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Medicina
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Humanistic Approaches to Medical Practice
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Humanistic Approaches to Medical Practice

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: closed (1 January 2022) | Viewed by 50857

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editors

Prof. Dr. Beatrice Gabriela Ioan

E-Mail Website
Guest Editor
Legal-Medicine Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania
Interests: bioethics; medical law; legal medicine; medical malpractice; medical communication; violence against medical professionals; burnout in medical professionals
Special Issues, Collections and Topics in MDPI journals
Dr. Magdalena Iorga

E-Mail Website
Guest Editor
Behavioral Sciences Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania
Interests: behavioral sciences; medical psychology; chronic diseases; child psychology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Medical practice is science and art, technique and humanism. Medicine is the field in which the importance of the human being is more obvious than in any other. At the center of the medical act is the patient, and at its base and of the entire medical system is placed the relationship that is established between the patient and the medical staff. Modern medicine involves overspecialization, the approach of professionals to increasingly narrow fields, which makes patients routinely treated by multidisciplinary teams. This draws attention to the importance of an appropriate relationship between members of the medical team for the success of the therapeutic approach. In the context of technological progress in medicine, the need to relate to the humanistic values of the medical profession and the complexity of the medical act in which technical aspects are intertwined with cultural, ethical, legal, psychological, and sociological issues becomes increasingly clear. That is why, dear colleagues, we invite you to contribute to this Special Issue dedicated to the humanistic values of medical practice, which we hope will achieve a complex picture of what medicine and medical act mean today.

Literature reviews, metanalyses, and research papers are welcomed for this Special Issue. Studies focusing on the humanistic approach to medicine as a practice and art, medical ethics, medical psychology, continuing education of medical students and professionals working in the medical field, doctor–patient relationship, moral dilemmas in medical practice, factors related to practice and malpractice in the medical filled, etc. will find their place in this issue.

Prof. Dr. Beatrice Gabriela Ioan
Prof. Dr. Magdalena Iorga
Guest Editors

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Keywords

  • Medical practice
  • Bioethics
  • Culture
  • Medical law
  • Medical malpractice
  • Medical psychology
  • Medical sociology

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Published Papers (13 papers)

