The Patient
Kluwer Academic / Plenum Publishers (Verlag)
978-0-306-41985-0 (ISBN)
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I. On Becoming a Patient: Psychosocial Considerations.- 1. Illness and Help-Seeking Behavior.- Concepts and Definitions: Help-Seeking Behavior and Illness Behavior.- Factors That Influence Help-Seeking Behavior.- Factors That Influence How Symptoms and Illness May Be Perceived.- Demographic Factors.- Role of Stress.- Role of Previous Experience ("Priming Factors").- Taxonomy of Medical Help-Seeking Behavior.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- 2. The Sick Role.- Sick-Role Expectations.- Sick-Role Performance by Patients.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- 3. Expectations in the Consulting Room.- Relief from Distress.- Communication of Information.- Effect of Priming Factors on Expectations.- The Physician's Covert Expectations.- Society's Expectations of the Physician-The "Doctor Role".- Technical Competence.- Universalism.- Functional Specificity.- Affective Neutrality.- Collectivity Orientation.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- II. On Being a Patient: Psychophysiological Considerations.- 4. Anxiety.- Phenomenology of Anxiety.- Theories of Anxiety and Emotions.- Learning-Theory Model.- Psychoanalytic Signal Theory of Anxiety.- Physiology of Anxiety.- Brain Mechanisms of Anxiety.- Central Neurotransmitters in Anxiety.- Function of Anxiety.- Dysregulation of Anxiety.- Fainting.- Hyperventilation Syndrome.- Stress-Related Disorders.- Classification of Anxiety Dysregulation Syndromes.- Evaluation of Anxiety.- Contexts of Anxiety.- Differential Diagnosis of Anxiety States.- Management of Anxiety.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- 5. Psychological Defense Mechanisms.- Distress, Anxiety, and Defense Mechanisms.- Classification of Defense Mechanisms.- Defenses Listed According to Their Main Subsystem Effects.- Illustrations of Defense Mechanisms as They May Be Encountered in Medical Practice.- Defense Mechanisms That Manifest Their Main Effects in the Input Subsystem.- Defense Mechanisms That Manifest Their Main Effects in the Internal Processing Subsystem.- Defense Mechanisms That Manifest Their Main Effects in the Output (Action) Subsystem.- Defense Mechanisms the Main Effects of Which Are More Evenly Distributed in All the Subsystems by Affecting the Decider or Executive Subsystem Itself.- Defense Mechanisms, Anxiety, Character, and Coping Styles.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- 6. Depression, Mania, and Suicide: Affective Disorders.- Affect, Mood, Depression, and Mania.- Phenomenology of Depression and the Depressive and Manic Syndromes.- Separation, Bereavement, and Grief.- Phenomenology.- Course.- Pathological Grief Reactions.- Separation in Children.- Separation in Infant Monkeys.- Function of Depression.- Significance of Bereavement, Depression, and Affective Disorders.- Epidemiology of Affective Disorders.- Brain Mechanisms of Affective Disorders.- Biogenic Amines.- Receptor Sensitivity.- Acetylcholine.- Other Putative Neurotransmitters and Neuromodulators.- Intracellular Sodium.- Psychological Aspects.- A Hypothetical Integrated Model.- Physiology and Endocrinology of Affective Disorders.- Neuroendocrinology.- Physiological Signs of Depression (Depressive Syndrome).- Evaluation of Depression.- Dexamethasone Suppression Test.- Physical Symptoms in Depressive Syndrome Associated with Major Affective Disorders.- Evaluation of Suicide Potential.- Risk Factors.- Suicide Attempt.- Evaluation of Suicide Attempt.- Management of Depression.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- 7. Psychosis.- Psychosis, Madness, and Insanity.- General Phenomenology of Psychosis.- Schizophrenia-A Classic Psychosis.- Brief History.- Definition.- Clinical Features and Diagnostic Criteria.- Course and Prognosis.- Mortality.- Epidemiological Aspects.- Etiological Aspects.- Nature of Psychosis.- Evaluation of Psychosis.- Biological Dimension.- Personal Dimension.- Environmental Dimension.- Differential Diagnosis of Psychosis.- Management of Psychosis.- Biological Dimension.- Personal Dimension.- Environmental Dimension.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- 8. Confusion, Delirium, and Dementia: Organic Brain Syndromes and the Elderly Patient.- Definitions and Phenomenology.- Organic Brain Syndrome.- Delirium.- Dementia.- Epidemiology of Organic Brain Syndromes.- Pathophysiology of Organic Brain Syndromes.- Prevalence of Dementia in the Elderly.- Alzheimer's Disease and Multiinfarct Dementia.- Alzheimer's Disease.- Multiinfarct Dementia.- Clinical Course of the Dementias in the Elderly.- Memory Dysfunction in the Elderly.- Evaluation of Organic Brain Syndromes.- Biological Dimension.- Personal Dimension.- Environmental Dimension.- Differential Diagnosis of Organic Brain Syndromes.