This paper propounds two main theses. First, it asserts that the boundaries of the doctor-patient relationship are not clearly delineated, but they are clarified by the clarified contexts in which they are formed. Second, there is a need to formulate a set of guidelines that are flexible enough to accommodate ambiguous situations and yet definitive enough to define the limits of the interaction between the doctor and the patient. In order to advance the aforementioned theses, this paper will clarify what boundary transgressions are, how they come about, and how they could avoided.
Human ; PROFESSIONAL-PATIENT RELATIONS ; PHYSICIAN-PATIENT RELATIONS

Humans ; Physicians ; Professional-Patient Relations

Introduction: Open disclosure is poorly understood in Malaysia but is an ethical and professional responsibility. The objectives of this study were to determine: (1) the perception of parents regarding the severity of medical error in relation to medication use or diagnosis; (2) the preference of parents for information following the medical error and its relation to severity; and (3) the preference of parents with regards to disciplinary action, reporting, and legal action. Methods: We translated and contextualised a questionnaire developed from a previous study. The questionnaire consisted of four case vignettes that described the following: medication error with a lifelong complication; diagnostic error with a lifelong complication; diagnostic error without lifelong effect; and medication error without lifelong effect. Each case vignette was followed by a series of questions examining the subject’s perception on the above areas. We also determined the content validity of the questionnaire. We invited parents of Malaysian children admitted to the paediatric wards of Tuanku Jaafar Hospital to participate in the study. Results: One hundred and twenty-three parents participated in the study. The majority of parents wanted to be told regarding the event. As the severity of the case vignettes increased, the desire for information, remedial action, acknowledgement of responsibility, compensation, punishment, legal action, and reporting to a higher agency also increased. The findings did not have strong evidence of a relationship with subject’s demographics. Conclusion: This study gives insights into previously unexplored perspectives and preferences of parents in Malaysia regarding open disclosure. It also highlights the opportunity for more research in this area with potentially broad applications.
Disclosure ; Professional-Patient Relations ; Patient Rights

Inservice Training ; Integrative Medicine ; Physicians ; organization & administration ; Professional-Patient Relations

Contemporary medical ethics is far from the traditional concept of "In-Sul (benevolent art)" or "Yul-Li (ethics)", which emphasizes so much the personality or the character of a doctor. Nowadays, medical ethics should be considered as "professional ethics" which regulates the acts and medical practices of ordinary doctors in their daily practice. The key concepts of the professional ethics are "autonomy", "integrity", and "professional standard" established by medical organizations such as medical societies or associations. Most of Korean doctors have not been familiar with the concept of professional ethics or professionalism, which is due to the modern history of Korea. However, the concept of professional ethics is really critical to Korean doctors from the perspective of professional dignity and social respect to this profession. The current healthcare system of Korea is suffering from many problems of both private and public sector. Nonetheless, the professional ethics is urgently demanded for that very reason.
Delivery of Health Care ; *Ethics, Medical ; *Ethics, Professional ; Humans ; Physician-Patient Relations

PURPOSE: This paper is a report of a concept analysis of 'quality of pediatric nursing care'. METHODS: Rodgers's evolutionary method of concept analysis was used. Data were collected from published literature related to quality of pediatric nursing care. RESULTS: Quality of pediatric nursing care was identified with three dimensions and seven attributes: 1) nurse's character: technical competence, interpersonal competence, 2) nurse's activities: developmentally appropriate care, attentiveness, entertainment, 3) nurse-parent interaction: nurse-parent partnership, emotional support. Antecedents of quality of pediatric nursing care were 'child and parent's expectation about pediatric nursing care', 'previous caring experience of pediatric nurses'. Consequences of quality of pediatric nursing care were 'meet child and parent's needs' and 'better health outcomes.' CONCLUSION: 'Quality of pediatric nursing care' is a core concept in pediatric nursing practice. Appropriate instruments to operationalize the concept need to be developed.
Child ; Humans ; Nurse-Patient Relations ; Nurses/psychology ; Pediatric Nursing/*standards ; Professional Competence ; *Quality of Health Care

