patient, an appropriate therapist-patient relationship is crucial; moreover, skillful management of this relationship can, in itself, be the most effective and safe treatment. The authors present a conceptual model, based on self psychology and interpersonal theory, for reframing the borderline symptoms and the therapist's reactions. Case examples demonstrate effective relationship management and therapeutic interventions.
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
Sponsored by the Picker/Commonwealth Program for Patient-Centered Care In this comprehensive, research-based look at the experiences and needs of patients, the authors explore models of care that can make hospitalization more humane. Through the Patient's Eyes provides insights into why some hospitals are more patient-centered than others; how physicians can become more involved in patient-centered quality efforts; and how patient-centered quality can be integrated into health care policy, standards, and regulations. The authors show how, by bringing the patient's perspective to the design and delivery of health services, providers can improve their ability to meet patient's needs and enhance the quality of care.
"On Learning from the Patient is concerned with the potential for psychoanalytic thinking to become self-perpetuating. Patrick Casement explores the dynamics of the helping relationship - learning to recognize how patients offer cues to the therapeutic experience that they are unconsciously in search of. Using many telling clinical examples, he illustrates how, through trial identification, he has learned to monitor the implications of his own contributions to a session from the viewpoint of the patient. He shows how, with the aid of this internal supervision, many initial failures to respond appropriately can be remedied and even used to the benefit of the therapeutic work. By learning to better distinguish what helps the therapeutic process from what hinders it, ways are discovered to avoid the circularity of pre-conception by analysts who aim to understand the unconscious of others. From this lively examination of key clinical issues, the author comes to see psychoanalytic therapy as a process of re-discovering theory - and developing a technique that is more specifically related to the individual patient. The dynamics illustrated here, particularly the processes of interactive communication and containment, occur in any helping relationship and are applicable throughout the caring professions. Patrick Casement's unusually frank presentation of his own work, aided by his lucid and non-technical language, allows wide scope for readers to form their own ideas about the approach to technique he describes. This Classic Edition includes a new introduction to the work by Andrew Samuels and, together with its sequel Further Learning from the Patient, will be an invaluable training resource for trainee and practising analysts or therapists."--
The book is structured into eight chapters: 1. Skin anatomy. This chapter is intended to describe the pertinent anatomy related to IPL applications. In addition to the described main structural elements of the skin, the chapter has important points about skin aging and histological aspects which gives the reader a better understanding of the etiology of skin lesions and the need for Intense Pulsed Light (IPL) treatment. 2. Light-tissue interaction. This chapter describes the interaction between IPL and different skin structures. Target skin structures (chromophores) are described in detail. The results of this interaction are detailed as being important to understanding the goals and principles of IPL treatment. 3. IPL safety and legal issues. This chapter describes the needs of the environment for a safe treatment. The necessary equipment and things to avoid pitfalls which may lead to lawsuits are detailed. Several aspects of IPL legal issues are also described: how to avoid medical liabilities and how to manage them are also included in this chapter. 4. Patient selection. This chapter describes the pearls and pitfalls in selecting patients for IPL treatment. This is not an easy task and proper patient selection is extremely important to have satisfied patients. Problematic patient types are also described here. 5. Skin rejuvenation. This chapter starts with a description of skin aging. Intrinsic and extrinsic mechanisms are detailed. The most common skin lesions related to aging that can benefit from IPL treatment for rejuvenation are detailed. The chapter continues with treatment protocols which describe strategies for achieving optimal results. A review of the literature is included, presenting the treatment parameters of different studies and their results. 6. Hair removal. This chapter starts with a description of the hair follicle cycle, hair types and important structures for treatment. Treatment strategies are emphasized and detailed, starting from choosing the right parameters to post-treatment recommendations. A literature review is presented regarding treatment parameters and results according to different authors. 7. Vascular lesions treatment. This chapter describes the types of vascular lesions that can benefit from IPL treatment. The treatment protocol is emphasized and all the steps for performing this application are described in detail. A literature review is presented and different results are compared regarding treatment parameters. 8. Complications. It is inevitable that any medical treatment can end with complications. The possible complications of the most common IPL applications (skin rejuvenation, hair removal, pigmented and vascular lesion treatment) are detailed. The way to avoid them and how to handle them is also described. At the end of each chapter, there is a section on the practical points highlighting the most important points of the chapter. An extensive literature review of this technology is presented alongside numerous illustrations, tables and color pictures. The book will benefit any doctor or healthcare professional who uses IPL for cosmetic purposes, such as plastic surgeons, dermatologists, ophthalmologists, maxillofacial surgeons and otolaryngologists dealing with aesthetics of the face, as well as residents interested in learning the subject.
