Professionalism within the clinical context of the patient-podiatrist relationship

Background: Podiatry aims and professes to undertake patient centred practice. However no podiatric literature was sourced which examines or discusses that most central component of our practice - the nature of our relationship with our patients, nor has any published research specifically focussed...

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Bibliographic Details
Main Author: Ellis, Mairghread J. H.
Published: University of Brighton 2007
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Online Access:http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.486669
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Summary:Background: Podiatry aims and professes to undertake patient centred practice. However no podiatric literature was sourced which examines or discusses that most central component of our practice - the nature of our relationship with our patients, nor has any published research specifically focussed on this area. Aim This study aimed to explore the nature of the patient podiatrist relationship from the perspective of both private and National Health Service practitioners. Methodological approach: A phenomenological approach, with a hermeneutic focus was utilised to construct meaning and understanding from the data of semi structured interviews with eight participants. The researcher acknowledges herself as situated within the research; and a reflexive approach is demonstrated throughout. Iterative thematic analysis was undertaken to enable development of meaning and understanding. Findings: Findings were developed into six categories - relationship, engagement, role, image, reward, and personal development; coming together in one overarching theme, that of Professionalism Discussion and application: Professionalism is considered through theories of dramaturgy, Iiminality and the concept of macro- and microprofessionalism. The patient-podiatrist relationship can be a lens through which to consider aspects of micro professionalism. Dramaturgical theory positions the podiatrist on the healthcare stage, as . 'actor' performing for the patient as 'audience'. Uniform, as costume, and names and titles as forms of address are also explored within this theory. Liminality - the concept of being 'betwixt and between', is used to position both the participants' perceptions of practice, and their relationships with patients within current models of healthcare practice. It may explain participants' sometimes ambiguous feelings around their role and status. Findings suggest that while macro aspects of professionalism are explicit to practitioners, micro aspects such as relationship, communication and connection are developed through experiential learning and may be tacit in nature. Within both NHS and private practice, the personal connection between podiatrist and patient is seen as an essential element of an effective therapeutic relationship, and not, as may have been previously considered, an unprofessional over involvement. Thus the core message of this thesis is that professionalism be redefined from an explicit and public corporate concept, to its demonstration at an individual level - accepting that it is indeed professional to 'care', both for and about the patient; and that caring is beneficial to both patient and practitioner. Caring is truly the bedrock of the patient-podiatrist relationship, and of professionalism.