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Research

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16 pages, 601 KiB  
Article
Socio-Demographic, Professional and Institutional Characteristics That Make Romanian Doctors More Prone to Malpractice Complaints
by Bianca Hanganu, Magdalena Iorga, Lavinia Maria Pop and Beatrice Gabriela Ioan
Medicina 2022, 58(2), 287; https://doi.org/10.3390/medicina58020287 - 14 Feb 2022
Cited by 8 | Viewed by 2214
Abstract
Background and objectives: Medical malpractice is a phenomenon that shadows current medical practice, the number of complaints following an upward trend worldwide. The background for complaints is related both to the doctor and medical practice in general, as well as to the [...] Read more.
Background and objectives: Medical malpractice is a phenomenon that shadows current medical practice, the number of complaints following an upward trend worldwide. The background for complaints is related both to the doctor and medical practice in general, as well as to the patient. The aim of this study was to identify a profile of the Romanian doctors who are more prone to receiving complaints, by analyzing the socio-demographic, professional and institutional characteristics. Materials and Methods: We conducted a quantitative, prospective research, the data being collected using a newly developed questionnaire. Data analysis was performed with the IBM Statistical Package for Social Sciences (SPSS, version 24). We used counts, percentages, means and standard deviation, and comparative and correlational analyses. A logistic regression model was applied to select a statistically best-fit model to identify independent predictors for receiving complaints; a Hosmer–Lemeshow test was used to check the performance of the prediction model. Results: The study group consisted of 1684 doctors, of which 16.1% had been involved in a malpractice complaint. Results showed that men, senior doctors from surgical specialties who perform a greater number of on-call shifts, those who work in regional or county hospitals, those who have greater fear of receiving complaints and those whose life partner is a doctor with the same specialty are more prone to receiving complaints. Conclusions: The profile identified by the present research underlines the main characteristics that could be targeted with specific measures in order to prevent the ongoing increase of malpractice complaints in Romania. Full article
(This article belongs to the Special Issue Humanistic Approaches to Medical Practice)
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10 pages, 312 KiB  
Article
The Impact of COVID-19 on Behavior and Physical and Mental Health of Romanian College Students
by Sînziana Călina Silișteanu, Maria Totan, Oana Raluca Antonescu, Lavinia Duică, Elisabeta Antonescu and Andrei Emanuel Silișteanu
Medicina 2022, 58(2), 246; https://doi.org/10.3390/medicina58020246 - 6 Feb 2022
Cited by 5 | Viewed by 2788
Abstract
Background and Objectives: The COVID-19 pandemic caused by SARS-CoV-2 significantly marked people’s lives with respect to their behavior, and their physical and mental health. Materials and Methods: This is a cross-sectional study that was conducted in 2021 for a period of [...] Read more.
Background and Objectives: The COVID-19 pandemic caused by SARS-CoV-2 significantly marked people’s lives with respect to their behavior, and their physical and mental health. Materials and Methods: This is a cross-sectional study that was conducted in 2021 for a period of 5 months. The study sample included 218 students from the College of Physical Education and Sports of the University of Suceava who filled in a questionnaire on mental, physical and behavioral symptoms caused by the COVID-19 pandemic, as well as the Anxiety Assessment Questionnaire (STAI). Results: The responses indicated increased anxiety, physical symptoms, altered behavior, and increased perception of social restrictions. Regression analyses indicated that the levels of anxiety during the COVID-19 outbreak were strongly correlated with cognitive, physical and behavioral symptoms of the students. These were influenced by the living arrangements, location (urban vs. rural), age group and study year. Conclusions: The results show that first-year students did not exhibit significant physical and cognitive symptoms despite reporting anxiety, probably due to their enthusiasm as beginners. The 3rd year students were prone to anxiety and reported cognitive symptoms, possibly due to the prospects of an uncertain future. Full article
(This article belongs to the Special Issue Humanistic Approaches to Medical Practice)
13 pages, 559 KiB  
Article
Mature Adults at the GP: Length of Visit and Patient Satisfaction—Associations with Patient, Doctor, and Facility Characteristics
by Marta Rzadkiewicz, Gorill Haugan and Dorota Włodarczyk
Medicina 2022, 58(2), 159; https://doi.org/10.3390/medicina58020159 - 20 Jan 2022
Cited by 1 | Viewed by 2755
Abstract
Background and objectives: The consultation time for more mature adults is often perceived as longer, increasing with the patient’s age and boosting their satisfaction with the visit. However, factors determining patient satisfaction (PS) or the consultation time (CT) in the population aged [...] Read more.
