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1
Dealing with the difficult older patient.应对难缠的老年患者。
CMAJ. 1986 May 15;134(10):1122-6.
2
[Incidence and importance of "non-cognitive" symptoms in dementia of the Alzheimer type: productive psychotic symptoms, depressive disorders and behavioral disorders].[阿尔茨海默型痴呆中“非认知”症状的发生率及重要性：幻觉、抑郁障碍和行为障碍]
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3
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J Pers Assess. 1982 Aug;46(4):345-9. doi: 10.1207/s15327752jpa4604_3.
4
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5
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Prim Care. 2005 Sep;32(3):793-810. doi: 10.1016/j.pop.2005.06.010.
6
[Psychiatric disorders in Alzheimer's disease and organization of care].
Rev Med Suisse Romande. 1997 Sep;117(9):639-42.
7
Behavioural disturbances in dementia patients and quality of the marital relationship.痴呆症患者的行为障碍与婚姻关系质量
Int J Geriatr Psychiatry. 2003 Feb;18(2):149-54. doi: 10.1002/gps.807.
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Cognitive screening in the primary care setting. The role of physicians at the first point of entry.基层医疗环境中的认知筛查。医生在首诊环节的作用。
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Beliefs that foster physician avoidance of psychosocial aspects of health care.那些促使医生回避医疗保健中社会心理方面的观念。
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本文引用的文献

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Allocative medicine: efficiency, disease severity, and the payment mechanism.
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Family practice residents' perceptions of behavioral science training, relevance, and needs.家庭医学住院医师对行为科学培训、相关性及需求的看法。
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The objective tangent.目标切线。
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应对难缠的老年患者。

Dealing with the difficult older patient.

作者信息

Laurence M K

出版信息

CMAJ. 1986 May 15;134(10):1122-6.

PMID:3697858
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1491066/
Abstract

Physicians are often asked to intervene when elderly patients in acute or long-term care facilities are disruptive, demanding or abusive. Though medication may be the immediate response, it often fails to solve the problem, which, being situational and behavioural, calls for a situational and behavioural solution. An organized approach to solving such problems is presented that takes into account the interactions among the patient, family, staff, setting and circumstances. The role of the physician as leader in the process is also discussed.

摘要

当急性或长期护理机构中的老年患者出现扰乱秩序、提出过分要求或有辱骂行为时，医生常常会被要求进行干预。尽管药物治疗可能是直接的应对措施，但它往往无法解决问题，因为这个问题是情境性和行为性的，需要情境性和行为性的解决方案。本文提出了一种有组织的解决此类问题的方法，该方法考虑到了患者、家属、工作人员、环境和具体情况之间的相互作用。还讨论了医生在这一过程中作为领导者的角色。