Understanding Patient Reactions and Healthcare Principles

Defense Mechanisms When Sick

• Regression: The patient reverts to a less independent state, seeking comfort and support.
• Evasion: The patient avoids reality and creates a fantasy world.
• Aggression: The patient blames healthcare providers for their illness and expresses dissatisfaction.
• Reproach: The patient isolates themselves due to their illness.
• Disclaimer: The patient denies their illness and suppresses unpleasant thoughts or feelings.

This can be produced in three ways:

• Masochistic: The patient views illness as a just and deserved punishment.
• Dower: The patient feels absolved of responsibility and entitled to help from others.
• Hypochondriac: The patient exhibits excessive worry about their health.

Appropriate Reactions to Disease

• Reaction of overcoming the disease: The patient has a genuine desire to heal and collaborates with the physician.
• Reaction of resignation: The patient has a strong desire to heal and cooperates with the physician but demonstrates low initiative.
• Reaction of acceptance of the disease: The patient accepts the disease and makes necessary lifestyle changes.

Professional-User Communication

Professional-user communication involves three components:

• Theoretical Component: Knowledge base.
• Technical Component: Skills and communication strategies.
• Creative Component: Unique approaches to establishing relationships with others.

Leader Characteristics

Intelligence, Domain, Self-confidence, Theoretical Knowledge, Dynamism

Leadership Styles

Ordering, Persuading, Participating, Delegating

Healthcare Regulations and Oversight

Superintendent of Health

Supervises Isapre (private health insurance) and Fonasa (public health insurance) regarding beneficiaries' rights. It also oversees compliance with GES (Explicit Health Guarantees) and accredits healthcare providers.

Deputy Regional Health Minister

Responsible for all regulatory and oversight terms of health provision. Controls the three experimental establishments.

Undersecretary of Health

Regulatory link in the health sector.

Assistant Secretary of Networks

In charge of technical and policy oversight of health services.

GES (Explicit Health Guarantees)

• Access: Guaranteed by law.
• Opportunity: Timely care.
• Financial Protection:
  • AB = 0% copay
  • C = 10% copay
  • Isapre and D = 20% copay
• Quality: Based on established standards.

Philosophical and Ethical Considerations

Philosophy

A guide that establishes the values underpinning the development of a discipline.

Science

Observation, identification, description, experimental investigation, and theoretical explanation of natural phenomena. A paradigm is a way of thinking, seeing, and understanding the world that influences the development of knowledge and skills within a discipline.

Metaparadigm

Perspectives encompassing an entire discipline.

Legislation

A set of laws in a state.

Ethics

A philosophical discipline that indicates what a person should do and how they should interact with others.

Morality

What one should always do and what to avoid doing (conscience).

Codes of Ethics

A set of principles accepted by all members of a profession, establishing ideals of conduct.

Code of Ethics in Nursing

Nursing serves individuals, families, and communities, promoting, providing, restoring health, and relieving suffering.

Elements of the Deontological Code

• The Patient/Individual: Respect, information, confidentiality, satisfaction, and a caring environment.
• The Practice of Nursing: Professional competence, personal health, behavior, and respectful use of technology.
• The Nursing Profession: Application and compliance with standards for practice, management, research, and training.

Bioethical Principles

• Autonomy: Independence and the capacity to act according to one's personal choices.
• Beneficence: Positive outcomes of an action; acts of kindness.
• Non-maleficence: Avoiding intentional harm.
• Justice: Fairness and equity.

Factors Influencing Patient Reactions to Disease

• Patient's Personality: Regression or denial of the severity of the disease.
• Patient's Age: Young people may be incredulous and look for mistakes, while older adults may accept their problems more readily.
• Type of Disease: Heart, respiratory, cancer, and sexually transmitted diseases can elicit different reactions.
• Family and Friends: Social support plays a crucial role.