PURPOSE: Delivering bad news is a task that occurs in most medical practices, rendering communication skills essential to competent patient care. The purpose of this study was to identify factors that are associated with scores on an assessment of medical students' communication skills in delivering bad news to help develop more effective curricula to enhance these essential skills. METHODS: One hundred fifty-four fourth-year medical students at Pusan National University were included. Skills for delivering bad news were assessed using the SPIKES protocol in the CPX. The students were categorized into three main groups according to total scores: 'Exceeds expectations (E)', 'Meets expectations (M)', and 'Needs development (N)'. Personal experiences with misfortune and attitudes toward breaking bad news were surveyed, and school records were collected. The differences between the E and N groups were analyzed based on performance test and survey. RESULTS: Compared with students in the N group, E group students acquired significantlyhigher scores on the items of Perception, Invitation, a division of Knowledge, Empathy and Strategy, and Summary but not on Setting and a part of Knowledge. E group students had better records in classes and clerkships. There were no differences in personal experiences and attitudes toward breaking bad news between the groups. CONCLUSION: Personal experience with delivering bad news does not guarantee better communication, and attitudes toward this task do not influence student performance. We expect that deliberate educational programs will have a positive impact on improving communication skills for delivering bad news.
Curriculum ; Empathy ; Humans ; Patient Care ; Personality Inventory ; Professional-Family Relations ; Students, Medical

Confidentiality ; Electronic Mail ; Ethics, Medical ; Humans ; Internet ; Patient Education as Topic ; Physician-Patient Relations ; Professional Role ; Social Support

Clothing ; Infectious Disease Transmission, Professional-to-Patient ; Methicillin-Resistant Staphylococcus aureus/*isolation & purification ; Physician-Patient Relations ; Safety ; Staphylococcal Infections/*transmission

PURPOSE: This study was done to explore experiences of persons living through the periods of cancer diagnosis, treatment, and self-care. METHODS: With permission, texts of 29 cancer survival narratives (8 men and 21 women, winners in contests sponsored by two institutes), were analyzed using Kang's Korean-Computerized-Text-Analysis-Program where the commonly used Korean-Morphological-Analyzer and the 21st-century-Sejong-Modern-Korean-Corpora representing laymen's Korean-language-use are connected. Experiences were explored based on words included in 100 highly-used-morphemes. For interpretation, we used 'categorizing words by meaning', 'comparing use-rate by periods and to the 21st-century-Sejong-Modern-Korean-Corpora', and highly-used-morphemes that appeared only in a specific period. RESULTS: The most highly-used-word-morpheme was first-person-pronouns followed by, diagnosis.treatment-related-words, mind-expression-words, cancer, persons-in-meaningful-interaction, living and eating, information-related-verbs, emotion-expression-words, with 240 to 0.8 times for layman use-rate. 'Diagnosis-process', 'cancer-thought', 'things-to-come-after-diagnosis', 'physician.husband', 'result-related-information', 'meaningful-things before diagnosis-period', and 'locus-of-cause' dominated the life of the diagnosis-period. 'Treatment', 'unreliable-body', 'husband . people . mother . physician', 'treatment-related-uncertainty', 'hard-time', and 'waiting-time represented experiences in the treatment-period. Themes of living in the self-care-period were complex and included 'living-as-a-human', 'self-managing-of-diseased-body', 'positive-emotion', and 'connecting past . present . future'. CONCLUSION: The results show that the experience of living for persons with cancer is influenced by each period's own situational-characteristics. Experiences of the diagnosis and treatment-period are negative disease-oriented while that of the self-care period is positive present-oriented.
Family Relations ; Female ; Humans ; Male ; Neoplasms/diagnosis/*psychology/therapy ; Patient Acceptance of Health Care ; Professional-Patient Relations ; Program Development ; Self Care ; User-Computer Interface