Parents’ needs for physician-parent communication in the face of life-threatening illness: qualitative analysis

   Introduction. Parents of a child diagnosed with a life-threatening illness often experience the state of cognitive and emotional disorganization. The key factor determining parents-physicians cooperation is the quality of their relations. That is why physicians should be familiar with conditions that may help or disturb parents to manage this extreme situation. Competent communication leads to more effective treatment as well as fewer medical malpractice claims and lawsuits filed against doctors. Material and methods. The aim of this paper is the description and analysis of the needs of 23 parents whose children were diagnosed with life-threatening illnesses that led to death. The deceased children were treated mainly in hospitals or in hospices. The study was conducted in the period of one up to four years following the death of a child. A semi-structured interview was constructed and used for the purpose of this research. The transcription was analysed according to the rules of Qualitative Content Analysis with applying NVivo 9 software. Results. The results have revealed five categories of parents’ needs addressed to physicians: 1) a greater intensity of direct parent-physician contact; 2) experience of doctors’ thorough knowledge about the child and their illness; 3) a greater doctors’ involvement in the search for the causes of the disease and further treatment; 4) parents’ established position in the healthcare system, especially when the treatment lasted for a long time 5) more clear information about the applied treatment and condition of the child. Conclusions. The research indicates that the challenge of communication with parents is not only clear information about the course of a disease, providing facts about functioning of the entire health care system and this is particularly important for the parents whose child has been undergoing a long-term treatment. A physician should emphasise the meaning of palliative care as an integrated system of support. Parents’ decision-making about medical treatment on the early stage of an illness may cause too heavy strain to some of them

Phenomena connected with autobiographical memory during genogram session on the course of family therapy

W artykule przedstawione jest wykorzystanie techniki genogramu podczas sesji rodzinnych dla rekonstruowania pamięci autobiograficznej. Opisane są niektóre procesy pamięci autobiograficznej: zapamiętywanie, odpamiętywanie, zmienność wspomnień i ich reinterpretowanie, a także zjawisko wzajemnego wpływu osób pozostających w bliskiej relacji na treść ich wspomnień. Przedstawione są zjawiska występujące podczas analizy genogramu, m.in. grupowe ustalanie wspomnień, społecznie współdzielone zapominanie wybranych informacji, prozdrowotna reinterpretacja wspomnień.The aim of the presented paper is to describe the mechanisms of autobiographical memory, especially processes such as memorizing, memory retrieval and reinterpreting memories, which may be useful in work of family therapists during genogram sessions. The changeability of the content of memories, especially when an original event is transformed during its memorization and retrieval, are presented. It is also shown how these processes can facilitate healthy reinterpretation of the elements of the memories. Autobiographical memory is an unstable and flexible phenomenon and the records of past events change over time. If family therapists take it into consideration, they create a new space for the therapists-families interactions. Patients may believe that what they reminiscent are the real events and give them an obvious interpretation, although the psychological knowledge indicates that this interpretation is already adapted to the auditorium of listeners. A genogram session presents a unique opportunity to modify the way patients interpret important events from the past. A new, more “friendly” way of how each partner understands his or her past fosters more mature explanation of present and past behaviour. Family therapists may benefit from taking into consideration memories as a fluid matter, which is not a reliable record of past events but rather a result of reflection of the relational and cognitive processes that occurred in the past, and is still in progress during a genogram session. This could be supported by therapists when they create a good alliance with the family, invite everyone to share memories about families of origin, or stimulate the dialogue about these memories

Who is a tired student? Fatigue and its predictors from a gender perspective.

The level of fatigue among medical students is increasing. Exhaustion is an essential symptom of burnout, which may occur even while a student. Our exploratory study sought to identify the characteristics of tired students and to describe factors determining fatigue among medical students. The studied group consisted of second-year medical students (N=193) from a Polish medical university. Statistically significant differences in fatigue appeared between male and female students. We obtained positive correlations between intensity of fatigue and sleepiness, pain intensity, stress, anxiety, depression and negative health conditions, life satisfaction, emotional stability, conscientiousness, and self-efficacy. Predictors relevant for female fatigue were sleepiness, health condition, depression, and conscientiousness (the whole model explains 46% of variance in fatigue). Predictors relevant for male fatigue were sleepiness, health condition, anxiety, and agreeableness (the whole model explains 55% of variance in fatigue). We did not observe differences in fatigue between sleepless, overloaded, or stressed people. Explaining the differences between male and female predictors and levels of fatigue in terms of personality traits through the prism of defined stereotypical social roles is worth considering

Aesculapius on the "black list". The phenomenon of evaluating doctors in the online rankings

Do oceniania lekarzy w przestrzeni Internetu pacjenci wykorzystują specjalne, ogólnodo­stępne rankingi i ser wisy, a także fora, które służą tworzeniu tak zwanych czarnych list. Z badań przeprowadzonych w Stanach Zjednoczonych wynika, że większość pacjentów wie o istnieniu takiej możliwości, ale korzysta z niej 28%. W artykule opisujemy zjawisko oceniania lekarzy w przestrzeni Internetu. Przedstawiamy skalę zjawiska oraz to, jakie wymiary oceny pracy lekarza obejmuje. Wielu lekarzy nie monitoruje jakości, czy nawet poprawności ogólnodostępnych, zamieszczanych w Internecie na swój temat informacji. Mimo że 65% lekarzy ma negatywną opinię na temat wszelkiego rodzaju elektronicznych rankingów, to większość nie czuje, aby miały one realny wpływ na ich pracę.To evaluate physicians on the internet, patients use special, public rankings and web sites, as well as various forums that allow the creation of so-called „black lists”. Studies conducted in the United States show that most patients are aware of the existence of such possibilities, while 28% actually use them. In this article we analyze internet services for assessment of physicians. Studies that show how many doctors receive opinions, what they are and what dimensions of patient satisfaction they cover are reviewed. Researchers point to the fact that currently many physicians do not monitor the quality or even the correctness of information about themselves on the internet. Although 65% of doctors have a bad opinion about any kind of web rankings, most of them do not feel that such rankings influence their work

Availability of psychological support for medical students in Poland

ObjectivesMedical students suffer from a considerable level of stress, which can result in the deterioration of their mental health, including depression or suicidal ideation. They are afraid to seek help due to stigmatization and environmental ostracism. The goal of the study is to analyze the psychological support and stress management programs for students supported by medical schools in PolandMaterial and MethodsThe authors sent out e-mails with 9 questions regarding the issue being analyzed to all 19 medical schools in Poland. They obtained answers from 15 such schools, which corresponds to a response rate of 79%. The study was conducted in 2018–2019, before the SARS-CoV-2 pandemic.ResultsDue to the lack of central regulations, support is provided by medical schools individually. Those solutions focus on short-term, temporary therapy. If a longer therapy is needed, students are redirected to external health providers. Moreover, information about the support is not transferred by student-friendly communication channels. Conclusions: Support should be flexible, and it should quickly adapt to the emerging trends and consider students’ feedback. A future model of psychological support could be a center organized as a transfer point between a university problem-solving facility and external health providers, concentrating on short-term activity. Quick support would eliminate potential complications and more serious mental problems