{"id":3141,"date":"2014-09-08T12:00:24","date_gmt":"2014-09-08T10:00:24","guid":{"rendered":"http:\/\/www.easistent.ro\/?p=3141"},"modified":"2014-10-15T10:03:18","modified_gmt":"2014-10-15T08:03:18","slug":"comunicarea-adecvata-cu-pacientul","status":"publish","type":"post","link":"https:\/\/www.easistent.ro\/?p=3141","title":{"rendered":"Comunicarea adecvata cu pacientul"},"content":{"rendered":"<p><strong>Exist\u0103 secrete ale unei comunic\u0103ri adecvate cu pacientul?<\/strong><\/p>\n<p><em><a href=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2014\/09\/13.jpg\"><img class=\"alignleft size-full wp-image-3142\" src=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2014\/09\/13.jpg\" alt=\"1\" width=\"182\" height=\"121\" \/><\/a>\u201d<\/em><em>Pacientul nu poate fi implicat \u00een fiecare decizie a actului medical. Pentru c\u0103, \u00een anumite privin\u021be, pacientul nu are competen\u021ba necesar\u0103 s\u0103 sprijine decizia. \u00cens\u0103 ne poate spune dac\u0103 are nevoie sau prefer\u0103 capsule sau lichide, sau dac\u0103 e mai bine pentru el sau ea s\u0103 ia medicamentul de 2 ori pe zi \u0219i nu de 3 ori pe zi. A\u0219a c\u0103 pacien\u021bii pot fi implica\u021bi \u00een acest gen de decizii.\u00a0 <\/em><\/p>\n<p><em>Este foarte important ca ei s\u0103 fie consulta\u021bi \u0219i implica\u021bi, dac\u0103 este posibil, pentru c\u0103 astfel vor respecta mai bine tratamentul\u201d, <\/em>ne m\u0103rturiseaPreben Ulrich Pedersen, Profesor Doctor, Danish Center for Clinical Guidelines \u2013 Clearinghouse, Department of Medicine and Technology, University of Alborg \u00eentr-un interviu acordat \u00een exclusivitate Revistei eAsistent \u00een timpul lucr\u0103rilor celei de a V-a Conferin\u021be OAMGMAMR \u2013 filiala Bucure\u0219ti (16, 17 mai 2014).<br \/>\nEste o abordare care pune accentul pe comunicarea \u00een ambele sensuri, at\u00e2t dinspre cadrul medical spre pacient, dar \u0219i invers, fiindc\u0103 dialogul joac\u0103 un rol esen\u021bial, aduc\u00e2nd beneficii tangibile calit\u0103\u021bii \u0219i rezultatelor finale ale actului medical.Aceast\u0103 implicare a pacientului \u00een diversele decizii necesare \u00een timpul actului medical este un aspect cheie al filozofiei \u00eengrijirilor medicale centrate pe pacient.<\/p>\n<p>\u00cencurajarea unei comunic\u0103ri adecvate de ambele p\u0103r\u021bi este un element fundamental \u00een construirea unei culturi a \u00eengrijirilor medicale centrate pe pacient, abordare care este din ce \u00een ce mai promovat\u0103 de c\u0103tre unit\u0103\u021bile medicale care vor s\u0103 fac\u0103 saltul decisiv spre un nou nivel de calitate, eficacitate \u0219i eficien\u021b\u0103.<\/p>\n<p>Filozofia \u00eengrijirilor medicale centrate pe pacient are patru principii de baz\u0103:<\/p>\n<p>1) <strong>comunicare deschis\u0103 \u0219i complet\u0103<\/strong> \u2013 cadrele medicale \u00eemp\u0103rt\u0103\u0219esc pacientului, la timp, informa\u021bii complete \u0219i obiective, \u00eentr-un mod care este \u00eencurajator \u0219i util pacientului, astfel \u00eenc\u00e2t acesta s\u0103 poat\u0103 participa la luarea deciziilor medicale;<\/p>\n<p>2) <strong>demnitate \u0219i respect<\/strong> \u2013 cadrele medicale \u00eei asculta pe pacien\u021bi \u0219i iau \u00een calcul valorile, convingerile \u0219i preferin\u021bele acestora \u00een luarea deciziilor medicale;<\/p>\n<p>3) <strong>participare<\/strong> \u2013 pacien\u021bii \u0219i familiile lor sunt \u00eencuraja\u021bi \u0219i sprijini\u021bi pentru a participa \u00een actul medical \u0219i deciziile pe care le implic\u0103;<\/p>\n<p>4) <strong>colaborare<\/strong> \u2013 cadrele medicale, pacien\u021bii, familiile lor \u0219i conducerea administrativ\u0103 a unit\u0103\u021bilor medicale colaboreaz\u0103 pentru realizarea unui act medical de \u00eenalt\u0103 calitate, eficacitate \u0219i eficien\u021b\u0103.