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Biomedical subjects

A Kleinman

Publications and source records attributed to A Kleinman.

At least 55 records · Page 3Linked to original sources
PubMed1981

The medical care abuser: differential diagnosis and management.

The differential diagnosis of patients who are abusive of or seem addicted to medical care is discussed using the approach outlined in the new Diagnostic and Statistical Manual III of the American Psychiatric Association. These are generally chronic disorders and their managements, using the substance abuse/addiction model, are aimed at protecting both patients and physicians from unnecessary, expensive, and potentially lethal medical interventions. The disorders considered include somatization disorder (Briquet's syndrome), psychogenic pain disorder (psychalgia), hypochondriasis, factitious disorder, and malingering.

Adult↗
PubMed1980

Psychiatric consultation-liaison service: patients, requests, and functions.

Prospective data were gathered from 388 psychiatric consultations performed in a general hospital setting. Data included demographic, medical, psychiatric, and illness behavior characteristics of the patients seen, as well as consultant functions and recommendations. Results indicate that consulted patients suffer from a wide variety of medical problems, are frequently taking psychoactive medications before the consultation, and experience a spectrum of psychosocial problems in coping with their disease. Primary physicians infrequently provided any psychiatric data or reasons for referral other than for depression. Consultants determined what they felt were the motivating reasons for referral and besides patient psychopathology found a significant amount of maladaptive illness behavior and staff/patient conflict. Comparison with other studies supports the high incidence of primary (21%) and secondary (18%) depression in this population and the active involvement in its treatment by consultation-liaison psychiatrists. Research, training, and clinical issues generated by the findings are discussed.

Adaptation, Psychological↗
PubMed1980

Ambulatory medical care in the People's Republic of China: an exploratory study.

One hundred thirty-eight persons in varying outpatient settings in the People's Republic of China were interviewed briefly. Hospital outpatient utilization appeared to reflect not only severity of illness, but also patients' attitudes and beliefs, illness behavior patterns, and convenience, modifying the formal system of care to some extent. Traditional clinics in commune and county hospitals were typically used to treat psychiatric disorders (defined as physical conditions), chronic illness, and other conditions for which Western medicine offers only symptomatic treatment.

Adult↗
PubMed1980

A biopsychosocial approach to surgical evaluation and outcome.

There is increasing necessity for including an evaluation of psychosocial as well as biomedical factors when assessing the need for surgical intervention and its possible outcomes. Potential problems between patient and surgeon can arise when these factors are not taken into account. Recent behavioral science literature supports the use of a conceptual framework and concise clinical method for evaluating psychosocial factors and negotiating treatment with a patient. Such a method may be useful in reducing patient-surgeon conflicts and the negative outcomes (such as patient noncompliance, dissatisfaction, medical-legal suits and poor patient care) that can result when such an assessment is not mutually discussed.

Adult↗
PubMed1980

An exploration of the dimensions of illness behavior.

Illness behavior is typically studied from the perspective of medical care practitioners. Problems for which people seek medical care are often deemed to be the universe of such ailments whereas actually they represent a small percentage of total illness experienced. This paper describes the rest of the iceberg of health problems. By using a health diary, all problems recorded by 107 participants over a three-week period were analyzed. A total of 348 problems (3.25 per person) were recorded with less than six percent of the problems receiving professional medical care. Stated differently, individuals were experiencing at least one health problem on approximately half of all study days. Health beliefs regarding selected problems were also obtained, along with non-orthodox practitioner (eg, chiropractors and naturopaths) utilization patterns.

Adolescent↗
PubMed1979

Some observations of mental illness and its treatment in the People's Republic of China.

A visit to the People's Republic of China provided impressions of the use of psychiatric concepts and the organization of mental health services. The Chinese report of low rates of mental illness appears to reflect narrow definitions of disorder and somatic expressions of personal and social distress which are viewed by health personnel as physical conditions. Acute mental health services are provided at commune and county hospitals, and special psychiatric hospitals are maintained for more intractable patients. Chronically disturbed patients may receive long term care in sanatoriums associated with large industries or may be maintained in home beds in their production brigades assisted by family and barefoot doctors. Psychiatric practice in teaching hospitals is similar to psychiatric practice in the West, although little attention is devoted in general medical care to psychosocial problems. Question for future visits and possible collaborative research are suggested.

Adult↗
PubMed1978

Clinical relevance of anthropological and cross-cultural research: concepts and strategies.

The author presents a method through which findings from anthropological and cross-cultural research can be applied to problems affecting patient care. The clinical social science approach emphasizes the distinction between disease and illness and cultural influences on the ways "clinical reality" is conflictingly construed in the ethnomedical models of patients and the biomedical models of practitioners. The relevance of such research extends beyond special clinical concerns arising from ethnic differences to ubiquitous problems that result from cultural influences on all aspects of health care. Consultation-liaison psychiatry is a particularly appropriate vehicle for introducing clinical social science into medical and psychiatric teaching and practice.

Anthropology, Cultural↗