|Year : 2012 | Volume
| Issue : 2 | Page : 59-60
Patient-centered care and therapeutic patient education: Vedic inspiration
Sanjay Kalra1, Navneet Magon2, Sonia Malik3
1 Department of Endocrinology, Bharti Hospital and B.R.I.D.E, Karnal, Haryana, India
2 Department of Obstetrics and Gynecology, Air Force Hospital, Kanpur, Uttar Pradesh, India
3 Department of Obstetrics and Gynecology, Southend Fertility and IVF Centre Holy Angels Hospital, Vasant Vihar, New Delhi, India
|Date of Web Publication||11-Dec-2012|
Department of Obstetrics and Gynecology, Air Force Hospital, Kanpur, Uttar Pradesh
|How to cite this article:|
Kalra S, Magon N, Malik S. Patient-centered care and therapeutic patient education: Vedic inspiration. J Mid-life Health 2012;3:59-60
Patient-centered care (PCC) is an accepted part of medical practice today. Initially proposed in psychology as client-centered care, this term was popularized by bodies such as the Picker Institute and Institute of Medicine through popular publications , Recent approaches on management of many mid-life diseases such as diabetes, sexual dysfunction, and female stress incontinence have further reinforced the need for patient centeredness, some using the term "patient-centered approach" in their nomenclature. ,, Experts also accept the need for, and importance of, therapeutic patient education (TPE) in management of chronic diseases.  The contribution of ancient Indian medicine to PCC, as evidenced by the Quadruple of Atreya, has been highlighted.  The basis of patient-centeredness, however, goes much beyond modern medicine or Atreya. Critics often point to the lack of acceptance of PCC in traditional, oriented culture, which follows a system of eminence and age-based hierarchy. Nothing can be further from the truth.
| Edic Wisdom|| |
One respected source of wisdom, known for its versal applicability, is the Bhagavad Gita. Also called the celestial song, the Gita is a conversation between Lord Krishna and Arjuna. Lord Krishna counsels his friend Arjuna, who is faced with an important dilemma. In many ways, this conversation mirrors the discussion between a doctor and patient. The Bhagavad Gita is suitable for, and acceptable to almost all people, though it belongs to a particular religious denomination.
The Upanishads are a series of books, including the Mahabharata. These holy texts represent a collection of thought and wisdom, which form the crux of Hinduism. In terms of number of adherents, Hinduism is the world's third largest religion, with over a billion followers. It is the major religion of Nepal, India, and Mauritius. More than 10% of the population of Guyana, Fiji, Bhutan, Trinidad and Tobago, Suriname, and Sri Lanka are Hindus. Bangladesh, Qatar, Reunion, Malaysia, Bahrain, Kuwait, and United Arab Emirates have reported Hindus to represent 5% or more of the population. 
Some important verses from these books which are relevant to modern medicine, especially to care of mid-life diseases, are highlighted here. They can be used to counsel and motivate patients during the process of therapeutic patient education. These verses also reinforce the relevance of PCC in disease management.
| Selected Verses|| |
Therapeutic patient education
Bhagavad Gita 4.42
Therefore, the doubts which have arisen in your heart out of ignorance should be slashed by the weapon of knowledge. Armed with yoga [knowledge], O Bharata, stand and fight.
Importance of physical care
Bhagavad Gita 17.6
Those who parch the material elements of this body, and the Super soul within it, are to be known as demons.
Importance of diet
Maitri Upanishad Book 6 v 11
Food is the highest form of the self, for breath is made of food.
Maitri Upanishad Book 6 v 13
Food keeps away old age; Food, it is said, makes folks well disposed, Food is the breath of animals; Food is the eldest; food it is said, is medicine.
Bhagavad Gita 3.4
Not by merely abstaining from work can one achieve freedom from reaction, nor by renunciation alone can one attain perfection.
Bhagavad Gita 3.8
Perform your prescribed duty, which is better than not working. A man cannot maintain his physical body without work.
