RESUMEN
This article conceptualizes a predictable set of tensions that medical students experience in their new roles with patients on clinical clerkships: empathy versus over-identification, objectivity versus avoidance, collaboration versus coercion, and self-confidence versus "special-ness." These tensions are framed in a developmental context for students and are used to highlight potential boundary difficulties. The role of supervision in teaching students and other beginning trainees about possible boundary issues is discussed.
Asunto(s)
Prácticas Clínicas , Relaciones Médico-Paciente , Psiquiatría/educación , Estudiantes de Medicina/psicología , Adulto , Curriculum , Mecanismos de Defensa , Empatía , Femenino , Humanos , Internado y Residencia , Masculino , Personalidad , Distancia PsicológicaRESUMEN
The novel antipsychotic medications clozapine and olanzapine provide well-documented clinical improvement for some patients with psychosis. We interviewed 15 patients with chronic psychosis who demonstrated significant improvement on these new medications and offer a conceptual framework to organize their narratives. In our conceptual model, our patients' descriptions are divided into three broad areas: sense of self, sense of connection, and sense of purpose. We also highlight the opportunities for psychotherapy with this population.
Asunto(s)
Antipsicóticos/farmacología , Clozapina/farmacología , Objetivos , Relaciones Interpersonales , Pirenzepina/análogos & derivados , Esquizofrenia/tratamiento farmacológico , Psicología del Esquizofrénico , Autoimagen , Adulto , Benzodiazepinas , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Psicológicos , Olanzapina , Pirenzepina/uso terapéuticoRESUMEN
Psychiatric consultation in general medical settings is a valuable corollary to the work of other health care professionals. In various contexts, such consultation can be debased, however, to the point that the psychiatrist is serving as a technician rather than as a consultant in relation to several aspects of the informed consent process. The authors identify five inappropriate models of psychiatric consultation and review the proper approach to obtaining true informed consent.
Asunto(s)
Testimonio de Experto/legislación & jurisprudencia , Consentimiento Informado/legislación & jurisprudencia , Relaciones Interprofesionales , Grupo de Atención al Paciente/legislación & jurisprudencia , Psiquiatría , Encefalopatías , Humanos , Teoría PsicoanalíticaRESUMEN
Men experiencing erectile dysfunction may appreciate attending a clinic where staff deal specifically with this problem. Several treatments are available for impotence, including hormone replacement, penile injections and vacuum therapy.