scholarly journals Pszichoszomatikus tünetek és betegségek: a medicina vakfoltja

2021 ◽  
Vol 162 (7) ◽  
pp. 252-261
Author(s):  
Péter Rajna
Keyword(s):  
Health Care Providers ◽  
Interdisciplinary Cooperation ◽  
Care Providers ◽  
Psychosomatic Disorders ◽  
Dual Nature ◽  
Psychiatric Institutions ◽  
Psychosomatic Problems ◽  
Therapeutic Recommendations ◽  
The Given ◽  
Medical Protocols

Összefoglaló. Bevezetés: A pszichoszomatikus medicina területéhez tartozó betegek ellátása rossz hatásfokú. Ez egyaránt jelentős terhet jelent a betegek és az egészségügy számára. Célkitűzés: A pszichoszomatikus tünetek és betegségek megjelenésének és ellátási ajánlásainak vizsgálata az irányadó hivatalos szakmai anyagban. Módszer: Az adatgyűjtés időpontjában elérhető 531 Szakmai irányelvből annak a 134 dokumentumnak a részletesebb elemzése, amelynek témájában pszichoszomatikus tünetek/betegségek gyakoribbak. Ebből 39 egyértelműen pszichoszomatikus vonatkozású anyag tartalmi vizsgálata, továbbá a Szakmai Kollégiumok listáján szereplő három pszichiátriai szakterület összes (26) szakmai irányelvének hasonló szempontú értékelése. Eredmények: A megvizsgált irányelvek töredéke tartalmaz csupán a pszichoszomatikus tünetképzésre, illetve kezelésre, megelőzésre vonatkozó megállapítást. A releváns témájú irányelvekben szereplő diagnosztikai utalások aránya: direkt 10,25, indirekt forma 23,7, a terápiás ajánlások között direkt 25,64, indirekt forma 15,38%. A megelőzésre vonatkozóan alig (5,12%-ban) szerepel említés, a pszichés betegségek egyidejű fennállásának esélyére is mindössze 10,25%-ban történik megállapítás. A szorongásos zavarok befolyásáról kevesebb, mint minden harmadik irányelv számol be (30,76%). A pszichiátriai irányelvek között pszichoszomatikus betegségekre vonatkozóan nincs célzott szakmai irányelv. Következtetés: A pszichoszomatikus medicina a hatékony betegellátás követelményeit meghatározó szakmai irányelvekben elégtelen arányban jelenik meg. Okait szemléleti zavarokban, a pszichiátriai szakmai konszenzus és a szakmaközi együttműködés hiányosságaiban kell keresni. Mind a vonatkozó kutatásokban, mind az irányelvek fejlesztése során erőfeszítéseket kell tenni a fentiek miatt kallódó nagy betegpopuláció hatékonyabb ellátása érdekében. A szerző javaslatot tesz a szükséges konkrét lépésekre. Orv Hetil. 2021; 162(7): 252–261. Summary. Introduction: The care of patients with psychosomatic disorders has bad efficacy. It beards hard both for the patients and the health care providers. Objective: Review of presentrecommendations for psychosomatic symptoms and illnesses in the recent Hungarian medical protocols. Method: A detailed evaluation of 134 medical protocols from altogether 531 protocols with closer connection with psychosomatic disorders were carried out, their diagnostic and therapeutic recommendations were analyzed. Further review of 39 (of the 134)directly related to psychosomatics was done. Investigation of psychiatric protocols for the same aspects was carried out, as well. Results: Only a small part of the protocols contain recommendations for psychosomatic disorders. Ratios of their presence: diagnostic – direct 10.25, indirect 23.7, therapeutic – direct 25.64, indirect 15.38%. Efforts for prevention are only in 5.12% of the materials and 10.25% of the protocols mention a possible dual nature of the given clinical manifestation. Anxiety disorders occur only in 30.76%. Psychiatric protocol directly aiming psychosomatic problems is lacking. Conclusion: Presence of psychosomatic medicine in clinical guidelines defining the conditions of successful care of patients is practically minimal. Possible explanations: confusion in approaches, lack of consensus among the psychiatric institutions, and deficiency of interdisciplinary cooperation. Both in relevant clinical research and in development of medical protocols common additive efforts are necessary for achieving a more successful care of high numbers of patients presently neglected because of the mentioned causes. Author advises some concrete steps for the solution. Orv Hetil. 2021; 162(7): 252–261.

