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Author: Laure Suing
Publisher:
ISBN:
Category :
Languages : fr
Pages : 0
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Contexte : Le premier épisode psychotique est l'un des modes d'entrée dans la schizophrénie. Une prise en charge médicale précoce de la maladie semble indispensable au vu des constats épidémiologiques concernant les patients schizophrènes. Il existe en effet une espérance de vie diminuée et une prévalence de comorbidités somatiques importante dans cette population. Dans notre étude, l'objectif était de décrire certains éléments du parcours de soins des patients (hospitalier ou ambulatoire) en regard des recommandations somatiques et de mettre en évidence les défauts de prise en charge. Materiel et méthode : Nous avons mené une étude en deux parties. Dans un premier temps, nous avons réalisé une synthèse des recommandations existantes sur la prise en charge somatique du premier épisode psychotique. Dans un second temps, nous avons réalisé un travail observationnel. Il s'agissait d'analyser des dossiers médicaux de patients ayant été hospitalisés pour un premier épisode psychotique. Une grille d'adéquation aux recommandations a été complétée pour chaque patient. Résultats : Trente et un dossiers médicaux ont été analysés. Le parcours de soins a été décrit en plusieurs parties : bilan somatique initial en hospitalisation et suivi somatique (hospitalier et/ou ambulatoire). Le bilan somatique initial était présent dans 100% des dossiers analysés. Les données de l'interrogatoire y étaient variables. La pratique d'un examen clinique a été notifiée dans 97% des cas. Le bilan initial était complété par des examens paracliniques : biologie incluant un bilan métabolique (90%), imagerie cérébrale (74%) et électrocardiogramme (87%). Concernant le suivi somatique, la prise en charge des comorbidités addictives a été abordée chez 20% des consommateurs. Le courrier de sortie somatique a été retrouvé dans 77% des cas. Concernant le suivi métabolique au Centre Médico-Psychologique, nous avons observé un suivi de poids et d'Indice de Masse Corporelle dans 8% des dossiers. Nous n'y avons retrouvé aucune information sur le suivi biologique métabolique ou le suivi des comorbidités. Conclusion : Il semble que l'adéquation aux recommandations de prise en charge somatique dans le premier épisode psychotique est faible. Les constats les plus parlants concernent le suivi des comorbidités et le suivi métabolique en ambulatoire. Une optimisation de la prise en charge de ces patients parait indispensable afin de prévenir au mieux l'évolution de la maladie et les complications qui y sont associées. Les solutions pourraient notamment passer par une meilleure organisation des soins.
Author: Laure Suing
Publisher:
ISBN:
Category :
Languages : fr
Pages : 0
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Book Description
Contexte : Le premier épisode psychotique est l'un des modes d'entrée dans la schizophrénie. Une prise en charge médicale précoce de la maladie semble indispensable au vu des constats épidémiologiques concernant les patients schizophrènes. Il existe en effet une espérance de vie diminuée et une prévalence de comorbidités somatiques importante dans cette population. Dans notre étude, l'objectif était de décrire certains éléments du parcours de soins des patients (hospitalier ou ambulatoire) en regard des recommandations somatiques et de mettre en évidence les défauts de prise en charge. Materiel et méthode : Nous avons mené une étude en deux parties. Dans un premier temps, nous avons réalisé une synthèse des recommandations existantes sur la prise en charge somatique du premier épisode psychotique. Dans un second temps, nous avons réalisé un travail observationnel. Il s'agissait d'analyser des dossiers médicaux de patients ayant été hospitalisés pour un premier épisode psychotique. Une grille d'adéquation aux recommandations a été complétée pour chaque patient. Résultats : Trente et un dossiers médicaux ont été analysés. Le parcours de soins a été décrit en plusieurs parties : bilan somatique initial en hospitalisation et suivi somatique (hospitalier et/ou ambulatoire). Le bilan somatique initial était présent dans 100% des dossiers analysés. Les données de l'interrogatoire y étaient variables. La pratique d'un examen clinique a été notifiée dans 97% des cas. Le bilan initial était complété par des examens paracliniques : biologie incluant un bilan métabolique (90%), imagerie cérébrale (74%) et électrocardiogramme (87%). Concernant le suivi somatique, la prise en charge des comorbidités addictives a été abordée chez 20% des consommateurs. Le courrier de sortie somatique a été retrouvé dans 77% des cas. Concernant le suivi métabolique au Centre Médico-Psychologique, nous avons observé un suivi de poids et d'Indice de Masse Corporelle dans 8% des dossiers. Nous n'y avons retrouvé aucune information sur le suivi biologique métabolique ou le suivi des comorbidités. Conclusion : Il semble que l'adéquation aux recommandations de prise en charge somatique dans le premier épisode psychotique est faible. Les constats les plus parlants concernent le suivi des comorbidités et le suivi métabolique en ambulatoire. Une optimisation de la prise en charge de ces patients parait indispensable afin de prévenir au mieux l'évolution de la maladie et les complications qui y sont associées. Les solutions pourraient notamment passer par une meilleure organisation des soins.
