It is not always easy for people to accept their medical state, which can lead to denial. When this happens, managing that patient grows more challenging.
As a result, according to medical writer Naveed Saleh, MD, MS, patients in denial may receive poor medical care. Whereas inpatient settings allow physicians to consult with psychiatric professionals, doctors in an outpatient setting
must rely on patients to responsibly manage that care. Unfortunately, such patients may end up compromising their medical state by missing appointments or not taking medications.
Denial can help patients stay positive when first learning of their medical situation and may protect against depression. However, it may also ultimately hinder the ability to make appropriate healthcare decisions.
Based on a Stat Pearls article, some patients suffer from extreme, unconscious denial, or anosognosia. While anosognosia can be a neurological or a psychiatric disorder, it most often results from structural damage due to events like ischemic stroke. Dr. Saleh stresses that such situations can prove dangerous for patients who, for instance, may not recall pertinent information like the timing of the stroke. Authors of the Stat Pearls article emphasize that, for a patient with anosognosia, it is crucial to take measures like simplifying tasks, demonstrating empathy, and fostering a structured environment.
While some patients in denial may fully refuse to accept their medical condition, others may acknowledge their diagnosis but refuse to accept treatment. According to a JAMA Psychiatry article, a blending techniques like motivational interviewing and shared decision-making would likely be warranted for such situations. The authors suggest that these approaches can aid in increasing a patient’s willingness to adhere to treatment and management protocols, allowing them to take more ownership of their situation. Such strategies enable patients to make more informed and self-guided decisions.
Above all, it is crucial not to place judgement. Sachin H. Jain, MD, MBA, wrote a Forbes article discussing how denial can sometimes occur as a means for coping with a grave diagnosis. Dr. Jain urges healthcare professionals to approach such patients with curiosity, seeking to understand the denial’s root cause and then, with sensitivity, helping patients to acknowledge that root cause.
