Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Resistance to Recovery: Education

Educational Foundation for Understanding the Physical Diagnosis

Patient education procedures vary according to age and academic background. The process of educating the patient is also impacted by the academic training, philosophies and standards of the clinicians involved in treatment. The patient may be provided with clinical nosology regarding the disease or condition without clarification sufficient to enhance understanding of that condition. The explanation can vary from non-existent, to cursory description, to the complex and confusing detailed delineation.

Informed consent is often structured around insuring that the patient has been duly informed of the risk-benefit ratio of clinical procedures. Informed consent does not always seek to determine the depth to which the patient understands the necessity of a procedure or the process by which treatment will occur. Perhaps more important is that the anxiety associated with physical disorders increases when treatment occurs in clinical environs in which the patient is stripped of control at a minimum, and often of identity itself.

Regardless of the amount of time or materials provided the patient, the capacity
to internalize the data is then compromised.

The first impact of anxiety upon cognitive functioning is to disrupt attention and its more complex associated skill, concentration. Regardless of the extent to which the patient is “educated,” the question remains how much information is the patient capable of retaining and in the absence of the retained data, to what extent is the patient threatened, confused or alarmed by their own lack of education.

Among the means by which these issues can be addressed by the doctor are included the following patient queries:
a.Has anyone spent sufficient time with you explaining both your condition and the treatment recommended?
b.Do you have lingering confusion as to what has been found and what treatment is indicated?
c.Are you able to understand the terms used by those treating you, and are you able to ask questions regarding those terms when you need more clarification?
d.Do you feel that the educational material is appropriate for you or are you being provided with too little data to answer your questions or too much data resulting in increased confusion.

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