3. Endogenous disorders within the provider: these refer to a pre-existing, ongoing state in
the provider, due to a variety of conditions and their associated treatments that may lead to
predictable errors and poor outcomes in patient management. Healthcare providers would be
expected to be just as vulnerable to affective disorders as any other segment of the population, if
not more so. A recent meta-analysis found aggregate suicide ratios to be 1.4 in male physicians,
and 2.3 for female physicians compared to the general population.66 The endogenous disorders
include: (1) depressive disorders (major depressive disorder, dysthymic disorder, and depression
due to medical conditions or substance abuse); (2) anxiety disorders (generalized anxiety
disorder, panic disorder, phobic disorder, obsessive compulsive disorder, post-traumatic stress
disorder, and anxiety due to a medical condition or substances); (3) mania and hypomania. These
endogenous states would be expected to be associated with varying degrees of compromise in
emotional and cognitive control, and therefore in patient safety.
4. Conscious or Unconscious Emotional Dysregulation: Interactions with
patients may produce expected emotional reactions or countertransference in providers. 25,67
When these emotions are avoided, they may result in a wide variety of symptoms and behaviors
that compromise patient safety. Some of these patterns include: (1) unconscious defenses that
prevent the provider from experiencing his or her own emotions through isolation of affect,
repression of affect, and projection; (2) unconscious anxiety in the forms of muscle tension,
smooth muscle tension and cognitive-perceptual disruption; 68 (3) excessive emotional
involvement with patients such as sexualizing behaviors, rescuing behaviors or acting out anger
towards patients and (4) excessive emotional detachment from patients in the form of neglect and
abandonment.
3. Endogenous disorders within the provider: these refer to a pre-existing, ongoing state in
the provider, due to a variety of conditions and their associated treatments that may lead to
predictable errors and poor outcomes in patient management. Healthcare providers would be
expected to be just as vulnerable to affective disorders as any other segment of the population, if
not more so. A recent meta-analysis found aggregate suicide ratios to be 1.4 in male physicians,
and 2.3 for female physicians compared to the general population.66 The endogenous disorders
include: (1) depressive disorders (major depressive disorder, dysthymic disorder, and depression
due to medical conditions or substance abuse); (2) anxiety disorders (generalized anxiety
disorder, panic disorder, phobic disorder, obsessive compulsive disorder, post-traumatic stress
disorder, and anxiety due to a medical condition or substances); (3) mania and hypomania. These
endogenous states would be expected to be associated with varying degrees of compromise in
emotional and cognitive control, and therefore in patient safety.
4. Conscious or Unconscious Emotional Dysregulation: Interactions with
patients may produce expected emotional reactions or countertransference in providers. 25,67
When these emotions are avoided, they may result in a wide variety of symptoms and behaviors
that compromise patient safety. Some of these patterns include: (1) unconscious defenses that
prevent the provider from experiencing his or her own emotions through isolation of affect,
repression of affect, and projection; (2) unconscious anxiety in the forms of muscle tension,
smooth muscle tension and cognitive-perceptual disruption; 68 (3) excessive emotional
involvement with patients such as sexualizing behaviors, rescuing behaviors or acting out anger
towards patients and (4) excessive emotional detachment from patients in the form of neglect and
abandonment.
การแปล กรุณารอสักครู่..