<\/p>\n<p>Comunicarea adecvat\u0103 cu pacien\u021bii \u0219i familiile lor, primul dintre cele 4 principii de baz\u0103 ale asisten\u021bei medicale centrate pe pacient, a fost inclus\u0103 \u00een topul factorilor care determin\u0103 gradul lor de satisfac\u021bie \u00een privin\u021ba \u00eengrijirilor medicale primite de c\u0103tre pacien\u021bii consulta\u021bi \u00een cadrul unor focus grupuri organizate \u00een 2008 de Planetree si Picker Institute.<\/p>\n<p>Punctul de vedere al pacien\u021bilor este \u00eent\u0103rit de opiniile liderilor \u0219i personalului medical din spitalele incluse \u00een studiu, spitale care promoveaz\u0103 abordarea centrat\u0103 pe pacient, ace\u0219tia afirm\u00e2nd c\u0103 o comunicare adecvat\u0103 cu pacien\u021bii \u0219i familiile lor este esen\u021bial\u0103 \u00een realizarea unui act medical de calitate.<\/p>\n<p>Astfel, dup\u0103 cum sublinia \u0219i invitatul la Conferin\u021ba OAMGMAMR filiala Bucure\u0219ti din 16-17 mai 2014, profesor dr. Preben Pedersen, s-a demonstrat c\u0103 pacien\u021bii care sunt \u00eencuraja\u021bi s\u0103 poarte un dialog cu cei care le ofer\u0103 \u00eengrijiri medicale, de exemplu pun\u00e2nd \u00eentreb\u0103ri ca s\u0103 \u00een\u021beleag\u0103 corect \u0219i complet informa\u021biile primite \u0219i exprim\u00e2ndu-\u0219i preferin\u021bele pentru un anumit mod de administrare a tratamentului, sunt mai \u00eenclina\u021bi \u0219i reu\u0219esc mai bine s\u0103-\u0219i accepte problemele medicale, s\u0103 \u00een\u021beleag\u0103 op\u021biunile de tratament, s\u0103-\u0219i schimbe comportamentul \u00een sensul dorit \u0219i s\u0103 adere mai riguros la respectarea tratamentului.<\/p>\n<p>Studiile ne arat\u0103 c\u0103 atunci c\u00e2nd lipse\u0219te o comunicare real\u0103, \u00een ambele sensuri, pacien\u021bii resimt aceasta \u00een mod palpabil, iar anxietatea, vulnerabilitatea \u0219i sentimentul lipsei de control se accentueaz\u0103. Un pacient declara c\u0103 \u201d<strong><em>atunci c\u00e2nd ai nevoie de \u00eengrijiri medicale, comunicarea \u00ee\u021bi aduce alinare, c\u0103ci a nu \u0219tii ce se \u00eent\u00e2mpl\u0103 te sperie \u0219i mai mult<\/em><\/strong>\u201d.<\/p>\n<p>Comunicarea adecvat\u0103 cu pacien\u021bii \u0219i familiile lor urm\u0103re\u0219te s\u0103 transmit\u0103 un mesaj clar \u0219i s\u0103 stabileasc\u0103 o leg\u0103tur\u0103 \u00eentre cadrul medical \u0219i ace\u0219tia, pornind de la valorile primordiale ale profesiei medicale \u2013 dorin\u021ba de a ajuta, at\u00e2t prin \u00eengrijiri de calitate, c\u00e2t \u0219i prin sprijin moral, pe cineva care sufer\u0103.<\/p>\n<p>Dar ce \u00eenseamn\u0103 o comunicare adecvat\u0103 cu pacien\u021bii, cum o putem transforma dintr-un concept care poate p\u0103rea teoretic \u00eentr-o practic\u0103 de zi cu zi \u00een saloanele de spital? Ce putem face pentru a umaniza \u0219i personaliza chiar \u0219i cele mai de rutin\u0103 interac\u021biuni cu pacien\u021bii, aceasta este \u00eentrebarea fundamental\u0103 a \u00eengrijirilor medicale centrate pe pacient, comunicarea adecvat\u0103 reprezent\u00e2nd o condi\u021bie absolut necesar\u0103 pentru calitatea actului medical.<\/p>\n<p>Iat\u0103 ce recomand\u0103ri primesc cadrele medicale de la Spitalul Northern Westchester din SUA pentru a putea construi u\u0219or o comunicare optim\u0103 cu pacien\u021bii:<\/p>\n<p>1. Preg\u0103te\u0219te-te \u00eenainte de \u00eent\u00e2lnirea cu pacientul rememor\u00e2nd importan\u021ba urm\u0103toarelor comportamente adecvate:<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00cei voi acorda acestui pacient \u00eentreaga mea aten\u021bie.<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Voi asculta cu aten\u021bie ce-mi spune pacientul \u00eenainte de a-i r\u0103spunde.<\/p>\n<p>2.