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PNEIFERT: AN INNOVATIVE CLINICAL MODEL FOR A PERSONALIZED AND PARTICIPATORY CARE IN
REPRODUCTIVE MEDICINE
Liliana Trovalusci & Pietro Russo
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Pierorusso2015
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CNS ANS
immune system
Pierorusso2017
endocrine system
stress THE PNEI NETWORK
geneticsepigenetics
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REPRODUCTION
chances of conceivement
diseases risk factors
geneticsepigenetics
Pierorusso2015
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MULTIFACTORIAL CONDITION
INFERTILITY
Pierorusso2017
PSYCHOSOCIAL BURDEN
AFFECTED BY STRESS
CAN BE PREVENTED(risk factors)
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HOW DO WE PLAY THIS GAME...
Pierorusso2017
ART(ASSISTED REPRODUCTIVE TECHNOLOGY)
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Pierorusso2017
IVF
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Pierorusso2017
ART:IT DOES SOLVE
PROBLEMS,BUT ALSO CREATES
FALSE EXPECTATIONS
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Pierorusso2017
BIOMECHANICS IS NOT THE ONE AND ONLY ANSWER
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ABOUT BODY AND SOUL(or the body of soul...)
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PSYCHE CULTURE
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WHERE OUR CULTURAL IMAGERY COMES FROM
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DIVINE ACTION
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DIVINE MEDIATION
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COMMUNITY MEMBERSHIP
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HUMANIZATION PROCESS THROUGH RELATIONSHIP
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THE ADVENT OF THE BODY
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BODY PARTIALISATION
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SOCIO-ECONOMIC CAUSES
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FAMILY GHOSTS AND TRANSGENERATIONAL
MANDATES
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SOCIAL CONTROL
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SEXUAL DEPOLARIZATION
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LATE ADOLESCENCES
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DIFFERENT FAMILY STRUCTURES
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NARCISSISM AND ONNIPOTENCE FANTASIES
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EPIGENETIC RECURRENCES
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MORE INVISIBLESDREAMS AND TRANSPERSONAL
UNCONSCIOUS IMPLICIT TRASCENDENT ELEMENTS
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SUFFERING
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SENSE OF INADEQUACY TOWARDS PROCREATION
REQUIREMENTS
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VISIBLE
SCIENCE AND TECHNOLOGY
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LIMITS AWARENESS
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HOW DO WE PLAY THIS GAME...
Pierorusso2017
WE NEED A PATIENT-CENTRED TEAM TO MANAGE A FERTILITY CLINIC
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Pierorusso2015
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Pierorusso2015
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
������ �����������������������������������������
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/
1 of 1 10/06/15 19.58
Pierorusso2015
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ESHRE!Psychology!and!Counselling!Guideline!Development!Group!
March!2015!
Routine!psychosocial!care!in!infertility!and!medically!assisted!reproduction!–!A!guide!for!fertility!staff!
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! ! ! ! ! ! ! ! ! !
1!!
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Pierorusso2015
๏ 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
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endocrinologistgynecologyst
THE FERTILITY CLINIC TEAMAS TODAY
urologist
biologist(clinical embryologist)
psychologist
geneticianmidwife
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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
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IS THIS ENOUGH?
WE NEED AN EDUCATIONAL PROCESS TO BUILD A PATIENT-CENTRED TEAM TO
MANAGE A FERTILITY CLINIC
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PNEIFERT: AN INNOVATIVE CLINICAL MODEL FOR A PERSONALIZED AND PARTICIPATORY CARE IN
REPRODUCTIVE MEDICINE
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BASICS
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ACTIVATING THE ENERGETIC FIELDBUILDING-UP THE THERAPEUTIC ALLIANCE
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THERAPEUTIC RELATIONSHIP
KEEPING THE BALANCE, AVOIDING TO YELD TO PATIENT’S COMPLEXUALITY IN A NEVROTIC COMPULSORY URGE TO
REALIZE THE IMPOSSIBLE
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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
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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
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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
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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
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Dammi l’acquadammi la manodammi la tua parolache siamo,nello stesso mondo.(Chandra Livia Candiani)
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Pierorusso2015
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
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WHO DOES PLAY THIS?
Pierorusso2017
THE WHOLE TEAMunder the psychologist’s supervision
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WHAT’S GOING ON...
Pierorusso2017
PILOT EDUCATIONAL PROGRAM IN A FERTILITY CLINIC (CENTRO CHEMIS, NAPLES)
BUILDING A CONSULTANT NETWORK OF FERTILITY SPECIALISTS (SR BIOS, CATANIA)
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SMILES AT WORKBYE, FOR NOW...