The Patient's Feeling about the Need of Physician
to Nurture the Patient
Arfah Mardiana Lubis
1
, Harmein Nasution
2
, Zulfendri
3
and Juanita
3
1
Mahasiswa S3, Fakultas Kesehatan Masyarakat, Universitas Sumatera Utara, Jl. Universitas No. 21, Medan, Indonesia
2
Fakultas Tekink, Universitas Sumatera Utara, Jl. Almamater, Medan, Indonesia
3
Fakultas Kesehatan Masyarakat, Universitas Sumatera Utara, Jl. Universitas No. 21, Medan, Indonesia
Keywords: Patient's feeling, Physician need, Physician trait, Physician attitude, Need for nurturance
Abstract: The invisible motive of physicians to see patients recover quickly raises disappointment in the patient and the
patient's family. The need to cure patient is called need for nurturance. In the need for nurturance, there are
affectionate and tenderness as trait, also sympathetic, protective, supporting, and humanitarian as attitude of
need for nurturance. Therefore, researchers want to see how the patient's feelings about the needs of physician
to nurture the patients, from the side of trait and attitude of support the needs of the physician. Descriptive
research was conducted on 100 patients in each inpatient room at the Haji Adam Malik Hospital Medan. The
data were obtained by interview using the need for nurturance questionnaire developed from Murray's
personality theory, then analyzed descriptively. Results concluded that patients feel the physician has a need
to nurture the patient. However, physicians are less able to show the nature of affection, humanitarian and
sympathetic attitudes, so that patients feel physicians are less able to provide the best health services to
patients. It is recommended that physicians strengthen the need for nurturances as a motive in providing the
best health care to patients by showing the nature of affection, humanitarian attitude and sympathetic.
1 INTRODUCTION
One of the motives of physician to provide the best
health care to patients is to see patients recover
quickly (Dewi, et. all., 2015). However, this is not
seen in physicians in Indonesia, especially physician
in the city of Medan. Based on the opinion of
Pasaribu (2011), physicians who are abroad have
more need to cure patients compared to physician in
Indonesia, especially physician in Medan City. This
resulted in many patients in the city of Medan
medical treatment abroad. It is estimated that on
average 1.000 Medan residents went to Penang every
month (Adisasmito, 2008; Herqutanto, 2009; Adhani,
2014). Indonesia losses due to the large number of
patients seeking treatment abroad, based on the
opinion of Almatsier (2013), amounted to ± 1.6
trillion rupiah each year.
Based on the results of the study of Sarassati
(2008), Ombi (2012) and Wattimena (2014), it is
shown that the patients who choose to seek medical
treatment abroad because the patient has already felt
disappointed with medical services in Medan.
Disillusionment experienced by patients more
physicians to provide the best health services to
patients, one of which is to see the patient quickly
recovered. Patients then get information that health
services abroad better. Eventually the patient chose to
seek treatment abroad and feel good health care
abroad. After returning to Indonesia, the patient told
others about good overseas health services, so that
more patients feel that physicians abroad have more
motives to see patients heal faster than physicians in
Medan.
The absence of a physician's motive to see
patients recover quickly raises disappointment in the
patient and the patient's family. Whereas based on the
opinion of Lumenta (1989), the patient has an
important role as a social control for the medical
profession. Social control is a planned or not planned
and controlled way and process aimed at engaging,
educating, and even forcing citizens to comply with
the norms and social values prevailing within their
group (Setiadi and Kolip, 2013). This Lumenta
opinion in accordance with the Regulation of the
Minister of Health of the Republic of Indonesia
number 755 of 2011, ie patients and families of
patients who feel disappointed with the health
services provided by physicians, can provide reports
on the behavior of physicians in the hospital to the
Lubis, A., Nasution, H., Zulfendri, . and Juanita, .
The Patient’s Feeling about the Need of Physician to Nurture the Patient.
DOI: 10.5220/0010078305570560
In Proceedings of the International Conference of Science, Technology, Engineering, Environmental and Ramification Researches (ICOSTEERR 2018) - Research in Industry 4.0, pages
557-560
ISBN: 978-989-758-449-7
Copyright
c
2020 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
557
ethics subcommittee and professional discipline in
the hospital
Based on the opinion of Murray (1947) the need
for healing is called need for nurturance. In the need
for nurturance, there are affectionate and tenderness
as trait, sympathetic, protective, supporting, and
humanitarian as the attitude from need for nurturance.
