Professional Documents
Culture Documents
Planul cursului
Introducere
I.
early
undifferentiated stages
decision making
based on incidence Specific
and prevalence
acute and
chronic health
problems
promotes
health and
wellbeing
problem
Comprehensive
solving skills
approach
responsible for
health of the
community
Community
orientation
care coordination
and advocacy
Primary care
management
first contact,
open access,
all health problems
longitudinal
continuity
centred on
patient and
context
Person-centred
care
doctor-patient
relationship
physical, psychological, social, cultural
and existential
Holistic
approach
European Definition of
Family Medicine:
Core Competencies and
Characteristics
(Wonca 2005)
attitude
context
scienceholistic a paci
Abordarea
Holism, istorie
Holism
i atomism - Parmenides i
Democritus (sec 5 .e.n.)
Spinoza sec. XVII
Hegel
Karl Marx
Holismul i tiina
Antropologia
Ecologia
Economia
Filosofia
Sociologia
Teologia
Aplicarea holismului
Holismul
n architectur i dizainul
industrial
Reforme n educaie
Music holistic
Holismul n medicin
early
undifferentiated stages
decision making
based on incidence Specific
and prevalence
acute and
chronic health
problems
promotes
health and
wellbeing
problem
Comprehensive
solving skills
approach
responsible for
health of the
community
Community
orientation
care coordination
and advocacy
Primary care
management
first contact,
open access,
all health problems
longitudinal
continuity
centred on
patient and
context
Person-centred
care
doctor-patient
relationship
physical, psychological, social, cultural
and existential
Holistic
approach
European Definition of
Family Medicine:
Core Competencies and
Characteristics
(Wonca 2005)
attitude
context
scienceholistic a paci
Abordarea
grija
10
Abordare holistic
11
12
Modelul Bio-Psiho-Social n
practica medical
Majoritatea bolilor,
fie somatice sau
psihiatrice, sunt un
fenomen biologic,
psihologic i social.
SOCIAL
BILOGIC
PSIHOLOGIC
13
Modelul Bio-Psiho-Social n
practica medical
Parametrii
14
Modelul Bio-Psiho-Social n
practica medical
Medicii
15
Modelul Bio-Psiho-Social n
practica medical
Pentru a evalua i dirija aspectele
psihosociale ale problemelor pacienilor
adecvat medicii trebue s fie capabili s
estimeze i menin relaiile terapeutice
medic-pacient cu diferite tipuri de
pacieni.
16
De
17
Studiu de caz
Smbta diminea fiica l-a
adus pe tatl su de 75 de
ani la practica Dvs.
Cunoatei c locuete singur
acum de 3 luni, dup ce a
decedat soia sa.
El a abandonat vizitele
programate la clinic timp de
ultimele 6 luni. Astzi arat
mult mai ru dect ultima dat
cnd l-ai vzut. Este obosit.
A sczut n greutate fiindc
nu are poft de mncare. Este
murdar i miroase a alcool.
Abordarea holistic a paci
18
19
Formularea cazului
Parametrii biologici
Parametrii psihologici
Parametrii sociali
Formularea biopsihosocial
Managementul biopsihosocial
Intervenie bilogic
Intervenie psihologic
Intervenie social
Sumar
20
Modelul biopsihosocial n
practica medical
21
Decesul soului/soiei
Divorul
Separarea n cuplu
Condamnarea la nchisoare
Decesul membrului familiei apropiat
Accident sau boal personal
Cstorie
mpucat la serviciu
Reunirea cuplului
Pensionarea
...
Abordarea holistic a paci
22
A fi bolnav cronic
23
24
25
26
Particulariti bio-psiho-sociale n
relaia medic-pacient
27
Modificri comportamnetale
28
( dupa G. F.
Brenner)
DURERE
Imobolitate
Tensiune
muscular
STRES
DIZABILITATE
Pierderea
confortului
Pierderea
respectului
de sine
29
DEPRESIE
Abordarea holistic a paci
Caracteristici evolutive
Pentru
pacient, contientizarea
problemei, fr ns a avea o idee clar
a extinderii acesteia, este adesea
frustrant.
Pacienii au fric adesea c simptomele
pezentate de ei nu sunt luate n serios.
30
Reacii posibile:
oc
Aacceptare
Furie
Negare
Dezndejde
Treistee
31
boal
admitei incertitudinea
Aciuni
orientate pe problem
simptomalogic
nvaai pacientul s controleze ciclul bolii cronice
32
33
de activitate profesional,
casnic
Alegera activitii de recuperare
Sexualitate
Reacii emoionale
Relaii sociale
34
Compliana bolnavilor
Compliana bolnavilor cronici este n general
bun datorit bolilor de care sufer i temerilor
legate de posibilitatea decesului
Un element care justific o complian mai bun
la vrstnici este faptul c durerea reprezint
simptomul cel mai frecvent la aceti bolnavi
83% dintre persoanele peste 60 de ani prezint
dureri cel puin ntr-o singur zon
18% n cel puin 4 zone dureroase
35
Explicatiile non-compliantei
Probleme financiare
Negare sau insuficient informare asupra
severitii bolii
Credine culturale
Programe complexe de medicaie
Efecte adverse ale medicamentelor
Supraestimarea rezultatelor tratamentului
Discomfortul provocat de tratamentul de lung
durat
Abordarea holistic a paci
36
37
38
39
40
41
42
early
undifferentiated stages
decision making
based on incidence Specific
and prevalence
acute and
chronic health
problems
promotes
health and
wellbeing
problem
Comprehensive
solving skills
approach
responsible for
health of the
community
Community
orientation
care coordination
and advocacy
Primary care
management
first contact,
open access,
all health problems
longitudinal
continuity
centred on
patient and
context
Person-centred
care
Holistic
approach
doctor-patient
relationship
physical, psychological, social, cultural
and existential
European Definition of
Family Medicine:
Core Competencies and
Characteristics
(Wonca 2005)
attitude
context
scienceholistic a paci
Abordarea
43
ABORDAREA HOLISTIC.
CUM POATE FI IMPLEMENT
N PRACTIC?
44
Studiu de caz
Smbta diminea fiica l-a
adus pe tatl su de 75 de
ani la practica Dvs.
Cunoatei c locuete singur
acum de 3 luni, dup ce a
decedat soia sa.
El a abandonat vizitele
programate la clinic timp de
ultimele 6 luni. Astzi arat
mult mai ru dect ultima dat
cnd l-ai vzut. Este obosit.
A sczut n greutate fiindc
nu are poft de mncare. Este
murdar i miroase a alcool.
Abordarea holistic a paci
45
ABORDAREA HOLISTIC
Obiectivele
46
TRANSLAREA N PRACTIC
Care sunt
recomandrile
mele practice
i aciunele?
Cum tolerez
emoiile proprii?
47
Sfaturi
TEMELE DE STUDIU
Antropologie Medical
MBD
Deprinderi de
comunicare
48