Monday, October 23, 2017

Monday, October 23, 2017

Tonight's picture was taken in October of 2005. That year Mattie wanted to be a calico cat, just like our cat, Patches. Mattie wasn't into typical store bought costumes because they were itchy against his skin, so I decided to make this calico cat costume. Mattie and I went to the craft store and bought felt together and we picked out a black sweat suit at Target. The rest was cutting, gluing, and assembly. I made his cat tail with my black stockings, and his cat ears using a black headband of mine! 

Unfortunately that year Mattie never got to wear his costume on Halloween. Instead, Mattie had an un-diagnosed ear infection (thanks to his doctor), that turned into sepsis. Mattie landed up in the hospital for several days in 2005, and one of those days in the hospital happened to be Halloween. However, this was a hospital that did not have a pediatric unit or a child life specialist. So Halloween was not celebrated in any way. Fortunately the costume was very loose on Mattie, so he officially got to wear it for Halloween 2006.


Quote of the day: We cannot live only for ourselves. A thousand fibers connect us with our fellow men; and among those fibers, as sympathetic threads, our actions run as causes, and they come back to us as effects. ~ Herman Melville


Peter and I get Google alerts on the latest psychosocial studies that relate to medicine. It helps us keep up to speed with what is being produced and circulated around in the health care industry. Today's link that came to us had me chuckling. Chuckling because I would have hoped that the medical community had an intuitive sense (rather than needing data to uncover this reality) for the importance of treating patients as human beings rather than as a medical subject. Clearly however, research on this subject matter was conducted in an in-patient setting to understand what impact the patient-doctor relationship has on the patient's perceptions of care and satisfaction. 

Part of me of course is skeptical as to why such a study was performed in the first place! Hospitals are now being evaluated to see if they are assessing for distress in their patients, and not complying with such a task can impact hospital accreditation. For more information on the Commission on Cancers distress screening standard go to.............................. p.56; 
https://www.facs.org/~/media/files/quality%20programs/cancer/coc/2016%20coc%20standards%20manual_interactive%20pdf.ashx. 

Nonetheless, I would like to think (I'm being wishful!!!) that even without the incentive of hospital accreditation, medical personnel have the interest to provide better patient care! Of course providing better care and actually "TALKING" to the patient are sometimes deemed as SCARY and TAKING TOO MUCH TIME. Therefore, the majority of physicians are not eager to delve into the psychosocial world of their patients because they are afraid of the potential delays to their schedule and worse, that they will not know what to do or how to manage this information. 

I encourage you to check out the link below to the article entitled, Effects of a Brief Psychosocial Intervention on Inpatient Satisfaction: A Randomized Controlled Trial. Within this study, they wanted to assess whether administering a brief psychosocial survey to patients in the hospital, would improve the patient-doctor relationship and therefore cause the patient to feel he/she was receiving better care! The survey administered is the Background, Affect, Trouble, Handling, and Empathy (BATHE), and it is designed to address patients’ psychological distress and strengthen the physician-patient relationship. The survey invites the patient to talk about whatever is important to him or her, and prompts the physician to express empathy and elicit positive coping. Here are the questions on the BATHE.

I am not sure how you feel about this, but again I was chuckling over the fact that a survey has to be created to prompt doctors to offer empathetic statements to their patients! What on earth?! However, given the medical environment, it is clear to me as a recipient of A LOT of care, that empathy is TRAINED OUT of the budding physician. Whereas in psychological based programs, we learn the art and value of empathy, this is not a sought after skill in medicine. So as a result, I believe physicians do need this prompt! Or in essence the permission to be human. Being human doesn't mean that you lose objectively!  

In any case, patients who received this study's survey were not more likely to perceive that their physician spent adequate time with them, showed them respect, or communicated well about their care. Rather, they were more likely to report that their physician was friendly and showed a “genuine interest in me as a person.” The added value of the survey appears to have been to create a daily moment where the physician acknowledged the patient as a whole person rather than solely as a medical patient. It is this actual connection that caused the patient to feel more satisfied about care. Hopefully more studies such as this can be conducted on larger sample sizes, to enable medical personnel to see the value of the human connection and how it can directly affect treatment. I really believe at times, medical personnel forget how vulnerable patients and families are and also the reason why they entered the medical helping profession to begin with. Given Mattie Miracle's mission to bring awareness to the psychosocial issues and needs associated with childhood cancer care, we felt this study deserved to be mentioned. 

Effects of a Brief Psychosocial Intervention on Inpatient Satisfaction: A Randomized Controlled Trial:

http://www.stfm.org/FamilyMedicine/Vol49Issue9/Pace675