\u00a0\u00a0 Creaz\u0103 un climat care favorizeaz\u0103 dialogul \u0219i stabilirea unei leg\u0103turi:<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 M\u0103 voi adresa pacientului folosind numele pe care \u00eel prefer\u0103.<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 M\u0103 voi prezenta \u0219i voi \u00eemp\u0103rt\u0103\u0219i c\u00e2te ceva despre mine.<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 M\u0103 voi a\u0219eza l\u00e2ng\u0103 pacient \u00een loc s\u0103 stau \u00een picioare.<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Voi avea contact vizual cu pacientul.<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Voi fi con\u0219tient(\u0103) de limbajul corpului meu \u0219i cum ar putea fi acesta interpretat de c\u0103tre pacient.<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00cemi voi ar\u0103ta sprijinul moral fa\u021b\u0103 de pacient oferindu-i atingeri de \u00eencurajare de c\u00e2te ori este posibil.<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Voi verifica c\u0103 am \u00een\u021beles corect ce mi-a spus pacientul, reformul\u00e2nd ce a spus acesta cu cuvintele proprii.<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Voi acorda aten\u021bie membrilor familiei care sunt prezen\u021bi, recunosc\u00e2nd rolul lor important \u00een \u00eengrijirea pacientului.<\/p>\n<p>3. \u00a0Ofer\u0103 informa\u021bii \u0219i confirm\u0103 cu pacientul c\u0103 ai \u00een\u021beles corect ce-\u021bi spune acesta:<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Voi explica informa\u021biile pe care le transmit \u0219i voi acorda pacientului timp suficient s\u0103 proceseze \u0219i integreze aceste informa\u021bii.<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00cel voi ruga pe pacient s\u0103-mi explice ce a \u00een\u021beles.<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00cemi voi sprijini pacien\u021bii pentru a deveni parteneri \u00een procesul de \u00eengrijire oferindu-le acces la informa\u021bii despre procesul de evolu\u021bie a bolii lor. Le voi semnala articolele, site-urile, c\u0103r\u021bile, etc., care i-ar putea ajuta \u00eena-\u0219i \u00een\u021belege mai bine condi\u021bia medical\u0103.<\/p>\n<p>4. Cere-i pacientului p\u0103rerea despre stilul t\u0103u de comunicare:<\/p>\n<p>&#8211; \u00a0\u00a0\u00cen\u021beleg c\u0103 fiecare persoan\u0103 \u00eenva\u021b\u0103 \u00een mod diferit.<\/p>\n<p>&#8211;\u00a0 Ca s\u0103 m\u0103 asigur c\u0103 reu\u0219im s\u0103 stabilim un dialog deschis \u0219i clar, \u00eel voi \u00eentreba pe pacient dac\u0103 modul \u00een care comunic este adecvat din punctul lui de vedere.<\/p>\n<p><a href=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2014\/09\/23.jpg\"><img class=\"alignleft wp-image-3143\" src=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2014\/09\/23.jpg\" alt=\"2\" width=\"200\" height=\"150\" \/><\/a><\/p>\n<p>\u00cen plus de comunicarea verbal\u0103, sunt c\u00e2teva lucruri pe care le pute\u021bi face pentru a-i \u00eencuraja pe pacien\u021bi s\u0103 v\u0103 abordeze f\u0103r\u0103 temeri \u0219i s\u0103 comunice deschis:<\/p>\n<p>\u2013\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 panouri pentru comunicarea cu pacien\u021bii \u0219i familiile lor, unde cadrele medicale pot posta informa\u021bii utile pacien\u021bilor, ca, de exemplu, c\u00e2nd este programat\u0103 o anumit\u0103 interven\u021bie\/radiografie, etc.;<\/p>\n<p>\u2013\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 sisteme de televiziune pentru pacien\u021bi, unde se pot difuza filme medicale educa\u021bionale;<\/p>\n<p>\u2013\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 carne\u021bele pentru ca pacien\u021bii s\u0103-\u0219i noteze pe loc \u00eentreb\u0103rile pentru medici \u0219i asisten\u021bii medicali, pentru a nu le uita p\u00e2n\u0103 la o eventual\u0103 \u00eent\u00e2lnire cu ace\u0219tia;<\/p>\n<p>\u2013\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 campanii\/postere \u201c\u00centreaba-ne! A\u0219a putem s\u0103-\u021bi satisfacem mai bine nevoile pentru ca \u0219ederea ta aici s\u0103 fie c\u00e2t mai confortabil\u0103!