Zukier Henri
The Hebrew University of Jerusalem, Jerusalem, Israel.
Rambam Maimonides Med J. 2017 Jul 1;8(3):e0034. doi: 10.5041/RMMJ.10310.
Medicine has evolved in two opposite directions. Evidence-based medicine focuses more on laboratory and computer data than on the patient. Yet experimental data also provide growing evidence for the importance of the patient's social-psychological "demand" side of medicine, to complement the doctor's bio-cognitive "supply" side. The patient's mindset has major diagnostic and therapeutic effects. The patient's experience is shaped by perceptions of four dimensions: meaning, agency, self-image, and temporal focus. The patient's perceptions are linked in part to the therapeutic context, through the interaction between doctor and patient. In that proximal setting, the dimensions can be reshaped, for better and worse. These dynamics point to the inherently interactional nature of medicine and to the significant role of medical social sciences in the therapeutic context.
医学朝着两个相反的方向发展。循证医学更关注实验室和计算机数据而非患者。然而，实验数据也越来越多地证明了患者医学中社会心理“需求”方面的重要性，以补充医生生物认知“供给”方面。患者的思维模式具有重大的诊断和治疗作用。患者的体验由意义、能动性、自我形象和时间焦点这四个维度的认知塑造。患者的认知部分通过医患互动与治疗环境相关联。在这种直接环境中，这些维度可能会向好或向坏的方向重塑。这些动态变化表明医学本质上具有互动性，以及医学社会科学在治疗环境中的重要作用。