Bhagavad Gita 6.16,17
There is no possibility of one's becoming a yogi, O Arjuna, if one eats too much or eats too little, sleeps too much or does not sleep enough. He who is regulated in his habits of eating, sleeping, working and recreation can mitigate all material pains.
Menopausal hot flash! Hypoglycemia!
Bhagavad Gita 1.27-28; 29; 30
I feel the limbs of my body quivering and my mouth drying up. My whole body is trembling, and my hairs are standing on end. My bow Gandiva is slipping from my hand, and my skin is burning. I am now unable to stand here any longer. I am forgetting myself, and my mind is reeling. I foresee only evil.
Importance of team work
Brhadaaranyaka Upanishad V. 5.4
Together may it protect us two
Together may it profit us two
Together may we do a hero's work
May we learn intelligently,
May we never hate one another.
Responsibility of the physician
Bhagavad Gita 18.7
Prescribed duties should never be renounced. If by illusion, one gives up his prescribed duties, such renunciation is said to be in the mode of ignorance.
Bhagavad Gita 18.8
Anyone who gives up prescribes duties as troublesome, or out of fear, is said to be in the mode of passion. Such action never leads to the elevation of renunciation. Every endeavor is covered with some sort of fault, just as fire is covered by smoke. Therefore, one should not give up the work which is born of his nature, O son of Kunti; even of such work is full of fault.
Bhagavad Gita 2. 37-38
Therefore, get up and fight with determination. Do thou fight for the sake of fighting, without considering happiness or distress, loss or gain, victory or defeat; and by so doing, you shall never incur sin.
Importance of choice
Mundaka Upanishad 1.1
Two birds, companions and friends cling to the same tree. One of them eats the sweet pipal-ber. The other looks on, without eating.
The final call
Bhagavad Gita 18.63
Thus I have explained to you the most confidential of all knowledge. Deliberate on this fully and then do what you wish to do.
| Conclusion|| |
The verses listed above have versatile applicability, as they can be used in a wide variety of clinical situations. They lend themselves to motivation of both patients and physicians, who try to meet the challenges of providing PCC and TPE to patients with chronic disease. This includes stakeholders involved with the management of not only menopause or andropause, but also other chronic medical diseases. Their holistic and all-encompassing essence will make them useful for practitioners working in mid-life health, diabetes, cardiovascular disease, and mental health. We hope these gems of knowledge from the Vedas and the Bhagavad Gita continue to inspire us to practice PCC in its true spirit.
| References|| |
|1.||Gerteis M, Edgman-Levitan S, Daley J, Delbanco TL. Through the patient′s eyes: Understanding and promoting patient-centered care. San Francisco: Calif Jossey-Bass;1993. |
|2.||Institute of Medicine, Crossing the Quality Chasm: A New Health System for the 21 st Century. Washington, DC: National Academy Press; 2001. p. 6. |
|3.||Inzucchi S, Bergenstal R, Buse J, Diamant M, Ferrannini E, Nauck M. Management of hyperglycaemia in type 2 diabetes: A patient-centered approach. Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2012;55:1577-96. |
|4.||Magon N, Kalra B, Malik S, Chauhan M. Stress urinary incontinence: What, when, why, and then what?. J Midlife Health 2011;2:57-64. |
|5.||Magon N, Babu KM. Medicalisation of female sexuality. Int J Clin Cases Invest 2011;2:1-2. |
|6.||Kalra S, Baruah M, Ganapathy M, Ganie A, Sahay R, Unnikrishnan A. Patient centred approach To diabetes management: The dawn philosophy. The Internet Journal of Family Practice; 2010. DOI: 10.5580/1f72. |
|7.||Kalra S, Kalra B, Agrawal N. Therapeutic patient education: Lessons from ayurveda -The Quadruple Of Atreya. The Internet Journal of Geriatrics and Gerontology; 2010. DOI: 10.5580/25a. |
|8.||Hinduism. Available form: http://en.wikipedia.org/wiki/Hinduism. [Last accessed on 2012 Jul 31]. |