After the launching of the health reform in the sphere of primary medical aid and a comparatively successful 20-years' accomplishment, a need has arisen for an update of the medical standards ratifying the activity of the general medical practice (2011). The study of the work of the general practitioner in an ergonomic aspect requires the construction of a reliable complex of methodological studies providing a realistic assessment of the organization of the working process and of basic psycho-physical functions in the daily and weekly dynamics, carried out on the background of a dominant attachment of the physician to the chosen area of expertise. The basic approaches for determination of the structure and expenses of the working time, or the efficiency coefficient (EC) respectively and intensity of labour involve the photochronometric- and the method of linear timing (also tracing the synchronization of the activity of the medical team); the spatial timing measuring the working trajectories, evidencing the degree of provision of functional working equipment and the objective conditions of labour. Sociological studies provide data on the style of communication with the patient and the occurrence of dilemmas of bioethical nature, as well as the strategies for their overcoming; sanitary and hygienic conditions of the working environment and their observation in accordance with the required criteria and indicators. The methodologies enable objective assessment of the workload and structure of the physician's working time and the resulting fatigue. Preconditions are created for the implementation of optimal organizational and technological operations in the provision of medical services, aiming to increase in the efficiency of the working process, and establishment of a physiological regime of labour in the general medical practice within the framework of the effective legislation.
A brief historical-analytical review of the origin, essence, and development of empathy has been made. The theoretical measurements in the study of the empathic ability are subject to special attention. On the basis of topical definitions of the concept, the application of the approach in different spheres of life, and more specifically in medical practice, has been discussed. The types of communicative behavior in primary medical practice have been differentiated. A theoretical, applied method of communication intervention within the framework of operationalization and scaling of the empathic interaction is proposed. On the basis of the assumption of a genetically determined property of co-experience, the preconditions for the establishment of optimal interpersonal context upon exchange of information between the physician and the patient and making medical decisions have been outlined. Led by the so systematized and analyzed models and considering the specification of the transformed and activated empathic resources in cases of terminal conditions, an attempt has been made for the presentation of an extensive type of empathic interaction, applied in palliative medicine. The outlining of key messages in cases of terminal conditions in the specified model is complex and at the same time an open, dynamic process, requiring adaptation and enrichment with parameters of religious, ethnical and social nature, and other factors of psychological, spiritual and bio-ethical type in the complex interactive space of palliative medicine.
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