Wilhelmsen I, Bødtker J
Medisinsk avdeling Diakonissehjemmets Sykehus Haraldsplass, Bergen.
Tidsskr Nor Laegeforen. 1996 Mar 10;116(7):861-4.
In this article we present a model for the interaction between physical, psychological and social factors in the production of subjective somatic complaints, which is the most common reason for visiting a doctor. Especially if the patient has subjective somatic symptoms for which there is no apparent organic reason it may be important to motivate the patient to examine all the different factors that contribute to the vicious circle he/she often enters into. The following elements of this circle are explained: Physical (symptoms, signs, findings), beliefs (thoughts, cognitive processes and cognitive schemas), feelings (emotions), behaviour (all we say and do) and the so-called X-factor, which represents everything we do not know. The model might help us in our relationship to the patients, and can be used both in connection with known somatic disease and with conditions with a multifactorial genesis, like somatoform disorders.
在本文中,我们提出了一个关于身体、心理和社会因素在产生主观躯体不适方面相互作用的模型,主观躯体不适是就医的最常见原因。特别是当患者有主观躯体症状但没有明显的器质性原因时,促使患者审视导致其常常陷入的恶性循环的所有不同因素可能很重要。下面对这个循环的要素进行解释:身体(症状、体征、检查结果)、信念(想法、认知过程和认知模式)、感受(情绪)、行为(我们所说和所做的一切)以及所谓的X因素,它代表我们未知的一切。该模型可能有助于我们与患者相处,并且可用于已知的躯体疾病以及具有多因素成因的病症,如躯体形式障碍。