Author: Harvey Max Chochinov
Publisher:
ISBN: 0195301072
Category : Family & Relationships
Languages : en
Pages : 591
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Book Description
Psychiatric, or psychosocial, palliative care has transformed palliative medicine. Palliation that neglects psychosocial dimensions of patient and family experience fails to meet contemporary standards of comprehensive palliative care. While a focus on somatic issues has sometimes overshadowed attention to psychological, existential, and spiritual end-of-life challenges, the past decade has seen an all encompassing, multi-disciplinary approach to care for the dying take hold. Written by internationally known psychiatry and palliative care experts, the Handbook of Psychiatry in Palliative Medicine is an essential reference for all providers of palliative care, including psychiatrists, psychologists, mental health counselors, oncologists, hospice workers, and social workers.
Author: Laurence J. Kirmayer
Publisher: Springer Science & Business Media
ISBN: 1461476151
Category : Psychology
Languages : en
Pages : 365
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Book Description
Based on a recently completed project of cultural consultation in Montreal, Cultural Consultation presents a model of multicultural and applicable health care. This model used clinicians and consultants to provide in-depth assessment, treatment planning, and limited interventions in consultation with frontline primary care and mental health practitioners working with immigrants, refugees, and members of indigenous and ethnocultural communities. Evaluation of the service has demonstrated that focused interventions by consultants familiar with patients’ cultural backgrounds could improve the relationship between the patient and the primary clinician. This volume presents models for intercultural work in psychiatry and psychology in primary care, general hospital and specialty mental health settings. The editors highlight crucial topics such as: - Discussing the social context of intercultural mental health care, conceptual models of the role of culture in psychopathology and healing, and the development of a cultural consultation service and a specialized cultural psychiatric service - Examining the process of intercultural work more closely with particular emphasis oto strategies of consultation, the identity of the clinician, the ways in which gender and culture position the clinician, and interaction of the consultant with family systems and larger institutions - Highlighting special situations that may place specific demands on the clinician: working with refugees and survivors of torture or political violence, with separated families, and with patients with psychotic episodes This book is of valuable use to mental health practitioners who are working in multidisciplinary settings who seek to understand cultural difference in complex cases. Psychiatrists, psychologists, social workers, nurse practitioners, primary care providers and trainees in these disciplines will make thorough use of the material covered in this text.
Author:
Publisher:
ISBN:
Category : Psychiatry
Languages : en
Pages : 558
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Author: Robert Greifinger
Publisher: Springer Science & Business Media
ISBN: 0387716955
Category : Medical
Languages : en
Pages : 588
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Book Description
Public Health Behind Bars From Prisons to Communities examines the burden of illness in the growing prison population, and analyzes the impact on public health as prisoners are released. This book makes a timely case for correctional health care that is humane for those incarcerated and beneficial to the communities they reenter.
Author: Michel Foucault
Publisher: Macmillan
ISBN: 9780312203313
Category : Medical
Languages : en
Pages : 420
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Book Description
In Psychiatric Power, the fourth volume in the collection of his groundbreaking lectures at the Collège de France, Michel Foucault addresses and expands upon the ideas in his seminal Madness and Civilization, sketching the genealogy of psychiatry and of its characteristic form of power/knowledge. Madness and Civilization undertook the archeology of the division according to which, in Western Society, the madman found himself separated from the sane. That book ends with the medicalization of madness at the beginning of the nineteenth century. Psychiatric Power continues this discourse up to the end of the nineteenth century, and the double "depsychiatrization" of madness, now dispersed between the neurologist and the psychoanalyst. Presented in a conversational tone, Psychiatric Power brings fresh access and light to the work of one of the past century's preeminent thinkers.
