Hamiel Daniel, Moss Donald, Shvartzman Pesach
Bril's Tel-Aviv Mental Health Center, Clalit Health Services, Israel.
Harefuah. 2003 Mar;142(3):193-6, 238.
In the beginning of the 21st century, a need for a different medical approach arises among the medical systems in the world. This new attitude, beyond laboratory tests, imaging procedures, and pharmacological treatment, emphasizes the significance of the role of the patient, and transfers the control to the patient himself and his/her family. This is the biopsychosocial medical approach. In such a system the medical staff considers not only the traditional biological factors, but also the mental and environmental factors, when it plans the treatment course. The lack of consideration of the real medical and psychological needs of the patient can result in misuse of essential resources. It can also lead to the frustration of the patient and the medical personnel. Clinical psychophysiology is a treatment implementation of the biopsychosocial approach, and it is supposed to meet the biological and psychological needs of the patient. The biopsychosocial method integrates physiological treatments and behavior-cognitive care. The article describes in detail various processes of the clinical psychophysiology, according to the current professional literature. We conclude that the clinical psychophysiology might be useful in treating many problems in primary medicine, such as chronic pain, hypertension, sleep disturbances, and attention disorders. The primary care system is the optimal place to practice the biopsychosocial method, and the challenge is to develop the appropriate doctrines, which would enable the medical staff to help the patients in need. In the article we discuss in details five strategies which allow broader use of the instruments of the clinical psychophysiology: 1) Expansion of doctors education; 2) Allied health professionals involvement; 3) Integration of behavioral medical treatment in primary care; 4) Causing effective modification with minimal medical staff contiguity; 5) Referral for follow-up treatment. The clinical psychophysiology, in the framework of primary care, is a powerful integration of the biomedical and bio-social models.
在21世纪初，世界医疗体系中出现了对一种不同医疗方法的需求。这种新态度超越了实验室检查、成像程序和药物治疗，强调了患者角色的重要性，并将控制权交给患者本人及其家庭。这就是生物心理社会医学方法。在这样的体系中，医务人员在规划治疗过程时，不仅会考虑传统的生物学因素，还会考虑心理和环境因素。忽视患者实际的医疗和心理需求可能会导致基本资源的滥用。这也可能导致患者和医务人员的挫败感。临床心理生理学是生物心理社会方法的一种治疗实践，旨在满足患者的生物学和心理需求。生物心理社会方法整合了生理治疗和行为认知护理。本文根据当前专业文献详细描述了临床心理生理学的各种过程。我们得出结论，临床心理生理学可能有助于治疗初级医学中的许多问题，如慢性疼痛、高血压、睡眠障碍和注意力障碍。初级保健系统是实践生物心理社会方法的最佳场所，挑战在于制定适当的学说，使医务人员能够帮助有需要的患者。在本文中，我们详细讨论了五种策略，这些策略可以更广泛地使用临床心理生理学工具：1）扩大医生教育；2）联合健康专业人员的参与；3）将行为医学治疗整合到初级保健中；4）以最少的医务人员接触实现有效改变；5）转诊进行后续治疗。在初级保健框架内，临床心理生理学是生物医学和生物社会模式的有力整合。
