Management of Somatic Symptoms

2018 ◽  
Author(s):  
Andreas Schröder ◽  
Joel E Dimsdale
Keyword(s):  
Clinical Presentation ◽  
Health Anxiety ◽  
Management Strategies ◽  
Somatic Symptoms ◽  
Conversion Disorder ◽  
Effective Management ◽  
Patient Interaction ◽  
Step Care ◽  
Physician Patient

Somatic symptoms that cannot be attributed to organic disease account for 15 to 20% of primary care consultations and up to 50% in specialized settings. About 6% of the general population has chronic somatic symptoms that affect functioning and quality of life. This chapter focuses on the recognition and effective management of patients with excessive and disabling somatic symptoms. The clinical presentation of somatic symptoms is categorized into three groups of patients: those with multiple somatic symptoms, those with health anxiety, and those with conversion disorder. The chapter provides information to assist with making a diagnosis and differential diagnosis. Management includes ways to improve the physician–patient interaction that will benefit the patient, a step-care model based on illness severity and complexity, and psychological and pharmacologic treatment. The chapter is enhanced by figures and tables that summarize health anxiety, symptoms, differential diagnoses, and management strategies, as well as by case studies and examples. This review contains  5 highly rendered figures, 10 tables, and 235 references.

Management of Somatic Symptoms

2014 ◽  
Author(s):  
Andreas Schröder ◽  
Joel E Dimsdale
Keyword(s):  
Clinical Presentation ◽  
Health Anxiety ◽  
Management Strategies ◽  
Somatic Symptoms ◽  
Conversion Disorder ◽  
Effective Management ◽  
Patient Interaction ◽  
Step Care ◽  
Physician Patient

Somatic symptoms that cannot be attributed to organic disease account for 15 to 20% of primary care consultations and up to 50% in specialized settings. About 6% of the general population has chronic somatic symptoms that affect functioning and quality of life. This chapter focuses on the recognition and effective management of patients with excessive and disabling somatic symptoms. The clinical presentation of somatic symptoms is categorized into three groups of patients: those with multiple somatic symptoms, those with health anxiety, and those with conversion disorder. The chapter provides information to assist with making a diagnosis and differential diagnosis. Management includes ways to improve the physician–patient interaction that will benefit the patient, a step-care model based on illness severity and complexity, and psychological and pharmacologic treatment. The chapter is enhanced by figures and tables that summarize health anxiety, symptoms, differential diagnoses, and management strategies, as well as by case studies and examples. This review contains  5 highly rendered figures, 10 tables, and 235 references.

Management of Somatic Symptoms

2017 ◽  
Author(s):  
Andreas Schröder ◽  
Joel E Dimsdale
Keyword(s):  
Clinical Presentation ◽  
Health Anxiety ◽  
Management Strategies ◽  
Somatic Symptoms ◽  
Conversion Disorder ◽  
Effective Management ◽  
Patient Interaction ◽  
Step Care ◽  
Physician Patient

Somatic symptoms that cannot be attributed to organic disease account for 15 to 20% of primary care consultations and up to 50% in specialized settings. About 6% of the general population has chronic somatic symptoms that affect functioning and quality of life. This chapter focuses on the recognition and effective management of patients with excessive and disabling somatic symptoms. The clinical presentation of somatic symptoms is categorized into three groups of patients: those with multiple somatic symptoms, those with health anxiety, and those with conversion disorder. The chapter provides information to assist with making a diagnosis and differential diagnosis. Management includes ways to improve the physician–patient interaction that will benefit the patient, a step-care model based on illness severity and complexity, and psychological and pharmacologic treatment. The chapter is enhanced by figures and tables that summarize health anxiety, symptoms, differential diagnoses, and management strategies, as well as by case studies and examples. This review contains  5 highly rendered figures, 10 tables, and 235 references.

