An epistemic tool for facilitation of person-centered relationships in cardiovascular care

Abstract

Objectives. Person-centered physician-patient relationships are more effective than common paternalistic, however demand more time and specific communication skills. They are of great importance in working with behaviour change in setting of cardiovascular pathology, especially post-myocardial infarction. A tool might be useful, for clinical data gathering and precision actions provision, based on the in-depth view on patient's experiences. Methods. Male patients (n=21), economically active age, with first myocardial infarction (hospitalized, day 2-7 from onset, and 2-3 months post-discharge) were interviewed in-depth using Rogerian PCA skills. Recordings transcribed verbatim. Analysis included descriptive phenomenology with non-verbal semiotics analysis. Current stage of work. A list of units has been formulated that includes 1) specific experiences that follow the situation of the disease and are not expressed unless addressed (e.g. sense of vulnerability, loss of independence, loss of future perspectives); 2) changes in self-image and worldview; 3) specifics of social stress in patients' routines; 4) view on behaviour change that is expected, and on former behaviour. Expected results. Next step is formulation of a questionnaire addressing precise points to facilitate clinician's care provision making it more patient/person-centered. Last step is testing the questionnaire in real practice. Discussion. The units that have been found, can be classified under nosogenic reaction or PTSD or personality types as A or D. However, in routine practice clinicians need exact data, not the abstract formulations. Current work might be of help creating better understanding and more confident relations in post-myocardial infarction outpatient setting.