scholarly journals Sexuality, vulnerability to HIV, and mental health: an ethnographic study of psychiatric institutions

2007 ◽  
Vol 23 (9) ◽  
pp. 2224-2233 ◽  
Author(s):  
Diana de Souza Pinto ◽  
Claudio Gruber Mann ◽  
Milton Wainberg ◽  
Paulo Mattos ◽  
Suely Broxado de Oliveira
Keyword(s):  
Mental Health ◽  
Health Care Providers ◽  
Ethnographic Study ◽  
Care Providers ◽  
Outpatient Mental Health ◽  
Psychiatric Institutions ◽  
Severely Mentally Ill ◽  
Hiv Sexual Risk ◽  
Mental Health Clients ◽  
Hiv Vulnerability

This paper presents data from the ethnographic based formative phase of the Interdisciplinary Project on Sexuality, Mental Health, and AIDS (PRISSMA), sponsored by the National Institute of Mental Health (NIMH) and carried out in two psychiatric institutions in the city of Rio de Janeiro, Brazil. Results from ethnographic observations, focus groups, and key informant interviews with different groups of mental health care providers and day hospital and outpatient mental health clients regarding conceptions of sexuality and HIV vulnerability are described. The results suggest a diversity of notions about sexuality by both groups and point out the high HIV sexual risk in this psychiatric population. This formative phase has served as the basis for the cultural adaptation and creation of a Brazilian intervention for HIV prevention in the severely mentally ill, the feasibility of which has been successfully evaluated in the pilot phase.

Malpractice & Negligence: Cal. Supreme Court Clarifies Negligence Provisions under State’s Elder Abuse Act

1999 ◽  
Vol 27 (2) ◽  
pp. 203-203
Author(s):  
Kendra Carlson
Keyword(s):  
Health Care ◽  
Supreme Court ◽  
Health Care Providers ◽  
Elder Abuse ◽  
Skilled Nursing Facility ◽  
Pressure Sores ◽  
Care Providers ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
The Supreme Court

The Supreme Court of California held, in Delaney v. Baker, 82 Cal. Rptr. 2d 610 (1999), that the heightened remedies available under the Elder Abuse Act (Act), Cal. Welf. & Inst. Code, §§ 15657,15657.2 (West 1998), apply to health care providers who engage in reckless neglect of an elder adult. The court interpreted two sections of the Act: (1) section 15657, which provides for enhanced remedies for reckless neglect; and (2) section 15657.2, which limits recovery for actions based on “professional negligence.” The court held that reckless neglect is distinct from professional negligence and therefore the restrictions on remedies against health care providers for professional negligence are inapplicable.Kay Delaney sued Meadowood, a skilled nursing facility (SNF), after a resident, her mother, died. Evidence at trial indicated that Rose Wallien, the decedent, was left lying in her own urine and feces for extended periods of time and had stage I11 and IV pressure sores on her ankles, feet, and buttocks at the time of her death.