Construct Validity and Reliability of the Questionnaire on the Quality of Physician–Patient Interaction in Adults With Hypertension

2017 ◽  
Vol 25 (1) ◽  
pp. 17E-30E
Author(s):  
Ronald L. Hickman ◽  
John M. Clochesy ◽  
Breanna Hetland ◽  
Marym Alaamri
Keyword(s):  
Construct Validity ◽  
Community Dwelling ◽  
Self Management ◽  
Validity And Reliability ◽  
Reliable Measure ◽  
Convenience Sample ◽  
Patient Interaction ◽  
Test Retest Reliability ◽  
Physician Patient

Background and Purpose: There are limited reliable and valid measures of the patient– provider interaction among adults with hypertension. Therefore, the purpose of this report is to describe the construct validity and reliability of the Questionnaire on the Quality of Physician–Patient Interaction (QQPPI), in community-dwelling adults with hypertension. Methods: A convenience sample of 109 participants with hypertension was recruited and administered the QQPPI at baseline and 8 weeks later. Results: The exploratory factor analysis established a 12-item, 2-factor structure for the QQPPI was valid in this sample. The modified QQPPI proved to have sufficient internal consistency and test– retest reliability. Conclusions: The modified QQPPI is a valid and reliable measure of the provider–patient interaction, a construct posited to impact self-management, in adults with hypertension.

166-EVALUATION OF A QUESTIONNAIRE TO ASSESS THE QUALITY OF PHYSICIAN-PATIENT INTERACTION

2004 ◽  
Vol 56 (6) ◽  
pp. 655-656
Author(s):  
KG Müller ◽  
C Bieber ◽  
K Blumenstiel ◽  
A Richter ◽  
D Eisenbeiß ◽  
...  
Keyword(s):  
Patient Interaction ◽  
Physician Patient

scholarly journals VA Video Telehealth and Training Programs During the COVID-19 Response

2021 ◽  
Author(s):  
Rhonda Johnston ◽  
Rita F. Kobb ◽  
Claire Marty ◽  
Padraic McVeigh
Keyword(s):  
Online Survey ◽  
Surgical Care ◽  
Office Visits ◽  
Face To Face ◽  
Patient Interaction ◽  
Telemedicine Consultation ◽  
Physician Patient ◽  
And Training

Study Design: An online survey modeled after the TeleENT Satisfaction Questionnaire and the Medical Communication Competence Scale (MCCS) were administered to gauge patient experience with electronic medical record-based telemedicine visits. Results: Participants noted several advantages of telemedicine visits over traditional in-office visits: shorter visits, saving money, and avoiding potential exposure during the pandemic. Thirty-six percent of the patients agreed that the quality of care was hindered by the lack of a physical exam, and 61.7% of the patients agreed that they prefer a face-to-face visit rather than telemedicine consultation. Most patients were satisfied with the care they received via telemedicine (Likert 6.19/7), and 95.8% of the patients would use telemedicine again. Participants self-reported an average saving of $108.70 when using telemedicine. When comparing the telemedicine cohort to the in-office control, the telemedicine patients noted an improved ability to communicate with their physician in 5 out of 8 domains of the MCCS. Conclusion: Surgical preoperative consultation, postoperative follow-up, and routine visits were conducted via telemedicine during the COVID-19 pandemic, representing a new direction for surgical appointments and consultations. This study shows that telehealth provides satisfactory care and increases access to surgical care for patients when external factors prevent the traditional physician–patient interaction. With better-perceived communication via telemedicine appointments, patients may subjectively feel that they can express their symptoms and gather information from the doctor regarding their diagnosis more efficiently.

Quality of Physician–Patient Interaction

2010 ◽  
Author(s):  
Christiane Bieber ◽  
Knut G. Müller ◽  
Jennifer Nicolai ◽  
Mechthild Hartmann ◽  
Wolfgang Eich
Keyword(s):  
Patient Interaction ◽  
Physician Patient

Physician–patient interaction and medication adherence in lupus nephritis

Lupus ◽  
2020 ◽  
Vol 29 (10) ◽  
pp. 1168-1178
Author(s):  
Sofia Georgopoulou ◽  
Louise Nel ◽  
Shirish R Sangle ◽  
David P D’Cruz
Keyword(s):  
Decision Making ◽  
Medication Adherence ◽  
Lupus Nephritis ◽  
Shared Decision Making ◽  
Interpersonal Trust ◽  
Shared Decision ◽  
Patient Interaction ◽  
Physician Patient ◽  
The Relationship

