Читать книгу Medical Communication: From Theoretical Model To Practical Exploration - Tao Wang - Страница 11

Medical communication is related to but different from medical science popularization. To systematically clarify the differences, we begin with the relationship between them.

Science popularization, as an organized practice, was born in the second half of the 19th century. It uses simple language to report and explain the progress of science and technology to the public. Suffering from world war, western governments generally recognized the importance of raising citizens’ support for science and technology. Science popularization is a paradigm that aims to improve public scientific knowledge and scientific literacy. The landmark event at this stage was the establishment of the Royal Science Association in 1799 and the establishment of the Science Promotion Association in 1831. Since the 1950s, popular science in China has been incorporated into the government system. A set of professional science popularization systems has been established from the central cities to the county. It is the state (government), not the public, that is taking advantage of science popularization under this paradigm. Therefore, as the famous scientific historian Liu Huajie said, “traditional science popularization takes a government position.”

The scientific community at that time (including scientists and relevant decision-makers) believed that the reason why public distrust science is due to an inadequate understanding of science. The United Kingdom and the United States have been conducting scientific mass communication activities under the leadership of the scientific community since the 1980s. During this period, the Royal Society published an important report, Public Understanding of Science, in 1985 and stated the Deficit Model that illustrated that the public did not support science because of the lack of scientific knowledge. In their opinion, if citizens understand science, they will gradually conform to the opinions of scientists and support science. This paradigm is the scientific community position. In the 1990s, the paradigm of Public Understanding of Science was accepted to some extent in China.

A new paradigm of Public Engagement or Participation in Science and Technology (PEST) was created. It is also known as “dialogue mode” or “democratic model”. This paradigm argues that the public should be involved in scientific progress, that is, the public participates in setting the scientific agenda as a way of dialogue with the scientific community. The formation of this paradigm brought about the establishment of disciplines in science communication.

Figure 1.1 Relationship and difference between medical communication and medical science popularization.

We can find the change of the paradigm from traditional medical science popularization to present medical communication. Medical communication is not limited to the dissemination of knowledge about the treatment and the prevention of diseases like the patriotic health campaign launched in the 1950s, which advocated “hygiene to eliminate the four evils”. It has more connotations due to the participation of the public. From Figure 1.1, we can roughly understand the relationship between medical communication, medical science popularization, science popularization, and science communication. Science popularization is a kind of social education, which introduces the knowledge of natural science and social science to the general public in a simple way, popularizes the application of science and technology, advocates scientific methods, disseminates scientific ideas, and promotes scientific spirit. In the paradigm of science popularization, if the content involved is medical knowledge, it belongs to medical science popularization. Therefore, medical science popularization belongs to science popularization. In the paradigm of science popularization, citizens can understand science and further participate in it, which forms the paradigm of science communication. If the content of science communication is medical knowledge, it is medical communication. Medical communication is the intersection of science communication and medicine. Medical science popularization is not medical communication unless it is understood and effectively participated by the citizens.

The content of medical communication has three levels in details.

First is the talk about “Disease”, which is the knowledge of prevention, health care, and rehabilitation of diseases. It is the most understandable and basic level of medical communication. That is the main content of traditional medical science. Taking a very common disease “hypertension” as an example, medical communication needs to be carried out in the following aspects: The first step is the prevention of hypertension mainly for the citizens without high blood pressure and the target population who are likely to have high blood pressure in the future (susceptible population). The content includes which groups of people are susceptible to high blood pressure; how to measure blood pressure in a normal population; how do susceptible populations adjust their diet, exercise, and lifestyle; what are the symptoms of high blood pressure; and other medical content related to hypertension prevention. The second step is the treatment and health care of hypertension mainly for hypertensive (patients) and the relatives and friends of patients. The content includes how hypertensives adjust their diet, exercise, and lifestyle; how to properly measure blood pressure; what are the treatments for hypertension; what are the indications and side effects of different drugs; how to choose high blood pressure drugs; how to apply hypertension drugs correctly; what symptoms do you need to pay attention to; and other medical content related to hypertension treatment and health care. The third step is the rehabilitation of hypertension mainly for hypertensives who have had complications or dysfunction due to high blood pressure and their relatives and friends. The content includes how to avoid cardiovascular and cerebrovascular complications in hypertensives, how to treat and rehabilitate the hypertensives with complications, how to help the disabled with dysfunction to reenter their jobs or take care of themselves, how to guide relatives and friends to help patients recover together, and other medical content related to the rehabilitation of hypertension.