Background and objectives: The consultation time for more mature adults is often perceived as longer, increasing with the patient’s age and boosting their satisfaction with the visit. However, factors determining patient satisfaction (PS) or the consultation time (CT) in the population aged 50+ are not clearly identified. A cross-sectional design was used to identify factors specific to the facility (e.g., size, staff turnover), doctor (e.g., seniority, workload), and patient (e.g., self-rated health, impairment of activities) that are related to PS and the CT. Our secondary focus was on the relation of PS to the CT along with the role of the patient’s age and gender for both. Materials and Methods: Doctors (n = 178) and their 1708 patients (aged 50–97) from 77 primary care facilities participated in the study. The Patient Satisfaction with Visit Scale score and the CT were the outcome measures. Results: We identified associations with the CT in terms of the facility-related factors (number of GPs, time scheduling); doctors’ workload and health; and patients’ education, time attending GP, and impairments. PS was additionally governed by doctors’ perceived rate of patients aged 65+, as well as the patients’ hospitalization in the prior year, frequency of visits, and impairments. For adults aged 50+ the CT was unrelated to PS and both remained independent of patients’ age. Conclusions: Specific factors in terms of the facility, GP, and patient were identified as related to PS and the CT for participating adults in primary care. During visits of patients aged 50+ at their GP, there is scope for both time-savings and patient satisfaction improvements, when paying attention, e.g., to the time scheduled per visit, the number of doctors employed, and the patients’ impairments. Full article
(This article belongs to the Special Issue Humanistic Approaches to Medical Practice)
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12 pages, 812 KiB  
Article
Patient and Physician Perspectives on Asthma and Its Therapy in Romania: Results of a Multicenter Survey
by Dragos Bumbacea, Carmen Panaitescu and Roxana Silvia Bumbacea
Medicina 2021, 57(10), 1089; https://doi.org/10.3390/medicina57101089 - 12 Oct 2021
Cited by 4 | Viewed by 1959
Abstract
Background and Objectives: Patient’s behaviours, attitudes and beliefs related to asthma and its treatment were shown to influence the adherence to therapy and the level of asthma control. This survey aimed to assess the level of asthma control and patient-reported behaviours, attitudes [...] Read more.
Background and Objectives: Patient’s behaviours, attitudes and beliefs related to asthma and its treatment were shown to influence the adherence to therapy and the level of asthma control. This survey aimed to assess the level of asthma control and patient-reported behaviours, attitudes and expectations related to their disease in Romanian patients. Materials and Methods: This cross-sectional quantitative survey was performed in February-March 2019 and enrolled 70 specialist physicians experienced in asthma management and 433 asthma patients under their care. Results: Of the 433 patients enrolled, 19.4% had mild asthma, 60.5% moderate asthma and 20.1% severe asthma. For the previous 12 months, asthma symptoms, exacerbations and emergency room visits were common in the sample analysed, with significantly higher figures in severe asthma patients (p < 0.001). The most important treatment goal for asthma patients was participation in all activities of daily living, while for physicians this was preventing asthma exacerbations. The valuation of the treatment goals was different between patients with severe asthma and those with mild and moderate forms. Based on the patients’ responses, 3 attitude clusters were identified: empowered savvy (36.5% of the patients), pessimistic non-compliers (43.2%), and anxious strugglers (20.3%). “Empowered savvy” had the lowest frequency of severe asthma, the highest adherence to maintenance therapy and the highest level of confidence in the effectiveness of asthma medication. The opposite of this attitude cluster is the “anxious strugglers”, containing more patients with severe asthma, a higher score for worries about asthma therapy and better self-reported knowledge of their treatment, contrasting with a proportion of 25% taking maintenance therapy only when having breathing difficulties. Conclusion: Asthma control in Romania remains poor, with frequent exacerbations and hospitalizations. The differences in treatment goals found between patients and physicians and between different asthma severity groups suggest the need for more patient-centred approaches. Full article
(This article belongs to the Special Issue Humanistic Approaches to Medical Practice)
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13 pages, 352 KiB  
Article
Assessing the Opinion of Mothers about School-Based Sexual Education in Romania, the Country with the Highest Rate of Teenage Pregnancy in Europe
by Magdalena Iorga, Lavinia-Maria Pop, Nicoleta Gimiga, Luminița Păduraru and Smaranda Diaconescu
Medicina 2021, 57(8), 841; https://doi.org/10.3390/medicina57080841 - 19 Aug 2021
Cited by 8 | Viewed by 5172
Abstract
Background and Objectives: Without mandatory school-based education, Romania is a leading European country in teen pregnancy. This survey aimed at assessing the level of knowledge and the opinions about sexual education and sexual-related issues among mothers of female teenagers aged 13–18 years old. [...] Read more.
