Le positif pour l’hôpital, le négatif chez le patient

Context

In the context of increasing chronic disease, and limited resources, the current hospital reform is mobilizing patients towards a positive approach meant to allow everyone to choose for themselves. Health promotion and self-care practices are the main intentions of this change. If this evolution is part of the ongoing history of the hospital, it exists in the current societal environment. This latter is characterized by multitude of choices. The situation of patients struggling to keep up with this change should encourage hospital decision-makers to question this quest for effective care.

Objective

The clinician meets patients who are mobilized by resistance, or even negativity, in a “system” that solicits positive abilities. These patients seem to mobilize the assistance of the healthcare environment, unable to meet them where they are. This article proposes pathways for an articulation of the system with the singularity of the patient-individuals who encounter it.

Method

Returning to the history of the hospital and its current intentions, we question the quest for effective care for all patients. The situation of patients who “resist” the apparatus of positivity could shed light on the stakes of certain changes in the works.

Results

The juxtaposition of the current hospital environment and the story of a patient who is “resistant” to it suggests a mutual influence.

Interpretation

With patients increasingly passing through the hospital, instead of staying, they are encouraged to become autonomous actors of their own care. Those patients who require more support from the hospital put to the test the latter's capacity for care experienced in the register of negativity.