Alle Publikationen
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2017
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(2017): Kultursensible Aspekte während der Diagnostik von psychischen Belastungen bei Flüchtlingen – Zwei kommentierte Fallberichte. In: Psychotherapie, Psychosomatik, medizinische Psychologie 67 (3-04), S. 109-118. DOI: 10.1055/s-0042-107802
DOI: http://www.ncbi.nlm.nih.gov/pubmed/27706544 Abstract: High levels of mental disorders, especially PTSD, are commonly known among groups of people forced to leave their homeland as a consequence of war-related experiences (e. g. armed conflict, torture or persecution). Depending on the cultural background the perceptions of illnesses vary, different symptom presentation and thereupon different coping strategies respectively expectations towards health care services exist. To minimize the danger of misdiagnosis by different experts working with refugees in the host countries, a culture-sensitive diagnostic approach is needed from the beginning. This article describes important aspects of culture-sensitive diagnostics by means of 2 commented case reports. Special focus is set on the aspect of linguistic and in a broader sense cultural comprehension between therapist, client and if necessary language mediator.
Keywords: Adult, Communication Barriers, Culturally Competent Care, Culture, culture sensitive, Disziplin, Female, Germany, Humans, Kultur, Kulturtheorie, Life Change Events, Linguistik, Male, Mental Disorders/diagnosis/ethnology/psychology, Observablen/Kriterien für sozial angemessenes Verhalten und dessen Bewertung, Pathologie, Physician-Patient Relations, PREJUDICE, Psychologie, Refugees/psychology, Social Identification, Somatoform Disorders/diagnosis/ethnology/psychology, Stress Disorders, Post-Traumatic/diagnosis/ethnology/psychology, Suicidal Ideation, Translating 2015
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(2015): Teaching professional and humanistic values. Suggestion for a practical and theoretical model. In: Patient education and counseling 98 (2), S. 162-167. DOI: 10.1016/j.pec.2014.10.022
DOI: http://www.ncbi.nlm.nih.gov/pubmed/25468396 Abstract: OBJECTIVES To suggest and describe a practical and theoretical underpinning for teaching professional and humanistic values. METHODS The author describes four learning methods that together comprise a model for teaching professional and humanistic values. The author defends this model by citing evidence and relevant literature as well as his extensive experience with numerous colleagues in successfully applying the model in large scale programs. RESULTS The combination of teaching methods that comprise the model evolved over 30 years from the experience of several large collaborations with educators in teaching learners at all levels of medical education. The four teaching methods are (1) experiential learning of skills, (2) critical reflection, (3) a supportive group process, and (4) a sufficiently longitudinal curriculum. Together, these methods create a theoretical model with mutually reinforcing elements for enhancing commitment to core values and optimizing professional identity formation. CONCLUSIONS This paper describes the combined model and the methods in detail and reviews evidence favoring incorporation into curricula. PRACTICE IMPLICATIONS The combined model educationally enhances core values that underlie the professional identity formation of physicians. The model is practical and generalizable, and should be used by curriulum planners.
2011
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(2011): Courteous but not curious. How doctors' politeness masks their existential neglect. A qualitative study of video-recorded patient consultations. In: Journal of medical ethics 37 (11), S. 650-654. DOI: 10.1136/jme.2010.041988
DOI: http://www.ncbi.nlm.nih.gov/pubmed/21610269 Abstract: OBJECTIVE To study how doctors care for their patients, both medically and as fellow humans, through observing their conduct in patient-doctor encounters. DESIGN Qualitative study in which 101 videotaped consultations were observed and analysed using a Grounded Theory approach, generating explanatory categories through a hermeneutical analysis of the taped consultations. SETTING A 500-bed general teaching hospital in Norway. PARTICIPANTS 71 doctors working in clinical non-psychiatric departments and their patients. RESULTS The doctors were concerned about their patients' health and how their medical knowledge could be of service. This medical focus often over-rode other important aspects of the consultations, especially existential elements. The doctors actively directed the focus away from their patients' existential concerns onto medical facts and rarely addressed the personal aspects of a patient's condition, treating them in a biomechanical manner. At the same time, however, the doctors attended to their patients with courteousness, displaying a polite and friendly attitude and emphasising the relationship between them. CONCLUSIONS The study suggests that the main failing of patient-doctor encounters is not a lack of courteous manners, but the moral offence patients experience when existential concerns are ignored. Improving doctors' social and communication skills cannot resolve this moral problem, which appears to be intrinsically bound to modern medical practice. Acknowledging this moral offence would, however, be the first step towards minimising the effects thereof.
2008
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(2008): Etiquette-based medicine. In: The New England journal of medicine 358 (19), S. 1988-1989. DOI: 10.1056/NEJMp0801863
DOI: http://www.ncbi.nlm.nih.gov/pubmed/18463374 Abstract: Patients ideally deserve to have a compassionate doctor, but might they be satisfied with one who is simply well-behaved? When I hear patients complain about doctors, their criticism often has nothing to do with not feeling understood or empathized with. Instead, they object that “he just stared at his computer screen,” “she never smiles,” or “I had no idea who I was talking to.” During my own recent hospitalization, I found the Old World manners of my European-born surgeon — and my reaction to them — revealing in this regard. Whatever he might actually have been feeling, his behavior — dress, manners, body language, eye contact — was impeccable. I wasn't left thinking, “What compassion.” Instead, I found myself thinking, “What a professional,” and even (unexpectedly), “What a gentleman.” The impression he made was remarkably calming, and it helped to confirm my suspicion that patients may care less about whether their doctors are reflective and empathic than whether they are respectful and attentive.
Keywords: Disziplin, Education, Medical/methods, Etikette, Etiquette, Fachetiketten, Favoriten, Humans, Medizin, Observablen/Kriterien für sozial angemessenes Verhalten und dessen Bewertung, Patient Care, Physician-Patient Relations, Professional Competence, Rolle (Beruf), Soziale Angemessenheit, Zugeschriebene Kompetenz
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