“Seeing a doctor” is easy to ignore. In a broad sense, it refers to all medical treatment–related content including the process of medical treatment (X-ray examination is required for patients with fractures after plastering in order to confirm the reset situation, which some patients misunderstand as repeated examination), various medical treatment–related systems (the difference between outpatient and emergency), regulations (legal system of body donation), policies (the use of medical insurance), and various medical guidance (how to call an ambulance). Take chest pain as an example. First of all, patients need to know where to go to see a doctor, outpatient or emergency, and the daily routine of the hospital (medical system). If the patient is so unwell and unable to seek medical treatment on his own, then how to call an ambulance? How could he rescue by himself before the arrival of ambulance crews (professional medical guidance)? If the patient arrives at the hospital without medical insurance card in a hurry, how could he seek medical treatment without a medical insurance card? How could he reimburse the medical insurance bureau after the event (medical policy)? During the diagnosis, the doctor judged that the patient needs to complete an electrocardiogram, take a chest radiograph, and do a blood test (medical procedure). The patient was diagnosed with pneumothorax and cured after treatment. The disease may be related to silicosis caused by a large amount of dust in the work environment. To determine whether it is silicosis, the patient should go to the designated institution for identification and clarification according to the Law of the People’s Republic of China on the Prevention and Control of Occupational Diseases (medical regulations). On the whole, each part involved in the case is the content of medical communication. Occasionally, the lack of the knowledge mentioned above could be fatal. There was a real case. A patient with a history of coronary heart disease immediately dialed 120 emergency calls during a myocardial infarction and 120 ambulance departed in time. But in the end, because of the neglect of some details, the best rescue time was delayed. It turned out that the patient had just moved to a new community that implemented “human-car diversion” and the address provided by the patient on the phone was the pedestrian entrance, not the entrance to the car. The golden rescue time was delayed for a few minutes to re-find the entrance. Communicating the knowledge of “seeing a doctor” can help people become familiar with the medical treatment process, reduce the waiting time for medical treatment, and help the public master many medical skills.

Finally, talking about “disease cognition” means to spread medical science thoughts and promote the spirit of medical science. It is the highest level and the most overlooked part of medical communication. To prompt the public about the limitations of medicine with a scientific perspective is favorable to establish a good trust of doctors and patients and rational allocation of social medical resources.

Take depression as an example. Some people think it as a flood of beasts and incurable disease, whereas others may think depression is nothing but a disease-free symbol of nothing to look for. These two concepts are wrong. Depression is a very common mental illness that requires attention and care. It requires the necessary psychological and medical treatment as well. If it is not identified and intervened in time, it may have serious consequences. The misunderstanding of this is a popular content for medical communication.

If you have advanced cancers, will you choose to give up any treatment, or go bankrupt and seek medical attention at all costs to continue life? In modern medicine, there is a concept of “survival with cancer,” that is, you can think of cancer as a chronic disease as hypertension or diabetes. For those patients who are already in the advanced stage of cancer and have no active treatment, they can coexist with the cancer, taking only symptomatic treatment to soothe the symptoms and reduce the pain of the patient. For those patients at the end of the disease, who are expected to live for less than half a year, they can also carry out hospice care. Physically, try to reduce the patients’ pain as much as possible and mentally, help patients and their relatives and friends reduce fear and anxiety and prepare patients to leave. It requires both medical knowledge and humanistic spirit. The famous American doctor, Trudeau said, “sometimes heal, often help, always comfort.” Medicine is not omnipotent. Doctors are not omnipotent. Even though today’s medicine has reached the molecular level, many diseases are still incurable. The role of medical communication is to help people to treat diseases correctly and rationally, to understand the natural laws of “life and death”, to choose the most appropriate treatment and treatment methods, and to apply medical resources reasonably.