Relation of People-centered public health and person-centered healthcare management: a case study to reduce burn-out

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Drozdstoy Stoyanov Stoyanov
C Robert Cloninger


Healthcare management is one practical tool for mediation and implementation of public health into clinical health care outcomes and is taken in our case study as an exemplar arena to demonstrate the vital importance of the person-centered approach.Health care personnel are frequently at risk for the ‘burn out’ syndrome. However, modern measures of burn out  recognize burn out only at a late stage when it is fully developed. There are no available methods to assess the risk for vulnerability to burn out in health care systems. Our aim was therefore to design a complex person-centered model for detection of high risk for burn out at an early stage, which we have termed ‘flame up’. We accept the observation that decreased personal performance is one crucial expression of burn out.  Low personal performance and negative emotions are strongly related to low self-directedness as measured by the Temperament and Character Inventory (TCI). At the same, time burn-out is characterized by decreased interest and positive emotions from work. Decreased positive emotion is directly related to low self-transcendence as measured by the TCI. Burn-out is also frequently associated with feelings of social alienation or inadequacy of support, which is in turn related to low TCI Cooperativeness. However, high Persistence and Harm Avoidance are predisposing traits for burn-out in health care professionals who are often overly perfectionistic and compulsive, predisposing them to anxiety, depression, suicide, and burn-out.  Hence, people at risk for future burn-out are often highly conscientious over-achievers with intense mixtures of positive and negative emotions.  The high demand for perfection comes from both intrinsic characteristics and from features of the social milieu in their psychological climate. Letting go of the unfulfillable desire to be perfect by increasing self-transcendence allows acceptance of the imperfection of the human condition, thereby preventing burn-out and other negative emotions while promoting positive emotions and work in the service of others.Hence we can evaluate vulnerable populations via a person-centered diagnostic method using the TCI and also relate well being to the psychological climate of the work place. The proposed diathesis-stress model can directly impact on the management of human resources and related decision-making. The introduction of such person-centered assessments can encourage and improve public health outcomes by promoting the personal wellbeing of health care employees.

Article Details

Contributions to the advancement of person-centered care
Author Biography

Drozdstoy Stoyanov Stoyanov, University Center for Philosophy and Mental Health, Bulgaria

Drozdstoj (Drossi) Stoyanov was born on July, 20th 1980 in Sofia, Bulgaria in the family of outstanding psychiatrists. He graduated from the high school at the age of 15 (1996), and received his MD from the Medical University of Sofia at the age of 21 (2002). Prof. Stoyanov developed and defended a PhD thesis in the field of neurology and psychiatry in 2005, certified in December 2007 by the Government Specialty Board with the rank of Psychiatrist and was elected associate professor of medical psychology in 2008. He is co-founder of the Balkan Association of History and Philosophy of Medicine (2005) as well as the Balkan Academy for Philosophy, Psychiatry and Psychology (2007) and designed the peer-reviewed project for the establishment of the first University Centre in Philosophy and Mental Health (UCPMH) in South-Eastern and Central Europe. The Centre organized two consequent international symposia in the field in 2008 and 2009. Prof. Stoyanov was invited at the discretion of the Chair into the Philosophy Special Interest Group of the Royal College of Psychiatrists in 2007 and was awarded Postgraduate Certificate in Philosophy of Mental Health from the University of Central Lancashire, United Kingdom in October 2010. In 2009 the Center for Philosophy of Science, University of Pittsburgh, USA elected Prof. Stoyanov for Visiting Fellow.Prof. Stoyanov hold the position of Vice Dean for International Affairs of the Faculty of Public Health, University of Medicine, Plovdiv from 2009 to 2011. Since 2011 he has been appointed assoc. professor in the Faculty of Medicine, Department of Psychiatry and Medical Psychology and Special Advisor Strategic Parnerships to the Vice Rector. Besides he still acts as Deputy Director and Scientific Secretary of the Expert Board of UCPMH and  works as practicing psychiatrist in the ‘St. Ivan Rilski’ State Psychiatric Hospital.He published and/or edited about 110 papers, three monographs and a textbook of psychology and received a number of awards for his research such as Hippocratic Medal from the International Hippocratic Foundation for his contributions in philosophy of medicine. Drossi’s latest publications are on the convergent trans-disciplinary validity of the methods and categories in psychology and psychiatry.Since 2007 Prof. Stoyanov acts as a member of the Editorial board, secretary coordinator (2009) and most recently as Deputy Editor-in-chief (2010) of the International Annual for History and Philosophy of Medicine. Besides he has been Chair of Conceptual group in the Global Network for Diagnosis and Classification launched by the World Psychiatric Association (2008) as well as member of the teaching committee of the European Association for Communication in Healthcare (2010).  Selected publications list:Stoyanov,D. (1999) About Schweitzer, In: Young medics about Albert Schweitzer, Albert Schweitzer World Academy of Medicine, Ed. K. Imjelinsky, WarsawStoyanov, D. S. et Al (2006), Comorbidity Monograph 4, Perspectives across Europe, European Collaborating Centers for Addiction Studies, Eds A.Baldacchino, J.Corkery, LondonStojanov, D.S.(2007), Validation theory - from basic neuroscience to pharmaco-psychology, SA Journal of Psychiatry, Vol.13, 3, 2007:116Stoyanov, D. St (2009)., Review - Psychiatry as Cognitive Neuroscience: Philosophical Perspectives, Metapsychology, Volume 13, Issue 47Stoyanov, D.St.(2009),The Cross-Validation in the Dialogue of Mental and Neuroscience, Dial Phil. Ment. Neuro. Sci,  2(1): 24-28Stoyanov, DS, PK Machamer and KF Schaffner (2010), In quest for scientific status of psychiatry: towards bridging the explanatory gap, In: Traditions and Innovations in Psychiatry, World Psychiatric Association, St. Petersburg: 44-45Stoyanov, D and KWM Fulford (2010), Values based medical practice: challenges before the system of education and healthcare in Bulgaria, In: Public Health and Health Care in Greece and Bulgaria: the challenge of cross-border collaboration, Papazissis Publishers, Athens: 327-334Stoyanov D (2010), Why a logical-pragmatic perspective on validity in mental health is not sufficient: introduction of the principle of convergent trans-disciplinary cross-validity, Dial Phil. Ment. Neuro. Sci, 3(1): 25-26


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