Suchman A L, Matthews D A
Department of Medicine, University of Rochester, New York.
Ann Intern Med. 1988 Jan;108(1):125-30. doi: 10.7326/0003-4819-108-1-125.
Physicians do not receive from the medical model the same explicit guidance in relating to their patients as in making diagnoses and prescribing pharmacologic and other treatments. To meet this need, we offer a framework for expanding the model. Therapeutic contact takes place within a connexional, or transpersonal, dimension of human experience, within which basic human needs for connection and meaning are met. Although seldom explicitly recognized, connexional experience is basic to medical care. Awareness of this dimension of experience leads clinicians to appreciate that establishing a therapeutic relationship is one of the principal goals of medical practice. It also reframes the doctor's task to make clinical uncertainty more tolerable and situations in which there is no appropriate biomedical response (such as care of the terminally ill) less frustrating and more fulfilling.
与进行诊断以及开出处方药和实施其他治疗相比，医生在与患者建立关系时，并未从医学模式中获得同样明确的指导。为满足这一需求，我们提供了一个扩展该模式的框架。治疗接触发生在人类体验的连接性或超个人维度内，在这个维度中，人类对连接和意义的基本需求得到满足。尽管连接性体验很少得到明确承认，但它是医疗护理的基础。意识到这一体验维度会使临床医生认识到，建立治疗关系是医疗实践的主要目标之一。它还重新界定了医生的任务，使临床不确定性更易于承受，使没有适当生物医学应对措施的情况（如对绝症患者的护理）不那么令人沮丧，而更有成就感。
