Liliana Trovalusci & Pietro Russo - SIPNEI the fertility journey Human Reproduction keynote lecture...
Transcript of Liliana Trovalusci & Pietro Russo - SIPNEI the fertility journey Human Reproduction keynote lecture...
PNEIFERT: AN INNOVATIVE CLINICAL MODEL FOR A PERSONALIZED AND PARTICIPATORY CARE IN
REPRODUCTIVE MEDICINE
Liliana Trovalusci & Pietro Russo
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CNS ANS
immune system
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endocrine system
stress THE PNEI NETWORK
geneticsepigenetics
REPRODUCTION
chances of conceivement
diseases risk factors
geneticsepigenetics
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MULTIFACTORIAL CONDITION
INFERTILITY
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PSYCHOSOCIAL BURDEN
AFFECTED BY STRESS
CAN BE PREVENTED(risk factors)
HOW DO WE PLAY THIS GAME...
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ART(ASSISTED REPRODUCTIVE TECHNOLOGY)
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IVF
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ART:IT DOES SOLVE
PROBLEMS,BUT ALSO CREATES
FALSE EXPECTATIONS
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BIOMECHANICS IS NOT THE ONE AND ONLY ANSWER
ABOUT BODY AND SOUL(or the body of soul...)
PSYCHE CULTURE
WHERE OUR CULTURAL IMAGERY COMES FROM
DIVINE ACTION
DIVINE MEDIATION
COMMUNITY MEMBERSHIP
HUMANIZATION PROCESS THROUGH RELATIONSHIP
THE ADVENT OF THE BODY
BODY PARTIALISATION
SOCIO-ECONOMIC CAUSES
FAMILY GHOSTS AND TRANSGENERATIONAL
MANDATES
SOCIAL CONTROL
SEXUAL DEPOLARIZATION
LATE ADOLESCENCES
DIFFERENT FAMILY STRUCTURES
NARCISSISM AND ONNIPOTENCE FANTASIES
EPIGENETIC RECURRENCES
MORE INVISIBLESDREAMS AND TRANSPERSONAL
UNCONSCIOUS IMPLICIT TRASCENDENT ELEMENTS
SUFFERING
SENSE OF INADEQUACY TOWARDS PROCREATION
REQUIREMENTS
VISIBLE
SCIENCE AND TECHNOLOGY
LIMITS AWARENESS
HOW DO WE PLAY THIS GAME...
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WE NEED A PATIENT-CENTRED TEAM TO MANAGE A FERTILITY CLINIC
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focus onREPRODUCTION
// MAY 2015� Look ahead to Lisbon � ESHRE news� Best of ESHRE & ASRM 2015
� Developments in infertility counselling� The case for patient centred treatment
On the fertility journey
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Human Reproduction keynote lecture
“Preconception stress increases the risk of infertility:results from a couple-based prospective cohort study,the LIFE study”, the article of Dr Courtney D. Lynchfrom Ohio State University, has been chosen as thisyear’s Human Reproduction Keynote lecture.Dr Lynch’s presentation will take place on 15 June2015 from 8.30 to 9.00 and will be the opening lectureof ESHRE’s 31st Annual Meeting.
Her paper can be read in Human Reproduction
ESHRE 2015 http://www.eshre2015.eu/
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ESHRE!Psychology!and!Counselling!Guideline!Development!Group!
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Routine!psychosocial!care!in!infertility!and!medically!assisted!reproduction!–!A!guide!for!fertility!staff!
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๏ INTEGRATION OF COMPETENCES๏ INTERVISION๏ EFFECTIVE COMMUNICATION๏ FREQUENT STAFF MEETINGS FOR SHARING AND
INTEGRATING OF DATA AND FOR PLANNING OF DIAGNOSTIC AND THERAPEUTIC STRATEGIES
๏ TIMELINES KEEPING๏ SOP - QC
TEAM WORKING
endocrinologistgynecologyst
THE FERTILITY CLINIC TEAMAS TODAY
urologist
biologist(clinical embryologist)
psychologist
geneticianmidwife
endocrinologistgynecologyst
urologist
biologist(clinical embryologist)
psychologist(better with etnopsychological
compentences)
genetician
nutritionist(not just loosing weight...)
midwife
acupuncturist qi-gong, tuina, yoga...
THE FERTILITY CLINIC PNEI TEAMAS TOMORROW
phytotherapy osteopathy
IS THIS ENOUGH?
WE NEED AN EDUCATIONAL PROCESS TO BUILD A PATIENT-CENTRED TEAM TO
MANAGE A FERTILITY CLINIC
PNEIFERT: AN INNOVATIVE CLINICAL MODEL FOR A PERSONALIZED AND PARTICIPATORY CARE IN
REPRODUCTIVE MEDICINE
BASICS
ACTIVATING THE ENERGETIC FIELDBUILDING-UP THE THERAPEUTIC ALLIANCE
THERAPEUTIC RELATIONSHIP
KEEPING THE BALANCE, AVOIDING TO YELD TO PATIENT’S COMPLEXUALITY IN A NEVROTIC COMPULSORY URGE TO
REALIZE THE IMPOSSIBLE
WELCOMINGto make people feel they are entering in their own healing place
EMPATHIC LISTENINGto the stories, the body language, the invisibles, beyond filling out of an anamnesis form
ANALYSING THE QUESTIONwhat lies beyond the search of conceivement
CLINICAL EVALUATIONinfertility conditions and risk factors
DIAGNOSIS AND REPRODUCTIVE PROGNOSISanswer the Questions: can I conceive? Why cannot I conceive?
PNEIFERT - working steps #1
COMMUNICATION AND CURE
Guides and aims
๏ balancing posture๏ personal empowerment๏ restoration of decisional power๏ respect of autonomy๏ information and technical consulting๏ facilitatory role๏ personalization of cures๏ support throughout the process
PNEIFERT - working steps #2
PNEIFERT - working steps #3THERAPEUTIC STRATEGIES
๏ before IVF (all we can do to avoid IVF)๏ reducing and eliminating risk factors๏ curing infertility conditions๏ IVF (when needed)
๏ beyond IVF (all we can do to effectively support patient’s health as a whole)
๏ psychological route๏ integrated medicine (TCM, phytotherapy, osteopathy...)๏ timelines keeping๏ best cost/benefit ratio
NEW AND SYNCRETIC LANGUAGE๏ acquired and shared by the team๏ accessible to patients๏ not childish๏ technically correct๏ minding of body and soul
PNEIFERT - tools
A PNEI LANGUAGE: AN AWARE LANGUAGE AIMING THE DEEP
COMPREHENSION AND EVOKING NEW THOUGHTS CAPABLE TO MODIFY BOTH MIND AND BODY
Dammi l’acquadammi la manodammi la tua parolache siamo,nello stesso mondo.(Chandra Livia Candiani)
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a process to effectively support patient’s health as a whole, beyond results, as an
evolutionary opportunity even to transform parentshood desire into wide creative
potentialities
WHO DOES PLAY THIS?
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THE WHOLE TEAMunder the psychologist’s supervision
WHAT’S GOING ON...
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PILOT EDUCATIONAL PROGRAM IN A FERTILITY CLINIC (CENTRO CHEMIS, NAPLES)
BUILDING A CONSULTANT NETWORK OF FERTILITY SPECIALISTS (SR BIOS, CATANIA)
SMILES AT WORKBYE, FOR NOW...