Abstract

Review Article

Psychological phenomena in the doctor- Elderly patient relationship

Jose Luis Turabian*

Published: 08 April, 2020 | Volume 4 - Issue 1 | Pages: 019-023

The doctor-patient communication and the aging of the patients attended by the general practitioner are two important concepts that constantly impact medical consultations. This article raises some reflections and conceptualizations about the main psychological phenomena that have a special importance in the doctor-elderly patient communication and relationship: 1) Stereotypes and prejudices; 2) Regression; 3) Transference, countertransference and resistance; 4) Rapport; 5) Empathy; and 6) Paternalism. The GP must be alert about what affecting the communication with the old man and he should put the means to get a warm relationship. Consequently, to achieve effective communication with an older adult: The GP have to take it easy; to be patient; avoiding stereotypes and prejudices; allowing the patient to establish a benign regressive relationship, until if it is possible due to the biopsychosocial context of the elderly patient, he can begin the non-regressive relationship again; recognizing fact of transference, which put the doctor in another place, is inevitable, but taking into account that it greatly affects his relationship with the patients; avoiding countertransference; considering that the therapeutic alliance or rapport is particularly fragile in elderly patients with chronic diseases; giving greater importance to empathy; knowing that the elderly patient frequently accepts the authority of the doctor, but avoiding falling into an iatrogenic paternalism; and smile.

Read Full Article HTML DOI: 10.29328/journal.apmh.1001013 Cite this Article Read Full Article PDF

Keywords:

Elderly; Doctor-Patient Communication; Communication Skills; Prejudice; Paternalism; Empathy; Transference (Psychology); General Practice; Framework

References

  1. Turabian JL. Psychology of doctor-patient relationship in general medicine. Arch Community Med Public Health. 2019; 5: 62-68.
  2. Adler HM. The Sociophysiology of Caring in the Doctor-patient Relationship. J Gen Intern Med. 2002; 17: 883-890. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12406360
  3. Farin E. Patient-provider communication in chronic illness: current state of research in selected areas. Rehabilitation (Stuttg). 2010; 49: 277-291. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20963669
  4. Cesa-Bianchi M, Critini C, Cesa-Bianchi G.. Anziani e comunicazione tra salute e malatia. Milano: Guidotti. 2000.
  5. Turabian JL. Differential Characteristics in Communication and Relationship of the General Practitioner with the Elderly Patient. J Fam Med. Forecast. 2019; 2: 10-17.
  6. Robinson II TE, White GL, Houchins JC. Improving Communication With Older Patients: Tips From the Literature. Fam Pract Manag. 2006; 13: 73-78. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17022433
  7. Turabian JL. Relevant Characteristics for Elderly Patient Biopsicosocial Care in General Medicine. Archives of Community and Family Medicine. 2019; 2: 48-55.
  8. Reyes Ortiz CA, Gheorghiu S, Mulligan T. Oblivion of psychological phenomena in the elderly doctor-patient relationship. Colombia Médica. 1998; 29.
  9. Hekmat-panah J. The “Elderly” in Medicine: Ethical Issues Surrounding This Outdated and Discriminatory Term. Inquiry. 2019.
  10. Larsson H, Edberg A-K, Bolmsjö I, Rämgård M. Contrasts in older persons’ experiences and significant others’ perceptions of existential loneliness. Nurs Ethics. 2019; 26: 1623-1637. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/29772961
  11. Daurella N. Basic failure and therapeutic relationship: the contribution of Michael Balint to the relational conception of psychoanalysis. Temas de Psicoanálisis. Revista de la Sociedad Española de Psicoanálisis. 2019; 18.
  12. Balint M. Thrills and regressions. Londres: Hogarth Press. 1959.
  13. Balint M. The Basic Fault: Therapeutic Aspects of Regression. Londres: Tavistock Publications. 1968.
  14. Kvale JN, Dayringer R. The transference phenomenon in the care of the elderly patient. Fam Med. 1987; 19: 141-143. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/3596096
  15. Urbina-Méndez R, Hernández-Vargas CI, Hernández-Torres I, Fernández-Ortega MA, Irigoyen-Coria A. Psychodynamic Analysis of Transference and Countertransference in the Formation of Family Physicians in Mexico. Atención Familiar. 2015; 22: 33-62.
  16. Strachey J. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XII (1911-1913): The Case of Schreber, Papers on Technique and Other Works. ii-vii. The Hogarth Press and the Institute of Psycho-analysis, London. 1958.
  17. Teófilo TJS, Veras RFS, Silva VA, Cunha NM, Oliveira J dos S, et al. Empathy in the nurse–patient relationship in geriatric care: An integrative review. Nurs Ethics. 2019; 26: 1585–1600. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30071772
  18. Williams SL, Haskard KB, DiMatteo MR. The therapeutic effects of the physician-older patient relationship: Effective communication with vulnerable older patients. Clin Interv Aging. 2007; 2: 453-467. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18044195
  19. Coulehan JL, Platt FW, Egener B, Frankel R, Lin CT, et al. “Let Me See If I Have This Right...”: Words That Help Build Empathy. Ann Intern Med. 2001; 135: 221-227. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11487497
  20. Talking with Your Older Patient. Understanding Older Patients. NIH. National Institute on Aging.
  21. Cañete Villafranca R, Guilhem D, Brito Pérez K. Medical paternalism. Rev Med Electrón. 2013; 35.
  22. McKinstry B. Paternalism and the doctor-patient relationship in general practice. Br J Gen Pract. 1992; 42: 340-342. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/1457157

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