排序方式： 共有23条查询结果，搜索用时 15 毫秒
1.
The main objective of this study was to investigate the prevalence of dissociation and its relationships to symptom reporting in fibromyalgia (FM) and other rheumatic disorders (non-FM). The participants were 73 women with FM and 85 relatively matched women with other rheumatic disorders. The participants were administered the Dissociative Experiences Scale (DES), the Profile Of Mood States (POMS), and a 50-item medical checklist. The prevalence of dissociation (DES q 25) was significantly higher in FM patients(30.1%) compared to other rheumatic disorders (7.0%). Symptom reporting correlated with measures of dissociation in both patient groups (FM:R = 0.42, p < .001; non-FM:R = 0.44, p < .001), when controlled for age, depression, and anxiety. A regression analysis confirmed the strong linkage between somatic variation and dissociation. The results suggest that dissociation is a problem for a substantial segment of patients with fibromyalgia and that dissociation is related to certain physical symptoms of fibromyalgia. Dissociation offers a different perspective on medically unexplained symptoms and may need to be addressed in future research. 相似文献
2.
Objective: Worry is an important perpetuating factor of Medically Unexplained Symptoms (MUS). Former research has shown that a worry postponement instruction is effective in reducing Subjective Health Complaints (SHC) in non-clinical samples. This study aimed to (1) replicate these findings in a MUS-analogue student-sample and (2) assess alexithymia as a moderator.
Design: The current study had an experimental design with two waves of data collection: pre- and post-intervention.
Main outcome measures: A MUS-analogue student-sample consisting of 114 undergraduate students with high self-reported health worry and a minimum of two doctor visits in the previous year with no current diagnosis for a (chronic or acute) disease were instructed to register their worry frequency and duration eight times per day via an experience sampling-application on their smartphones. The intervention group additionally postponed their worries to a 30-minute period in the evening. SHC were assessed pre- and post-intervention.
Results: The intervention did not have an effect on worry or SHC. Alexithymia did not moderate this effect (p’s > .05).
Conclusion: Our study did not find evidence for the effectiveness of the worry reduction intervention on SHC in a MUS-analogue student-sample. This finding contributes to several previous studies that have found mixed evidence for the effectiveness of the worry reduction intervention on SHC and suggests that the worry intervention may not be effective in all cases. 相似文献
3.
Objective: The classic perspective in the psychosomatic literature is that patients with medically unexplained syndromes do not acknowledge psychologically-based causes for their conditions and will not engage in psychological treatments. These assumptions were tested by contrasting the illness models and reported treatment experiences of individuals with fibromyalgia (FM), a syndrome with a currently unknown organic origin, with those of individuals with rheumatoid arthritis (RA), a ‘legitimate’ (i.e. organic) condition. Method: 193 patients with FM and 176 with RA completed measures assessing their views about the causes of their condition, the treatments they had used and their judged effectiveness. Results: Contrary to prediction, compared to patients with RA, patients with FM were more likely to endorse psychological causes for their condition and reported having used more psychological management approaches. Moreover, patients with FM considered psychological approaches to be more effective than narcotics. Conclusion: These findings indicate that patients with FM do not react defensively to the implication of psychogenic causes. Rather, as a group, they tend to acknowledge both the psychosocial influences on and the effectiveness of psychological management approaches for their condition. 相似文献
4.
5.
Micha Selders Rosanne Visser Wilbert van Rooij Jurrijn A. Koelen 《Psychoanalytic Psychotherapy》2013,27(2):182-198
The primary aim of this equivalence study was to compare the outcome of a brief group therapeutic intervention, based on the principles of dynamic interpersonal therapy (DIT) with an intervention based on cognitive behavioural therapy (CBT) in patients suffering from medically unexplained somatic symptoms (MUSS). Participants were 89 patients (aged 18 to 62) who were offered 20 sessions of either DIT or CBT, as central part of a treatment package, consisting of art therapy, psychomotor therapy, social therapy and physical therapy. Measurements were conducted at baseline, 10 weeks and 20 weeks, using self-rating scales measuring the level of anxiety and depression, the severity of medically unexplained symptoms and quality of life. Results showed that CBT and DIT were comparable. The conclusion was that it is recommended to design a larger scale randomised controlled trial to further elaborate the short-term and long-term effects of this novel psychodynamic group therapy for MUSS patients. 相似文献
6.
