Upload
others
View
3
Download
0
Embed Size (px)
Citation preview
Dealing with difficult persons
Dr. Bander Shayem Alrowaily
The Difficult Patients
• Angry patient غاضب
• Hidden agenda أجندة خفية
• Crying بكاء
• Denying نافي ومنكر
• Dependent اعتمادي
• Demanding مطالب
• Self-destruction متحطم
• Manipulation متلاعب
The ideal patient
• Suit the medical staff
• -Shows respect and agree without resistance
• -Shows trust, honesty and grateful
• -Answer the questions only
• -Satisfied with the amount of communication
The difficult patient
• The opposite of the "ideal patient“ • Impedes the clinician's ability to establish a therapeutic
relationship
• The "difficult patient“: • Asks for too much • Refuses investigations and treatment, • Shows suspicious behavior • Criticize the medical team and service • Untrusting • Aggressive • Ungrateful.
Fact • Improving physician communication can lead
to:
• Increased patient satisfaction
• Increased health care professional satisfaction
• Improved patient health outcomes
• Decrease in complaints
Fact
• Understanding the patient’s agenda and expectations
• Improves:
• Compliance and follow up
• Reduce fears of serious illness
• Reduce patient complaints at follow-up visits
The Demandingمطالب
Insist that they are not receiving good care
The Dependent Clingingاتكالي اعتمادي
• Want to be noticed
• - Extreme defense for own care
• - Not respond to medical care limitation
The Manipulativeمتلاعب
• Present frequently with new complain
• - Exposed to multiple treatments
• - Deeply attached and depend on the doctor
The Self-destructive Deniers مدمر منكر للذات
• No hope
• Self-destruction is a path to self-actualization
• Aggressive reactions
The angry patientالغاضب
• Expression of emotion
• Respond to threat to his or her equilibrium.
Differential diagnosis
• -Anxiety.
• -Depression.
• -OCD.
• -Schizophrenia.
• -Hypochonderiasis.
• -Chronic disease.
• -Personality disorder.
General Guidelines
• 1. Accept the reaction/ behavior
• 2. Accept the symptoms as an expressions of anxiety
• 3. Structure a program for each patient
• 4. Show interest in the person’s life, work; rather than the complaints
• 5. Reassurance with caution
• 6. Give more time fairly
General Guidelines
•7. Be honest about understanding of the problems.
•8. Accept that there are some people no one can help.
•9. Do not abandon the patient.
•10. Remember: the consultation is often the therapy
•11. Take extra care with the familiar patient and those who brings gifts.
Guidelines for handling the angry patient
• 1. Remain calm, keep still and establish eye contact• 2. Step back and try to analyze what is happening• 3. Ask the patient to sit down and try to adopt a similar position• 4. Address the patient with appropriate name• 5. Appear comfortable and controlled• 6. Be interested and concerned about the patient and the problem• 7. Use clear, firm, non-emotive language• 8. Listen intently• 9. Allow patients to ventilate their feelings• 10. Allow patients to be themselves• 11. Give appropriate reassurance• 12. Allow time, at least 20 minutes
Thank you