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

The Need for Nurse Training to Promote Improved Patient-Provider Communication for Patients With Complex Communication Needs

2013 ◽  
Vol 22 (2) ◽  
pp. 112-119 ◽  
Author(s):  
Debora Downey ◽  
Mary Beth Happ
Keyword(s):  
Health Care Providers ◽  
Communication Disorders ◽  
Provider Communication ◽  
Nurse Training ◽  
Care Providers ◽  
Speech Language Pathologists ◽  
Complex Communication Needs ◽  
Team Members ◽  
Patient Provider Communication ◽  
Communication Needs

Abstract Hospitalized patients across the age continuum often present with complex communication needs (CCN) due to motor, sensory, cognitive, and linguistic barriers they may experience during their admission. Although hospitals recognize the need to enhance communication to improve quality and safety for all patients, the emphasis has been primarily on improving ”care coordination” amongst the health care providers the patient encounters across all points of admission. Most hospitals have yet to focus on improving the patient-provider communication experience, especially for patients with CCN. However, this population no longer can be ignored, as new standards mandate efforts to improve communication for patients with CCN. Nurses, as the team members responsible for continuous care during hospital stays, and speech-language pathologists, as communication disorders specialists, are positioned distinctively to facilitate patient communication and prevent miscommunications between patients and care providers. This article highlights the need to enhance the patient-provider communication experience for patients with CCN. We review the state of nurse training for patients with CCN, discuss the role speech-language pathologists can play in developing and implementing nurse training protocols, and outline basic elements nurse training modules should include.

Interdisciplinary Therapy Assessments for the Older Adult

2012 ◽  
Vol 17 (1) ◽  
pp. 11-16
Author(s):  
Lynn Chatfield ◽  
Sandra Christos ◽  
Michael McGregor
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Standardized Testing ◽  
Health Care Providers ◽  
Outcome Measurement ◽  
Care Providers ◽  
Patient Centered ◽  
Screening Process ◽  
Evidenced Based ◽  
Changing Economy

In a changing economy and a changing industry, health care providers need to complete thorough, comprehensive, and efficient assessments that provide both an accurate depiction of the patient's deficits and a blueprint to the path of treatment for older adults. Through standardized testing and observations as well as the goals and evidenced-based treatment plans we have devised, health care providers can maximize outcomes and the functional levels of patients. In this article, we review an interdisciplinary assessment that involves speech-language pathology, occupational therapy, physical therapy, and respiratory therapy to work with older adults in health care settings. Using the approach, we will examine the benefits of collaboration between disciplines, an interdisciplinary screening process, and the importance of sharing information from comprehensive discipline-specific evaluations. We also will discuss the importance of having an understanding of the varied scopes of practice, the utilization of outcome measurement tools, and a patient-centered assessment approach to care.

The Interaction of Pulmonary Physiology and Swallowing: A Juggling Act for the Physician and Speech-Language Pathologist

2009 ◽  
Vol 18 (1) ◽  
pp. 34-40
Author(s):  
Karen J. Dikeman ◽  
Marta S. Kazandjian ◽  
Elbert Tun ◽  
Panina Niyazova ◽  
Tien-Tsai Tsai ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Medical Condition ◽  
Team Approach ◽  
Care Providers ◽  
Geriatric Population ◽  
Pulmonary Physiology ◽  
Speech Language Pathologist ◽  
Ventilator Dependence ◽  
Clinical Case Studies ◽  
Single Disease Entity

Abstract Patients who are dependent upon tracheostomy and/or ventilator use present a particular challenge to health-care providers. The interaction of pulmonary physiology and deglutition is complex, as illustrated in the course of patients who are in the weaning process. Speech language pathologists (SLPs) should work closely with their physician colleagues to understand the influence of multiple medical co-morbidities on intervention. In traditional medicine, the clinician's objective is to connect a patient's many symptoms and complaints to a single disease entity. However, in caring for the ventilator dependent geriatric population, a symptom such as dysphagia typically results from the interplay of various, multi-organ symptoms, and conditions. This article strives to demonstrate the “juggling act” that the physician and SLP must balance between the patient's current medical condition, pulmonary dysfunction, and disordered swallowing. Clinical case studies illustrate the benefit of swallowing intervention on quality of life. While the care of patients with tracheostomy and ventilator dependence requires a team approach, with respiratory therapy and nursing vital members, this article emphasizes the roles of the SLP and physician.

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