Background and Objectives: Without mandatory school-based education, Romania is a leading European country in teen pregnancy. This survey aimed at assessing the level of knowledge and the opinions about sexual education and sexual-related issues among mothers of female teenagers aged 13–18 years old. Material and Methods: The survey was conducted between 2015 and 2017 and had four parts, collecting data about sociodemographic variables, the level of knowledge about sexuality, sexually transmitted diseases, and contraception. The respondents were mothers of female teenagers hospitalized in a tertiary pediatric clinic. Data were analyzed using IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows, version 25 (Inc., Chicago, IL, USA). Results: One hundred and thirty-five mothers (42.46 ± 6.81 years old) were included in the research. Most of them were from rural areas, had graduated secondary school, were Christian-orthodox, married, and with a stable job. More than half of the mothers (61.42%) declared that they personally knew adolescents that were already mothers. In great proportion, mothers proved good knowledge about sexual education, contraception, and STDs. They considered that the minimum age for becoming married, in general, is about M = 18.62 ± 2.09 years old but in the case of their daughters, mothers appreciated that the best age would be 23.56 ± 9.37. Mothers considered that they had good communication with their daughters (M = 4.28 ± 0.99) and two-thirds sustained that they had discussed with them about sexual activity, pregnancy, sexually transmitted diseases, and contraception. In case of unwanted pregnancy of their daughters, one-third of the mothers (38.50%) would advise their girls to continue the pregnancy and 7.40% mentioned the termination of pregnancy. Two-thirds of them (74.10%) agreed to school-based sexual education. In the order of preferred sources for sexual education, mothers mentioned parents (85.90%), teachers (33.30%), and family doctors (24.40%). Comparative results regarding their own sex life and that of their daughters are presented. Conclusions: School-based programs should meet parental beliefs about sexuality and sexual education. School, as a creator of values and models, should find the golden ratio to better shape the personal, familial, and social needs for the healthy sexual behavior of the new generation. Full article
(This article belongs to the Special Issue Humanistic Approaches to Medical Practice)
8 pages, 449 KiB  
Article
Perspectives and Values of Dental Medicine Students Regarding Domestic Violence
by Oana-Maria Isailă, Sorin Hostiuc and George-Cristian Curcă
Medicina 2021, 57(8), 780; https://doi.org/10.3390/medicina57080780 - 30 Jul 2021
Cited by 3 | Viewed by 2248
Abstract
Background and Objectives: The purpose of this study is to evaluate dental medical students’ opinions concerning domestic violence from a social and medical standpoint and from the perspective of the moral values of the physician–patient relationship. Materials and Methods: We performed [...] Read more.
Background and Objectives: The purpose of this study is to evaluate dental medical students’ opinions concerning domestic violence from a social and medical standpoint and from the perspective of the moral values of the physician–patient relationship. Materials and Methods: We performed an observational study with 4- and 5-year dental medical students at the UMF “Carol Davila” in Bucharest from October 2020–May 2021, using a questionnaire containing 20 items on domestic violence (DV). The questionnaire was uploaded online on the e-learning platform where the students have access. To collect the data, we used Microsoft Excel 365, and the statistical analysis was performed using Jamovi. Results: Of the 600 students enrolled, 415 answered the questionnaire, the answering rate being 69.16%. A total of 215 (53.1%) personally knew victims of DV, 4 (1.0%) considered that violence within a couple is necessary for certain situations, 401 (99.0%) considered that domestic violence is a fundamental problem in today’s society, and 170 (41.5%) felt that in domestic violence situations, the blame lies solely with the partner who resorts to physical violence. Regarding the role of the physician, 220 (56%) considered that the physician should breach confidentiality and report cases when patients state they are a victim of DV, 337 (88.2%) thought that free medical treatment should be provided for DV victims who have a dire financial situation, and 212 (56.7%) considered that victims of DV are non-compliant patients. Conclusions: Domestic violence is a phenomenon well-known to stomatology students, which creates the premise of an excellent physician–patient relationship with them, aiding in proper management of ethical issues such as a potential need to breach confidentiality or evaluate the potential conflicts between autonomy and beneficence. Full article
(This article belongs to the Special Issue Humanistic Approaches to Medical Practice)
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15 pages, 1419 KiB  
Article
Gender Differences in Healthy Lifestyle, Body Consciousness, and the Use of Social Networks among Medical Students