However, the explanation of need for nurturance
Murray (1947) is not devoted to physicians. The
explanation of need for nurturance specifically for
physicians may be derived from the results of several
studies (Mondloch,, 2001; Bendapudi., 2006;
Puddester, 2009; Lubis, 2013; Ratnamiasih,, 2014 ;
Wicaksono, 2014; Beach., 2015; Dewi,, 2015;
Mandagi, 2016; Razzaghi and Afshar, 2016; Keller.,
2017).
From the results of these studies it can be
concluded that when dealing with patients, physicians
must have the need to nurture the patient and feel
comfortable with the presence of the patient. The
physician's comfort is shown by taking sufficient time
with the patient (humanitarian); caring, caring and
sensitive to pain suffered by the patient
(sympathetic); treat patients with respect, dignity and
affectionate, help to manage the need for non-medical
needs of patients (supporting). However, there is no
research that examines the feelings of patients about
the needs of physicians to nurture the patient; from
the side of trait and attitude that support these
physicians need. Therefore, researchers want to see
how the patient's feelings about the needs of
physicians to nurture the patient, from the side of trait
and attitude that support these physicians need.
2 RESEARCH METHODS
This research is a descriptive research. The
population of this study were all patients in inpatients
room who came to the Haji Adam Malik Medan
Hospital in July-August 2017. However, the number
of inpatients population is not known, and then the
determination of the sample is used Lemeshow
formula.
(Zα
/2
)
2
x p x q
n
=
_________________
e
2
(1)
Description:
n = The minimum number of samples required
Zα = The default value of the corresponding
distribution value α = 5% = 1.96
p = The prevalence of learning outcomes, because
the data have not been obtained, then used 50%
q = 1 – p
e = The level of precision 10%
Based on the formula 1, then :
(1.96)
2
x 0.5 x 0.5
n =
____________________________
= 96.04
0.1
2
(2)
Obtained a minimum sample size of 96 people and
rounded up to 100 people. Sampling technique with
incidental sampling. Data were obtained by
interviewing 100 research samples using a need for
nurturance questionnaire developed from Murray's
personality theory
(1947). Interview data are then
analysed descriptively.
3 RESULTS AND DISCUSSION
Based on interviews to 100 sampled patients, 100
patients were treated by 36 physicians. The
questionnaire was asked to each patient to evaluate
the physician who handled it.
Table 1: Physician’s need for nurturance from patient’s
feeling.
Need
100
patient
Percentage
36
physician
Percentage
Nurturance
90
90
32
89
Trait
100
patient
Percentage
36
physician
Percentage
Affectionate
59
59
18
50
Tenderness
76
76
27
75
Attitude
100
patient
Percentage
36
physician
Percentage
Sympathetic
64
64
22
61
Protective
85
85
31
86
Supporting
86
86
31
86
Humanitarian
68
68
19
53
From the analysis of the questionnaire data, table
1, seen 90 patients (90%) felt 32 physicians (89%)
had a need to nurture the patients. This is supported
also by the attitude of Supporting 31 physicians
(86%) felt by 86 patients (86%), Protective attitude
31 physicians (86%) felt by 85 patients (85%), and
Tenderness nature 27 physicians (75%) felt by 76
patients (76%).
However, from the analysis of the questionnaire
data, it was also seen that 59 patients (59%) felt that
18 physicians (50%) gave less affection to patients,
64 patients (64%) felt that 17 physicians (47%) were
less humanitarian, and 68 patients (68%) felt that 14
physicians (39%) were less able to show sympathy to
ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramification Researches
558
the patient. In the opinion of Murray (1947) it can be
concluded that affection is a must-have for patients to
cure, as well as humanitarian and sympathetic, which
is the attitude that physicians should show when they
want to heal the patient
The lack of physician's affectionate will affect the
patient's anxiety and decrease patient's satisfaction
and compliance with the advice given by the
physician, so that the patient's healing expected by
both physicians and patients is not achieved. This is
consistent with the results of the research of (Street,
2009), (Sep, 2014), and (Hesse and Rauscher, 2018)
who examined the effect of physician's affectionate
attitudes that the physician's affectionate can reduce
anxiety, improve patient satisfaction and compliance,
which can then improve patient health.
The same thing happens in the physician's
humanitarian attitude. The lack of visible attitudes of
the physician's humanitarian attitudes will affect
patients on the level of patient satisfaction in the
health services provided by physicians. This is in
accordance with the results of the study (Cantwell,
2010) ie humanitarian physician will spend sufficient
time with the patient to ensure that patients not only
feel better physically but also emotionally. Physicians
who can spend sufficient time with patients, based on
research (Kuteyi, 2010), contributed significantly and
positively to the level of patient satisfaction in health
services provided by physicians.
