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Li H, Li L, Liu T, Tan M, He W, Luo Y, Zhong X, Zhang L, Sun J. Risk management and empirical study of the doctor-patient relationship: based on 1790 litigation cases of medical damage liability disputes in China. BMC Health Serv Res 2024; 24:521. [PMID: 38664671 PMCID: PMC11044444 DOI: 10.1186/s12913-024-10952-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 04/04/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Compensation for medical damage liability disputes (CMDLD) seriously hinders the healthy development of hospitals and undermines the harmony of the doctor-patient relationships (DPR). Risk management in the DPR has become an urgent issue of the day. The study aims to provide a comprehensive description of CMDLD in China and explore its influencing factors, and make corresponding recommendations for the management of risks in the DPR. METHODS This study extracted data from the China Judgment Online - the official judicial search website with the most comprehensive coverage. Statistical analysis of 1,790 litigation cases of medical damage liability disputes (COMDLD) available from 2015 to 2021. RESULTS COMDLD generally tended to increase with the year and was unevenly distributed by regions; the compensation rate was 52.46%, the median compensation was 134,900 yuan and the maximum was 2,234,666 yuan; the results of the single factor analysis showed that there were statistically significant differences between the compensation for different years, regions, treatment attributes, and trial procedures (P < 0.05); the correlation analysis showed that types of hospitals were significantly negatively associated with regions (R=-0.082, P < 0.05); trial procedures were significantly negatively correlated with years (R=-0.484, P < 0.001); compensat- ion was significantly positively correlated with years, regions, and treatment attributes (R = 0.098-0.294, P < 0.001) and negatively correlated with trial procedures (R=-0.090, P < 0.01); regression analysis showed that years, treatment attributes, and regions were the main factors affecting the CMDLD (P < 0.05). CONCLUSIONS Years, regions, treatment attributes, and trial procedures affect the outcome of CMDLD. This paper further puts forward relevant suggestions and countermeasures for the governance of doctor-patient risks based on the empirical results. Including rational allocation of medical resources to narrow the differences between regions; promoting the expansion and sinking of high-quality resources to improve the level of medical services in hospitals at all levels; and developing a third-party negotiation mechanism for medical disputes to reduce the cost of medical litigation.
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Affiliation(s)
- Hui Li
- School of Health Care Management, Anhui Medical University, 230032, Hefei, China
| | - Limin Li
- School of Health Care Management, Anhui Medical University, 230032, Hefei, China
| | - Tong Liu
- School of Health Care Management, Anhui Medical University, 230032, Hefei, China
| | - Meiqiong Tan
- The Second Clinical Medical College, Anhui Medical University, 230032, Hefei, China
| | - Wanwan He
- The Second Clinical Medical College, Anhui Medical University, 230032, Hefei, China
| | - Yuzhu Luo
- The Second Clinical Medical College, Anhui Medical University, 230032, Hefei, China
| | - Xuerong Zhong
- The Second Clinical Medical College, Anhui Medical University, 230032, Hefei, China
| | - Liping Zhang
- School of Marxism, Anhui Medical University, 230032, Hefei, China.
| | - Jiangjie Sun
- School of Health Care Management, Anhui Medical University, 230032, Hefei, China.
- School of Management, Hefei University of Technology, 230039, Hefei, China.
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Li H, Zhang C, Li L, Liu T, Zhang L, Hao J, Sun J. Bibliometric and visualization analysis of risk management in the doctor-patient relationship: A systematic quantitative literature review. Medicine (Baltimore) 2024; 103:e37807. [PMID: 38640335 PMCID: PMC11029958 DOI: 10.1097/md.0000000000037807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/21/2024] Open
Abstract
OBJECTIVES This paper analyzed the research on risk management in the doctor-patient relationship (DPR) based on a systematic quantitative literature review approach using bibliometric software. It aims to uncover potential information about current research and predict future research hotspots and trends. METHODS We conducted a comprehensive search for relevant publications in the Scopus database and the Web of Science Core Collection database from January 1, 2000 to December 31, 2023. We analyzed the data using CiteSpace 6.2.R2 and VOSviewer 1.6.19 software to examine the annual number of publications, countries/regions, journals, citations, authors, and keywords in the field. RESULTS A total of 553 articles and reviews that met the criteria were included in this study. There is an overall upward trend in the number of publications issued; in terms of countries/regions, the United States and the United Kingdom are the largest contributors; Patient Education and Counseling is the most productive journal (17); Physician communication and patient adherence to treatment: a meta-analysis is the most cited article (1637); the field has not yet to form a stable and obvious core team; the analysis of high-frequency keywords revealed four main research directions: the causes of DPR risks, coping strategies, measurement tools, and research related to people prone to doctor-patient risk characteristics; the causes of DPR risks, coping strategies, measurement tools, and research related to people prone to doctor-patient risk characteristics; the keyword burst analysis revealed several shifts in the research hotspots for risk management in the DPR, suggesting that chronic disease management, is a future research direction for the continued development of risk management in the DPR. CONCLUSIONS The visualization analysis of risk management literature in the DPR using CiteSpace and VOSviewer software provides insights into the current research status and highlights future research directions.
