Hospitals

[Background] Intermediate care is a limited-time service founded on patient-centered care (PCC) that ensures continuity and quality of care during the transition between home and acute care services, promotes recovery, and restores independence and confidence. In Japan, systematic education on intermediate care for care providers is lacking. [Method] The present study explored the relationship between a Japanese scale used to evaluate individualized discharge support skills, a Japanese version of a tool for evaluating intermediate care based on PCC, and a tool that measures the shared decision making of care providers, which is the pinnacle of PCC. [Results] Clear correlations were found between the concepts evaluated using these three tools. Some concepts were not correlated between the Japanese scale that evaluated individualized discharge support skills and intermediate care based on PCC. [Conclusions] Elucidating the perspectives that help expand discharge care to intermediate care based on PCC will contribute to future education on intermediate care for Japanese care providers and to enriching patient-centered intermediate care. Full article

Neurology holds a unique perspective that embodies the art of capturing a patient’s story. Despite medical advancements, many neurological conditions leave patients permanently impaired. This sudden loss of independence can be demoralizing and, in most cases, directly changes a person’s identity. It is therefore a necessary part of a neurologist’s trade to know their patient’s history—their story. Their tales reveal intimate details of their personality changes, memory loss, sensory deprivation, and movement disorders. A true neurologist is a person that remains vulnerable through their willingness to take a history—the story of their patient—and remain curious, vulnerable, and compassionate through their journey to heal and comfort the patient. To understand the patient’s illness experience in neurology, the underlying themes of patient recovery (compassion, determination, and patience) are explored with regard to the neurological patient’s experience. These themes are then expanded to include the neurology patient’s mental perceptions of themselves, and their illness’ influences over their identity, recovery, and daily life. In addition to the patient’s experience, the neurologist’s awareness and emotional response to the patient’s illness experience can provide an opportunity to develop a strong therapeutic bond with their patient and improve patient outcomes. Given that their neurological impairment causes a loss of independence and control over their identity and self-worth, neurologists can incorporate the patient’s experience into their management and treatment, to better address their emotional and spiritual needs as they come to terms with their identity. Full article

This essay focuses on so-called obstetric violence, i.e., the medical malpractice consisting of disrespect and/or abuses to the detriment of women during their labor or when they give birth, as well as during health care services concerning the sexual and reproductive sphere. The main goal is to start a debate on a topic already considered by foreign lawmakers, also for punishment purposes. After an empirical-criminological survey of the cases and the misconduct to be labelled as “obstetric violence”, this essay analyses the legal tools available in Italy. From a law reform perspective, the author reflects on the (non-criminal) strategies to prevent distortions of the doctor–patient relationship as well as on the harm to women’s self-determination and dignity, particularly in respect of the rules on informed consent. Full article