Something different happens to the physician's
Sympathetic attitude. Less noticeable Sympathetic
attitude of the perceived physician of the patient will
have an impact on the malpractice demands of the
patient's family. This is in line with Campbel's
opinion cited by (Ellis and Patel, 2012), ie the
sympathy attitude of physicians is more aimed at
avoiding malpractice demands from the patient's
family than to improve the patient's cure or to
improve patient satisfaction. Campbel's opinion is
also reinforced by the results of research from (Shane,
2016) who disclose the patient and the patient's
family identifies the physician's sympathy as a
physician's admission and a physician's apology that
the physician is incapable of healing the patient, and
the physician is grieved for his inability.
4 CONCLUSIONS AND
SUGGESTIONS
From the results of the study can be concluded that
patients feel the physician has a need to nuture the
patient. However, physicians are less able to show the
nature of affection, humanitarian and sympathetic
attitudes, so that patients feel physicians are less able
to provide the best health services to patients, the
patient's healing expected by both parties, whether
physician or patient, not achieved, decreased patient
satisfaction at health services provided by physicians,
which ultimately lead to malpractice demands from
the patient's family.
Therefore, it is recommended that physicians
strengthen the need for nurturance as a motive in
providing the best health care to patients by showing
the nature of affection, humanitarian and sympathetic
attitudes.
REFERENCES
Adhani, R., 2014. Etika dan Komunikasi: Dokter-Pasien-
Mahasiswa, PT. Grafika Wangi Kalimantan.
Kalimantan Selatan.
Adisasmito, W., 2008. Kesiapan rumah sakit dalam
menghadapi globalisasi, Fakultas Kesehatan
Masyarakat, Universitas Indonesia. Jakarta.
Almatsier, M., 2013. Upaya MKDKI Mengawal Penerapan
Profesionalisme Praktisi Medis. Sewindu Konsil
Kedokteran Indonesia, Konsil Kedokteran Indonesia.
Jakarta Pusat.
Beach, M. C., Forbes, L., Branyon, E., Aboumatar, H.,
Carrese, J., Sugarman, J., and Geller, G., 2015. Patient
and family perspectives on respect and dignity in the
intensive care unit. Narrative inquiry in bioethics, 5(1),
15A-25A. doi: 10.1353/nib.2015.000.
Bendapudi, N. M., Berry, L. L., Frey, K. A., Parish, J. T.,
and Rayburn, W. L., 2006. Patients' perspectives on
ideal physician behaviors. Articel Presentation at Mayo
Clinic Proceedings. Elsevier. 81, 338-344. doi:
10.4065/81.3.338.
Cantwell, B., O’Brien, C., Miner, D., Sutton, F., López, A.
M., and Milem, J., 2010. Humanism in medical
education: What do GHHS members have to say?
Arnold P. Gold Foundation. Amerika Serikat.
Dewi, S. P., Arya, I. F. D., Achadiyani, and Achmad, T. H.,
2015. Gambaran Motivasi Menjadi Dokter pada
Mahasiswa Tahun Pertama Fakultas Kedokteran
Universitas Padjadjaran. Jurnal Sistem Kesehatan,
1(1), 24-29. doi: 10.24198/jsk.v1i1.10338.
Dewi, S. P., Arya, I. F. D., Achadiyani, and Achmad, T. H.,
2015. Gambaran Motivasi Menjadi Physician pada
Mahasiswa Tahun Pertama Fakultas Kephysicianan
Universitas Padjadjaran. Jurnal Sistem Kesehatan,
1(1), 24-29. doi: 10.24198/jsk.v1i1.10338.
Ellis, T. E., and Patel, A. B., 2012. Client Suicide: What
Now? Cognitive and Behavioral Practice, 19(2), 277-
287. doi: 10.1016/j.cbpra.2010.12.004.
Herqutanto. 2009. Wahai Dokter Indonesia,
Berkomunikasilah. Majalah Kedokteran Indonesia,
59(02).
Hesse, C., and Rauscher, E. A., 2018. The Relationships
Between Physician-Patient Affectionate
The Patient’s Feeling about the Need of Physician to Nurture the Patient
559
Communication and Patient Perceptions and Outcomes.
Health communication, 1-11. doi:
10.1080/10410236.2018.1439269.
Keller, E. J., Crowley-Matoka, M., Collins, J. D., Chrisman,
H. B., Milad, M. P., and Vogelzang, R. L., 2017.
Fostering better policy adoption and inter-disciplinary
communication in healthcare: A qualitative analysis of
practicing physicians’ common interests. PloS one,
12(2), 1-15. doi: 10.1371/journal.pone.0172865.
