Caring for the cardiac patient. "Ego infarction" psychological reactions to a heart attack.
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Biomedical subjects
Publications and source records attributed to N H Cassem.
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The acute coronary experience is divided into three parts. In the first, the pre-hospital phase, attention is devoted to the widespread phenomenon of patient delay. Evidence is given to indicate that the source of delay is entirely psychological and centers around the inability to decide whether or not to seek help. The second part, or hospital phase, describes the response of the patient to the various aspects of the coronary care unit, including monitoring, false alarms, witnessing and sustaining a cardiac arrest. The third phase, the post-hospital convalescence, centers on the principal psychological problem of this period, depression. Its causes, manifestations, and methods of management are discussed.
The recent widespread interest in the problems of the dying patient is reviewed, and the dynamics of the psychological process involved in dying are discussed. Recommendations for the management of the dying patient are presented, with special attention to the issues of 1) truth telling, 2) the essential features patients request themselves in their own care and management, and 3) the unique and individualized goals of treatment.
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