La medicina centrata sul paziente

The dominant model in medical practice today has been defined as the "disease-centered" model. In the past few years, it has been attacked for oversimplifying the problems of illness because it assumes disease to be fully accounted for by deviations from the norm of measurable biological variables. This article describes a patient-centered model that integrates the traditional understanding of disease with each patient's experience of illness. The transformed clinical method involves three major changes: 1) new tasks for the consultation: the patient-centered method focuses on disease and on four principal dimensions of the patients, i.e., their ideas about the illness, their feelings and fears, the impact of their problems on their lives, their expectations about what should be done; 2) new strategies to obtain these objectives: new interviewing skills and communication techniques, e.g., attentive listening; open questions; 3) new modes of teaching and learning, e.g., the use of role-playing and videotaping. Research has shown that patient-centered medicine enables better clinical results to be obtained and is associated with increased patient and physician satisfaction.