Desde la psicología – Pedro T. Sánchez

One of the keys to understand the development of our culture consists in the management that we make out of the information. It’s so much so that many of the expectations than what we considered “quality of life” go at the present time by the personal disposition of a good information. For this reason in all the organizations (and specially the ones of the sanitary system ) the information is raising the category of a specific opinion of excellence and quality, in the hospital context the concepts of communication and information are essential in the conception of healthcare quality.
Society claims a healthcare model able to render a specialized, comprehensive and integrative attention of the different sanitary resources to us, from the same moment of diagnosis. In order to be able to answer to this request we needed to displace, to some degree, the focus of our attention from the disease toward the sick person, stops in terms of their needs and of his particular process to provide it with the concrete conditions that we arrange the best possible cares of. The application of this new helping model compromised with a possible, coherent attention and with unified criteria, need the realization of changes in different levels, but it is especially important in one of them: The relation that we establish with the patient.
The need to establish a new shape of helping relation with the patient and your relatives appears each time with more force like a social, labor and legislative request. Our society weighs manifestly like plus sign and important the concept of personal self-determination to be able to make a decision and to elect ( on your disease and treatment ) according to your will and to your deepest convictions. And on the contrary refuse, each time with bigger disposition, the paternalism based on he I know what is better for you.

Establishing a new shape relational it requires, however, for part of the sanitary professionals of an important formative effort regarding abilities and techniques in touch and information. An obvious example of this effort is the development of named Documents of assist in decision making, these documents are conceived to promote the patient’s participation presenting in concrete pathologies the different therapeutic alternatives, quantifying the results for options, maintaining ever-present the possible personal values.
Within the category of Skills in touch we grouped those capacities or abilities that we can learn generically or developing centered in relieving the suffering of those that suffer the disease ( patients ) and or your consequences ( relatives ), and also those attitudes that they allow us to go with the patient in your vital vicissitude.
Of late years, terms communication and information have become habitual in the scientific publications, although almost always put forward in his relation with he how we should give bad news. Informing has in our language the significance of giving news be more than enough. Something, being the considered information therefore a punctual, conscious and voluntary act. In comparison, Communicating and Communication hold a significance that are reciprocated with participating jointly or laying eggs in relation. To communicate is a concept that needs at least two people, that includes the non-verbal aspects and that should be understood from an orbicular perspective then ( We got in touch ).

Communication and Relation, they are concepts that are complemented, we related ourselves inasmuch as we got in touch and got in touch inasmuch as we related to each other. Besides, from a perspective relational it is impossible her no communication, any behavior that we can develop in a social, included context he remaining in silence is a kind of communication.
In order to learn be more than enough what and how reporting to the patients, we have then that to learn previously on the communication with the patients. For understanding our communication with the patients we should establish the relational model that we wished to hold with our patients.

Numerous models on the shapes relational in terms of the theoretic used perspective exist, and it is not our aspiration developing the theme here, only taking aim that in the traditional model the perspective of communication focused on the Information since the sick person was considerate in any measure incapacitated to take the decisions on its disease approximately exclusively and, therefore, only it was supposed to be told on his treatment.

Continuity of care model elaborated in the oncology, he proposes to develop a model of responsibility shared in the helping relation that comes defined for the premise I have a formation and an experience in this pathology, you he has some personal needs and some values. The perspective of communication no longer focuses on the information but in how to establish the relation. What’s fundamental in this context is learning how we should behave to communicate the available information, stops in association with the patient appraising the existent alternatives at the treatment the patient is considered here like a person totally qualified to choose among the different therapeutic strategies on his disease, and therefore is to be told on the best possible alternatives of treatment attending to their peculiarities and to their needs.

In this context, we should assume than our bad pledged communication to the patient and to your relatives incrementing uncertainty notably, the despair and the suffering, generating an increment of the cost of the treatment (including psychopharmacology prescriber’s), and a frustration in the very helping staff.
Surpassed sometimes for a request that you do not do but to grow, we forgot a lot of professionals than precisely the patient’s vulnerability, it requires for our part more than ever, an effort for knowledge recognition of that one than being only one more, you recognize us singularly. From anthropology you do time that they warn about to us this freak already: “The physical integrity does not resist the dilution of the social personality ”, the more that he gets worse and or extend disease, more the sensation of helplessness develops in the person and of solitude, for this reason it does more necessary the social recognition for part itself of the ones that are one referent for us.

Also we needed to learn how to Listen. The studies accomplished by us show that in spite of the found improvements we needed to make our own formation perfect. Because listening-in ( sometimes we forgot it to understand her like a monotonous mechanism in the consultation ) implies a little bit more that to quit talking and to hear, need our complete attention and interest. Few there can be things so important and gratifying in the relation like feeling listened to. We will not get tired for so much of repeating that the active Listening is an ability that needs a continued formation.

If informing signifies giving news on something, reporting to the patient on any aspect of its disease has the objective to transmit a knowledge to him that knowledge is a right that the very patient has although in no case an obligation can be considered, therefore, the decision concerns to him of how far he wants to know. Granted that our professional obligation is informing the patient, the informational sense has to help the patient to know its reality allowing him keeping on making my own decisions. However, we have to accept that the information is never neuter, according to the context, the shape of transmission, the expectations the same information can become in the eyes of the patient one good or in a bad news.

We owe then to be aware of all intrinsic advantages that you provide us the fact of establishing a good communication relation:
• You help us to establish a relation based in respect and in confidence.
• Humanize the treatment incrementing so much the quality of life of the patient like his satisfaction for the received deal, optimizing his level from emotional adaptation to the disease when decreasing fears, the sentiment of solitude, the anguish and the uncertainty of the process.
• Improve also the sensation self-checking and therefore his self-esteem giving him forces to face hardest moments of disease.
• Decrease the level of professional stress significantly; Make easy the control of the symptoms and increment satisfaction and adherence to the prescribed treatment.

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