Article Impact Level: HIGH Data Quality: STRONG Summary of The Lancet, 404(10462), 1514–1515. https://doi.org/10.1016/S0140-6736(24)02269-4 Dr. Luna Dolezal et al.
Points
- Shame affects both patients and healthcare professionals, influencing patient engagement, communication, treatment adherence, provider effectiveness, and openness.
- Patients may feel shame related to health conditions like mental illness or obesity, while providers may experience shame over medical errors or outcomes, negatively affecting care quality.
- The concept involves recognizing and addressing shame in healthcare settings, aiming to minimize its impact on patient care and workplace dynamics.
- These include awareness of shame, recognizing its patterns, avoiding its induction, providing support, and fostering an organizational culture that embeds these practices.
- Integrating shame competence into training and policies can improve patient outcomes, foster empathy, strengthen patient-provider relationships, and enhance workplace satisfaction and equity.
Summary
A recent article highlights the critical role of shame in healthcare settings and proposes “shame competence” as a necessary skill for medical professionals. Shame is an emotion that patients and healthcare providers experience but often goes unaddressed. Patients may feel ashamed about their health conditions, particularly in cases of mental illness, obesity, sexually transmitted infections, or substance use. These feelings of shame can be exacerbated by perceived judgment from healthcare professionals, which may impact patient engagement, communication, and treatment adherence. Similarly, healthcare professionals may experience shame related to patient outcomes or medical errors, hindering their ability to provide adequate care and engage in open communication.
The article’s authors propose that increasing awareness of shame and developing “shame competence” within healthcare organizations could lead to better patient care and improved workplace dynamics. Shame competence involves recognizing and minimizing shame in healthcare settings and fostering an environment where patients and providers feel supported and understood. The article outlines five pillars of shame competence: maintaining awareness of shame, recognizing its patterns and manifestations, avoiding the inadvertent induction of shame, providing proactive support when shame occurs, and transforming organizational culture to embed these competencies. These practices align with broader initiatives, such as trauma-informed care and creating psychologically safe workplaces.
The study concludes that integrating shame competence into healthcare training and organizational policies could significantly improve patient outcomes and overall well-being. By addressing the destructive potential of shame, healthcare settings can foster empathy, improve patient-provider relationships, and enhance professional satisfaction. The authors argue that healthcare systems must prioritize shame competence to ensure more compassionate, effective, and equitable care.
Link to the article: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02269-4/abstract
References Dolezal, L., & Bynum, W. (2024). Shame competence: Addressing the effects of shame in health care. The Lancet, 404(10462), 1514–1515. https://doi.org/10.1016/S0140-6736(24)02269-4