Kuteyi, E. A., Bello, I. S., Olaleye, T., Ayeni, I., and Amedi,
M., 2010. Determinants of patient satisfaction with
physician interaction: a cross-sectional survey at the
Obafemi Awolowo University Health Centre, Ile-Ife,
Nigeria. South African Family Practice, 52(6), 557-62.
Lubis, A. M., Salmah, U., and Syahri, I. M. 2013.
Designing Performance Assesment Systems 360
Degrees Based On Method Of Competence Spencer at
Klinik KSGH RASYIDA Medan, Researcher Institute of
USU. Medan.
Lumenta, B., 1989 Dokter: citra, peran dan fungsi,
Kanisius. Yogyakarta.
Mandagi, C. K. F., 2016. Analysis of the quality of Services
Patient Satisfaction with Physician Care RSU GMIM
Bethesda Tomohon. Community Health, 1(2).
Mondloch, M. V., Cole, D. C., and Frank, J. W., 2001. Does
how you do depend on how you think you'll do? A
systematic review of the evidence for a relation
between patients' recovery expectations and health
outcomes. CMAJ: Canadian Medical Association
Journal, 165(2), 174-9.
Murray, H. A., 1947 Explorations in Personality: a Clinical
and Experimental Study of Fifty Men of College Age
(New York: Oxford University Press)
Ombi, I. P., 2012. The trust Patients against Doctors and
local Doctors overseas: study Comparisons in patients
who seek treatment abroad. Universitas Sumatera
Utara. Medan, Bachelor's Thesis.
Pasaribu, J., 2011 Seminar Sehari, Peran Pemerintah
Sumatera Utara dalam Pengelolaan Manajemen
Kesehatan unntuk Mencegah Pelarian Investasi
(Capital Outflow) pada Kasus Kecenderungan
Masyarakat Berobat ke Luar Negeri, Universitas
HKBP Nommensen Medan dan Kamar Dagang dan
Industri (KADIN) Sumateran Utara. Medan.
Puddester, D., Flynn, L., and Cohen, J., 2009. CanMEDS
physician health guide: a practical handbook for
physician health and well-being, The Royal College of
Physicians and Surgeons of Canada. Ottawa.
Ratnamiasih, I., Govindaraju, R., Prihartono, B., and
Sudirman, I., 2014. The competence of human
resources and quality service of hospital. Trikonomika
Journal, 11(1), 49-57.
Razzaghi, M. R., and Afshar, L., 2016. A conceptual model
of physician-patient relationships: a qualitative study.
Journal of Medical Ethics and History of Medicine,
9(14), 1-7.
Regulation of the Minister of Health of the Republic of
Indonesia number 755 year 2011 about the Organizing
Committee's Medical Hospital, Ministry of health of
Indonesia. Jakarta.
Sarassati, I 2008 Factors that Affect the community Choose
medical treatment Abroad (Study on the community of
Medan which medical treatment to Penang, Malaysia),
Universitas Sumatera Utara. Medan, Undergraduate
Thesis.
Sep, M. S., Van Osch, M., Van Vliet, L. M., Smets, E. M.,
and Bensing, J. M., 2014. The power of clinicians’
affective communication: how reassurance about non-
abandonment can reduce patients’ physiological
arousal and increase information recall in bad news
consultations. An experimental study using analogue
patients. Patient Education and Counseling, 95(1), 45-
52.
Setiadi, E. M., and Kolip, U., 2013 Introduction to
Sociology: understanding the facts and symptoms of
social problems: theory, applications and possible
solution, Kencana. Jakarta.
Shane, S., Kate, B., Thomas, F. H., Susan, M., Shelley
Raffin, B., Harvey, M. C., and Neil, A. H., 2016.
Sympathy, empathy, and compassion: A grounded
theory study of palliative care patients’ understandings,
experiences, and preferences. Palliative Medicine,
31(5), 437-447. doi: 10.1177/0269216316663499.
Street, R. L., Makoul, G., Arora, N. K., and Epstein, R. M.,
2009. How does communication heal? Pathways
linking clinician–patient communication to health
outcomes. Patient Education and Counseling, 74(3),
295-301.
Wattimena, I., 2014. Tracing the flow of medical
examination and treatment abroad. Journal of ners
lantera, 2 (1).
Wicaksono, A., 2014. The relationship between the
professional conduct of doctors at the beginning of the
inspection and satisfaction service of doctors. Andalas
Medical Magazine, 37(3). doi:
10.22338/mka.v37i6.197.
ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramification Researches
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