As a pediatrician I do it all the time. These parents are...this and that. They should behave like this...like that. But with time (15 years of practice) I slow down on judging patients. More and more I accept them. maybe because I listen to them and try mainly to help and coach them. Sometimes I am amazed how far I can go with this "non-judging attitude"
Quality of life in small children is a complex equilibrium between somatic health [most of our patients are presented by family with fever, pain, or other obvious signs of disease] and mental well-beeing.
Some parents are unable to provide high standards of care according to westernized lifestyle but are loveing parents and provide an excellent [in terms of feeling secure and haveing a lot of emotional stimuli] environement for the child development.
I started learning that quality of life can be worsened by a physician that "intrudes" in a traditional lifesyle just in order to "fix" it.
If parents are not inflicting a physical pain to the infant or promote a really dangerous lifestyle it is very good to learn from their perspective.
I fully agree that parental judgement by physician is be futile [in many cases their culutural beliefs and emotional inteligence can not be changed or fully understood] and generate a real distortion of the real problem of a child
Thank you both for these inputs!
Question would be then....What should be done to improve these situations?
It depends on what you mean by "judging" and your motive for doing it. I guess most of us do.In a way you have to to some extent.Getting a feel of where these parents are coming from may help you in management. Judging needs to be empathetic and sympathetic and also positive and not negative.You look for unspoken evidence from their body language from what they don't say. This is what I call the art of paediatrics. It helps you get the answer behind the answer,especially as more often than not our patients cannot speak for rhemselves
Dear Alessandro,
Thanks for your important questions. I agree with your comments.
Yes, as a clinical psychologist, I've caught myself judging my clients/patients and their family members from time to time, although I was trained to be empathic and non-judgmental.
As I grew in my clinical practice experience, I noticed my two inclinations. First, I tended to pre-judge less and understand my clients/patients more because I realized from my experience that most clients and their family members were trying their best under their circumstances. Second, I'd jump to my conclusion sometimes quite quickly based on my experiences and improved skills. For the most part, I was accurate, but I'd also make mistakes occasionally.
To improve the situation of not pre-judging our clients/patients, I remember reading about the meaning of the word "diagnosis." It means to "know someone through and through." In order to do a good job of diagnosing, one needs to withhold judgement and understand one's patients/clients fully by skillfully listening to and observing them.
Yes, hard not to judge. As a hypothesis, possibly over the last 200 years we have witnessed a transition from a patriarchal model to a model where patients are accepted as they are and listened to. These papers may be useful:
1. Storm, M., Hausken, K., and Mikkelsen, A. (2010), “User Involvement in In-patient Mental Health Services: Operationalization, Empirical Testing, and Validation,” Journal of Clinical Nursing 19, 13, 1897-1907.
2. Storm, M., Hausken, K., and Knudsen, K. (2011), “Inpatient Service Providers’ Perspectives on Service User Involvement in Norwegian Community Mental Health Centres,” International Journal of Social Psychiatry 57, 6, 551-563.
3. Storm, M., Knudsen, K., Davidson, L., Hausken, K., and Johannessen, J.O. (2011), “‘Service User Involvement In Practice’: The Evaluation of an Intervention Program for Service Providers and Inpatients in Norwegian Community Mental Health Centers,” Psychosis 3, 1, 29-40.
4. Heggland, L.H., Øgaard, T., Mikkelsen, A., and Hausken, K. (2012), “Patient Participation in Surgical Treatment Decision-Making from the Patients’ Perspective: Validation of an Instrument,” Nursing Research and Practice, Article ID 939675, 8 pages, doi:10.1155/2012/939675.
5. Heggland, L.H. and Hausken, K. (2013), “A Qualitative Identification of Categories of Patient Participation in Decision-Making by Healthcare Professionals and Patients During Surgical Treatment,” Clinical Nursing Research 22, 2, 206-227.
6. Heggland, L.H., Mikkelsen, A., and Hausken, K. (2013), “Models, Phases, and Cases of Patient Participation in Decision-Making in Surgical Treatment in Norway: A Qualitative Study,” Nursing and Health Sciences 15, 1, 39-44.
7. Heggland, L.H. and Hausken, K. (2014), “Patient Participation, Decision Makers, and Information Flow in Surgical Treatment,” Journal of Clinical Nursing 23, 9-10, 1430-1444.
8. Heggland, L.H., Mikkelsen, A., Øgaard, T., and Hausken, K. (2014), “Measuring Patient Participation in Surgical Treatment Decision-Making From Healthcare Professionals’ Perspective,” Journal of Clinical Nursing 23, 3, 482-491.
9. Heggland, L.H. and Hausken, K. (2015), “Four Categories of Patient Participation in Treatment and Their Linkage to Decision-Making in a Structure of 81 Models,” Nursing Reports 5, 4783, 1-12.
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