by Lavinia-Maria Pop, Magdalena Iorga, Lucian-Roman Șipoș and Raluca Iurcov
Medicina 2021, 57(7), 648; https://doi.org/10.3390/medicina57070648 - 24 Jun 2021
Cited by 21 | Viewed by 6072
Abstract
Background and Objectives: The goal of this survey was to identify the relationship between the level of satisfaction with body image, perceived health, and the usage of social media among freshmen medical university students. The influence of social media and peers was [...] Read more.
Background and Objectives: The goal of this survey was to identify the relationship between the level of satisfaction with body image, perceived health, and the usage of social media among freshmen medical university students. The influence of social media and peers was also related to body image. Materials and Methods: An online survey was distributed among freshmen healthcare students. The questionnaire collected sociodemographic, anthropometric data, and information about students’ perception about healthy lifestyle using open-ended questions, as well as their opinion about the importance of perfect body image and the level of satisfaction with their physical appearance. Questions focusing on the use of social media and the relationship with body image collected data on the use of social networks and how they affect students’ opinion about their own body image. Psychometric data were also gathered using the Body Consciousness Scale. For the statistical analysis, QSR NUD*IST (Non-numerical Unstructured Data Indexing Searching and Theorizing) Vivo 12 was used for qualitative data and IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows, version 23 (SPSS Inc., Chicago, IL, USA) was used for descriptive and comparative results. Results: In total, 77 students aged 20.09 ± 2.47 years, of which the majority were women (75.30%), were included in the survey. The use of social network was about 4.81 ± 3.60 h/day. Facebook was the most used social networking site (94.80%), followed by Instagram (92.20%), Snapchat (16.90%), WhatsApp (15.60%), and TikTok (10.40%). The most common reason for using these sites was socialization. We found that 64.90% of healthcare students were normal weight. The main barriers for having a healthy lifestyle, as they were perceived by students, were the busy schedule and the lack of time needed to prepare healthy meals, lack of motivation, and lack of money. Women scored higher for the Private Body Consciousness and Public Body Consciousness scales. The main aspects related to a healthy lifestyle referred to physical activity, consumption of fruit and vegetables, water consumption, and a good quality of sleep. Gender differences were discussed as well. Conclusions: The results illustrated the complexity of the relationship between social media and body image and the need to prevent body image concerns, especially in young women. Full article
(This article belongs to the Special Issue Humanistic Approaches to Medical Practice)
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10 pages, 319 KiB  
Article
Metabolic Syndrome Prevalence and Cardiovascular Risk Assessment in HIV-Positive Men with and without Antiretroviral Therapy
by Win-Long Lu, Yuan-Ti Lee and Gwo-Tarng Sheu
Medicina 2021, 57(6), 578; https://doi.org/10.3390/medicina57060578 - 5 Jun 2021
Cited by 8 | Viewed by 2930
Abstract
Treatment of HIV infection is a lifelong process and associated with chronic diseases. We evaluated the prevalence and predictors of metabolic syndrome (MetS) and cardiovascular diseases (CVDs) with individual antiretroviral drugs exposure among HIV-infected men in Taiwan. A total of 200 patients’ data [...] Read more.
Treatment of HIV infection is a lifelong process and associated with chronic diseases. We evaluated the prevalence and predictors of metabolic syndrome (MetS) and cardiovascular diseases (CVDs) with individual antiretroviral drugs exposure among HIV-infected men in Taiwan. A total of 200 patients’ data were collected with a mean age of 32.9. Among them, those who had CD4 positive cell number less than 350/mL were eligible to have highly active antiretroviral therapy (HAART). Patients were divided into group-1 that contains 45 treatment-naïve participants, and group-2 that includes 155 HAART treatment-experienced participants. MetS prevalence between group-1 and group-2 was 18% and 31%, respectively. The Framingham Risk Score (FRS) for the naïve and experienced groups were 4.7 ± 4.2 and 3.87 ± 5.92, respectively. High triglyceride (TG > 150 mg/dL) in group-1 and group-2 were 15.6% and 36.6% (p < 0.05), whereas, lower high-density lipoprotein (HDL < 39 mg/dL) in group-1 and group-2 presented as 76.7% versus 51% (p < 0.05), respectively. In group-2, treatment with protease inhibitors (PIs) resulted in higher TG levels when compared with non-nucleotide reverse transcriptase inhibitors (NNRTIs) and integrase inhibitors (InSTIs). The prevalence of MetS in the treatment-naïve group was lower than that of the treatment-experienced group; high TG level resulted in higher MetS prevalence in the treatment-experienced group. In contrast, the cardiovascular risk of FRS in the treatment-naïve group was higher than that of the treatment-experienced group, which may result from the low HDL level. Although group-1 participants have a higher risk of developing CVDs, in group-2, an increasing TG level in PIs user indicated higher CVDs risk. TG and HDL are two significant biofactors that required regular evaluation in HIV-positive individuals. Full article