- Management of Organic Brain Syndromes.- Biological Dimension.- Personal Dimension.- Environmental Dimension.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- 9. Pain.- Definitions and Functions of Pain.- Qualities of Pain.- Nature of Pain.- Neurophysiology of Pain.- Historical Neurophysiological Theories of Pain Perception.- Role of Endorphins in Pain Mechanisms.- Descending Influences from the Brain.- Central Neuropharmacology of Pain.- Psychosocial Factors That Influence Pain Experience.- Placebo Effect.- Use of Placebos in Medical Practice.- Psychological Meanings of Pain.- "Psychogenic" Pain.- Management of Pain.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- 10. Sleep and Dreaming.- Stages of Sleep.- NREM Sleep.- REM Sleep.- Basic Rest-Activity Cycle.- Biological Rhythms.- Brain Mechanisms of Sleep.- Dreams.- Functions of Sleep and Dreaming.- Sleep Needs.- Environmental Factors That Affect Sleep.- Sleep Disorders.- Classification.- Insomnia.- Hypersomnia.- Narcolepsy.- Somnambulism (Sleepwalking).- Enuresis (Bed-Wetting).- Night Terrors.- Nightmares.- Sleep Apnea.- Medical Conditions Affected by REM Sleep.- Hyperthyroidism and Hypothyroidism.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- III. On Assessing a Patient: A Clinical Systems Approach.- 11. Approach to a Patient: The Patient Evaluation Grid.- The Patient, the Patient's Components, and the Patient's Environment.- Disease, Illness, and Distress.- Patient Evaluation Grid (PEG).- What Goes into the PEG.- Significance of Contexts.- Significance of Dimensions.- Rational Patient Management.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- 12. Current Context.- Current Context in the Biological Dimension.- Current Context in the Personal Dimension.- Outline of the Mental-Status Examination.- Current Context in the Environmental Dimension.- Interaction among the Current-Context Dimensions.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- 13. Recent Context.- Recent Context in the Biological Dimension.- Recent Context in the Personal Dimension.- Recent Context in the Environmental Dimension.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- 14. Background Context.- Background Context in the Biological Dimension.- Background Context in the Personal Dimension.- Personality as a Factor in the Pathogenesis of Disease.- Background Context in the Environmental Dimension.- Intersystems Interaction in the Background Context-Development.- Freud.- Erikson.- Piaget.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- IV. On Managing a Patient.- 15. The Case of the "Sick Tarzan": A Challenging Case History.- 16. The Doctor-Patient Relationship.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- 17. The Patient's Personality.- Personality and Character.- Concept of Personality Types in Patients.- Personality Types and the Sick Role.- Dependent, Demanding Patients.- Orderly, Controlling Patients.- Dramatizing, Emotional Patients.- Long-Suffering, Self-Sacrificing Patients.- Guarded, Suspicious Patients.- Superior and Special Patients.- Seclusive, Aloof (Schizoid) Patients.- Impulsive Patients with a Tendency to Act Out.- Patients with Mood Swings.- From Types to Individuals.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- 18. The Hospitalized Patient.- The Hospital as a Social System.- Kinds of Hospitals.- The People in a Hospital.- Organization of an Inpatient Unit.- The Hospital and Outside Organizations.- The Hospital Environment.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- 19. Therapeutic Dimensions.- Approaches in the Biological Dimension.- Approaches in the Personal Dimension.- Psychotherapy in Medical Settings.- Formal Psychotherapy.- Approaches in the Environmental Dimension.- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- 20. Drugs That Affect Behavior.- Drugs Affect All Dimensions of the Patient.- Psychotropic Drugs.- Antianxiety Drugs (Minor Tranquilizers).- Drugs That Affect Mood.- Antipsychotic Drugs (Major Tranquilizers, Neuroleptics).- Summary.- Implications.- For the Patient.- For the Physician.- For the Community and the Health-Care System.- Recommended Reading.- References.- 21. Some Illustrative Patients.- Management of the "Sick Tarzan".- Biological Dimension.- Personal Dimension.- Environmental-Interpersonal Dimension.- The Case of the Catatonic Patient with Enlarged Ventricles.- History and Course.- Comments.- The Case of the Suicidal Terminal Cancer Patient.- History.- Evaluation.- Course of Management.- Comments.- 22. Summary and Perspectives.- References.
Zusatzinfo | 24 black & white illustrations, biography |
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Verlagsort | Dordrecht |
Sprache | englisch |
Themenwelt | Medizin / Pharmazie ► Gesundheitswesen |
ISBN-10 | 0-306-41985-8 / 0306419858 |
ISBN-13 | 978-0-306-41985-0 / 9780306419850 |
Zustand | Neuware |
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