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Affiliation(s)
- Hui Li
- Health Management College, Anhui Medical University, Hefei, China
| | - Chenchen Zhang
- First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Limin Li
- Health Management College, Anhui Medical University, Hefei, China
| | - Tong Liu
- Health Management College, Anhui Medical University, Hefei, China
| | - Liping Zhang
- School of Marxism, Anhui Medical University, Hefei, China
| | - Jiqing Hao
- First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Jiangjie Sun
- Health Management College, Anhui Medical University, Hefei, China
- Clinical Medical College, Anhui Medical University, Hefei, China
- School of Management, Hefei University of Technology, Hefei, China
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AlFaris E, Irfan F, Abouammoh N, Zakaria N, Ahmed AM, Kasule O, Aldosari DM, AlSahli NA, Alshibani MG, Ponnamperuma G. Physicians' professionalism from the patients' perspective: a qualitative study at a single-family practice in Saudi Arabia. BMC Med Ethics 2023; 24:39. [PMID: 37287002 DOI: 10.1186/s12910-023-00918-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 05/23/2023] [Indexed: 06/09/2023] Open
Abstract
INTRODUCTION Professionalism is a crucial component of medical practice. It is a culturally sensitive notion that generally consists of behaviors, values, communication, and relationships. This study is a qualitative study exploring physician professionalism from the patients' perspective. METHODS Focus group discussions with patients attending a family medicine center attached to a tertiary care hospital were carried out using the four gates model of Arabian medical professionalism that is appropriate to Arab culture. Discussions with patients were recorded and transcribed. Data were thematically analyzed using NVivo software. RESULTS Three main themes emerged from the data. (1) In dealing with patients, participants expected respect but understood delays in seeing physicians due to their busy schedules. In communication, participants expected to be informed about their health conditions and to have their questions answered. (2) In dealing with tasks, participants expected proper examination and transparency of diagnosis, but some expected the physician to know everything and did not appreciate them seeking outside opinions. They expected to see the same physician at every visit. (3) In physician characteristics preferences, participants preferred friendly smiling physicians. Some cared about the outer appearance of the physician whereas others did not. DISCUSSION/CONCLUSIONS The findings of the study explained only two themes of the four gates model namely dealing with patients and dealing with tasks. Cultural competence and how to benefit from patients' perceptions to be an ideal physician should be incorporated into the process of physicians' training.
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Affiliation(s)
- Eiad AlFaris
- Department of Family and Community Medicine, College of Medicine, King Saud University Chair for Medical Education Research and Development, King Saud University, Riyadh, Saudi Arabia.
