Talbott J A, Linn L
Psychiatr Q. 1978 Fall;50(3):218-27. doi: 10.1007/BF01064712.
This contribution reports a study of chronic schizophrenics hospitalized in state hospitals who suffer from serious and life-threatening medical and surgical illnesses. Four primary findings are described and discussed: lack of verbalization of pain and discomfort; bodily self-mutilation; toleration and exhibition of loathsome lesions; and inability or unwillingness to tolerate medical care. Some examples of exceptions to these four findings are also presented. Possible explanations for the findings are discussed in terms of their biological, social, and psychological components, recognizing that no single factor can explain the findings in this complex and varied population. It is concluded that treatment staffs in the hospital or community must be alert to changes in patient state, must utilize compromise methods of care and must anticipate or deduce a patient's needs while the patient is physically ill.
本论文报告了一项针对在州立医院住院的慢性精神分裂症患者的研究,这些患者患有严重且危及生命的内科和外科疾病。文中描述并讨论了四项主要发现:疼痛和不适的表达缺失;身体自残行为;对令人厌恶的损伤的耐受和展示;以及无法或不愿接受医疗护理。文中还列举了这些发现的一些例外情况。针对这些发现,从生物学、社会和心理因素方面进行了可能的解释探讨,认识到在这个复杂多样的群体中,没有单一因素能够解释所有这些发现。得出的结论是,医院或社区的医护人员必须留意患者状态的变化,必须采用折中的护理方法,并且在患者身患躯体疾病时必须预见或推断出患者的需求。