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人文主义与精神病:与患有精神疾病且可能存在医学合并症的患者合作。

Humanism and Psychosis: Working With Patients Who Have Potential Medical Comorbidities Along With Mental Illness.

作者信息

Singh Mona, Agustines Davin

机构信息

Osteopathic Medicine, Western University of Health Sciences, Pomona, USA.

Psychiatry, Olive View University of California Los Angeles Medical Center, Los Angeles, USA.

出版信息

Cureus. 2024 Aug 14;16(8):e66903. doi: 10.7759/cureus.66903. eCollection 2024 Aug.

Abstract

Marginalized groups, such as Black participants experiencing homelessness and diagnosed with schizophrenia, often face significant barriers to care. Improvements in treatment can be achieved by incorporating patient views, addressing stigmas, avoiding medical jargon, respecting patient preferences, and demonstrating transparency and positive affect. We discuss one example in our case report where a newly unhoused woman with schizophrenia, highlighting the impact of medical mistrust, discrimination, and ineffective communication in mental health care. We retrospectively used the Brief Psychiatric Rating Scale (BPRS) score to assess the severity of the patient's psychiatric condition after her workup. The severity of the BPRS scale is graded as mild (31-40 total score), moderate (41-52 total score), and severe (above 52 total score). Using this scale and our case report, we aim to highlight the importance of emphasizing the rationale of the plan of care to patients, explaining their diagnoses, and reasoning of diagnostics without using medical jargon.

摘要

边缘化群体,如无家可归且被诊断患有精神分裂症的黑人参与者,在获得医疗护理方面往往面临重大障碍。通过纳入患者观点、消除污名、避免使用医学术语、尊重患者偏好以及展现透明度和积极态度,可以实现治疗的改善。我们在病例报告中讨论了一个例子,该例子涉及一名新无家可归的精神分裂症女性,突出了医疗不信任、歧视以及心理健康护理中无效沟通的影响。我们回顾性地使用简明精神病评定量表(BPRS)得分来评估患者检查后的精神疾病严重程度。BPRS量表的严重程度分为轻度(总分31 - 40)、中度(总分41 - 52)和重度(总分高于52)。通过使用该量表和我们的病例报告,我们旨在强调向患者强调护理计划的基本原理、解释他们的诊断以及诊断推理而不使用医学术语的重要性。

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