| | - Farhana Irfan
- Department of Family and Community Medicine, College of Medicine, King Saud University Chair for Medical Education Research and Development, King Saud University, Riyadh, Saudi Arabia
| | - Noura Abouammoh
- Department of Family and Community Medicine, College of Medicine, King Saud University Chair for Medical Education Research and Development, King Saud University, Riyadh, Saudi Arabia
| | - Nasriah Zakaria
- Ehealth Unit, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
- College of applied science, Al maarefa university Riyadh Saudi Arabia, Riyadh, Saudi Arabia
| | - Abdullah Ma Ahmed
- Department of Family and Community Medicine, College of Medicine, King Saud University Chair for Medical Education Research and Development, King Saud University, Riyadh, Saudi Arabia
| | - Omar Kasule
- Academic and Training Affairs, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Dina M Aldosari
- King Khalid Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Nora A AlSahli
- King Khalid Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Ghatar Alshibani
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Gominda Ponnamperuma
- Department of Medical Education, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Yildiz A, Kurtoğlu A, Aciduman A. Urinary System Problems in al-Rãzî's Book, Man lã yaḥḍuruhu al-ṭabîb: Practical Advice for Those Who Cannot Access Physicians and Medical Recourses. EXP CLIN TRANSPLANT 2023; 21:1-4. [PMID: 37496333 DOI: 10.6002/ect.iahncongress.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
OBJECTIVES Abū Bakr Muḥammad ibn Zakariyyã al-Rãzî is a historical physician who made theoretical and practical contributions to medicine. The aim of al-Rãzî's book, Man lã yaḥḍuruhu al-ṭabîb, is to provide a valuable benefit to the general public. The book was written for people who do not have access to physicians, critical medical manuscripts, and medications. Our study aimed to add to the literature and discuss the issues concerning urinary tract problems in al-Rãzî's Man lã yaḥḍuruhu al-ṭabîb. MATERIALS AND METHODS The sections of al-Rãzî's Man lã yaḥḍuruhu al-ṭabîb dealing with the urinary system were discussed and translated from Arabic to English. RESULTS Urinary system problems are discussed in al-Rãzî's book under the headings of "Pains in the kidneys and bladder (nephritis and cystitis) and stones in the kidneys," "Hematuria," "Pyuria and painful micturition/dysuria," "Prescription for medicine on this subject," and "Drug for the difficulty of passing urine/strangury." The relevant sections mention drugs and approach to be used, particularly in the face of problems, rather than theoretical explanations. Changes in practice and treatment have been suggested in various symptomatic situations. CONCLUSIONS Rather than theoretical and etiological explanations for urinary problems, al-Rãzî provides accessible and applicable practical drugs and approaches for the general public, which can be considered suitable for the purpose mentioned in al-Rãzî's introduction to the book.
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Affiliation(s)
- Abdullah Yildiz
- From the History of Medicine and Ethics Department, School of Medicine, Ankara University, Ankara, Turkey
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Therapeutic alliance impact on analgesic outcomes in a real-world clinical setting: An observational study. ACTA PHARMACEUTICA (ZAGREB, CROATIA) 2022; 72:529-545. [PMID: 36651362 DOI: 10.2478/acph-2022-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/19/2022] [Indexed: 01/20/2023]
Abstract
A good therapeutic alliance is relevant for healthcare providers exposed to patients' suffering, especially since patients and physicians may understand the painful experience differently. Our aim was to explore the impact of therapeutic alliance on analgesic outcomes in a real-world interdisciplinary pain unit (PU). A cross-sectional observational study was conducted on outpatients (n = 69) using opioids on a long-term basis for the treatment of chronic non-cancer pain, where clinical pharmacologists and pharmacists advised patients about their opioid treatment. Responses to the patient-doctor relationship questionnaire (PDRQ), sociodemographic and clinical information (pain level, quality of life and hospital use) were collected, whereas pharmacology data (analgesic prescription, adverse events, and compliance) were obtained from electronic health records. Patients were predominantly middle-aged (75 % women, 72 % retired), experiencing moderate pain (VAS 40-70 mm) on average, and under a high morphine equianalgesic dosage (95 ± 88 mg per day, mainly tapentadol or fentanyl). Patients with better PDRQ outcomes, and therefore better therapeutic alliance, showed lower pain intensity than patients with worse PDRQ outcomes (pain intensity: high scores 60 ± 47 mm and medium scores 60 ± 45 mm vs. low scores 80 ± 75 mm, p < 0.01). Along with this, pain intensity was lower when patients affirmed that, thanks to the health-care providers, they "gained new insight", "felt better", or "felt content with their doctor's treatment". What´s more, patients who affirmed "I benefit from the treatment" experienced increased pain relief (benefit 40 ± 30 vs. non-benefit 19 ± 26 mm, p = 0.010) and improved quality of life (benefit 33 ± 25 vs. non-benefit 18 ± 16 mm, p = 0.031). However, there was a percentage of patients who did not fully understand the provided information, which is something to be taken into account to improve in clinical routine. Therapeutic alliance supported by pharmacist experts on pain management can be an effective strategy to improve analgesic outcomes. Further efforts are needed to improve communication strategies for pain management. Future directions of research should include the analysis of the role of the pharmacist in poly-professional consultations as related to the advice of patients about their medication, and the mutual trust with the patients.
