List B Flashcards
Somatization
5-10% of patients, real symptoms but not evidence on test results. Doctor needs to follow up for legal protection in case there is an underlying issue.
Vicious circle
Predisposing factors, triggering factors, maintaining factors, symptoms.
Can aggregate functional complaints (increase anxiety)
Reframing
Place complaint in psychosocial context, ask about personal life and triggering factors
Reattribution
Explain to patient how psychosocial factors may create physical symptoms
PLISSIT model
• Permission to ask personal questions
• Limited Information
• Specific Suggestions
• Intensive therapy
Anger management techniques (muns)
• Maintain Adequate distance
• Use calm tone of voice
• Stay polite
• Normalize
Depression
Persistent mood or illness, and not being sad or in a bad mood
Two question screening
During the past month, have you often been bothered about…
• Feeling down, depressed
• having little interest or pleasure
Beck’s triad
• Negative view about oneself
• Negative view about the world
• Negative view about the future
PHQ-9
Patient Health questionnaire
(Assess degree of depression)
FRAMES Model (Addicts)
• Feedback
• Responsibility
• Advice
• Menu
• Empathy
• Self efficacy
Breaking Bad news
Significant negative impact on how the patient or relatives envision their future
SPIKES
• Setting up
• Patient perception
• Invitation to bad news
• Knowledge
• Emotions
• Summary
Non-disclosure model
Does not share diagnosis with patient, shares with chosen person
Full disclosure model
Patient gets all information