パラメディカルに対する教育 : 医療従事者と患者の関係(総合医療体系の基幹としての心身医学-その教育)(第17回日本心身医学会総会)

抄録

With the ever-expanding knowledge and increased use of technology in the field of medicine, medical care has become multi-faceted and highly specialised . This development creates an environment of alienation for the hospital patient who cannnot grasp what is happening around him. Instead of helping the patient, the various services offred him might, at times, make him feel more confused and disorganized. The problem is that the "whole person" is being ignored, while "parts" of him are being treated. He may be identified as a bed number or by his diagnosis, not as a person. This creates additional anxiety in the patient whose existence as a human being is negated.Society as a whole is also moving in the direction of depaersonalization. Over-abundance of information, urbanization, multiple and diverse value systems reinforce the individuals sense of alienation and helplessness. This phenomenon is also apparent in the hospital setting where medical services and tratment modalities vary, leaving the patient feeling lost and with the impression that "no one person" is coordinating services upon which his life depends.It is impossible to carry out effective medical services without dealing with patients' anxiety.Handiling the patients' feelings, however, is not valued highly in the current educational and training systems for para-medicals. It is even viewed as a "waste of time" to sit and listen to a patient.As a social worker with many years of experience, I propose the following to implement the training program for staff to deal more effectively with patients. Ideally, this approach would be most effective when started in school. but a hospital setting would be an excellent alternative through an in-service training aimed toward producing "counseling-minded, patient-oriented" para-medicals.1. Team approach and standardization of terms.2. Establishment of personnel's communication system.3. Understanding of patients and their families.4. Understanding of patients' psychology.5. Understanding of group dynamics.6.Self-understanding of personnel.7.Establishment and implementation of hospital philosophy.8. Development of a supportive hospital milieu.9.Understanding and use of patients' dependency.10. Relating to the "layman's view point".11. Learning through experience-seeing through patients' eye.12. Effective use of authority figure.