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Alameddine M, Otaki F, Bou-Karroum K, Du Preez L, Loubser P, AlGurg R, Alsheikh-Ali A. Patients’ and physicians’ gender and perspective on shared decision-making: A cross-sectional study from Dubai. PLoS One 2022; 17:e0270700. [PMID: 36048748 PMCID: PMC9436052 DOI: 10.1371/journal.pone.0270700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 06/16/2022] [Indexed: 11/25/2022] Open
Abstract
Background Delivering patient-centered care is a declared objective of many health delivery systems globally, especially in an era of value-based health care. It entails the active engagement of the patients in healthcare decisions related to their health, also known as shared decision making (SDM). Little is known about the role of gender in shaping the perspective of patients on their opportunity for engaging in SDM in the Arabian Gulf Region. The aim of this study is to investigate the role of gender in shaping patients’ perspectives toward their opportunity for SDM in Dubai, UAE. Methods This study utilized a cross-sectional survey consisting of sociodemographic questions and the 9-item Shared Decision-Making Questionnaire (SDM-Q-9). A total of 50 physicians (25 females and 25 males), practicing at a large private healthcare delivery network in Dubai, were recruited using convenience sampling. Ten patients of every recruited physician (5 male and 5 female) were surveyed (i.e., a total of 500 patients). Statistical analysis assessed the differences in patients’ perceptions of physician SDM attitude scores by physicians’ and patients’ gender using independent t-test, ANOVA-test, and Chi-square analyses. Findings A total of 50 physicians and 500 patients (250 male patients and 250 female patients) participated in this study. The odd of patients agreement was significantly lower for male physicians, compared to their female counterparts, on the following elements of SDM: the doctor precisely explaining the advantages and disadvantages of the treatment (OR = 0.55, 95%CI: 0.34–0.88, p = 0.012); the doctor helping them understand the information (OR = 0.47, 95%CI: 0.23–0.97, p = 0.038), the doctor asking about preferred treatment option (OR = 0.52, 95%CI: 0.35–0.77, p = 0.001), and the doctor thoroughly weighting the different treatment options (OR = 0.60, 95%CI: 0.41–0.90, p = 0.013). No significant associations were observed between patients’ gender and their perception of their opportunity for SDM. Likewise, no significant associations were observed between the same or different physician-patient gender and patients’ perception of physicians’ SDM attitudes. Statistically significant associations were observed between physician-patient gender and preferred treatment option for patients (p = 0.012). Conclusion Study findings suggest that while there were no differences in patients’ perspective on SDM by the gender of patients, significant differences were observed by the gender of physicians. Female physicians, compared to their male counterparts, were more engaged in SDM, with both male and female patients. Male physician-female patient dyad received the lowest scores on SDM. This could be explained by the cultural, social, and religious sensitivities that infiltrate the physician-patient relationship in the Arab contexts. Despite the multi-cultural nature of the country, some female patients may still experience some discomfort in opening up and in discussion preferences with male physicians. For physicians, striking the right balance between assertiveness and SDM is necessary within the cultural context, especially among male providers. Offering targeted learning and development programs on the importance and practice of SDM is also necessary to ensure equitable opportunity for engagement in SDM for all patients irrespective of the gender of their provider.
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Affiliation(s)
- Mohamad Alameddine
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Farah Otaki
- Strategy and Institutional Excellence, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Karen Bou-Karroum
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Leon Du Preez
- Cardiac Anesthesiology, The City Hospital, Dubai Health Care City, Dubai, United Arab Emirates
| | | | - Reem AlGurg
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
- * E-mail:
| | - Alawi Alsheikh-Ali
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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Asamoah KT. The Pivotal Role of Effective Communication in Patient Care: A Case of Coronary Stent Thrombosis. J Patient Exp 2021; 8:23743735211039315. [PMID: 34514121 PMCID: PMC8427920 DOI: 10.1177/23743735211039315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Myocardial infarction is a significant cause of morbidity and mortality worldwide, resulting in millions of percutaneous coronary interventions being performed yearly. Coronary artery stents are, however, at risk of thrombosis, with a significant mortality rate. Stent thrombosis is, however, preventable using dual antiplatelets, barring other procedural or unique personal predisposing characteristics. Good communication with patients is indispensable in ensuring adherence to dual antiplatelet therapy, protecting the patient from stent thrombosis. This paper presents a patient who discontinued his dual antiplatelet therapy prematurely and developed stent thrombosis within a week after discharge, highlighting the importance of good communication in promoting adherence to an agreed management plan.