\u201d;<\/p>\n<p>\u2013\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 oferirea unei vestimenta\u021bii diferen\u021biate pentru diversele categorii de cadre medicale astfel \u00eenc\u00e2t pacien\u021bii s\u0103 \u0219tie mai u\u0219or pe cine pot aborda pentru un anumit tip de problem\u0103;<\/p>\n<p>\u2013\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 panouri cu poze ale cadrelor medicale din echipa de \u00eengrijiri; organizarea unor sesiuni periodice de comunicare cu familiile.<br \/>\nComunicarea adecvat\u0103 se bazeaz\u0103, deci, pe lucruri relativ simplu de pus \u00een practic\u0103, dar foarte eficace \u00een a stabili un dialog real \u0219i a construi un parteneriat \u00eentre cadrele medicale \u0219i pacien\u021bi \u0219i familiile lor. \u00a0Acesta este obiectivul fundamental al \u00eengrijirilor centrate pe pacient.<\/p>\n<p>Iar existen\u021ba unui parteneriat real este esen\u021bial\u0103 pentru \u00eembun\u0103t\u0103\u021birea deznod\u0103m\u00e2ntului actului medical, cresc\u00e2nd calitatea \u0219i siguran\u021ba acestuia, precum \u0219i satisfac\u021bia pacien\u021bilor.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Articol realizat de Mirela Musta\u021b\u0103, Redactor E-Asistent, Specialist<\/strong><strong> \u00een Comunicare \u0219i Rela\u021bii Publice, PhD.<\/strong><\/p>\n<p><strong>Surse:<\/strong><\/p>\n<p>1)\u00a0\u00a0\u00a0\u00a0\u00a0 <a href=\"http:\/\/www.patient-centeredcare.org\/chapters\/chapter7a.pdf\">http:\/\/www.patient-centeredcare.org\/chapters\/chapter7a.pdf<\/a><\/p>\n<p>2)\u00a0\u00a0\u00a0\u00a0\u00a0 <a href=\"http:\/\/www.supplementalhealthcare.com\/blog\/2012\/communicating-effectively-patients\">http:\/\/www.supplementalhealthcare.com\/blog\/2012\/communicating-effectively-patients<\/a><\/p>\n<p>3)\u00a0\u00a0\u00a0\u00a0\u00a0 Interviul acordat \u00een exclusivitate Revistei eAsistent in timpul lucr\u0103rilor celei de a V-a Conferin\u021be OAMGMAMR \u2013filiala Bucure\u0219ti (16, 17 mai 2014) \u2013 de catre Preben Ulrich Pedersen, Profesor Doctor, Danish Center for Clinical Guidelines \u2013 Clearinghouse, Department of Medicine and Technology, University of Alborg<\/p>\n<p>4)\u00a0\u00a0\u00a0\u00a0\u00a0 <a href=\"http:\/\/www.marylandpatientsafety.org\/documents\/AnnualConference2013\/Track-3-Kaufman-PPT-2.pdf\">http:\/\/www.marylandpatientsafety.org\/documents\/AnnualConference2013\/Track-3-Kaufman-PPT-2.pdf<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Exist\u0103 secrete ale unei comunic\u0103ri adecvate cu pacientul? \u201dPacientul nu poate fi implicat \u00een fiecare decizie a actului medical. Pentru c\u0103, \u00een anumite privin\u021be, pacientul nu are competen\u021ba necesar\u0103 s\u0103 sprijine decizia. \u00cens\u0103 ne poate spune dac\u0103 are nevoie sau prefer\u0103 capsule sau lichide, sau dac\u0103 e mai bine pentru el sau ea s\u0103 ia [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":3142,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[152,14],"tags":[],"_links":{"self":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/3141"}],"collection":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3141"}],"version-history":[{"count":1,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/3141\/revisions"}],"predecessor-version":[{"id":3155,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/3141\/revisions\/3155"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/media\/3142"}],"wp:attachment":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3141"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3141"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3141"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}