刘典恩 《医学与哲学(人文社会医学版)》2005,26(7):5-8
在案例分析的基础上,作出了医生是临床诊疗中适宜技术的主要选择者的判断;论证了运用适宜技术实现诊疗最优化的可行性;认为适宜技术难以选择和实施的主要原因是利益关系、责任心不强和管理措施不到位;提出了必须着力培育适合于适宜技术生长的土壤的对策,即:实行政策引导与资金支持、进一步加大监管力度、营造良好的氛围、高度重视并加强医生道德素质的培养。 相似文献
7.
This paper describes the conceptual underpinnings, structure and operations of a novel service, the City and Hackney Primary Care Psychotherapy Consultation Service – a service set up partly with the aim of addressing the needs of patients who present with ‘medically unexplained symptoms’. As part of the Tavistock and Portman NHS Trust, this service moves its clinical base, staff members and daily work, as well as the foundations of psychoanalytic thinking that define the Trust's work, into the heart of a community, and provides psychoanalytically informed clinical practice and consultation to patients and general practitioners in the City and Hackney, one of London's (and the UK's) most deprived and ethnically diverse boroughs. The authors describe the psychoanalytical underpinnings of the model, the design and structure of the service, patient demographics and preliminary outcome data, as well as an example of consultation work with general practitioners. The authors propose that psychoanalytic applications have a place in primary care and that psychoanalytic thinking can help general practitioners and patients alike, even when the clinical interventions offered are not solely based on psychoanalytic technique or therapeutic approaches. The paper concludes with thoughts about the model, its origins and its future. 相似文献
8.
For a little more than a decade, professional organizations and healthcare institutions have attempted to develop guidelines and policies to deal with seemingly intractable conflicts that arise between clinicians and patients (or their proxies) over appropriate use of aggressive life-sustaining therapies in the face of low expectations of medical benefit. This article suggests that, although such efforts at conflict resolution are commendable on many levels, inadequate attention has been given to their potential negative effects upon particular groups of patients/proxies. Based on the well-documented tendency among many African Americans to prefer more aggressive end-of-life medical interventions, it is proposed that the use of institutional policy to break decision making impasse in cases for which aggressive treatment is deemed “medically inappropriate” will fall disproportionately on that group. Finally, it is suggested that the development and application of institutional conflict-resolution policies should be evaluated in the context of historical and current experiences of marginalization and disempowerment, lest such policies exacerbate that experience. 相似文献
9.
Richard Taylor 《Psychoanalytic Psychotherapy》2013,27(2):156-159
Patients with ‘medically unexplained symptoms’ (MUS) remain an ongoing challenge to medical practitioners using conventional approaches to diagnosis and treatment. This challenge often creates tensions and defensive enactments in the doctor–patient relationship. In this viewpoint article, a personal reflection from current clinical practice is presented as a catalyst for further dialogue. In particular, psychoanalytic thinking around the issue of MUS is advocated as bringing a valuable focus by looking at ‘meanings’ behind symptoms. Medical practitioners may benefit considerably by working jointly with psychoanalytical practitioners. This could improve the care of patients with MUS and in addition bring beneficial understanding to the dynamics of the patient relationship. 相似文献
10.
适宜技术的选择要考虑简、便、廉、验,要从大多数患者的需求出发,要始终定位在医患等利益关系的结合点上,它是一种动态发展的技术或技术体系。然而,正是基于各种利益的结合点,在实际选择适宜技术中常常因为利益冲突的多主体性而变得复杂多样,并衍生出各种各样的利益冲突。分析利益冲突的产生根源对于寻求利益冲突的化解途径具有重要意义,同时也为各种途径提供了理论支持。 相似文献