Graves' Disease - Coping With Graves' Disease and The Patient-physician Relationship

Coping With Graves' Disease and The Patient-physician Relationship

Mentally, Graves' disease can be very disturbing. Mood swings, thinking impairment and other mental symptoms can be difficult to handle, and make it appear the patient is suffering from a severe mental disorder. Patients in some cases have been placed in mental institutions. Given the sometimes dramatic impact and long duration of the disease and its treatment, identifying and maintaining emotional support systems (which are frequently affected) can help patients and their families cope. Because emotional lability of the thyrotoxic patient may create interpersonal problems (often producing significant marital stress and conflict), thorough explanation of the disease can be invaluable. In Graves' disease, the accent should lie on written information, as a host of mental problems, such as decreased attention span and memory problems, can impair a patient’s ability to absorb details of doctor visits. In a complicated and difficult illness like Graves' disease, physicians should therefore furnish patients with educational materials or resources such as handouts, website links and community support groups.

However, many patients indicate they are not getting the information they need from the general medical community, and are concerned they do not fully understand their condition. Sympathetic discussion by the physician, possibly with assistance in environmental manipulation, is an important part of the general attack on Graves' disease. Patient education is the "drug of choice" for prevention and treatment of every medical condition, and open communication with health care professionals can be highly beneficial in maximizing health and outlook on life. During the initial and subsequent interviews, the physician must determine the level of the mental and physical stresses. Frequently, major emotional problems come to light after the patient recognizes the sincere interest of the physician. Personal problems can strongly affect therapy by interfering with rest or by causing economic hardship. Physicians are recommended to implement a social questionnaire as part of the initial intake, allowing patients to communicate essential, nonmedical information about their lives.

The communication and health management skills of Graves' disease patients can be seriously impaired. Physicians should be conscious of this while dealing with these patients, as mounting evidence demonstrates the effectiveness of the patient-physician relationship is directly related to health outcomes. The report of a large 2003 summit of physicians and patients notes a number of barriers to achieving desired patient-centered outcomes. It mentions insufficient or unreliable clinical information, lack of communication or inability to communicate effectively, lack of trust between patient and physician, lack of appropriate coordination of care, lack of physician cooperation, and the need to work with too many caregivers, all of which can be very relevant to Graves' disease.