Ferrari R
Baillieres Best Pract Res Clin Rheumatol. 2000 Dec;14(4):787-95. doi: 10.1053/berh.2000.0113.
Rheumatologists grapple in daily practice with many controversial syndromes including fibromyalgia, late whiplash syndrome, chronic fatigue syndrome, Gulf War syndrome, the adverse outcomes of silicon breast implants and so on. For decades, much of the debate surrounding, and the approach to these controversial syndromes has centred on a model creating two camps-organic versus non-organic. While each camp has its support, this model seems to have failed in achieving the desired understanding of these syndromes, most particularly in offering the rheumatologist a practical and coherent approach to effective treatment. This chapter will thus introduce the biopsychosocial model, its elements, its advantages over the traditional model and the practical application of this model. Examples will be given of how rheumatologists can approach the treatment of these syndromes through patient education and the implementation of a change in illness behaviour.
在日常临床实践中,风湿病学家面临着许多有争议的综合征,包括纤维肌痛、迟发性挥鞭样综合征、慢性疲劳综合征、海湾战争综合征、硅胶乳房植入物的不良后果等等。几十年来,围绕这些有争议综合征的许多争论以及应对方法都集中在一种形成两个阵营的模式上——器质性与非器质性。虽然每个阵营都有其支持者,但这种模式似乎未能实现对这些综合征的理想理解,尤其是未能为风湿病学家提供一种实用且连贯的有效治疗方法。因此,本章将介绍生物心理社会模式、其要素、相对于传统模式的优势以及该模式的实际应用。将举例说明风湿病学家如何通过患者教育和改变疾病行为来治疗这些综合征。