(This article belongs to the Special Issue Humanistic Approaches to Medical Practice)
19 pages, 678 KiB  
Article
How the SARS-CoV-2 Pandemic Period Influenced the Health Status and Determined Changes in Professional Practice among Obstetrics and Gynecology Doctors in Romania
by Magdalena Iorga, Camelia Soponaru, Răzvan-Vladimir Socolov, Alexandru Cărăuleanu and Demetra-Gabriela Socolov
Medicina 2021, 57(4), 325; https://doi.org/10.3390/medicina57040325 - 1 Apr 2021
Cited by 7 | Viewed by 2790
Abstract
Background and Objectives: The beginning of the SARS-Cov-2 pandemic period has had a strong impact on patients’ life, but also on doctors. The main goal of this research is to identify the difficulties related to the professional activity and personal life of [...] Read more.
Background and Objectives: The beginning of the SARS-Cov-2 pandemic period has had a strong impact on patients’ life, but also on doctors. The main goal of this research is to identify the difficulties related to the professional activity and personal life of obstetrics and gynecology doctors. Material and Methods: In total, 94 physicians from a single university center answered to an online questionnaire. Socio-demographic, health, family, and job-related data were collected. Data were processed using SPSS (v.25). Results: 7.4% of the doctors were confirmed infected with SARS-Cov-2 during the first 6 months of the pandemic, and 48.94% treated infected patients. Due to the large number of patients, 10.64% of the doctors have had no days-off during the last 6 months, and 22.34% of them have had new medical problems that led them to see a specialist. Seventeen to nineteen percent mentioned an increasing number of working hours and shifts per month due to the pandemic period, more than 10% used pills to cope with work-stress, and 25% of them had sleep disorders along with appetite loss. Extra-protection rules and negative consequences of wearing special equipment were identified: thermal discomfort that caused decreasing resistance and concentration during the surgery (52%), reduced mobility and accuracy of surgical or medical gestures (40%), and intraoperative visibility (47%). Doctors who were working with confirmed pregnant women preferred caesarean section. Conclusions: Working under the stress of an infection with SARS-Cov-2 is causing a lot of pressure and determines changes in personal, familial, social, and professional life. Understanding the challenges that ob-gyn doctors are facing will help institutions to better provide support. Full article
(This article belongs to the Special Issue Humanistic Approaches to Medical Practice)
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12 pages, 559 KiB  
Article
Fear-Avoidance Behavior and Sickness Absence in Patients with Work-Related Musculoskeletal Disorders
by Israel Macías-Toronjo, José L. Sánchez-Ramos, María J. Rojas-Ocaña and Esperanza Begoña García-Navarro
Medicina 2020, 56(12), 646; https://doi.org/10.3390/medicina56120646 - 26 Nov 2020
Cited by 4 | Viewed by 2037
Abstract
(1) Background and objectives: The purpose of this work is to determine the association of fear-avoidance attitudes with sickness absence status, its duration and disability in a work accident context. (2) Materials and Methods: This is a descriptive observational design, conducting the [...] Read more.
(1) Background and objectives: The purpose of this work is to determine the association of fear-avoidance attitudes with sickness absence status, its duration and disability in a work accident context. (2) Materials and Methods: This is a descriptive observational design, conducting the study in two occupational insurance provider clinics with patients with nonspecific low back and neck pain during the study period. Clinical variables were the Fear Avoidance Questionnaire, Roland Morris Disability Questionnaire, Neck Disability Index, Numerical Pain Scale; sociodemographic variables were sex, age, occupational, educational level, sickness absence status, and duration in days of absence from work. Multiple logistic and linear regressions were used to explore the association between variables. (3) Results: Fear-avoidance behavior is related to sickness absence status (OR = 1.048, p = 0.007), and the physical activity dimension (OR = 1.098, p = 0.013) is more relevant than the work dimension (OR = 1.056, p = 0.028). The duration of sickness absence is related to higher values on the fear-avoidance behavior scale in its global dimension (b = 0.84, p = 0.003, r = 0.327), and the results of the physical activity dimension (B = 1.37, p = 0.035, r = 0.236) were more relevant than the work dimension (B = 1.21, p = 0.003, r = 0.324). Fear-avoidance behavior is related to disability in both dimensions (B = 0.912, p ˂ 0.001, r = 0.505). (4) Conclusions: Fear-avoidance behaviors may influence the typification of sickness absence status, its duration both in its physical activity and work dimension, and its disability reported with higher values than in other healthcare contexts. Full article
(This article belongs to the Special Issue Humanistic Approaches to Medical Practice)
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Review

