We didn't start the fire…or did we?-a narrative review of medical gaslighting and introduction to medical invalidation.

IF 3.8 Q2 GASTROENTEROLOGY & HEPATOLOGY Translational gastroenterology and hepatology Pub Date : 2024-08-26 eCollection Date: 2024-01-01 DOI:10.21037/tgh-24-26
Alexandra Fuss, Christina H Jagielski, Tiffany Taft
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Abstract

Background and objective: Gaslighting is defined as behaviors inflicted on an individual which invalidate or call into question their ability to judge their own lived experience. Research into gaslighting in other contexts, such as domestic violence, underscore its potentially damaging effects. Medical gaslighting is an increasingly used, but poorly defined issue in a progressively more complex healthcare system in the United States. Limited studies constructively evaluate this breakdown in the provider-patient relationship and no studies exist evaluating gaslighting in the care of patients with digestive diseases. This narrative review aims to add clarity to the definition of medical gaslighting, evaluate the mechanisms that perpetuate gaslighting in gastroenterology practice and offer pragmatic solutions to begin to reduce its prevalence.

Methods: Narrative overview of the literature retrieved from searches of computerized databases.

Key content and findings: The potential root causes of gaslighting in gastroenterology practices are multifaceted and complex, and encompass patient, provider, and systemic factors.

Conclusions: An important distinction for medical gaslighting from other forms of gaslighting is the role of intent. As such, we propose the term "medical invalidation" be added to this construct and conceptualize medical gaslighting as occurring on a continuum. Within each facet of the relationship between system, provider and patient there are opportunities to prevent and recover from the occurrence of medical invalidation/medical gaslighting.

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我们没有放火......还是我们放火了?--医学毒气的叙述性回顾和医学无效的介绍。
背景和目的:所谓 "心理暗示"(gaslighting),是指对一个人施加的、使其判断自己生活经历的能力失效或受到质疑的行为。对家庭暴力等其他情况下的 "心理暗示 "的研究强调了其潜在的破坏性影响。在美国日益复杂的医疗保健系统中,医用毒气被越来越多地使用,但却没有得到很好的界定。对医患关系破裂进行建设性评估的研究非常有限,而且还没有研究对消化系统疾病患者护理过程中的 "精神折磨 "进行评估。这篇叙事性综述旨在进一步明确 "医疗气化 "的定义,评估胃肠病学实践中使 "气化 "现象长期存在的机制,并提供务实的解决方案,以着手降低其发生率:主要内容和发现:胃肠病学实践中的气体照明的潜在根源是多方面的、复杂的,包括患者、提供者和系统因素:医学气化与其他形式的气化的重要区别在于意图的作用。因此,我们建议在这一概念中加入 "医疗无效 "一词,并将医疗气化概念化为一个连续体。在系统、医疗服务提供者和患者之间关系的每一个方面,都有机会预防医疗无效/医疗气化的发生并从中恢复。
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