Challenged by patients: a qualitative study of clinical supervisions of endocrinologists conducted by psychiatric liaison clinicians.
Details
Serval ID
serval:BIB_328D846B381A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Challenged by patients: a qualitative study of clinical supervisions of endocrinologists conducted by psychiatric liaison clinicians.
Journal
BMC health services research
ISSN
1472-6963 (Electronic)
ISSN-L
1472-6963
Publication state
Published
Issued date
04/12/2024
Peer-reviewed
Oui
Volume
24
Number
1
Pages
1539
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Abstract
Clinical supervision by psychiatric liaison clinicians is frequently provided in medical settings such as oncology and palliative care, but rarely in endocrinology. Consequently, the specific psychosocial issues faced by endocrinologists in their daily clinical practice and how they deal with them remain largely unknown. We aimed to explore individual supervisions of endocrinologists to gain insight into what kind of clinical situations they present, how they react to them and how this is worked through in supervision.
The data set consisted of eight audio-recorded first supervision sessions of endocrinologists conducted by liaison psychiatry clinicians, which were transformed into written core stories accounting for key components of each session. A secondary analysis of these core stories was conducted using an interpretative approach, focusing on (i) the types of clinical situations and (ii) the supervisees' counter-attitudes towards patients. Additionally, particular attention was given to how the supervisors worked through these elements.
Endocrinologists presented patients who did not adhere to treatment, behaved inexplicably, or held moral values that differed from their own. Challenged by these situations, supervisees experienced negative emotions (e.g., anxiety, irritation, guilt), associated with behavioral reactions (e.g., avoidance) and/or defensive stances (e.g., denial, rationalization). In half of the supervisions, addressing these difficulties allowed supervisees to link key characteristics of the patient interaction with their own unresolved issues; in the other half, supervisees were less inclined to confront themselves with their own contributions to the patient interaction and the supervisor adopted a more active stance, making specific contributions (e.g. support, advise).
The findings call for training programs addressing "difficult" patients and advocate for closer collaboration between endocrinologists and liaison psychiatry clinicians.
The data set consisted of eight audio-recorded first supervision sessions of endocrinologists conducted by liaison psychiatry clinicians, which were transformed into written core stories accounting for key components of each session. A secondary analysis of these core stories was conducted using an interpretative approach, focusing on (i) the types of clinical situations and (ii) the supervisees' counter-attitudes towards patients. Additionally, particular attention was given to how the supervisors worked through these elements.
Endocrinologists presented patients who did not adhere to treatment, behaved inexplicably, or held moral values that differed from their own. Challenged by these situations, supervisees experienced negative emotions (e.g., anxiety, irritation, guilt), associated with behavioral reactions (e.g., avoidance) and/or defensive stances (e.g., denial, rationalization). In half of the supervisions, addressing these difficulties allowed supervisees to link key characteristics of the patient interaction with their own unresolved issues; in the other half, supervisees were less inclined to confront themselves with their own contributions to the patient interaction and the supervisor adopted a more active stance, making specific contributions (e.g. support, advise).
The findings call for training programs addressing "difficult" patients and advocate for closer collaboration between endocrinologists and liaison psychiatry clinicians.
Keywords
Humans, Qualitative Research, Female, Male, Psychiatry, Endocrinologists/psychology, Adult, Middle Aged, Endocrinology, Physician-Patient Relations, Attitude of Health Personnel, Patient Compliance/psychology, Liaison psychiatry, Supervision
Pubmed
Web of science
Open Access
Yes
Create date
09/12/2024 16:19
Last modification date
21/01/2025 7:17