Thinking differently in rheumatological psychosomatic conditions (changing the doctor's style of thinking)

The concept of a 'health care realm' is introduced. The healthcare realms considered were those patients who have only Physical Health Problems (PH), patients with neither physical nor mental health issues and who are seeking advice to remain healthy (HP), patients only with Mental Health...

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Main Author: M. E.Y. Capek
Format: Article
Language:Russian
Published: IMA-PRESS LLC 2021-04-01
Series:Современная ревматология
Subjects:
Online Access:https://mrj.ima-press.net/mrj/article/view/1116
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author M. E.Y. Capek
author_facet M. E.Y. Capek
author_sort M. E.Y. Capek
collection DOAJ
description The concept of a 'health care realm' is introduced. The healthcare realms considered were those patients who have only Physical Health Problems (PH), patients with neither physical nor mental health issues and who are seeking advice to remain healthy (HP), patients only with Mental Health Problems (MH), patients with both Physical Health and Mental Health Problems (PH&MH) and patients with Psychosomatic Health conditions (PS). Described is how patients' minds and bodies interact and its relevance to rheumatology practice. Presented is the culmination of 34 years of the author's experience of rheumatological disorders based in Family Medicine in a United Kingdom General Practice. Also presented are 2 small studies supplementing the main conclusions. The first small study counted the main consultation content of 246 patients, as considered by the principals in the practice. Of these 73.5% were for physical health conditions, 13.3% for health promotion, 11.5% for mental health conditions and 1.8% for psychosomatic conditions. The second small study was a survey of experienced GPs, Physicians and Psychiatrists, asking about their opinions on how well the patients in different health care realms were being managed across the healthcare system. Of the 5 realms, the collective view was that it was the patients in the PH realm who was clearly received the best care. The least good care was being given to patients in the PS realm and only marginally better were patients in the MH Realm. This paper argues that clinicians need a different thinking approach when meeting patients from different healthcare realms. It is known that when doctors treat PH patients, they consider the patient's symptoms against templates of knowledge for the conditions in the differential diagnosis. Furthermore, HP patients are assessed by comparing the patient's bio-measurements against known markers of good health When being consulted by patients in the MH or PS realms, it is advocated, not to follow the approach of PH patients. For patients in the MH realm it is best to address the patient's life as a whole and to consider, how did the person arrive to the situation he is in and what needs to be done to restore the patient's life back on track. For patients in the PS realm, ideally the aim is to help the patient make the link between the physical symptom and its psychological aetiology. A step towards this is to describe how the body physically mediates the symptom.
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spelling doaj.art-7bd0bfa6290e4addb25785ea204c7aca2023-03-13T08:39:28ZrusIMA-PRESS LLCСовременная ревматология1996-70122310-158X2021-04-0115271610.14412/1996-7012-2021-2-7-162337Thinking differently in rheumatological psychosomatic conditions (changing the doctor's style of thinking)M. E.Y. Capek0Greater Manchester Mental Health NHS Foundation Trust; Manchester Health & Care CommissioningThe concept of a 'health care realm' is introduced. The healthcare realms considered were those patients who have only Physical Health Problems (PH), patients with neither physical nor mental health issues and who are seeking advice to remain healthy (HP), patients only with Mental Health Problems (MH), patients with both Physical Health and Mental Health Problems (PH&MH) and patients with Psychosomatic Health conditions (PS). Described is how patients' minds and bodies interact and its relevance to rheumatology practice. Presented is the culmination of 34 years of the author's experience of rheumatological disorders based in Family Medicine in a United Kingdom General Practice. Also presented are 2 small studies supplementing the main conclusions. The first small study counted the main consultation content of 246 patients, as considered by the principals in the practice. Of these 73.5% were for physical health conditions, 13.3% for health promotion, 11.5% for mental health conditions and 1.8% for psychosomatic conditions. The second small study was a survey of experienced GPs, Physicians and Psychiatrists, asking about their opinions on how well the patients in different health care realms were being managed across the healthcare system. Of the 5 realms, the collective view was that it was the patients in the PH realm who was clearly received the best care. The least good care was being given to patients in the PS realm and only marginally better were patients in the MH Realm. This paper argues that clinicians need a different thinking approach when meeting patients from different healthcare realms. It is known that when doctors treat PH patients, they consider the patient's symptoms against templates of knowledge for the conditions in the differential diagnosis. Furthermore, HP patients are assessed by comparing the patient's bio-measurements against known markers of good health When being consulted by patients in the MH or PS realms, it is advocated, not to follow the approach of PH patients. For patients in the MH realm it is best to address the patient's life as a whole and to consider, how did the person arrive to the situation he is in and what needs to be done to restore the patient's life back on track. For patients in the PS realm, ideally the aim is to help the patient make the link between the physical symptom and its psychological aetiology. A step towards this is to describe how the body physically mediates the symptom.https://mrj.ima-press.net/mrj/article/view/1116майндфулнесс (управление вниманием, осознанность)симптомыпринятие клинических решенийзабота о здоровьеревматологияне объяснимые с медицинской точки зрения симптомыпсихическое здоровьесоматоформные расстройствафибромиалгия
spellingShingle M. E.Y. Capek
Thinking differently in rheumatological psychosomatic conditions (changing the doctor's style of thinking)
Современная ревматология
майндфулнесс (управление вниманием, осознанность)
симптомы
принятие клинических решений
забота о здоровье
ревматология
не объяснимые с медицинской точки зрения симптомы
психическое здоровье
соматоформные расстройства
фибромиалгия
title Thinking differently in rheumatological psychosomatic conditions (changing the doctor's style of thinking)
title_full Thinking differently in rheumatological psychosomatic conditions (changing the doctor's style of thinking)
title_fullStr Thinking differently in rheumatological psychosomatic conditions (changing the doctor's style of thinking)
title_full_unstemmed Thinking differently in rheumatological psychosomatic conditions (changing the doctor's style of thinking)
title_short Thinking differently in rheumatological psychosomatic conditions (changing the doctor's style of thinking)
title_sort thinking differently in rheumatological psychosomatic conditions changing the doctor s style of thinking
topic майндфулнесс (управление вниманием, осознанность)
симптомы
принятие клинических решений
забота о здоровье
ревматология
не объяснимые с медицинской точки зрения симптомы
психическое здоровье
соматоформные расстройства
фибромиалгия
url https://mrj.ima-press.net/mrj/article/view/1116
work_keys_str_mv AT meycapek thinkingdifferentlyinrheumatologicalpsychosomaticconditionschangingthedoctorsstyleofthinking