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13 pages, 617 KiB  
Review
The Psychosocial Role of Body Image in the Quality of Life of Head and Neck Cancer Patients. What Does the Future Hold?—A Review of the Literature
by Vlad Ioan Covrig, Diana Elena Lazăr, Victor Vlad Costan, Roxana Postolică and Beatrice Gabriela Ioan
Medicina 2021, 57(10), 1078; https://doi.org/10.3390/medicina57101078 - 9 Oct 2021
Cited by 13 | Viewed by 3526
Abstract
Background and Objectives: It is well known that among all cancers, cancers of the head and neck (HNC) have a major impact on patients’ quality of life. Disfigurement, anxiety and disabling physical and psychological symptoms affect people with HNC to such an extent [...] Read more.
Background and Objectives: It is well known that among all cancers, cancers of the head and neck (HNC) have a major impact on patients’ quality of life. Disfigurement, anxiety and disabling physical and psychological symptoms affect people with HNC to such an extent that the suicide rate in this category of patients is exceeded only by that of patients with pancreatic cancer. The aim of this review was to summarize the published literature describing the severity of body image and quality of life impairment in patients with HNC over time, and to examine the psychosocial and functional associations and interventions implemented to improve body image and quality of life. Materials and Methods: We conducted a literature search from 1 January 2018 to June 2021 that included electronic searches of six major databases (PubMed, ScienceDirect, ProQuest, PsycINFO, PsychArticles and Scopus) and review of references of articles screened. Of 620 records, only 9 articles met the eligibility criteria. Results: Numerous studies have been conducted to analyze various psychological variables, but there is still a lack of standardization in the assessment of body image perception (BI) and quality of life, resulting in small-scale testing of interventions with poor results. Conclusions: Expected longitudinal studies describing the flow of body image problems and the mediation and balance factors associated with body image will allow researchers to design methods aimed at limiting body image disorders and thus improving quality of life of patients with head and neck cancer. Full article
(This article belongs to the Special Issue Humanistic Approaches to Medical Practice)
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8 pages, 282 KiB  
Concept Paper
Teaching and Practicing Humanism and Empathy through Embodied Engagement
by Sana Loue
Medicina 2022, 58(3), 330; https://doi.org/10.3390/medicina58030330 - 22 Feb 2022
Cited by 1 | Viewed by 2547
Abstract
Concerns have been raised regarding medicine’s dehumanization of patients and providers and regarding the need to include, in the medical school curriculum, components that encourage the development of empathy and humanistic practice. This essay suggests that the development of humanistic practice requires attention [...] Read more.
Concerns have been raised regarding medicine’s dehumanization of patients and providers and regarding the need to include, in the medical school curriculum, components that encourage the development of empathy and humanistic practice. This essay suggests that the development of humanistic practice requires attention to not only the cognitive and affective/emotive aspects of humanism, but also to the nurturing of intersubjectivity between the provider and the patient through strategies designed to promote embodied awareness. Several approaches to the development of embodied awareness are discussed, including puppetry pedagogy, drama, and virtual reality applications. Full article
(This article belongs to the Special Issue Humanistic Approaches to Medical Practice)
7 pages, 261 KiB  
Case Report
Borderline Personality Disorder “Discouraged Type”: A Case Report
by Lavinia Duică, Elisabeta Antonescu, Maria Totan, Gabriela Boța and Sînziana Călina Silișteanu
Medicina 2022, 58(2), 162; https://doi.org/10.3390/medicina58020162 - 21 Jan 2022
Cited by 2 | Viewed by 11551
Abstract
Borderline Personality Disorder (BPD) is a mental illness associated with a significant degree of distress and impairment because of the difficulties in effectively regulating emotions. BPD is frequently associated with Depressive Disorders, most commonly Major Depressive Disorder and Dysthymia. Here, we present a [...] Read more.
Borderline Personality Disorder (BPD) is a mental illness associated with a significant degree of distress and impairment because of the difficulties in effectively regulating emotions. BPD is frequently associated with Depressive Disorders, most commonly Major Depressive Disorder and Dysthymia. Here, we present a case report of an 18-year-old female patient hospitalized with a severe depressive episode and psychotic symptoms. A few months after discharge, the interpersonal difficulties, unstable self-image, fear of chronic abandonment, feeling of emptiness, paranoid ideation, helplessness, obsessive-compulsive elements, perfectionism, and social retreat led to the patient’s impaired functionality. The spectrum of signs and symptoms presented were characteristic of BPD. The specific presentation of mixed dependent/avoidant pattern of personality, with persistent feelings of guilt and shame, social anxiety, emotional attachments, obsessions, and feelings of inadequacy have further narrowed the diagnosis to discouraged BPD, as described by Theodore Millon. In our case, this particular subtype of personality disorder can be understood as BPN associated with social perfectionism. Both BPD and perfectionism, as a trait personality, were thought to exacerbate issues with self-conception and identity formation in this patient. Full article
(This article belongs to the Special Issue Humanistic Approaches to Medical Practice)
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