Recognizing and adjusting to barriers in doctor-patient communication

Article Abstract:

Communication barriers can develop between physicians and patients, which can limit the potential of a therapeutic relationship. Barriers can limit the sense of trust, openness, curiosity and respect which is needed for a therapeutic relationship between doctors and patients. A strategy for recognizing barriers is presented, including: verbal and nonverbal mismatch, as when a patient says one thing, yet his body language says another; cognitive dissonance, when things that the patient says do not make sense, or do not add up; unexpected resistance of the patient to the doctor's questions or statements; and physician discomfort, anger, or defensiveness. Once a barrier is identified, the source of the barrier can be understood and actions can be taken to lower it. Basic communication skills of acknowledgement, exploration (e.g. asking of how a patient feels about a situation), empathy, and legitimization of feelings and reactions, can be used. When barriers cannot be easily worked through, negotiation strategies, including clarification of the conflict, focusing on common interests rather than differences, increasing objectivity, and creativity in the development of new solutions, can be used by both physician and patient. Both must be willing to confront the barrier, especially if it is critical to the therapeutic process. By uncovering and addressing barriers, the barrier can lead to effective communication, which may enhance therapeutic relationships. (Consumer Summary produced by Reliance Medical Information, Inc.)

Telecommunications systems, Physician and patient, Physician-patient relations, Physicians, Medical professions, Patients

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Detection of Epstein-Barr virus in epidermal skin lesions of an immunocompromised patient

Article Abstract:

Epstein-Barr virus (EBV) has been implicated in a number of different disorders, including Burkitt's lymphoma. The virus has a well-known affinity for B-lymphocytes (a type of white blood cell), but has also been shown to infect and replicate in epithelial cells in the pharynx (throat) and the uterine cervix. Studies in tissue cultures have shown that EBV can also replicate in epithelial cells of the skin. A patient was observed with skin lesions that were apparently the result of Epstein-Barr virus infection. The patient, a 73-year-old man who had been previously treated for chronic lymphocytic leukemia, had lesions which were reddened, showing visible hemorrhage into the tissue. Biopsy specimens were taken from both healthy skin, and affected areas of the patient. Techniques of in situ hybridization, which use radioactive DNA to detect complementary viral DNA strands in tissue sections, demonstrated the presence of EBV DNA within the lesions, but not in the healthy tissue. The polymerase chain reaction, which amplifies tiny amounts of DNA, was used as an independent technique to identify Epstein-Barr virus DNA on electrophoretic gels. The direct demonstration of EBV in the epithelial cells of inflammatory skin lesions of this patient suggests that EBV may be a possible cause of undiagnosed skin lesions, particularly in immunocompromized patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Identification and classification, Skin, Dermatitis, Epithelium, Immunodeficiency, Epstein-Barr virus

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Recall of skin diseases that disqualify people from preexposure smallpox vaccination

Article Abstract:

Some people cannot remember whether they or anyone they live with has ever had atopic dermatitis or eczema, according to a study of 455 people. The reason this is important is because people with these two common skin conditions should not receive the smallpox vaccine. If they did, they would be more likely than others to experience side effects of the vaccine that involve the skin.

Complications and side effects, Atopic dermatitis, Recollection (Psychology), Eczema, Recall (Memory), Smallpox vaccine, Smallpox vaccines

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