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Affiliation(s)
- Kofi T Asamoah
- National Cardiothoracic Centre, Korle-Bu Teaching Hospital, Accra, Ghana
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Alenazi F, Peddle M, Bressington D, Mahzari M, Gray R. A study protocol for a feasibility trial of telephone-delivered Adherence Therapy for adults with type 2 diabetes. Nurs Open 2021; 8:1510-1519. [PMID: 33471963 PMCID: PMC8046149 DOI: 10.1002/nop2.735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/08/2020] [Accepted: 11/05/2020] [Indexed: 01/13/2023] Open
Abstract
AIMS Adherence therapy is a candidate intervention to improve medication adherence and clinical outcomes in patients with type 2 diabetes. The feasibility of conducting a trial of adherence therapy in this population has not been established. The objective of this study is therefore to test the feasibility of conducting a randomized controlled trial of adherence therapy in a Middle Eastern context. DESIGN A single-centre randomized controlled feasibility trial of adherence therapy in patients with type 2 diabetes. METHODS We will undertake an initial cultural adaptation of a telephone-delivered form of adherence therapy in four patients in a Middle Eastern context. Our subsequent feasibility trial will aim to recruit 40 non-adherent diabetic patients that will be randomly allocated to receive eight weekly 30-min telephone adherence therapy sessions delivered by a diabetes educator versus treatment as usual. Key outcomes of interest include the number of patients invited to take part in the trial that consent to participate and then go on to complete treatment. RESULT The findings of this study will determine the feasibility of undertaking a full randomized controlled trial of adherence therapy in patients with type 2 diabetes.
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Affiliation(s)
- Fatimah Alenazi
- College of Science Health and EngineeringLa Trobe UniversityBundooraVICAustralia
- Department of Public HealthCollege of Public Health and Health InformaticsQassim UniversityAlBukayriyahSaudi Arabia
| | - Monica Peddle
- Lecturer in NursingSchool of Nursing and MidwiferyCollege of Science Health and EngineeringLa Trobe UniversityMelbourneAustralia
| | - Daniel Bressington
- Associate ProfessorSchool of NursingHong Kong Polytechnic UniversityKowloonHong Kong
- Adjunct Professor‐College of Nursing & MidwiferyCharles Darwin UniversityBundooraAustralia
| | - Moeber Mahzari
- Assistant professor of Medicine‐EndocrinologyKing Saud Bin Abdulaziz University for Health SciencesCollege of MedicineRiyadhKSASaudi Arabia
- Department of MedicineDivision of Endocrinology – Ministry of National Guard – Health AffairsRiyadhKSASaudi Arabia
- King Abdullah International Medical Research CenterRiyadhKSASaudi Arabia
| | - Richard Gray
- Professor of Clinical Nursing PracticeLa Trobe UniversityMelbourneAustralia
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Physician burnout, a new term, a well-known concept in the medieval era: a thematic review of Ruhawi’s Adab al-Tabib. Ir J Psychol Med 2019; 39:398-405. [PMID: 37039084 DOI: 10.1017/ipm.2019.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In 1974, Herbert Freudenberger introduced the phrase ‘Burnout in Healing Professional Workers’. Despite the existence of numerous investigations on physician burnout, only a few studies on its historical aspects can be found. This is the first research to present historical evidence on ‘physician burnout’ as pointed out in the book ‘Adab al-Tabib’ written by Ruhawi (9th century AD). He is shown to have an understanding of this concept by talking about job stress in his book, although he offers no exact equivalent definition for this state. In fact, finding an equivalent term to 20th century burnout in a book written a thousand years ago is almost impossible. Most interestingly, the same preventive strategies for physician burnout and its causes as those scientifically discovered in recent years can be evidenced to have been introduced by Ruhawi. Hence, ‘Adab al-Tabib’ is an outstanding work on physician burnout in the medieval era.
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Al-Saadoon M, Al-Adawi S. Informed Consent in Societies with Different Ethos of 'Selfhood'. Sultan Qaboos Univ Med J 2019; 19:e1-e3. [PMID: 31198587 PMCID: PMC6544067 DOI: 10.18295/squmj.2019.19.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/09/2019] [Accepted: 05/12/2019] [Indexed: 11/16/2022] Open
Affiliation(s)
- Muna Al-Saadoon
- Department of Child Health, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Samir Al-Adawi
- Department of Behavioural Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
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