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Οδηγίες για τις σχέσεις ασθενούς-γιατρού-φροντιστή

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"...
•All patient-physician-caregiver interactions should be based on respect for the patient's dignity, rights, and values.
◦To optimize appropriate patient autonomy and participation in decision-making, clinical encounters should be patient-centered.
◦To provide the patient's desired level of privacy, the physician should routinely evaluate the patient's preferences concerning the nature and degree of caregiver participation in the clinical visit.
•Support for the patient and family caregiver requires physician accessibility and effective communication.
◦The physician should educate the patient, family caregiver, and other family members so that they share an accurate understanding of the patient's condition and prognosis.
◦To provide both the family caregiver and physician with a clear understanding of the patient's wishes, the physician should facilitate discussion of the patient's healthcare values and advance care planning.
•The physician should acknowledge that family caregivers provide a useful source of continuity in the patient's medical and psychosocial history and facilitate the intellectual and emotional transition to the end stage of serious chronic disease.
◦Physicians should routinely validate the family caregiver's role and respect specific commitments the caregiver may have made regarding management of the patient's care.
◦Physicians should construct patient-specific and caregiver-specific care plans and offer education, referrals, and other resources to support implementation of those plans.
◦The physician should be watchful to detect distress in the family caregiver and to provide appropriate referrals.
◦Physicians should recognize unique challenges confronting geographically distant caregivers.
◦The palliative care plan should optimize quality of life for the caregiver as well as for the patient.
◦Shortly before as well as after the death of the patient, family caregivers should be monitored for distress related to loss.
•When the caregiver is a healthcare professional, the physician should identify and enforce appropriate boundaries so that the caregiver is not required to assume a professional role in caring for the patient and so that appropriate support, referrals, and services are provided to the caregiver.
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