Why intimidated patients may behave like hostages

Patients who end up clamming up during physician visits might be similar in some manner to hostages, a new study suggests.
 
Frozen in fear and confusion, patients may go through like they’re helpless and negotiating for his or her health, the research authors wrote.
 
“Hostage bargaining syndrome, where patients feel afraid of the physician, is an extremely real phenomenon that many patients experience, particularly individuals having a serious disease or inside a condition of effective vulnerability,” stated lead study author Dr. Leonard Berry of Texas A&M College attending college Station.

‘We’ve introduced the elephant in to the room that nobody wants to discuss and considering that elephant a reputation.A
– Dr. Leonard Berry

When Berry and colleagues were searching through sociology research about hostages, they saw a desire not to challenge authority. “That sounded to all of us like lots of patients,” he told Reuters Health by telephone.
 
Patients may go through like hostages negotiating for their health, even if doctors positively encourage conversation, Berry added. For instance, cancer patients and patients in intensive care units, as well as their families, may go through powerless and dependent on doctors for the following step of care. The issue may worsen when medical errors or unpredicted negative effects occur or the patient’s condition declines.

“One mother told [us] that when she observed a subtle change in her child’s conduct, she informed a nurse, who promptly performed a regular group of tests that indicated no cause for concern,” the study authors authored. “However the mother’s worry lingered, and she or he lay awake rehearsing things to tell the consultant each morning. She feared being perceived as disrespectful from the medical team’s expertise, or as demanding and overanxious.”
 
“This story (of the parent whose child gets extended inpatient care) could as fast be what 70-year-old man with coronary heart who’s unsure about the cardiologist’s recommendation for surgery but hesitates to question it, or perhaps a 27-year-old lady with cancer who not express her anxiety about treatment related infertility to her 
oncologist,” they added.

Patients might not wish to offend doctor 

Unlike consumer services for example eating out or attending a concert, where customers may go through in a position to speak up about bad service, medical services frequently produce a “need” and unequal power balance in which the physician may be the authority figure. Patients often hesitate to convey concerns, downplay serious questions or be worried about being “difficult.”
 
“Patients might not wish to risk offending the physician if they don’t accept the therapy,Inch Berry stated.
 
When hostage bargaining syndrome escalates, patients may feel helpless and find out no relief or escape, which could lead to neglect, passive reactions, loneliness and depression.
 
To combat the issue, Berry and colleagues suggest “shared decision-making,” where doctors present options and patients explain their preferences. This frequently results in less invasive, less intensive treatments, they are saying.
 
“We have introduced the elephant in to the room that nobody wants to discuss and considering that elephant a reputation,Inch Berry stated. “The purpose is not to become critical of doctors  … but to become aware and puppy nip the issue in the bud.”
 
To construct trust, doctors should demonstrate empathy, maintain patient privacy, have good communication skills and show curiosity about the individual like a person, the authors say. Body language and physical stance, for example sitting rather than standing before someone, signal the physician values what the individual states.
 
Simultaneously, physicians could easily react against this ‘hostage’ terminology, stated Dr. Kathy Mazor of Meyers Primary Care Institute in Worcester, Massachusetts, who studies patient-physician relationships but wasn’t involved with this research.
 
Patients ought to be encouraged and empowered to become more active within their healthcare, Mazor told Reuters Health by telephone. 

Doctors likewise need support in the business level so they can give patients time to speak and record visits correctly in electronic health records, she added.
 
“When there are just a lot of hrs per day, we’ve to think about how exactly organizations support both patients in speaking up and doctors in providing them with what must be done to provide good care,” she stated. “If one makes it progressively difficult, something is going to provide, so we do not want that to modify the patients.”

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