Objective The quality of physician–patient interaction can have a significant impact on medication adherence. Little is known about this relationship in patients with lupus nephritis. Methods A cross-sectional, quantitative study. Data collected included demographics, current medication, systemic lupus erythematosus disease activity index, medication adherence, beliefs about medicines, shared decision-making, patient–doctor depth of relationship, patient–doctor quality of relationship, interpersonal trust in a physician and illness perceptions. Results Ninety-eight patients with lupus nephritis completed the questionnaires. Logistic regression indicated that medication adherence was significantly predicted by (a) interpersonal trust in a physician (B = 0.85, Wald 3.94, 95% confidence interval (CI) 1.01, 5.44; P = 0.05); (b) timeline cyclical (B = –0.89, Wald 4.95, 95% CI 0.19, 0.90; P < 0.05) and beliefs about the necessity of medicines (B = 0.75, Wald 4.14, 95% CI 1.03, 4.38; P < 0.05). Mediation analysis showed that beliefs about the necessity of medicines significantly mediated the relationship between trust and medication adherence when adjusted for age (B = 0.48, 95% CI 0.06, 1.08; P < 0.01). A further mediation analysis showed that patient–doctor depth of relationship (B = 0.05, 95% CI 0.01, 0.09; P < 0.001), shared decision-making (B = 0.07, 95% CI 0.01, 0.13; P < 0.001) and patient–doctor quality of relationship (B = 0.08, 95% CI 0.01, 0.16; P < 0.001) significantly mediated the relationship between illness coherence and interpersonal trust in a physician. Conclusion The findings highlighted two key elements: (a) the importance of trust in relation to medication adherence; and (b) a good understanding of patients’ illness is linked to a better relationship with their doctor and greater participation in shared decision-making which is associated with increased trust. Tailored psycho-educational interventions could contribute to improving the patient–doctor relationship quality, trust and increased shared decision-making, which, in turn, might improve medication adherence in patients with lupus nephritis.

Somatic Symptoms Mediate the Relationship Between Health Anxiety and Health-Related Quality of Life over Eight Weeks

2016 ◽  
Vol 33 (3) ◽  
pp. 244-252 ◽  
Author(s):  
Karly M. Murphy ◽  
Adam P. McGuire ◽  
Thane M. Erickson ◽  
Amy H. Mezulis
Keyword(s):  
Quality Of Life ◽  
Health Anxiety ◽  
Somatic Symptoms ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Relationship

scholarly journals Updates and Knowledge Gaps in Cholesteatoma Research

2015 ◽  
Vol 2015 ◽  
pp. 1-17 ◽  
Author(s):  
Chin-Lung Kuo ◽  
An-Suey Shiao ◽  
Matthew Yung ◽  
Masafumi Sakagami ◽  
Holger Sudhoff ◽  
...  
Keyword(s):  
Middle Ear ◽  
Management Strategy ◽  
Clinical Presentation ◽  
Management Strategies ◽  
Effective Management ◽  
Comprehensive Understanding ◽  
Middle Ear Cholesteatoma ◽  
Acquired Cholesteatoma ◽  
Intracranial Complications ◽  
Extracranial Complications

The existence of acquired cholesteatoma has been recognized for more than three centuries; however, the nature of the disorder has yet to be determined. Without timely detection and intervention, cholesteatomas can become dangerously large and invade intratemporal structures, resulting in numerous intra- and extracranial complications. Due to its aggressive growth, invasive nature, and the potentially fatal consequences of intracranial complications, acquired cholesteatoma remains a cause of morbidity and death for those who lack access to advanced medical care. Currently, no viable nonsurgical therapies are available. Developing an effective management strategy for this disorder will require a comprehensive understanding of past progress and recent advances. This paper presents a brief review of background issues related to acquired middle ear cholesteatoma and deals with practical considerations regarding the history and etymology of the disorder. We also consider issues related to the classification, epidemiology, histopathology, clinical presentation, and complications of acquired cholesteatoma and examine current diagnosis and management strategies in detail.

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