Objectification of patients – Nashka Richards

When looking at this picture I see a patient in our healthcare system. A patient that is only watered in terms of physical health while well-being and mental health is neglected. It is growing, but is it growing to its full potential?

So, let me take it right back to what healthcare exactly mean. According to the (World Health Organization [WHO], 1948) health is defined as a “state of complete physical, mental and social well-being”, however the question still remains, are all these factors taken into account when clinicians assess and treat patients. Clinicians became so focused on not letting the tree die by only treating and restoring physical health and then looking the other way when it comes to the other factors that actually ensure quality of life. It is like watering a tree but neglecting it’s overall well-being. This is where the second component of healthcare comes into perspective. Care on the other hand, refers to a concerned feeling about the needs and interests of others. Personally, I feel that care can truly be shown once one has developed empathy for an individual’s situation. Just as that tree wants to be nourished, a person wants to be cared for. Within physiotherapy and rehabilitation the therapists are so occupied with their own aims and goals for the patient that they are completely unaware the patients emotional and psychological well-being. It is important to get the patient back to his/her full functional state, but not at the expense of their mental or emotional health. For a patient that is faced with emotional difficulty, rehabilitation can become a burden. Generally all their focus will be concentrated on the emotional struggles and getting back to a full functional state is like water under the bridge.

According to a study that was conducted, 87% of the time during patients visits only physical health was discussed, (Carson, Katz, Gao, Margarita, 2010). Too often clinicians in our health system just focus on the physical problem at hand, then trying to fix the patient out of pure obligation. What happened to the patient’s feeling and emotional and mental health state? Mental and social health are just as crucial as physical well-being, since it influences the behaviour and how people manage overall health, (Jessica Diaz, 2017). Several research studies have shown how important and efficient it is to treat mental health. Firstly, when people receive proper mental healthcare, the number of medical visits decrease by 90%, while other studies have shown that patients with untreated mental issues seek medical attention twice as much as those who receive mental treatment (Cummings, Dorken, & Pallak, 1990). With this being said, more attention can be focused on other patients who is in need of medical help, and resources can be managed better. Secondly, conditions associated with poor maintenance of mental health, such as depression, anxiety and stress can contribute to physical problems and a decrease in the ability of the immune system to fight off diseases (Comminications, 2017). It is also true that one’s mental health affects how they interact with others (Comminications, 2017) and how they react in society. Poor mental health can lead to poor social health, but the opposite is also true. A study performed by the McLean Hospital, shows that age, socioeconomic status and several other factors can lead to poor mental health (Germine & Dodell-Feder, 2018). Clinicians tend to look pass patients’ social history, in terms of patients’ who come from more disadvantaged socioeconomic backgrounds, that have to travel far whether it is by expecting them to get to the hospital or clinic for physical therapy sessions or medication. Social drive and motivation are lower for these people and they tend to get socially isolated (Germine & Dodell-Feder, 2018). Thus, the whole cycle complete once again as that will led to a lower mental and physical health.

 It is thus undeniable that physical, mental and social health is very much connected, seeing that patients struggling with mental health often have a more difficult time managing their overall health. Healthcare workers should stop to objectify patients and start to stepping up to the mark. The biopsychosocial model of health, introduced by George L. Engel in 1977, is a good guideline to follow in order to work towards a more complete form of health. Responsibility can also be taken by just building a client-practitioner rapport, since clinicians often overlook the importance of establishing a rapport. The client rapport not only provide good communication between the patient and the practitioner, but it also enhances client assessment on all healthcare factors, (Joffe, 2012). A strong client rapport can lead to better patient compliance and this could initiate the treatment of mental health conditions as patients would feel more confident to talk with clinicians with whatever issues they are facing. This then would be the first step in working towards rehabilitation of patients to a more complete form of health as well as promoting proper healthcare.

References:

  • Carson, N., Katz, A. M., Gao, S., & Alegría, M. (2010). Assessment of physical illness by mental health clinicians during intake visits. Psychiatric services (Washington, D.C.), 61(1), 32–37. doi:10.1176/appi.ps.61.1.32
  • Diaz, J. (2017). The Importance of Mental Health on Health Overall.
  • Joffe, H. (2012). Thematic analysis. Qualitative research methods in mental health and psychotherapy: A guide for students and practitioners, 1, 210-223.
  • Comminications, H. r. (2017, February 8). Importance of mental health and overall wellness. The University of British Columbia.
  • Cummings, N. A., Dorken, H., & Pallak, M. S. (1990, April). Impact on psycological intervention of healthcare utization and cost. Biodyne Institute.
  • Germine, L., & Dodell-Feder, D. (2018, June 19). Study on social interactions could improve understandng of mental health risks. Clinical Psychology Sciece.

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One thought on “Objectification of patients – Nashka Richards

  1. When reading your assignment I came closer to an understanding of how a patient might feel objectified by the South African health care system. Your photo illustrates well your topic, a plant surviving but not thriving very well.
    As you wanted to focus on all aspects of health, not only the physical aspects, you also mentioned social, emotional and mental aspects. I really like your focus on these other aspects of health and do agree that for a long time physiotherapists and other physicians have focused too much on the physical health at the expanse of mental and social health.
    I wonder if you use the term “biopsychosocial” for this kind of more holistic perspective on health in South Africa? In Norway we use this term and perhaps you could include it into your text as a theoretical basis for your explanations. It might also be used opposite to the sole biomedical perspective on health. The model was introduced by the American psychiatrist Geor L. Engel (1913-1999) in 1977 (SML, https://sml.snl.no/biopsykososial_modell, fetched 14.05.19).

    You argument well for the inclusion of non-physical aspects in healthcare built on the quotation of Jessica Diaz, 2017. And I think that your argument for less objectification in this way is well justified. I would like to learn more about the background for using the figure 87% connected to consultations, where only physical aspects where discussed, not mental or psychological aspects (Carson, Katz, Gao, Margarita, 2010). Is this percentage representable for all consultations with health caretakers or only in special occasions?
    Concerning references it seems that you quote the first common WHO definition of health from 1948 without marking it as quote. Here you might improve your academic approach by including a specific reference.
    In your last paragraph you mention a specific way to counteract a patient´s objectification: the establishing of client-practitioner rapport. Here I would have loved to read more about what the normal routines for a physiotherapist at a hospital or a private institute are for documentation of a patient´s treatment. In Norway we are by law obliged to document each consultation and the interventions we implement. If you do not follow these routines you can be deprived of your authorization as a physiotherapist (Health Personnel Act (1999)). Do you have similar rules in South Africa? Or did I misunderstand the term client-practitioner rapport?

    Overall your essay was very interesting to read and I feel confirmed in my intention of a holistic approach towards patients. I also gained more understanding of the patient’s point of view on client-practitioner rapports. I have mostly seen this rapport-routine as means of communication amongst health caretakers, but now I can see that it also might be important from a patient´s point of view.

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