Author: Avedis Donabedian
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 680
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Author: Andrea Maloney Schara
Publisher:
ISBN: 9780615928791
Category : Families
Languages : en
Pages : 318
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Book Description
"Your Mindful Compass" takes us behind the emotional curtain to see the mechanisms regulating individuals in social systems. There is great comfort and wisdom in knowing we can increase our awareness to manage the swift and ancient mechanisms of social control. We can gain greater flexibility by seeing how social controls work in systems from ants to humans. To be less controlled by others, we learn how emotional systems influence our relationship-oriented brain. People want to know what goes on in families that give rise to amazing leaders and/or terrorists. For the first time in history we can understand the systems in which we live. The social sciences have been accumulating knowledge since the early fifties as to how we are regulated by others. S. Milgram, S. Ashe, P. Zimbardo and J. Calhoun, detail the vulnerability to being duped and deceived and the difficulty of cooperating when values differ. Murray Bowen, M.D., the first researcher to observe several live-in families, for up to three years, at the National Institute of Mental Health. Describing how family members overly influence one another and distribute stress unevenly, Bowen described both how symptoms and family leaders emerge in highly stressed families. Our brain is not organized to automatically perceive that each family has an emotional system, fine-tuned by evolution and "valuing" its survival as a whole, as much as the survival of any individual. It is easier to see this emotional system function in ants or mice but not in humans. The emotional system is organized to snooker us humans: encouraging us to take sides, run away from others, to pressure others, to get sick, to blame others, and to have great difficulty in seeing our part in problems. It is hard to see that we become anxious, stressed out and even that we are difficult to deal with. But "thinking systems" can open the doors of perception, allowing us to experience the world in a different way. This book offers both coaching ideas and stories from leaders as to strategies to break out from social control by de-triangling, using paradoxes, reversals and other types of interruptions of highly linked emotional processes. Time is needed to think clearly about the automatic nature of the two against one triangle. Time and experience is required as we learn strategies to put two people together and get self outside the control of the system. In addition, it takes time to clarify and define one's principles, to know what "I" will or will not do and to be able to take a stand with others with whom we are very involved. The good news is that systems' thinking is possible for anyone. It is always possible for an individual to understand feelings and to integrate them with their more rational brains. In so doing, an individual increases his or her ability to communicate despite misunderstandings or even rejection from important others. The effort involved in creating your Mindful Compass enables us to perceive the relationship system without experiencing it's threats. The four points on the Mindful Compass are: 1) Action for Self, 2) Resistance to Forward Progress, 3) Knowledge of Social Systems and the 4) The Ability to Stand Alone. Each gives us a view of the process one enters when making an effort to define a self and build an emotional backbone. It is not easy to find our way through the social jungle. The ability to know emotional systems well enough to take a position for self and to become more differentiated is part of the natural way humans cope with pressure. Now people can use available knowledge to build an emotional backbone, by thoughtfully altering their part in the relationship system. No one knows how far one can go by making an effort to be more of a self-defined individual in relationships to others. Through increasing emotional maturity, we can find greater individual freedom at the same time that we increase our ability to cooperate and to be close to others.
Author: Giovanna Borradori
Publisher: University of Chicago Press
ISBN: 0226066657
Category : History
Languages : en
Pages : 225
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Book Description
The idea for Philosophy in a Time of Terror was born hours after the attacks on 9/11 and was realized just weeks later when Giovanna Borradori sat down with Jürgen Habermas and Jacques Derrida in New York City, in separate interviews, to evaluate the significance of the most destructive terrorist act ever perpetrated. This book marks an unprecedented encounter between two of the most influential thinkers of our age as here, for the first time, Habermas and Derrida overcome their mutual antagonism and agree to appear side by side. As the two philosophers disassemble and reassemble what we think we know about terrorism, they break from the familiar social and political rhetoric increasingly polarized between good and evil. In this process, we watch two of the greatest intellects of the century at work.
Author: Manal Guirguis-Younger
Publisher: University of Ottawa Press
ISBN: 0776621483
Category : Medical
Languages : en
Pages : 331
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Book Description
"Brings together leading and emerging researchers to advance understanding of the complex relationships between homelessness and health. Covering a wide range of topics from youth homelessness to end-of-life care, contributors outline policy and practice recommendations to respond to this public health crisis."--Back cover.
