It is a practice used hurt patients as little as possible during their care by counting with an appropriate coordination between knowledge, abilities and attitudes on the side of health workers, with the basic premise of considering the patient’s suffering as an specially personal fact and highly dependant on its particularities.
12 july 2016
It is important to take into account aspects such as respect to individuality, sensitivity towards suffering and compromise with the development of a decent human life. This is due to the fact that they are configured within an action frame which promotes health in a wide sense and reduces the patient’s perception of a possible manipulation in his relationship with the health worker. This was explained by Pilar Barreto, UV academic, J. Luís Díaz worker at the Hospital Clínico Universitario de Valencia and Gloria Saavedra from the Hospital de la Magdalena in Castellón; in his analysis “Acercamiento al sufrimiento a través del counselling”, published in 2010.
It is fundamental, hence, to develop basic attitudes such as empathy, sincerity and non-conditional acceptance. This is explained by the relationship between doctor and patient, because it is linked to situations in which the expert has to inform about a possible severe disease as well as alternatives and processes which shall be followed by the patient. Such tense moments are linked to high-levels of stress, anxiety, uncertainty and suffering for the patient. Hence, empathy would allow health workers to improve their understanding on a person’s vital situation during a disease.
It is fundamental, hence, to develop basic attitudes such as empathy, sincerity and non-conditional acceptance
At the same time, sincerity is basically an honest way of behaving that shows that you really mean to help. However, this can turn into problems for the health workers because a consolidated compromise on pain generates - usually and as stated by authors- personal discomfort. However, it also generated a feeling of satisfaction on the work performed. Beyond the application of techniques and knowledge, the implication with the patient is thorough.
A consolidated compromise on pain generates - usually and as stated by authors- personal discomfort
For its part, “non-conditional acceptance means accepting, in a non-judgemental way, the other person’s biography, lifestyle and behaviour”, academics point out. All this makes it easier to build a relationship of trust between the doctor and the patient, which improves the future promotion of the other’s well-being.
All this makes it easier to build a relationship of trust between the doctor and the patient
Counselling is supported by the following abilities:
- Assertive communication: it allows a deliberative relationship, although it is underdeveloped in extreme situations, such as facing your own death.
- Self-regulation personal abilities: emotional control eases the professionalization of the relationship.
- Problem-solving abilities: makes the decision-making easier.
- Emotional support: motivating change without giving advices that might clash with the patient’s state of mind. Identifying what information knows the patient before informing him in order to help clarifying this information.
So, despite the bad news, patients will be able to positively value the manners, which is vitally important for them. The last aspects which were mentioned: emotional support and information customized for the patient’s need are two indispensable elements to be taken into account because the “benefits seen on the patient in relation with the treatment arise from the doctor’s ability to generate hope”, the authors highlighted.
Emotional support and information customized for the patient’s need are two indispensable elements to be taken into account
However, the policy and legal reality linked to this field makes communication with the patients harder. This way, Ethics Committees have been developed as well as informed consents or living wills. Professionals are required to know about them because it “allows tracking the interests of patients and the respect to their autonomy”, the academics ensured.
Likewise, all of the above cannot be put into practice without a solid knowledge base on the specific problems to be assisted and which are inherent to the health worker’s profession. Providing information has been proved as a difficult task for professionals because patients are very diverse and require a specific attention. Still, there is a common element which is that all patients need emotional support. In this sense, the best option is counselling, which requires some kind of Ethics on the side of the health worker, as stated by authors.
