By Mitchell D. Feldman, John F. Christensen
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Additional resources for Behavioral Medicine in Primary Care: A Practical Guide
Patients can be important sources of information and support for each other individually, in groups, or on the web. THE HEALTH CARE TEAM Although it is usually the physician’s role to deliver the bad news, other team members play important roles. Nurses are trained to evaluate patients’ emotional and physical responses to treatment, their levels of comfort and activity, and their progress toward expected goals. They can be a witnessing presence when bad news is given, help interpret it if necessary, assist patients in verbalizing feelings and questions, and provide emotional support.
SUPPORT An expression of support tells patients that the physician cares about them and is willing to be present to their emotion. The expression can be verbal or nonverbal. Examples of nonverbal expression are handing the tearful patient a tissue or touching the patient. In judging whether touching a patient will be perceived as supportive, invasive, or inappropriate, the physician should consider such factors as culture, age, gender, sexual orientation, previous experience of abuse, and the presence or absence of psychiatric symptoms, such as paranoia.
JAMA 1993;269:1667–1668. Brothers L. A biological perspective on empathy. Am J Psychiatry 1989;146:10–19. Cohen-Cole S, Bird J. Building rapport and responding to the patient’s emotions (relationship skills). In: Cohen-Cole S, ed. The Medical Interview: The Three Function Approach. St. Louis, MO: Mosby Year Book, 1991. Halpern J. What is clinical empathy? J Gen Intern Med 2003;18:670–674. Hojat M, Gonnella JS, Nasca TJ, et al. Physician empathy: definition, components, measurement, and relationship to gender and specialty.
Behavioral Medicine in Primary Care: A Practical Guide by Mitchell D. Feldman, John F. Christensen